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ENTRY

Subduction
March 14, 2012

My next novel, Subduction, is finally at the printers. It should be shipped in a month. The novel has had quite a life of its own, starting in 1998 as a novella (20,000 words), then growing through at least a dozen versions to a fat novel of 120,000 words, and then whittled down through half a dozen versions to its present trimmed version of about 70,000 words. Here are the first couple of pages:

The patient, a healthy woman aged thirty-two recovering from a simple knee operation, suffered a fever spiking at 103 degrees. She moaned and rasped when, at the dragging end of a second consecutive day making rounds, I fought off a yawn and asked her where it hurt. Only a first-year resident, I was well on my way to becoming a brilliant diagnostician.

She could only wave a hand as if fanning herself from head to toe. Non-localized pain, I wrote in her file. Her surgery wound appeared clean from infection. There were no rashes or unusual skin discoloration. She moaned when I pressed lightly on her abdomen.

“What’s going on here, Endo?”

My supervisor, the knife-eyed Head Resident, peered over my shoulder.

“Fever, some pain, some sensitivity in the abdomen. No sign of infection but we should do a blood test.”

The Head Resident grabbed the file and scanned it. “We should not do a blood test. Clearly it’s gastroenteritis. Give her a dose of morphine for the pain. For the other, fluids and something for nausea.”

“But—”

The Head Resident’s face turned red as his eyes widened then narrowed to mere slits. He shoved the file into my hands and left me with the patient. I wrote up his diagnosis and treatment. A first-year resident never challenges a head resident. Not without consequences.

The case wasn’t the first time the Head Resident forced a diagnosis and treatment on me, but it was the first time I couldn’t sleep thinking about it. My usual reaction was to acknowledge my limitations, accept his superior diagnostic ability. I have to admit I wasn’t the best student in my medical school class. Okay, I was near the bottom, although I don’t believe I was less intelligent than my classmates; most were as average as eggs. The main trouble plaguing my performance was poor cognitive attention. In class I would listen to the professor until my mind wandered to some other thought. For instance, the professor might be talking about muscle tissue and I might wonder what causes cramps. I would be thinking about that for a few minutes, not listening to the lecture. When my attention returned, I’d be lost and would spend another few minutes figuring out what the professor was talking about. Of course, as soon as I caught up, my mind would wander again. I simply couldn’t help it.

Then there were the tests. Success on medical school exams is robustly correlated with gross memorization. As you can imagine, a med student with a wandering mind will have trouble trying to focus long enough to memorize all the facts. As in a lecture, I’d read a fact which would take me off on a different path from the topic at hand. I’d browse through reference books, trying to answer this question or that.

Back to the patient with the post-surgery fever. A simple blood test might have pointed to a possible cause of her fever and pain, but the Head Resident’s look told me it was an inefficient use of time and resources. Anyway, the Head Resident probably was correct in his diagnosis. So, no, it wasn’t the diagnosis keeping me awake; it was the image of the pain congealed around the patient’s eyes and mouth like a death mask.

I told her there was nothing to be alarmed about.

The doorbell to my hospital dorm room rang, waking me after what seemed a short nap, but the clock retorted it had been a solid seven-hour sleep. Still dressed from the day before, I groggily shuffled to the door and opened it to find the Head Resident and a senior hospital administrator.

I made spaces for them to sit down in my room, then opened the window to freshen the room’s stuffy air. Thinking an offer of something to drink would be appropriate, I started to mention it, but they didn’t look to be in the mood for refreshments. The hospital administrator rested her hands on her lap, properly and professionally. Contrasting with her, the tirelessly rigid Head Resident lounged casually as if bored.

After a brief apology for interrupting my downtime, the administrator said, “We regret to inform you that your patient, Ms. Sunada passed away.”

Ms. Sunada? The knee operation patient?

The Head Resident spoke so quietly I barely recognized his voice. “She died, Endo, of a burst appendix.”

“That’s severe but treatable.” I barely recognized my squeaky voice.

“She passed out from the morphine. No one checked on her until the morning.”

“By then it was too late,” added the administrator, her head bowed.

We were quiet for a moment, as if in respect for the dead. But I was reeling from the shock, my mind roiling and my heart thumping as if I’d sprinted up Mt. Fuji. I wanted to vomit violently.

The Head Resident broke the silence. “If only you’d done a simple blood test.”

My head whirled in his direction. His expression was as blank as the wall he was staring at, the wall of my dingy tiny room, my dingy tiny life. I knew then what was going to happen. And it was not good.

© 2013

COMMENTS

Number of comments: 8
click here to add a comment

Lee Witte
Can't wait to read!

