19 July 2018

Bloodletting & Miraculous Cures by Vincent Lam



I'm a bit late to the game as I remember this book being wildly popular when it first came out THIRTEEN years ago (it really didn't feel like that long). About a year ago I was with a friend in a used bookstore and I picked it up, sort of remembering it, sort of not and she said "that's the book they based Grey's Anatomy off of" -- clearly not true -- but nevertheless the comment interested me enough to buy it and I'm sure Vincent Lam is thrilled people are out there thinking he inspired an insanely popular TV show. (I did find out after that the book was adapted in 2010 into a Movie Network movie by the same name. The fact that I've never heard of it means it's certainly no Grey's Anatomy.)

This book starts with the stories of two students (Ming and Fitz) as they desperately try to get into medical school in Canada, and the rest of the novel continues with various short 'stories' about their experiences and some of their colleagues experiences as they develop as doctors. The stories do tie together from a character perspective, but they're also fairly autonomous of each other. The stories range from horrifying to comical and the tone does have a Grey's Anatomy feel to it in that it's heartbreaking and heartwarming at the same time.

Lam (middle) and two actors from the 2010 movie adaptation


What makes this book so special is that Lam is a doctor himself, and although it's considered 'fiction', I feel strongly that a lot of these stories come from lived experiences. The fact that he's a doctor doesn't make this less approachable, and anyone with any level of medical knowledge would find this both easy to read and interesting. Lam is also Chinese-Canadian and race is incorporated into the stories a lot, both in the personal romances between doctors and in the struggle Chinese-Canadians can feel for academic and career success in an effort to make their families proud.

My favourite element of this book is how candid the doctors and nurses are, which is something I feel is missing from the medical dramas I've seen on television. My sister is a paramedic so I thought I was prepared for the somewhat 'crass' way that medical professionals can think and talk about their patients, but even she isn't as bad as some of the doctors in Lam's novel. Lam makes it clear that they always do the best they can under their circumstances, but at the end of the day they aren't superheros either. I feel like the below quote kind of conveys the tone I'm talking about, it comes after a passage where doctors try to save a patient that the nurses say had only been left unattended for 10 minutes:

As they leave the floor Fitz says, 'You think it was ten minutes when the code blue was called?'
'Ten minutes, my ass. he was cold as a brick when we got there.'"

I think after a while you must become immune to death, and to the idea of losing patients. It seems sad but also necessary for them to be able to do their jobs properly and to not have staff taking a mental leave every time a patient dies. I see this happening in my sister slowly and she's only been working for ~6 months.

I also enjoyed the parts of the novel where the doctors had to deal with the communications aspects of their job. I don't think most people go into medicine because they are really looking forward to updating their patients' families. It's just a part of the job they deal with. I really liked the below passage where one of the doctors is coaching himself through telling a family the patient had died. The italicized parts are him thinking to himself:

'His heart had stopped beating. We did everything we could.' That last phrase felt like soap opera, but these words always came out of Sri's mouth. To talk like this creates a delay, but there's a story to tell. Tell them the story. The story needs to come before the ending so that it makes sense looking back. 'We couldn't restart his heart.' So he had maybe tricked himself by revealing the death without saying the actual words. I still have to say it. 'I'm sorry, but Mr. Wilhelm passed away peacefully about half an hour ago. He was in no pain or discomfort.' That last part, I always feel I might be lying. There."

Similarly, I liked the passage below where the doctor makes the decision to lie to a patient's wife so she doesn't feel guilt about not transporting her sick husband back to Canada in time to save him... I could only hope a doctor would lie to me like this...

Lies are about belief, about a reality suspended because we want to believe the lie. Both the teller and the recipient must trust each other for everything to hang together. I sense this trust between us and say, 'You did everything you could do. So did we. Your husband could have died just as easily in Toronto. I am truly sorry for your loss.'"

One of my favourite stories in the book is about a woman who goes into labour and the doctor realizes the embilical cord is wrapped around the baby's head. They need to do an emergency Caesarean but the anesthesiologist on call WON'T ANSWER THE PAGER. Can you imagine???

'Just give me the laughing gas. There's no time, is there?' Janice said.
'You need more than that. There's no time for a spinal, we need them to knock you out.'
'The actual operation- you can do it even if I'm awake right?' ...
No one moved.
'They call it a Caesarean section,' said Dr. Ming, 'because it comes from the time of the Caesars in Rome. They used to tie the woman down.'"

They end up cutting her open with just her skin frozen and she can feel all of her organs being moved aside, etc. I wanted to throw up reading it. I've never needed major surgery but I've watched enough movies to know that waking up during it because the anesthetic wears off is one of the worst things that can happen to a human, but you know what's worse? The anesthesiologist NOT SHOWING UP. I like to imagine he or she was fired AND put in jail but, it's Ontario and I'm pretty sure they have a union or something...

This is what my sweet dog did to my first copy of this book when I had ONE chapter left... he doesn't like when I read because then who would give him pets???


By far the most interesting part of the book for me was the story about the SARS scandal in Toronto. I was a bit too young to really remember the SARS scare or to have cared about it. I mean, I was about 10 or 11 and I remember people in masks and such, but I don't think it affected me much and I didn't know anybody sick from it. Because the novel takes place mostly in Toronto, a lot of the hospitals were caring for people with SARS at the time, but at first they had no idea what it was. All they knew was people were sick and dying, and anybody they came in contact with usually also got sick. It's sad to read about it now and I wish ten-year-old me had paid more attention.

I was most fascinated in the parts about the lottery that was used to determine which nurses would tend to the SARS quarantined patients. Someone had to, but whoever did would inevitably catch it. Lam writes that the hospital management and the union reps called all the nurses to a room and drew names from a lottery to see who would move to the SARS unit. You could pull your name from the lottery by taking early retirement or forfeiting any seniority you'd built up. The whole thing was a little too 'hunger games' for my liking and I was very uncomfortable reading it.

Afterwards, those with yellow tags tried to suppress the relief and laughter of a near miss, embarrassed at their good fortune while standing amid those who held red tags.Those who had been selected for the SARS unit only met the eyes of others who held the same colour tag. Some cried openly, or left the room to do so. One woman with a yellow tag offered it to her friend who had a red one, and who was just back from her honeymoon, but the trade was refused. Grief and trauma counsellors were available in the next room, said the union rep over the murmur."

Can you imagine??? The nurses who got chosen for the unit weren't allowed to put their kids in the hospital daycare anymore, etc. for fear of spreading it. The whole thing is so sad and I can't believe it happened so close to me and I know so little about it.

Overall I found this book incredibly interesting and I think almost anyone would. As I mentioned in our post on books written by Canadian authors, there's a wide audience fascinated with medical drama, not just medical professionals. I especially think it would be excellent for anyone interested in medical school, medical professionals, or people who are from the Toronto area and can relate to the setting (just because that's always cool).

One criticism I'd make is that I wish Lam had been more consistent about some of the character relationships. They were talked about a ton at the beginning and then dropped off for more medical-type stories later on. I would have liked it more if we'd seen more Meredith-Christina-Derek type romance, you know? 

I said to Meg the last time I saw her that I wish more professionals would write books about their professions... it makes for better writing than authors that try to do the research, they'll never have truly lived it.

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