Review of "The Symptoms of a Heart Break"

My review of Sona Charaipotra's "Symptoms of a Heart Break"

Characters

It is the main character of this novel that sets it apart. The story's protagonist is 16 year old girl, Saira Sehgal from New Jersey, who joins Princeton Presbyterian hospital (fictitious place) as a medical intern (junior doctor in her first year, and as Girl Genius, she is the youngest doctor in America).

One might think it is hard to make this a likable protagonist because we don't like child geniuses though we envy them. And it is even harder to like or trust a smart aleck of a child that has been put in a position to make life-and-death decisions, when she has dubious emotional maturity, and doesn't have years of experience. On top of that, she is treated differently by the State because of the age: less working hours, etc, which suggests that other colleagues have to work longer hours or cover for her in some ways. On top of that, the fact that her mother is a senior physician in the same hospital suggests nepotism. Because she works in a pediatric oncology unit (a place that cares for children with cancer), she could be about the same age as some of her patients.

On the flip side, the author has made us empathic towards her by making all these prejudice against her obvious. And has made a funny representation of her struggles with the system and her mother. I am not so fond of the prologue, which is a news article that talked about Saira's background. I think the information there could have been dished out in the main story, told in first person. The story proper starts with Saira making a few blunders on her first day of work: being late, forgetting the white coat, forgetting the packed lunch, and getting on the wrong foot with her supervisor. Worse, she is mistrusted even by her own aunt, who didn't want her child to be cared for by Saira.

The antagonist of the story is Dr Davis, a lesbian doctor whose wife had just passed away. She tends to be very tough on the other doctors. Initially, she was portrayed as a bureaucrat and insensitive to the plights of others. Towards the end, the fact that she raised funds for Alina shows she has a kind heart.

The support cast includes 

Lizzy (Saira's best friend)

Vish (Saira's pretend boyfriend, who is gay)

Taara (older sister, who decided to give up premed and focus on nutrition)

Saira's mother (a pediatrician)

Saira's grandmother (a wonderful cook)

Colleagues (Interns Dr Cho and Howard, Dr Arora and Dr Charles, the senior doctor who recommended Saira for the job)

Patients (Alina, Brendan, Pinky)

Plot

The main story is written as a love story between Saira and Link, the latter is a 16-year old music reality show contestant, and a rock star wannabe, and a cancer patient. There is a fairy tale feel to this plot, with Saira helping Link to get publicity and people to come forward to be tested as a potential match for Link's bone marrow transplant. Link is Asian-American so it's not easy to find a match.

Unlike the other medical fiction that portrayed the life of a medical intern, Saira seemed to have a much more reasonable work schedule and work load. This could be partly related to the fact that she was underage. I wonder though, if the State of New York would be so flexible in working arrangements for a medical intern under these circumstances. The youngest doctor in the world on record is Balamurali Krishna "Bala" Ambati, an Indian-American who graduated in 1995 from the Mount Sinal School of Medicine at the age of 17. He stood at 6 feet tall, and probably did not have the same kind of issues in appearance compared to the protagonist of this book.

The subplots of the novel are plenty and involve family members, colleagues or patients. I particularly like Taara's story, which is a coming of age story in itself. 

Themes

Many themes are explored in this story. The most potent is life and death. Diversity, including cultural and LGBT issues are also explored. Making the most of our lives is a recurring theme. Do we follow our dreams or adhere to our parents' expectations? Another major theme is about being accepted by one's peers. Saira finds herself lonely when interacting with anyone other than Lizzie and Vish, and that is because people see her as Girl Genius, and inherently elite and different.

Writing

Link is a songwriter and guitar player, and I love the lyrics to this song:

There will come a time/ when all I leave behind / is the melody of your name.

There will come a day / when the words we used to say / will all but fade away.

Will you still remember / the moments we spent together /

all those times we swore forever.

One of the distinctive features of this book is the emphasis on Indian culinary culture, and mention of Indian classic movies. 

She shuffles around steaming plates of tikkis, golgappa, chaat, samosas, and lots of tandoori maal, like chicken and kebabs; ... She piles a potato cake on my plate, dousing it with spicy, tangy chickpeas slathered in brown gravy, then tops them with cool yogurt, fresh onion, and mint and tamarind chutneys.

Other books you may like

In order to appreciate the distinctive feature of this book, one has to read the medical fiction genre widely.

Please read other medical fiction mentioned in my other blogs, "The House of God" by Samuel Shem, "The Big Free" by Martha Boone, and "This is going to hurt" by Adam Kay.

Let me know what you think.