March 07, 2016

Of Medical Mysteries and 9/11: Saad Shafqat's Breath of Death gets an 'Average' grade

I guess I should start this off with a disclaimer: of all the genres I gravitate towards, thrillers and mysteries interest me the least. So I don’t really know how to review medical thrillers because I have no experience with reading them; I don’t know the tropes of the genre, I don’t know what’s been done before and what hasn’t. That being said, it’s still easy to see where Breath of Death succeeds and where it fails, and the result is a balance right between too much and just enough in about every single aspect of this book.

The character choices are interesting – a middle aged neurologist teaming up with a young female student - but could have been more complex. The plot is appealing – a new, unknown disease is inflicting unrelated people in Pakistan in weird ways – but could have moved faster. The antagonists are well drawn – a terrorist and a brilliant microbiologist - but they could have been more remarkable. Basically, to sum it all up, this book was the most average of all averages.

Reasons you should read this book:

The headache came first. It crept up from nowhere to pierce through his forehead and pound on his temples, making his head feel like it would crack open.

It’s obvious right from the starting that Saad Shafqat has command over the English language, because the sentences are well constructed and easy-to-read. There’s a definite flow in the passages, an easy control over which adjective and which verb is used in which circumstance. In terms of well written, this book gets all the points.

This is shown even in small, simple situations; situations which other people might not have noticed but because I’ve so rarely seen easy affection between well-established couples in books by Pakistani authors, I paid all these paragraphs extra attention.

Asad stood up, collected his car keys , and kissed Seemi on the nose, as was his goodbye habit. He was out of the house without a word.

Of course, in a book about characters living in Pakistan, it’s impossible as a desi reader to not unconsciously look for moments of similarity, to read between the lines for things we recognize. And in this case, the book does deliver.

“The only thing the police are good at is asking for bribes all you’ll end up with is spinning your wheels in and out of court.”

Of course, as in all cases, most of these moments with which we can relate to situations in Pakistan involve corruption, poverty, or something equally depressing, but that’s a topic for another day.

This last time she almost made it through the traffic light – only for a beggar to come in front of her car at the worse moment. She had half a mind to run him over, but he was on crutches and looked pretty decrepit. But she quickly did the mental math – who knew if he was for real?

Another topic Pakistani writers cannot live without talking about is 9/11, which, okay, fair enough, was a huge deal and serves as the basic obsession for this book's terrorist and his plans and thus basically the whole plot. But a lot of books don’t know how to handle the post 9/11 reaction, and this book sort of gets it right, in some cases.

A few months after 9/11, Aziz sold his thriving orthopaedics practise and left Omaha for Karachi. He had been unable to stomach what he felt was subtle vilification of Muslims in American media and society.

Even in the case of the terrorists, who suffer the plight of being two-dimensional and reduced to cardboard figures in most books, there is an attempt to more clearly define their past in relation to 9/11 and the outcomes that led to islamophobia and its reaction among the Muslims.

Even prior to 9/11, he had understood and accepted that he would probably remain a permanent stranger in American society, but he had not been prepared for this attitude to invade the cocoon of his comfortable university life.

The book also does well when it descends to the level of the personal in terms of the medical stuff. Even though most of the medical jargon remains inscrutable, discussions about the Pakistan doctor’s lifestyle show that the author himself has intimate knowledge about what it feels like, for example, to relay the news of a patient’s death to the patient’s family.

After having grappled with these circumstances scores of times, Asad still felt he was a novice. The same anxious chill welled up inside him each time – the same fear that he might come across as callous or disrespectful, a guilt rooted in failure and helplessness, a dread of getting sucked into the vortex of his own emotions.

So in a number of ways, the book is worth reading, but in a number of ways, it’s also not.

Reasons it’s okay if you don’t read this book:

It’s so sad how often this book is almost about to get it right and then you can almost hear the author go, ‘Eh, eff it, I’ll just TELL them exactly what the character is like, who wants to waste all those pages on an interesting back story.’ You’d think the show, don’t tell rule was pretty much a basic tenet for every author worth his or her salt, but apparently not.

Farida was a natural in the role. She had been raised in a conservative household and educated at Karachi’s famous Parsi school for girls where any kind of leisure was considered frivolous and the values of hard work and pragmatism were drilled into your bones. She had approached medical school with remarkable single-mindedness and graduated with many honours.

Which is such a shame, because not only does it clearly serve as a mark of an amateur author, it also verges on condescension in the scenes where the dialogues are explained. Lines and lines are dedicated to explaining what certain dialogues actually meant or what they implied, which can get irritating in its disdain for the reader’s ability to contextualize.

