Doubleday Canada, 353 pp, $29.95, hardcover.

Was it Margaret Laurence who owned this joke? She's at a 1960s cocktail party-bosomy and likely bombed-and a surgeon chitchats that he plans to write a novel when he finally retires from medicine. "Yes, and I plan to do a little brain surgery after the writing dries up," Laurence snarks.

No, fiction's not brain surgery, but short stories demand similar fondness for detail, a steady hand, and faith in technique. Bloodletting and Miraculous Cures is the first book by emergency physician Vincent Lam. Like the postmidnight ER, the book pumps out breathless episodes but skirts the nuances and layers of character that inform life's more frantic moments.

Bloodletting's 12 stories are linked by four students we meet in med school and follow deep into their careers in Toronto. In the early material, Lam is strong: the exacting Ming is a young woman torn between family custom, great grades, and a thirst for intimacy. Fitzgerald, her study buddy and flirty friend, has a heart too open for medicine and too breakable for Ming. Lam-controlling and surprising-artfully expresses the incongruities of their lives as doc wannabes.

In those first stories, Lam is a writer who dissects obsessively and invites life's sharp corners to bark his shins. But once the real doctorin' starts, weak technique changes everything. There can be a thrilling energy in novice writing that blows off conventions. In Lam's case, weak scene structure, rampant italics, over-explaining, tag-team narrators, and endings that don't resolve or resonate suggest lack of control, not freshman high jinks.

Most of the book's second half is melodrama and moral dilemma stiffened by medical terms and graphic details; a SARS story suffers from contrived techniques and an inept mock transcription of a CBC newscast. Because a surgeon's care has not been afforded characters-or sentences-there's little we haven't seen on TV doc and cop shows with cuter interns.

So welcome to Can Lit's cocktail party, circa now. Here, the story's about the job the writer had before the book deal. Or the story's about what happened; it's not about the complex, astonishing why. And that's your life-threatening virus.