Michael Crichton has penned some of the
most engaging, timely, and thoroughly accessible tales to be published in the
last twenty-five years. What his novels lack in literary merit and distinctive
style they make up for in crisp plotting and edge-of-your-seat suspense. From
alien viruses to regenerated dinosaurs, from evil Japanese monoliths to the
insidious maneuverings of the modern corporation, Crichton latches onto the
scientific and political controversies of the day, and squeezes out of them
every last ounce of shock value. At least, that's usually what he does.
A Case Of Need could have used quite a bit
more shock value. The problem is largely a matter of timing; when the book came
out in 1969, the moral dilemma surrounding illegal abortions was still a hot
enough topic to seem ripped from the headlines. Though abortion certainly
remains a hot-button issue, the debate has shifted. For the time being, at
least, the argument centers on whether or not the act should be legal, not on
whether or not doctors are currently breaking the law by performing them.
The antiquated plot line is not the
story's main flaw. The biggest drawback here is a one-two punch of highly
technical prose employed to relate a thoroughly dull story. Karen Randall, the
daughter of an eminent physician, dies as the result of a botched abortion. Art
Lee, a Chinese obstetrician, is accused of performing the D & C that has
resulted in her death. Though Lee is known to be an abortionist, he vehemently
denies any involvement in the case. Lee calls upon his friend, forensic
pathologist John Berry, to clear his name.
John Berry careens back and forth from one
Boston hospital to another, trying to figure out who actually performed Randall's
abortion, and why it killed her. The investigation is complicated by the fact
that Randall was not even pregnant. Slowly, a picture emerges of Randall as a
freewheeling, loose woman with several abortions in her past, and connections
to some shadowy underworld characters. Berry ultimately discovers that a
drug-dealing musician was actually at fault for Randall's death.
Why did Michael Crichton write this book?
The answer seems fairly obvious. Still fairly immersed in his medical school
learnings, Crichton must have seen it as a chance to demonstrate just how much
knowledge he had gained during his time at Harvard. Numerous medical procedures
are described in detail, supplemented by footnotes and appendices for readers
not in the know.
All of this technical gobbledygook turns
out to be almost totally superfluous. Berry clears Lee's name largely through
old-fashioned detective work rather than through forensic pathology. That
Randall was not actually pregnant turns out to be one of the very few salient
clues that science reveals.
Of course, without all that medical
jargon, this book would have been almost entirely a study of law and American
society, with science providing little more than a context in which the story
can unfold. Crichton makes the terminology slightly more palatable by making
Berry a fairly sarcastic and cynical practitioner of his craft. Still, one can
only stomach so much detailed description of autopsies, biopsy examinations,
and crit readings.
It is surprising that Crichton devoted so
much ink to these scientific proceedings, when the ethics that lie behind the
novel's central act (or, at least, supposed central act) are so much more
engaging. The notion that abortion represents one of the murkiest legal and
moral issues in the medical community is mentioned, but not expounded upon in
any great detail.
Various statistics are quoted suggesting
that abortion is a fairly safe procedure, and a doctor friend of Berry's makes
a fairly eloquent speech regarding the positive aspects of getting rid of
unwanted pregnancies, but there is no strong case ever made for either side.
What would have been most engaging, in
course, would have been strong arguments made for both sides. There is perhaps
no issue as divisive as abortion, no modern medical procedure that elicits such
strong passion from advocate both for and against. Granted, Crichton was
writing a potboiler, and excessive philosophizing would have turned the book
into an even greater dud than it already is. However, a little solid,
even-handed consideration of the themes raised would have gone a very long way.
Another prominent ethical issue that
courses throughout the book is Berry's methods of investigating the case. The
story opens with an excerpt from the Hippocratic oath. Berry then proceeds to
gain information through impersonation, deceit, threats, and other assorted
trickeries. This is by no means, in and of itself, a misstep. Few doctors could
claim to be choirboys.
However, the ways in which Berry employs
highly questionable fact-gaining techniques should not be rendered with so
little self-consciousness. Berry is so driven by a desire to know the truth
that he will sacrifice his honesty to achieve that end. Like the moral quagmire
that is abortion, this dichotomy deserves far more attention than Crichton
seems willing to give.
Where does Crichton focus his attention?
He spends most of his time dazzling the reader with his intricate knowledge of
every medical procedure under the sun. Perhaps the editor is truly to blame for
this mind-numbingly dull aspect of the book. At least there were footnotes. At
least they tried. However, annotations can never replace clear, concise,
everyday prose. While investigating whether or not Randall was pregnant or not,
Berry learns this incredibly illuminating information from a colleague (p. 83):
"'Only proteins can be denatured, and
steroids are not proteins, right?
This'll be easy. See, the normal rabbit
test is chorionic gonadotrophin in urine.
