Noble Vision [Englisch] [Taschenbuch]

I don't usually write book reviews for novels or books that generally are considered to be works of "fiction," although I regularly read a great many novels for my own enjoyment, merely for the sake of recreation. Now and then, however, a novel comes along that I consider to be a work of "fiction that makes an important point." This is the case with Gen LaGreca's new novel, "Noble Vision." Written in the tradition of Ayn Rand's "The Fountainhead" and Dean Koontz's "Dark Rivers of the Heart," LaGreca's book does, indeed, "make an important point," and does it superbly. The battlefield is sociopolitical geography and the war is rational individualism against state totalitarianism.

The basic plot of the novel is really quite simple, but the philosophical ramifications are profound. Dr. David Lang, a noted and successful neurosurgeon, has discovered a way to regenerate nerve tissue. The government (of the state of New York, in this case) will not allow him to try his experimental procedure on Nicole Hudson, a professional ballerina who has become blind because of a fall which occurred during an explosion at the theater where she was performing. And why can't Dr. Lang help Nicole to possibly regain her sight with his new medical breakthrough? Well, because medical practice in New York is now regulated by the state's socialized medicine program (named, interestingly enough, "CareFree"), and Dr. Lang's procedure has not yet been "officially" approved. It doesn't matter, of course, that Nicole, as his patient, has granted him permission to try the new procedure.

There are a number of subplots in the story, adding complexity to both the major theme of the novel and the suspense experienced by the reader, and a cast of characters who are clearly drawn and with whom the reader will either identify or vilify. The state's governor is an exemplar of the truly corrupt politician; the head of the state's socialized medicine program is a compromised physician (who just happens to be Dr. Lang's father!); and Marie Lang, David's wife, who is also a physician but one who has caved in to the powers-that-be, has given up her dream of being a cardiologist to be a general practitioner because that was the "socially correct" thing to do. Other characters grace the pages of this fine novel and the reader has no trouble determining where they stand in relation to the main theme of the book. Yes, it's pretty much black and white, and that's the way good fiction ought to be when it's trying to get the reader to think about an important issue. This is what fiction in the "Romantic" tradition is meant to be. In LaGreca's novel there are no namby-pamby gray areas of moral indecisiveness; there are no colorless characters who couldn't be heroes or villains because they wouldn't know the difference; there is no compromise between true individualism and the suffocating policies of state collectivism. Hurray for that!

Remember Hilary Clinton's proposed healthcare program back in the 1990s? One thought that occurred to me as I read further into this novel was how close this story was to what probably would have occurred if her healthcare program had, in fact, been implemented. One point that stood out was this: in the Clinton program, as I recall, a physician could be fined and/or imprisoned for treating a patient privately. I found such a proposal shocking at the time. In "Noble Vision," this possibility becomes "real," in the sense that a novel can actually serve to illustrate just how such an immoral policy would be applied if executed, and the consequences of such a misguided program. I am old enough to remember the days when the practice of medicine was considered a "calling," and physicians were more concerned about treating their patients than about becoming rich or meeting the arbitrary whims of some bureaucrat. The practice of medicine does not mix well with politics; in fact, I would argue that politics would be (and yet may be) the death of good, sound medical practice.

There are, in my considered opinion, three types of people (or institutions) one should absolutely avoid: Those who say (1) "I know what is best for you"; (2) "I'm only doing this for your own good"; and (3) "This will hurt me more than it will you." Substitute the "State" or "government" for "I," or "I'm," or "me" in the above statements and you'll get my point and, I think, the warning that this novel provides. Socialized medicine is, in reality, "antisocial" medicine, and the evidence can be found in the failing programs implemented in countries such as England and Canada. LaGreca's novel simply brings this idea into "reality" by showing what would inevitably happen.