Gail
I put my name in the ring to get an "early reviewer" copy of your book at Library Thing. I hope I get it!!

Marilyn Colter
Will be excited to see this since I saw it in an early version. Know it will be interesting...

Gail
Yes! I snagged a copy of "Subduction" at Library Thing. So I will have the pleasure of reviewing this book when they finally send it to me. Besides Library Thing, I will post my review on Amazon as well. Can't wait!

Todd
Great news, Gail! Hope you enjoy it!

Gail
I really loved this book, and you can find my review of it on LibraryThing.

Gail
I also put a very slightly changed review on Amazon.

Todd
Thanks Gail, I really appreciate your insightful reviews!

ARCHIVE

date (comments)

Review: Paprika
April 21, 2013 (3)

Review: A Straight Road With 99 Curves
March 30, 2013 (1)

Gripping writing
Feb. 28, 2013 (2)

Review: Salvation of a Saint
January 19, 2013 (2)

2012 in review
December 30, 2012 (2)

Review: Ninja
September 30, 2012 (2)

Review: My Postwar Life
August 21, 2012 (1)

New interview with Colin Marshall
July 15, 2012 (3)

Book events
April 25, 2012 (2)

Subduction
March 14, 2012 (8)

Review: A Room Where the Star Spangled Banner Cannot Be Heard
January 14, 2012 (1)

Review: Plainsong
December 20, 2011 (3)

Review: The Devil's Disciple
November 29, 2011 (2)

Haruki Murakami
October 5, 2011 (2)

Busyness and demons
September 25, 2011 (2)

Characters: The Bully
July 30, 2011 (3)

Review: Manazuru
June 28, 2011 (2)

Deadlines!
June 24, 2011 (2)

Review: Butterfly's Sisters
May 18, 2011 (1)

Review: Isle of Dreams
April 20, 2011 (2)

Cades Award for Literature press release
April 12, 2011 (2)

Japan and other news
March 29, 2011 (1)

Borders bankruptcy
February 17, 2011 (2)

2010 review
December 17, 2010 (6)

Congratulations Mario Vargas Llosa
October 7, 2010 (2)

OH! wins best book award
September 23, 2010 (2)

Review: Kissing the Mask
August 22, 2010 (1)

Jonathan Lethem: Writing at the margins
July 12, 2010 (2)

Review: Love in Translation
June 22, 2010 (3)

Jose Saramago
June 18, 2010 (0)

Marketplace of Ideas interview
June 11, 2010 (2)

Imagining Memory
May 6, 2010 (1)

Upcoming Los Angeles events
April 7, 2010 (2)

Time and energy
March 30, 2010 (2)

Review: Botchan
February 28, 2010 (2)

J.D. Salinger
January 28, 2010 (1)

2009 Reviewed
December 31, 2009 (5)

Review: The Word Book
December 12, 2009 (1)

Chaat and Chat event with OH!
November 6, 2009 (2)

Home at last
November 2, 2009 (2)

Los Angeles events
October 17, 2009 (1)

Poets and poetry
October 7, 2009 (1)

Time + place
September 24, 2009 (1)

The future of books
September 23, 2009 (1)

October book tour
September 6, 2009 (1)

Blogging at Powell's Books
August 28, 2009 (2)

The evolution of an idea
August 3, 2009 (1)

The Poetics of Motoori Norinaga: A Hermeneutical Journey
July 9, 2009 (2)

Tour debrief
July 2, 2009 (3)

Book tour events
May 18, 2009 (3)

Simply in the mood
April 24, 2009 (2)

Book tour
April 8, 2009 (6)

The Necessary Book
March 2, 2009 (2)

"Murder Makes the Magazine"
February 7, 2009 (3)

John Updike
January 27, 2009 (2)

2008 misc. (good news, bad news)
January 1, 2009 (3)

Publishing woes and query letters
December 13, 2008 (4)

Punctuation compunction
November 16, 2008 (3)

The Fountain of Youth (and other Ideas)
October 10, 2008 (2)

David Foster Wallace
September 14, 2008 (2)

Ending it all
September 12, 2008 (2)

The mystery of plotting, the plotting of mysteries
August 29, 2008 (3)

Blocking out the block
August 20, 2008 (3)

"What kind of books do you write?"
August 8, 2008 (2)

Theory of Satisfaction: Part 4
July 21, 2008 (3)

Show and tell
July 14, 2008 (3)

Theory of Satisfaction: Part 3
July 7, 2008 (7)

Advice for first-time writers (Barry Gifford and me)
June 30, 2008 (6)

Theory of Satisfaction: Part 2
June 18, 2008 (3)

To be or not to be
June 10, 2008 (6)