But in this lab
we're geared to measure that, or
progesterone, or any of a
number of other eleven-beta hydroxylated
compounds. In
pregnancy, progesterone levels increase
ten times. Estriol
levels increase a thousand times. We can
measure a jump like that, no
sweat.'"
A jump like what? All of this technical
language does go a long way towards demonstrating that these are actual doctors
talking to each other, but the "Dr." that comes before their names
would have sufficed. All that is really being related here is that it can be
determined whether or not Randall was pregnant. The rest is quite literally
commentary, and particularly intelligible commentary at that.
This major flaw, however, also represents
the novel's greatest triumph. If one learns nothing else from the story, one
gains an appreciation from the importance of method in forensic pathology. The
painstaking details related about every step in the forensic process may be
overly specific, but they succeed at conveying how delicate, how intricate, and
how surprisingly exact a science it can be.
Each twist and turn in the examination is
detailed: the study of blood samples, the dissection of the corpse, the
consideration of diet, age, even the psychological profile of the victim. Those
these details range from gory to mundane, they manage to eloquently convey the
process involved, even as they obscure the relevance of each step in the
process.
With all this emphasis placed on Berry's
attention to detail, it is surprising how completely one important detail is
overlooked: the role of the police in such an investigation. A burly cop named
Peterson swaggers in and out of the story, but no serious mention is ever made
of what the authorities are doing to figure out what happened.
The
case against Lee rests entirely on Randall's mother's claim that her daughter
said that Lee performed the abortion. In reality, it is unlikely the police
would rest on such scant evidence.
Would they do it differently from Berry?
If so, how? There seems to be some suggestion that Berry is a renegade,
investigating the case by playing outside the rules, but this fails to become
an engaging aspect of the plot, because there is no rule-abiding investigator
with which to contrast him. One is led to believe that Berry's style is clever
and unconventional, but his choices actually seem rather practical. An
exploration of how such cases normally get handled would have made the tale far
more engaging.
While A Case Of Need does manage to ignore
its own central themes, make the accessible complicated, and forego even the
mildest attempt at illuminating character study, it still has a few things
going for it. The roles of racism, institutional power, and fear of
professional embarrassment in the course of a medical examination are cleverly
explored.
Dr.
Lee would not have found himself so easily railroaded had he only had the luck
to have been born Dr. Smith. Lee's lawyer, George Wilson, is himself not aided
any by his African-American heritage. As a recent trial that need not even be
named clearly demonstrated, in a criminal matter, science will always take a
back seat to racial politics. Crichton was well aware of this twenty-five years
before it became thunderingly clear to the rest of his fellow Americans.
Justice can be obscured by much besides
the color of the accused's skin. The power of the accuser is of great
importance as well. Lee is dumped into such hot water not because he might have
botched the abortion of some nameless young woman.
Karen Randall is the daughter of an eminent,
powerful doctor, a doctor willing to manipulate medical findings and force his
colleagues to rush to judgment in order that someone might be punished for
Karen's death. Without becoming preachy, Crichton reveals how corrupt and
selfish big medicine can be.
Another Randall is willing to play fast
and loose with the facts as well. Karen's uncle, Peter Randall, also a doctor,
performed two abortions on her in the past. Revealing this information might
help to bring the truth about her death to light, but it also would soil
Peter's pristine reputation.
Peter will go so far as to torch an
incriminating automobile rather than let the truth be known. From the evils of
the all-powerful hospital to the darker recesses of one physician's heart, the
cruelest and most self-serving side of the noblest science is placed out in the
sun for all to see.
It's interesting to consider what Crichton
might do today if he were given a chance to revise this story. Aside from the
twisters that would likely rip through Boston as computer-generated actors
morphed into velociraptors, there would likely also be a more concerted effort
to make the story not more three-dimensional, but less.
The reduction of complex issues to easily
grasp able arguments is what makes Crichton so fantastically popular. You don't
need a deeply considered position on the dangers of modern genetics to weigh in
on Jurassic Park. You don't need any understanding of the world economy to hiss
at the bad guys in Rising Sun. Those stories are focused, even though at may be
at the expense of telling the whole story. Here, the focus is hazy at best.
Berry's investigative techniques, the
importance of medical data, even the motives and actions of most of the minor
characters, go largely unexplained. We are left with the trees, but little
forest in which to view them. Crichton creates an intricate web of medical
intrigue, but then leaves the map to guide the reader through it shoddy and
half-finished.
Of course, Crichton is a skilled
craftsman, and this is why the book is not a total waste. By creating
interesting (if somewhat stereotypical) stock characters, and placing them in
somewhat contrived situations, Crichton does manage to explore some of the more
complex issues surrounding a medical crime.
However, through excessive detail and an
unwillingness to weigh in sufficiently on some of the more important ethical
dilemmas inherent to his tale, Crichton ends up obscuring more than he reveals.
A Case of Need is much like a botched autopsy: all the guts are ripped out into
the open, but we are able to learn little from them.
No comments:
Post a Comment