Winner of the 2006 Scotiabank Giller Prize
An astonishing literary debut centred around four students as they apply to medical school, qualify as doctors and face the realities of working in medicine, from a powerful voice in fiction.
Following the interlinked stories of a group of medical students and the unique challenges they face, from the med school to the intense world of emergency rooms, evac missions, and terrifying new viruses. Riveting, convincing and precise, Bloodletting & Miraculous Cures looks with rigorous honesty at the lives of doctors and their patients, bringing us to a deeper understanding of the challenges and temptations that surge around us all.
In this masterful collection, Vincent Lam weaves together black humour, investigations of both common and extraordinary moral dilemmas, and a sometimes shockingly realistic portrait of today’s medical profession.
About the author
Born in London, Ontario, Vincent Lam is an emergency physician who also works in international air evacuation and on expeditions. His non-fiction has been widely published in Canada. He and his wife live in Toronto.
- Winner, Scotiabank Giller Prize
Excerpt: Bloodletting & Miraculous Cures: Stories (by (author) Vincent Lam)
How to Get into Medical School, Part I
Desperate stragglers arrived late for the molecular biology final examination, their feet wet from tramping through snowbanks and their faces damp from running. Some still wore coats, and rummaged in the pockets for pens. Entering the exam hall, a borrowed gymnasium, from the whipping chaos of the snowstorm was to be faced with a void. Eyeglasses fogged, xenon lamps burned their blue-tinged light, and the air was calm with its perpetual fragrance of old paint. The lamps buzzed, and their constant static was like a sheet pulled out from under the snowstorm, though low enough that the noise vanished quickly. Invigilators led latecomers to vacant seats among the hundreds of desks, each evenly spaced at the University of Ottawa’s minimum requisite distance.
The invigilators allowed them to sit the exam but, toward the end of the allotted period, ignored their pleas for extra time on account of the storm. Ming, who had finished early, centred her closed exam booklet in front of her. Fitzgerald was still hunched over his paper. She didn’t want to wait outside for him, preferring it to be very coincidental that she would leave the room at the same time he did. Hopefully he would suggest they go for lunch together. If he did not ask, she would be forced to, perhaps using a little joke. Ming tended to stumble over humour. She could ask what he planned to do this afternoon – was that the kind of thing people said? On scrap paper, she wrote several possible ways to phrase the question, and in doing so almost failed to notice when Fitzgerald stood up, handed in his exam, and left the room. She expected to rush after him, but he stood outside the exam hall.
“Are you waiting for someone?” she asked.
Shortly after they arrived at the Thai-Laotian café half a block from campus, Ming said deliberately, “Fitz, I simply wanted to wish you the best in your future endeavours. You are obviously intelligent, and I’m sure you will be a great success.”
The restaurant was overly warm, and Fitz struggled out of his coat, wrestled his sweater over his head, leaving his hair in a wild, electrified state. He ran his hands over his head, and instead of smoothing his hair this resulted in random clumps jutting straight up.
“Same to you,” he said, smiling at her almost excitedly.
She watched him scan the bar menu. When she asked for water, he followed suit. She liked that.
She said, “Also, thank you for explaining the Krebs cycle to me.”
“Any time,” said Fitz.
“I feel guilty that I haven’t been completely open,” said Ming. She considered her prepared phrases and selected one, saying, “It didn’t seem like the right time in the middle of exams.”
“Nothing in real life makes sense during exams,” said Fitzgerald. He tilted in the chair but kept a straight back. Ming reassured herself that he had also been anticipating “a talk,” and so–she concluded with an administrative type of resolution–it was appropriate that she had raised the topic of “them.”
She leaned forward and almost whispered, “This is awkward, but I have strong emotional suspicions. Such suspicions are not quite the same as emotions. I’m sure you can understand that distinction. I have this inkling that you have an interest in me.” She didn’t blurt it out, instead forced herself to pace these phrases. “The thing of it is that I can’t have a romantic relationship with you. Not that I want to.” Now she was off the path of her rehearsed lines. “Not that I wouldn’t want to, because there’s no specific reason that I wouldn’t, but I– Well, what I’m trying to say is that even though I don’t especially want to, if I did, then I couldn’t.” The waiter brought shrimp chips and peanut sauce. “So that’s that.”
“All right,” said Fitzgerald.
“I should have told you earlier, when I first got that feeling.”
“You’ve given the issue some thought.”
“Not much. I just wanted to clarify.”
Fitz picked up a shrimp chip by its edge, dipped it in the peanut sauce with red pepper flakes, and crunched. His face became sweaty and bloomed red as he chewed, then coughed. He grasped the water glass and took a quick gulp.
Ming said, “Are you upset?”
He coughed to his right side, and had difficulty stopping. He reminded himself to sit up straight while coughing, realized that he wasn’t covering his mouth, covered his mouth, was embarrassed that his fair skin burned hot and red, wondered in a panicky blur if this redness would be seen to portray most keenly his injured emotional state, his physical vulnerability in choking, his Anglocentric intolerance to chili, his embarrassment at not initially covering his mouth, his obvious infatuation with Ming, or–worst of all–could be interpreted as a feeble attempt to mask or distract from his discomfort at her pre-emptive romantic rejection.
Ming was grateful for this interlude, for she had now entirely forgotten her rehearsed stock of diplomatically distant but consoling though slightly superior phrases.
