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"An Insistent Tide" and "Night Flight"

"Medicine is driven by the external, by the problem placed in front of me. Writing is very internal, and contemplative. It is driven by my mental journey."

~Vincent Lam

Summary: "An Insistent Tide" and "Night Flight" (304 KB)

Thoughts from Queen's campus

By Susan Korba, Director, Student Academic Success Services: Learning Strategies and the Writing Centre (

Writing well is an essential skill for university students, but even accomplished writers find writing challenging at times. The Writing Centre can help you make the transition to university-level academic writing, offering a variety resources to support you in your first year, including 1:1 sessions with professional writing consultants and trained peer writing assistants, general and discipline-specific workshops, and online resources.  

Visit the Student Academic Success Services website for online resources and workshops in the fall and winter terms (including “How to Write Your First University Essay” and “Effective Writing for First-Year Science Students”). You’ll also find details on booking an individual consultation with a professional writing consultant or learning strategist.

All our services are free for Queen’s students.

There are a couple of things I particularly appreciated about Vincent Lam’s ​Bloodletting & Miraculous Cures. The first is that Lam’s characters illustrate something I think is true of almost everyone at one time or another, whether just beginning university, making it through an internship or maneuvering through the complexities of a career: they all experience feelings of uncertainty, a lack of confidence, even a sense of fraudulence.  In “Take All of Murphy,” as Sri, Ming, and Chen are faced with their first cadaver dissection, they are obviously hesitant to begin, yet each tries to conceal his or her uncertainty from the others. All three assure their teammates—and themselves—that they “don’t mind” or that “it doesn’t matter” who makes the first cut (32), as if it’s really not a big deal. It is clear that they are nervous, even fearful, yet none of them are comfortable admitting to or sharing these feelings.  We see this again while Fitz works on “tubing” Mr. Dizon in “Code Clock,” as he repeatedly tells himself “I’m comfortable. I am” while attempting to complete the procedure (94). When Dr. Nigel asks him if he’s sure that he can do it, Fitz replies “Absolutely,” although he is actually not sure at all (96), and he fails to tape the tube until Nigel reminds him.  Fitz wants to appear competent, confident, in front of the more experienced doctor, but his desire to demonstrate his proficiency could have had dire consequences for his patient, had Mr. Dizon not already been “cold as a brick” when they arrived (100).  Chen, too, in “A Long Migration,” finds himself playing the role of medical expert when he is expected to care for his dying grandfather, even though he has only completed a year of medical school; he admits that he is “early in [his] medical training and wanted to pretend to be a doctor” (113). Ultimately, when his grandfather’s state worsens, Chen calls an ambulance, and, though he tries “to be medical and tell the paramedics about his condition,” he “couldn’t remember any of the details” (116).  Most of us can probably relate to all of these situations, and would likely acknowledge that admitting uncertainty or fear to others can sometimes seem even scarier than the feared thing itself. We tend to think that we’re the only ones who don’t get it or can’t do it, and we worry that sharing our insecurities will make us seem weak or incompetent.  But, while we can empathize with Lam’s characters and their fear of not meeting their own or others’ expectations, we can also see how potentially damaging and isolating it can be to deny our uncertainties and conceal our very natural need for support from those around us.

Bloodletting and Miraculous Cures illustrates another important truth: there is no one “right” way to be. Certainly, being open to advice and adapting when necessary are sensible and effective strategies, as we see when Fitz modifies his approach to studying by adopting the “Karl” method in “How to Get into Medical School, Part II.” However, Fitz also notes that, while “it was Karl’s study system that had brought Ming to medical school and himself to [the] interview,” the method itself was, in some ways, “irrelevant.” As Fitz puts it, “To study was to work. To work was to make it one’s own” (72). Fitz wisely takes from the Karl model what he needs in order to succeed, internalizing Karl’s method of “knowledge acquisition” in a way that allows him to then use that knowledge as if it originates “from the gut” (73).  Not all of Lam’s characters, however, modify their behavior or outlook, and that’s not necessarily a bad thing. Ming, for example, approaches most situations in a very matter-of-fact way, focusing on the goal in front of her rather than on emotion.  We see this mindset in how she views “Murphy,” a very different way of viewing than that demonstrated by Sri. She treats “Murphy” as a means to an end; he’s a “stupid corpse” (50). Her approach to dissection distresses and offends Sri, due to what he sees as its lack of empathy or respect for “Murphy” as a once-living person.  We might prefer Sri’s attitude and find Ming’s too callous; yet it is this same single-mindedness and ability to distance herself from emotion that allows Ming, in “An Insistent Tide,” to perform a Caesarian section on Janice in the absence of anaesthesia, saving her baby’s life.  Another key takeaway from Bloodletting, then, is the importance of learning from others without devaluing our own strengths, instincts, and ways of being.  We experience the world differently, have our own perceptions, approach things in ways that might work for us but that might not work for other people—and that’s okay.

Lam’s collection of stories really reflects the student experience (in reality, a universally human experience), and offers us some reassurance that it’s natural to struggle, to want to conceal our vulnerabilities, and to sometimes be unsure about whether we’re good enough just the way we are. At the same time, it’s important to know that, when we are struggling or working hard to conceal our uncertainties or feeling like maybe we really aren’t good enough, there are many great supports available at Queen’s, delivered by people who’ve been exactly where you are and who “get it.” As a first step, I would encourage you to visit Student Academic Success Services, where you can get help figuring out how to adapt your current academic skills to this new university context as well as feedback on what you’re already doing “just right.” Welcome to Queen’s!

Think about it

  1. What do Janice’s visions of the beach represent?  Are the visions drug induced, a relaxation exercise learned from pre-natal classes and books, or perhaps something else?
  2. From your understanding of Ming in previous short stories, would you have pictured her as an obstetrician?
  3. Why do you think Janice insists that the Caesarean section be done without anaesthesia?  What do Ming’s actions reveal about her own character?  Has she changed dynamically from the Ming we have seen previously?
  4. Similar to Janice in “An Insistent Tide,” why does Fitzgerald withhold information from Mrs. Amiel about her husband’s condition on page 247?
  5. “Night Flight,” “Eli,” and “Code Clock” and are written in the first person, and more specifically from Fitzgerald’s perspective.  Considering Fitzgerald’s extended story-line and previous narrative points of view, why might Lam use the first person perspective after Fitzgerald and Ming’s relationship dissolves?
  6. Do you think Fitz was right in telling Mrs. Amiel that her husband would have received the same care had he been in Canada?

Queen's connection

In "Night Flight," we see the importance of having good insurance coverage.  All Queen's students are enrolled in the AMS Health & Dental Plan, which covers health, dental, vision, and travel benefits.  Be sure to check out information on health-care networks, the claiming process, coverage, and more.  Already have sufficient insurance through another provider?  You'll have the opportunity to opt-out of the plan in September.

Media & links

Watch Vincent Lam speak to the medical students at Brown University's Alpert Medical School during the 20th annual Harriet W. Sheridan Literature and Medicine Lecture.  Throughout the hour-long talk, Lam meditates on the power of narrative and empathy in both his written works and his experiences as a physician.  



"Think about it" questions 1-5 adapted from "Bloodletting & Miraculous Cures Content Questions," Peel District School Board (.doc, 28.5 KB).