Theory of Satisfaction: Part 1
June 3, 2008 (6)

Virtual unreality
May 31, 2008 (4)

The purpose of this blog
May 21, 2008 (5)

Todd Shimoda's Writer's Blog home \| current \| forthcoming \| past \| contact
ENTRY Subduction March 14, 2012 My next novel, Subduction, is finally at the printers. It should be shipped in a month. The novel has had quite a life of its own, starting in 1998 as a novella (20,000 words), then growing through at least a dozen versions to a fat novel of 120,000 words, and then whittled down through half a dozen versions to its present trimmed version of about 70,000 words. Here are the first couple of pages: The patient, a healthy woman aged thirty-two recovering from a simple knee operation, suffered a fever spiking at 103 degrees. She moaned and rasped when, at the dragging end of a second consecutive day making rounds, I fought off a yawn and asked her where it hurt. Only a first-year resident, I was well on my way to becoming a brilliant diagnostician. She could only wave a hand as if fanning herself from head to toe. Non-localized pain, I wrote in her file. Her surgery wound appeared clean from infection. There were no rashes or unusual skin discoloration. She moaned when I pressed lightly on her abdomen. “What’s going on here, Endo?” My supervisor, the knife-eyed Head Resident, peered over my shoulder. “Fever, some pain, some sensitivity in the abdomen. No sign of infection but we should do a blood test.” The Head Resident grabbed the file and scanned it. “We should not do a blood test. Clearly it’s gastroenteritis. Give her a dose of morphine for the pain. For the other, fluids and something for nausea.” “But—” The Head Resident’s face turned red as his eyes widened then narrowed to mere slits. He shoved the file into my hands and left me with the patient. I wrote up his diagnosis and treatment. A first-year resident never challenges a head resident. Not without consequences. The case wasn’t the first time the Head Resident forced a diagnosis and treatment on me, but it was the first time I couldn’t sleep thinking about it. My usual reaction was to acknowledge my limitations, accept his superior diagnostic ability. I have to admit I wasn’t the best student in my medical school class. Okay, I was near the bottom, although I don’t believe I was less intelligent than my classmates; most were as average as eggs. The main trouble plaguing my performance was poor cognitive attention. In class I would listen to the professor until my mind wandered to some other thought. For instance, the professor might be talking about muscle tissue and I might wonder what causes cramps. I would be thinking about that for a few minutes, not listening to the lecture. When my attention returned, I’d be lost and would spend another few minutes figuring out what the professor was talking about. Of course, as soon as I caught up, my mind would wander again. I simply couldn’t help it. Then there were the tests. Success on medical school exams is robustly correlated with gross memorization. As you can imagine, a med student with a wandering mind will have trouble trying to focus long enough to memorize all the facts. As in a lecture, I’d read a fact which would take me off on a different path from the topic at hand. I’d browse through reference books, trying to answer this question or that. Back to the patient with the post-surgery fever. A simple blood test might have pointed to a possible cause of her fever and pain, but the Head Resident’s look told me it was an inefficient use of time and resources. Anyway, the Head Resident probably was correct in his diagnosis. So, no, it wasn’t the diagnosis keeping me awake; it was the image of the pain congealed around the patient’s eyes and mouth like a death mask. I told her there was nothing to be alarmed about. The doorbell to my hospital dorm room rang, waking me after what seemed a short nap, but the clock retorted it had been a solid seven-hour sleep. Still dressed from the day before, I groggily shuffled to the door and opened it to find the Head Resident and a senior hospital administrator. I made spaces for them to sit down in my room, then opened the window to freshen the room’s stuffy air. Thinking an offer of something to drink would be appropriate, I started to mention it, but they didn’t look to be in the mood for refreshments. The hospital administrator rested her hands on her lap, properly and professionally. Contrasting with her, the tirelessly rigid Head Resident lounged casually as if bored. After a brief apology for interrupting my downtime, the administrator said, “We regret to inform you that your patient, Ms. Sunada passed away.” Ms. Sunada? The knee operation patient? The Head Resident spoke so quietly I