A brief word about the writing itself. I am supersensitive to sentence structure and word usage when it comes to fiction. I will cease reading any novel when I begin to pay more attention to the writing itself than to the story. Fortunately, in this case, I have nothing but praise for the writing style of the author. She writes excellent prose; there is no excessive description, which means no superfluous adjectives and adverbs (so common these days), and no complex sentences to confuse the reader, but just a comfortable "flow" of words, driven by nouns and verbs, which propels the story forward and doesn't interfere with the readers' involvement in the story itself. LaGreca is not only a great storyteller, she is also a great story-stylist.

Now, does Dr. David Lang get to perform his experimental procedure on Nicole Hudson (with whom he is secretly in love), and does it all end well? I am not one to give away the ending of a book which will, I guarantee, keep you turning the pages into the night. An excellent story, highly recommended by one who doesn't do so lightly, especially when it comes to fiction. But, this novel is truly "fiction that makes an important point."

In many ways, this book is reminiscent of Ayn Rand's, The Fountainhead. The struggle of the neurosurgeon, David Lang, to do his work his way, is similar to the struggle of Howard Roark, but, in many ways, the struggle is more intense. Every medical student and resident should read this book. It is both an exceptionally well written novel in the great romantic tradition, and a warning of nightmarish consequences for every patient, if the government continues to increase its death grip over medicine.

Since I work in medicine Gen LaGreca's novel was especially pleasurable. The novel starts off the exceptionally talented Nicole Hudson performing at a ballet titled Triumph. It is a rewriting of the myths of Prometheus and Pandora. Prometheus brings fire to man and Zeus to punish him chains him to a rock. In an effort to punish Man, Zeus gives Pandora a golden box which as you know she opens. However, the ballet is rewritten where Pandora frees Prometheus and together they banish the evil released by the box and weather the wrath of Zeus. In a not so subtle effort at foreshadowing, the novel follows this basic plot. Dr. David Lang is a brilliant neurosurgeon who pioneers a technique to regenerate severed nerve tissues such as spinal cords and optic nerves. He lives in a New York State where there is socialized medicine but more advanced than that in current day Massachusetts. He and his fellow doctors are bound by rolls and rolls of red tape. The program called Carefree has seized complete control of medicine and punishes doctors with heavy fines and even jail for disobedience. To obtain treatments for patients doctors must plead with bureaucrats for approval. The fees are set by the state so even if a doctor performs 12 hours of surgery, the state will only pay for 6. Dr. Lang is unhappily married to Marie who is a general practitioner who each step of her life chose to appease the majority. He does enjoy the company of his brother Randy Lang who is the president of the hospital and seems more pragmatic. Dr. Lang finds relief and joy in stealing away to watch Nicole Hudson dance in Triumph. Then one day she is blinded in an accident while on the stage. Her career is at an end and her one means of happiness is cut off from her unless Dr. Lang steps in and risks his career, jail and the wrath of the state to see to it that Nicole will see again. There are a number of subplots and surprising twists that kept me reading even though I knew what was going to happen. The style, the plot, the characters and the philosophical basis for the book are heavily influenced by Ayn Rand and by a clear concern for the current direction of medicine. The first portion of the book, LaGreca's writing is clearly in the long shadow of Rand. Thankfully she breaks free in the second half of the book. As far as first novels go, the rough edges in this one are minimized by a driven plot, characters who I found myself caring about and making an important philosophical and political statement. Don't think it will actually happen? I wouldn't be so sure. Getting approval for procedures and radiology scans are already well established and insurance companies already set fees regardless of the actual work done. At least in our world if you are unhappy with one insurance company you can switch to another or if you are a doctor you can choose not to accept a certain type of insurance if you believe they are being unfair or are difficult to deal with. Despite very clear problems in current state programs, prominent physicians, professional societies and prestigious medical journals are all clamoring for more state intervention. This enjoyable novel will should make you question these recommendations and even offers solutions of its own in a way that you won't notice any soapboxes around. This novel isn't without its own flaws nonetheless I recommend it highly.