“Hot sauce. I’m fine,” he gasped, coughing.
There was a long restaurant pause, in which Ming was aware of the other diners talking, although she could not perceive what their conversations were about.
She said, “I’ve embarrassed us both.”
“I’m glad you mentioned it.”
“So you are interested,” she said. “Or you were interested until a moment ago. Is that why you’re glad that I mentioned it?”
“It doesn’t matter, does it? What you’ve just said has made it irrelevant. Or, it would be irrelevant if it were previously relevant, but I’m glad you brought up your feelings,” said Fitzgerald. He picked up the menu.
“Don’t feel obliged to tell me whether I needed to say what I just said.”
“It was great to study together. You’ve got a great handle on . . . on mitochondria.”
The waiter came. Ming felt unable to read the menu, and pointed at a lunch item in the middle of the page. She got up to use the bathroom, and wondered in the mirror why she had not worn lipstick – not taken a minute this morning to look good. Then, she reminded herself that she should have actually taken measures to appear unattractive. Nonetheless, Ming examined her purse for lipstick, finding only extra pens and a crumpled exam schedule. When she returned, they smiled politely at each other for a little while. They ate, and the noodles fell persistently from Fitzgerald’s chopsticks onto the plate, resisting consumption. Ming asked if he wanted a fork, and he refused. After a while, as Fitzgerald’s pad thai continued to slither from his grasp, Ming caught the waiter’s eye, who noticed Fitzgerald’s barely eaten plate and brought a fork without Ming having to ask.
Fitzgerald ate with the fork, and craved a beer.
“We’re great study partners,” said Ming, still holding her chopsticks. “I want to clarify that it’s not because of you.” She had to get into medical school this year, and therefore couldn’t allow distraction. Her family, she said, was modern in what they wanted for her education, and old-fashioned in what they imagined for her husband. They would disapprove of Fitzgerald, a non-Chinese. They would be upset with Ming, and she couldn’t take these risks while she prepared to apply for medical school. The delicate nature of this goal, upon which one must be crucially focused, superseded everything else, Ming reminded Fitzgerald. He stopped eating while she talked. She looked down, stabbed her chopsticks into the noodles, and twisted them around.
He asked, “What about you?”
“What do you mean, me?” she said.
“Telling me this. Did you feel . . . interested?”
“I thought you might be.”
“You might say that I’ve noticed you, but I accept the situation. Priorities.” The imperative of medical school applications carried the unassailable weight of a religious edict.
“Very well,” she said, as if they had clarified a business arrangement.
The bill came. Fitzgerald tried to pay and Ming protested. He said that she could get the bill next time and she insisted that they should share.
Winner of the 2006 Scotiabank Giller Prize
Amazon.ca Editor's Pick, Best Books of 2006
A Toronto Star Best Book of 2006
"[A] masterly debut."
"[A] compelling first book of fiction. . . . It adds up to a running start at a high-voltage literary career."
"Lam excels at this kind of steady accumulation of truths, a tangling of action and incident that renders judgement of the characters difficult, and futile besides. The writing is often lovely . . . [and] some of the best stories in Bloodletting & Miraculous Cures read like journalistic dispatches from the medical front lines, with careful psychological characterizations added. As such, Lam's book represents a promising demonstration of fiction's unique power to bring the news that stays news, in Ezra Pound's formulation, and to allow the reader to see through the eyes of those who experience events firsthand."
—New York Times Book Review
"Bloodletting & Miraculous Cures radiates the confidence you expect from a man whose other job is to make stalled hearts start. The advantage of fiction? Here, even the medical failures come to life, vividly."
—The Globe and Mail
"Bloodletting & Miraculous Cures is a satisfying, engrossing read, partly because of the intrinsically fascinating subject matter, but also because of Lam's patient characterizations and understanding of the human heart."
"Bloodletting is a swift, dynamic read. From story to story, Lam unveils his characters' lives in careful ellipses, leaving clues like puzzle pieces to twist this way and that, each detail eventually dovetailing to form a picture. . . . What makes Bloodletting so remarkable is its depth. The stories are entertaining on their own, but if you delve more deeply, you'll find human lessons sketched out with subtlety. . . . Lam entertains and educates with fluidity and style, and that just might be a miraculous cure of the literary kind."
—San Francisco Chronicle
"Lam takes us through the moral dilemmas of today's medical profession with dark humour but also with tenderness for the weak spots of each of the doctors. . . . [Characters'] vulnerable layers are methodically revealed through Lam's unique ability to make the reader meet his scientific pace. . . . The balancing act never stops."
"There's no information like inside information, and Lam puts his to good use. . . . [His] fiction strikes a balance between clinical and emotional detail. . . . [An] impressive first book, by all appearances."
—The Ottawa Citizen
"If you want to know what a person must go through to become a practicing physician in a Canadian hospital, reading this riveting collection will give you a better picture than if you pored over a truckload of treatises on public health."
"A searing, perfectly paced set of linked stories. . . . Tender insight into the fascinating emotional and social implications of a career that is, inherently, so much more than a job."
—Kirkus Reviews, starred review
"Vincent Lam crafts sentences that veteran writers will covet. His fresh and stunning talent will satisfy all readers who hunger for powerful stories."
—Wayson Choy, author of All That Matters