Dr. Vincent Lam’s first book, 2006 Scotiabank Giller Prize winner Bloodletting & Miraculous Cures, is a captivating and fast-paced glimpse into the moral conundrums of health care. The book immediately engrosses its readers in the premedical experiences of Ming and Fitz, undergraduate students at the University of Ottawa. In medical school at the University of Toronto, their stories intertwine with those of two other medical students, Sri and Chen. Lam aptly depicts the unique personalities and philosophies of these four characters, who each adopt a distinct approach to medicine. Each chapter brings medical interactions to life, from the psychosis of Sri’s patient Winston to the mid-labour thoughts of Ming’s obstetric patient Janice. The book culminates as Lam weaves Ming, Fitz, Sri and Chen’s stories back together, in the midst of the 2003 SARS epidemic. The fear and frenzy of this health crisis brings these characters’ flaws and strengths to the forefront, inciting readers to contemplate the dissonance between the idealized physician and reality. Though Bloodletting & Miraculous Cures highlights important challenges and misconceptions in medicine, it ends somewhat anticlimactically with the story of Chen’s struggle as a burnt out and dissatisfied emergency doctor.
Although this bleak final portrayal of medicine left me uneasy, my reading experience overall was cathartic, allowing me to consistently reflect on what it means to be a good physician. The transition from a linear to a more disjunctive plot heightened the suspense, and I felt deeply embedded within the various scenes Lam paints from one chapter to the next.
I was impressed by the way Lam articulates his characters’ emotions and thought processes to the reader, particularly those of Sri’s psychotic patient Winston. It becomes clear early on that Winston is mentally unwell, but only as the story progresses does the reader become fully aware of the extent of Winston’s disconnect with reality. When I discovered which of Winston’s memories were real and which were hallucinations, I felt the pleasant surprise of a cinematic twist. Bloodletting & Miraculous Cures triggered these moments of sudden comprehension again and again, as Lam vaguely introduced me to a new world with each story and skillfully put the pieces of that world together.
That being said, I did not immediately connect with the characters in Bloodletting & Miraculous Cures. At the beginning of the novel, I found Ming and Fitz’s conversations unnaturally formal and Ming’s cold demeanour unrealistic. However, as Lam develops his characters and I learnt more about Ming’s upbringing, my initial concerns about his writing style dissipated. Lam varies his choice of language and punctuation as the point of view shifts from third person narration to Chen and Fitz’s first person narratives. Through his versatile writing, Lam shapes distinct characters and reinforces their authenticity through descriptions of both their admirable and unethical thoughts. The public often expects physicians to be infallible and to epitomize virtuous behaviour; in Bloodletting & Miraculous Cures, Lam normalizes imperfection among physicians and illustrates that it is permissible to be flawed. He describes not only heroic efforts do to good, as exemplified by Chen during the SARS crisis, but also actions that might be scorned, like Fitz’ inaction during a passerby’s medical emergency.
As a medical student, Bloodletting & Miraculous Cures is personally relevant. Lam incorporates medical terminology throughout his book and even includes a glossary of terms such as ‘recombinant thrombolytic’ and ‘ceftriaxone’. For a non-medical reader, inclusion of such technical terms may disrupt the flow of reading. Conversely, for readers who are rooted in the medical culture, Lam’s nonchalant interspersing of these terms facilitates a profound connection between readers and his stories.
Overall, I would go so far as to say that this is a must-read for any medical student interested in the medical humanities. It is a quick but powerful read that leaves readers pondering the imperfections of physicians, who are so often expected to uphold the highest standards in society. By reflecting on one’s reactions of admiration or distaste towards the books’ characters, readers can elucidate their own values and consider the type of physician they aspire to become. Lam aptly conveys social issues in medicine, including the personal challenges and pressures of entering medical school, as well as the human reaction to the panic of an epidemic.
In short, Bloodletting & Miraculous Cures definitely set the stage for Lam’s writing career, which has since included non-fiction works and his first novel, The Headmaster’s Wager. Bloodletting & Miraculous Cures was adapted into a television miniseries by Shaftesbury Films, which aired in 2010.