Fiction Review

The Healer

(2005) Michael Blumlein, Pyr, US$25, hrdbk, pp359, ISBN 1-591-02314-9

In it's own way this quite a landmark work of interest to Concateneers into science fact and fiction. It will especially be valued by genre enthusiasts who are clinicians (medical doctors). Having said that, this is not a work of science fiction, not even science fantasy but fantasy. Although it could be fantasy science, if you appreciate the distinction, in that the medical practitioner allegories clearly resonate throughout this work. But enough, more later. Now on with the plot...

The Healer is set on a mythical world, that could perhaps be ours (they have lorries, railways and some other things like we do) albeit after thousands of years (to allow for speciation) after some apocalypse. Its protagonist is Payne (obvious geddit) who is a member of an offshoot species of humanity called the Grotesques, or Tesques, that have differently-shaped heads and an extra orifice in their thoraxes. The Tesques tend to be discriminated against but a small minority are valued as healers. They have the ability to meld, lying entwined with their patient, and synthesise, or distil, their patient's disease as a solid object that is then evacuated through their extra thorax orifice. The patient, removed of disease, is cured. However there is a price to pay and such healer Tesques are prone to burnout.

'Payne' is one such healer. He learns his craft and in the process has to overcome the fear and guarded respect that separates him from the rest of the community. Moving from an isolated mining community, through a pleasure city, he ends up at a citadel where the hardest healings take place, and the disease manifestations themselves appear to have a life of their own. Finally, from here Payne leaves for the wilderness for an encounter with mythology that could well change the world.

Michael Blumlein writes with a clear style and the plot, Payne's life, canters along at a respectable but, because of the discrete episodes that make up the book's multi-chapter sections, not hurried rate. He crafts an enjoyable read that on one hand is easy while on the other successfully conveying the differences of an other world necessary for his plot's development.

However, for the scientist, or science-loving SF enthusiast, it is the story's parallels with real medicine, rather medical practice, which is where the book really scores. This is not surprising for Michael Blumlein is what North Americans call an MD and he both practices and teaches medicine in California. (This is in addition to his novel and short story writing since the late 1980's, which explains his surety of footing with words.) Though not a clinician myself, I have had regular contact with practitioners of this applied science throughout my life both professionally (including a spell working for the British Medical Association) and socially. (Though, of course, in recent years I have spent more time in science communication work with biomedical researchers who are quite a different breed that provide the science underpinning medical application.) All of which to say is that my following comments are not plucked from thin air.

Medical doctors we all know in most parts of the world have to go through an extensive training lasting many years and paralleled only by science researchers in duration, though exceeded, once let loose to practice, in pay. They also become an integral, sometimes on a life and death basis, part of the community. As such they are on one hand traditionally, and are still often viewed as, respected pillars of the community. On the other there is some fear, and we all know folk who put off going to the doctors. Similarly in Payne's world he is respected and feared, a dichotomy with which he has to try to come to terms. His training and subsequently practice also takes him away from his family: in the book more so than real-life clinicians but for many this is true especially in the early (in the UK the 'junior doctor') years. Real clinicians also have a special relationship with their patients, that is more intimate than most of us have with our colleagues and social peers, and this is paralleled with Payne physically having to entwine with his patients. Cures, or attempted cures in real life can also cause problems and in some cases leave the patient with a different but bearable medical condition. (Sterility following extensive radiotherapy being but one obvious example.) Then again cures can also cause, or result in the creation of new diseases that then run rampant. This happens with some of the tough 'Concretions' that arise out of the Healers' distillations of their patients' ailments that are then excreted. In real life the parallels include antibiotic resistance and MRSA. Finally, Healers burnout, just as there is a tendency for medical doctors to do. (Not many know, in the UK at least, that suicide is more proportionally more common among doctors than the average population.) I say tendency for burnout for some doctors seem to manage quite well through to old age, but part of the trick seems to be knowing when to refer a patient on to a specialist. The problem is that medical doctors have to draw upon a considerable knowledge base that is itself being added to each week. Their decisions not too infrequently can also be a matter of life and death. So they have pressure, and in Payne's world this is represented by the burnout Healers seem to inevitably experience. Finally, there is the book's closing myth sequence, and here the allegory steps into the world of biomedical research and the promise that that holds with stem cell and genomic discoveries, that could change medicine, and possibly our very species just as the book's final developments potentially do for Payne's world.

I have only cited just some of the many examples of metaphorical parallels that can be drawn from Michael Blumlein's novel. My problem is, in some instances, knowing which the author consciously included and which bubbled up from his subconscious? However that's my problem that only Blumlein can solve (cure) probably with discussion (clinical counselling) over a pint (prescription).

In short this book can therefore be viewed as conveying one big metaphor of medicine. For the average reader you get an above average tale and I am sure that for them some of the applied science parallels may be missed. For the scientist, especially the natural scientist and certainly clinicians, this book firmly speaks on other levels. This 'speaking on other levels' is often said of many works by reviewers and 'arts academics', but actually they are usually talking about levels of plot, plots within plot, or that a book's plot may have some relevance to a real-life incidence, etc. In this case the book, while a work of art and fiction, does speak of a whole profession, and a key one at that to our society both local and global. Few books do that. I sincerely hope that the BMJ and the New England Journal of Medicine review it in their Christmas editions.

Jonathan Cowie

Pyr UK distributors are Lavis Marketing of Oxford but Amazon UK is probably as good a source as any, though ordering through a specialist bookshop is good-cause preferable.

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