barely recognized his voice. “She died, Endo, of a burst appendix.” “That’s severe but treatable.” I barely recognized my squeaky voice. “She passed out from the morphine. No one checked on her until the morning.” “By then it was too late,” added the administrator, her head bowed. We were quiet for a moment, as if in respect for the dead. But I was reeling from the shock, my mind roiling and my heart thumping as if I’d sprinted up Mt. Fuji. I wanted to vomit violently. The Head Resident broke the silence. “If only you’d done a simple blood test.” My head whirled in his direction. His expression was as blank as the wall he was staring at, the wall of my dingy tiny room, my dingy tiny life. I knew then what was going to happen. And it was not good. © 2013	COMMENTS Number of comments: 8 click here to add a comment Lee Witte Can't wait to read! Gail I put my name in the ring to get an "early reviewer" copy of your book at Library Thing. I hope I get it!! Marilyn Colter Will be excited to see this since I saw it in an early version. Know it will be interesting... Gail Yes! I snagged a copy of "Subduction" at Library Thing. So I will have the pleasure of reviewing this book when they finally send it to me. Besides Library Thing, I will post my review on Amazon as well. Can't wait! Todd Great news, Gail! Hope you enjoy it! Gail I really loved this book, and you can find my review of it on LibraryThing. Gail I also put a very slightly changed review on Amazon. Todd Thanks Gail, I really appreciate your insightful reviews!	ARCHIVE date (comments) Review: Paprika April 21, 2013 (3) Review: A Straight Road With 99 Curves March 30, 2013 (1) Gripping writing Feb. 28, 2013 (2) Review: Salvation of a Saint January 19, 2013 (2) 2012 in review December 30, 2012 (2) Review: Ninja September 30, 2012 (2) Review: My Postwar Life August 21, 2012 (1) New interview with Colin Marshall July 15, 2012 (3) Book events April 25, 2012 (2) Subduction March 14, 2012 (8) Review: A Room Where the Star Spangled Banner Cannot Be Heard January 14, 2012 (1) Review: Plainsong December 20, 2011 (3) Review: The Devil's Disciple November 29, 2011 (2) Haruki Murakami October 5, 2011 (2) Busyness and demons September 25, 2011 (2) Characters: The Bully July 30, 2011 (3) Review: Manazuru June 28, 2011 (2) Deadlines! June 24, 2011 (2) Review: Butterfly's Sisters May 18, 2011 (1) Review: Isle of Dreams April 20, 2011 (2) Cades Award for Literature press release April 12, 2011 (2) Japan and other news March 29, 2011 (1) Borders bankruptcy February 17, 2011 (2) 2010 review December 17, 2010 (6) Congratulations Mario Vargas Llosa October 7, 2010 (2) OH! wins best book award September 23, 2010 (2) Review: Kissing the Mask August 22, 2010 (1) Jonathan Lethem: Writing at the margins July 12, 2010 (2) Review: Love in Translation June 22, 2010 (3) Jose Saramago June 18, 2010 (0) Marketplace of Ideas interview June 11, 2010 (2) Imagining Memory May 6, 2010 (1) Upcoming Los Angeles events April 7, 2010 (2) Time and energy March 30, 2010 (2) Review: Botchan February 28, 2010 (2) J.D. Salinger January 28, 2010 (1) 2009 Reviewed December 31, 2009 (5) Review: The Word Book December 12, 2009 (1) Chaat and Chat event with OH! November 6, 2009 (2) Home at last November 2, 2009 (2) Los Angeles events October 17, 2009 (1) Poets and poetry October 7, 2009 (1) Time + place September 24, 2009 (1) The future of books September 23, 2009 (1) October book tour September 6, 2009 (1) Blogging at Powell's Books August 28, 2009 (2) The evolution of an idea August 3, 2009 (1) The Poetics of Motoori Norinaga: A Hermeneutical Journey July 9, 2009 (2) Tour debrief July 2, 2009 (3) Book tour events May 18, 2009 (3) Simply in the mood April 24, 2009 (2) Book tour April 8, 2009 (6) The Necessary Book March 2, 2009 (2) "Murder Makes the Magazine" February 7, 2009 (3) John Updike January 27, 2009 (2) 2008 misc. (good news, bad news) January 1, 2009 (3) Publishing woes and query letters December 13, 2008 (4) Punctuation compunction November 16, 2008 (3) The Fountain of Youth (and other Ideas) October 10, 2008 (2) David Foster Wallace September 14, 2008 (2) Ending it all September 12, 2008 (2) The mystery of plotting, the plotting of mysteries August 29, 2008 (3) Blocking out the block August 20, 2008 (3) "What kind of books do you write?" August 8, 2008 (2) Theory of Satisfaction: Part 4 July 21, 2008 (3) Show and tell July 14, 2008 (3) Theory of Satisfaction: Part 3 July 7, 2008 (7) Advice for first-time writers (Barry Gifford and me) June 30, 2008 (6) Theory of Satisfaction: Part 2 June 18, 2008 (3) To be or not to be June 10, 2008 (6) Theory of Satisfaction: Part 1 June 3, 2008 (6) Virtual unreality May 31, 2008 (4) The purpose of this blog May 21, 2008 (5)