Bloodletting and Miraculous Cures

Dr. Vincent Lam is an emergency physician in Toronto General and Bloodletting and Mirculous Cures is his first book. It is startling to read someone who has found the talent and time for two demanding careers. The most original book I have read lately, it depicts short and sharp episodes in the lives of four wannabe doctors. We follow Fitzgerald, Ming, Chen and Sri from their frantic days of dissecting at medical school into careers and lives outside the operating room. Not your usual dramas on primetime TV, the stories are more of the moral dilemmas faced by doctors on a daily basis.

In How To Get Into Medical School, Fitz and ultra-rational Ming explore a relationship that scatters in the face of her disapproving family and then by the extraordinary commitment demanded of medical students. In Take All of Murphy Ming, Chen and Sri face the challenge of their first dissection – and the unusual quandary of deciding whether following the anatomy textbook or keeping a tattoo intact is more important.

In Code Clock we have a patient, already dead when announced as having a heart attack by a nurse, and Fitzgerald still does the best to resuscitate the victim. In A Long Migration, we see Chen’s grandfather, once a flamboyant member of the Chinese expatriate community in Saigon before the Vietnam War. Now Percival Chen is dying in a Brisbane retirement home, and his grandson’s modern medical recommendations must make way for older potions that arrive for Percival from an older world.

Winston is the story I found myself most engaged by, where Sri gets a sleepless patient who is getting delusional about his upstairs neighbor, first convinced that she poisoned him, and then that she is about to either kill him or have an affair with him. In Eli, cops bring in a prisoner with a dubious gash in his forehead that they claim was caused by falling, and Fitzgerald gets bitten, after which he leaves a scissors within Eli’s reach deliberately.

In Afterwards, an old man falls dead in the middle of an orgasm in an illicit massage parlor, and the paramedic who picks him up sympathetically records it as a “hair salon”. In The Insistent Tide, Ming is forced to make do without anesthetic in an emergency cesearean section.

In Night Flight, Fitzgerald tries to ease the guilt and pain of a grieving widow by telling a white lie about the lousy medical care she arranged for her recently deceased  husband. Contact Tracing is the story that struck me because I have been in the unsettling situation where I had a baby in the middle of the SARS pandemic, and have seen the cringing of the hospital staff whenever I coughed or wheezed. This story of Fitzgerald contracting SARS and soon dying of it left me feeling guilty because I remembered being annoyed at what seemed to me the overdone precautions of the hospitals, their masks, their disposable scrubs, their frequent handwashings and sanitization.

Before Light is Chen, the ER physician’s frenetic nightly routine, where he battles sleep deprivation and exhaustion to race against the clock in the emergency room. I came away with the firm impression that the doctor is the guy next door mowing the lawn, the woman at the supermarket – in jobs where they try hard to meet the expectations of patients believing in the infallibility of modern medicine. But doctors are fallible inside and outside hospitals. Physicians constantly encounter moral dilemmas in their professional and personal lives. There are no clear answers and no permanent cures. The outcome of their choices are debatable. Lives are affected long after surgery. The human body is nothing but a mannequin that falls apart and needs fixing.

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