BOOK REVIEW / CRITIQUE DE LIVRE

**Bloodletting and miraculous cures.** By Vincent Lam. Toronto: Anchor Canada, 2006. 350 pages (soft cover). ISBN 978-0385661447. CDN$17.95.

Toronto emergency physician Vincent Lam caused quite a stir when his debut short story collection won the coveted Giller Prize. He even has a great story about his rise to fame: he took a job as a doctor on a cruise ship, and one of the passengers happened to be Margaret Atwood. Lam convinced her to read some of his stories, and Atwood, who can be brutally honest when unimpressed, was very complimentary. She encouraged him to publish the work, and the rest is Canadian literary history.

It's easy to see why the queen of CanLit was so taken. This is an impressive debut. Not many fiction writers have a medical background, and that alone makes these stories special. If you're looking for insight into the pressures and stresses of medicine, and the workings of the medical mind, you won't do better than Lam's stories.

Yet the stories are more than just realistic portrayals of the medical life. Lam is adept at creating sympathetic characters and constructing interesting plots. As he follows a set of characters from their premeded years through the early years of their careers, we see them grow and change.

The collection gets off to a rather slow start. Two of the early stories, both titled "How to get into medical school", are competent yet not terribly compelling. They chronicle the utterly predictable flowering and demise of first love between two young medical students. Boy meets girl, boy gets girl, girl gets into medical school, long distance and cultural differences take their toll on the relationship, and everything falls apart in the usual manner of first love affairs.

Luckily, things become more interesting from here. In "Take all of Murphy", medical students get to know their corpse intimately over the course of a semester and are faced with the dilemma of whether to properly dissect his arm or to change the dissection procedure to preserve the corpse's tattoo. Two of the students find themselves in conflict over the right thing to do.

Ethical dilemmas recur throughout the book. Do you tell a bereaved wife that her husband suffered a fatal heart attack while visiting a massage parlour? What do you do when police bring an injured man into the ER, and you suspect they were the ones who inflicted his injury? Is it right to tell a woman whose husband died in Cuba that you're sure he re-

ceived adequate medical care when you know that inadequate medical equipment likely played a role in his death?

Lam is excellent at portraying the patient's perspective as well as the physician's. In "Winston", a young man's first psychotic episode is brilliantly depicted from both his own and the doctor's points of view. In "An insistent tide", a woman suffers a complicated labour. In a lovely use of metaphor, the woman drifts in and out of consciousness, her contractions represented in her dreams as ocean waves washing over her.

The physical and mental stresses of medical life are well depicted in the book. Chen, an ER doctor, pulls an all-night shift and fights exhaustion on the drive home. Fitzgerald, who grew up with an alcoholic father, struggles with his own alcoholism, repeatedly denying to himself its impact on his work, while wondering whether his colleagues are wise to the fact that he's drinking on the job. A doctor fears he may have caught HIV (human immunodeficiency virus) after being bitten by an injection-drug-abusing patient. Two Toronto doctors end up in a SARS (severe acute respiratory syndrome) isolation ward after treating infected patients.

In my opinion, the most riveting story in the collection is "Contact tracing", an insider account of the SARS epidemic. Lam served in the emergency department of one of the hospitals affected by the epidemic, and his experience infuses this story with a palpable sense of panic. No media account brought the terror of SARS home to me in the way that Lam's account did. The scene in which hospital managers hold a lottery to determine which nurses will be assigned to the SARS ward is absolutely brilliant. You can almost smell the fear of the unlucky chosen, and the mix of guilt and euphoria felt by those exempt from SARS duty.

According to the book's author blurb, Lam is currently working on his first novel, about a Chinese schoolmaster in Saigon during the Vietnam War. Critics will be watching to see whether his storytelling skills are up to the challenge of both a longer work and a nonmedical setting. I think readers can look forward to being rewarded on both counts.

**Heather Ganshorn**

Health Information Network Calgary
Alberta Children's Hospital Knowledge Centre
2888 Shaganappi Trail NW
Calgary, AB T3B 6A8, Canada
E-mail: Heather.Ganshorn@ucalgary.ca