This sort of superciliousness is carried on in the self-serving tone our main protagonist employs when talking about how awesome he is for coming back to Pakistan, the land of the needy and the defunct, when he could have stayed in the amazing life he had in America.

There could be compelling reasons to return to Pakistan – the obligation to care for aging or disabled parents were probably the most forceful – but even that wasn’t enough to make people give up the attractive salaries for medical professionals in the United States.

This sort of, ‘oh look at me I came back to this country I demand your awe and gratitude’ tone that the book insinuates early on does it no favours. And neither does the excessive medical history that the story routinely tilts towards.  

‘Encephalo’ is derived from the Greek word enkephalos meaning the brain; ‘itis’ is a common medical suffix, also of Greek origin, signifying inflammation. The condition occurs sporadically (medical speak for randomly) but can also appear in epidemic forms.

Surely there’s supposed to be some difference between a textbook and a fictional novel. This book is literally filled with things that substantially decrease the strength of the story telling, such as the unnecessary medical background provided for a number of random characters. Why do we care why the man who comes only one time in the story decided to study medicine? The answer: we really don’t. But that sort of irrelevant material exists anyway.

The problem is that the story tries to do a lot of things right, but for some reasons continues to fail. Case in point: our young female protagonist is confident, feisty and opinionated. She takes her studies seriously but isn’t a two-dimensional nerd; she has a boyfriend but isn’t painted as an airhead or completely immoral. So while the author gets extra points for attempting to make her interesting, the fact of the matter is that these attempts feel too obvious. The boyfriend drama in the middle of a plot obsessed with a medical mystery feels pointless and stuffed-in, and doesn’t really manage to work.

That, then, is the basic problem of the story: you can almost see the workings behind the writing, and those workings might have good intentions, but their execution is cringe worthy. The background of the terrorist in this story remains monotonous, explained within three measly pages. Once again attempts at complex characterization can be seen in the deeply religious evil figure spending time with a prostitute, but some contradictions needed to be more fleshed out in order to make him something more.

Malik had set his threshold for tolerating uncertainly very low, forcing him to plug all holes in data gathering well before they could become an issue. His instinct, finely tuned like a virtuoso’s violin and season to near-perfection through almost a decade of the most secret, high-stakes reconnaissance work, was to smoke out all the relevant information from key sources.

One of the most obvious instances where this writing fails is when the author goes on and on about the terrorist’s supposed perfection at his job, who then fails and blunders almost constantly. It’s like the author wanted to create this character he had in mind, all sharp intellect and lithe in the shadows, but couldn’t produce him in the action scenes.

He had come to Avicenna with the specific aim of covertly sniffing out the medical details of Zafar Majeed. The situation required a clever plan with minimal or no risk, that combined stealth with a high likelihood of quality information retrieval.

Hamza, the scientist collaborating with the terrorist, is probably the most interesting character in this story because of his OCD and how he converts from being a well-known microbiologist to creating a biological weapon for a terrorist organization. In this, as in all other cases, the book fails just slightly, barely falling short of creating something worth reading.  

With the jingoistic American media reaction to 9/11, he had become very self-conscious about being a Muslim. Perhaps people looked at him differently, or perhaps he was imagining it. But as far as Hamza Qadri was concerned, the end result was the same – a discomfort of not blending in.

The conversations that lead Hamza down the path towards creating said biological weapon are interesting, but not persuasive to the reader. This book is like a good idea that you admire, but you’re not really sure is going to deliver.

Reasons why the whole thing is so confusing:

Basically, this book is somewhat good and also somewhat bad, and what I mean by that is that it has both moments when it feels like it represents the city well, but also moments when that very same representation feels clichéd.

Summer in Karachi is brutal. The heat alone is ugly and unforgiving. Add unrelenting humidity, and the elements become merciless. 

It’s hard to imagine an author hailing from Pakistan being creative and somehow managing to do without at least ONE description of the traffic or the weather, because at this point in time both these things seem such an integral part of living in this city. But no matter how well-written the descriptions or how interesting the conversations, it’s still hard to determine whether the appeal of being slightly cliché and thus relatable can afford to be this book’s saving grace or not.

“It’s not for you to judge who is a Muslim and who isn’t,”
“Come on, Aziz. You can’t chop an innocent man’s head off and be a true Muslim. It’s as simple as that.”
“Well, you obviously don’t know this, but this is the preferred Islamic method of dealing with your enemies. It’s in our history.”
“Doesn’t make it right.”


The mother was adamant about malaria, but the mufti looked unconvinced. He diagnosed demonic possession and ordered a beating to drive out evil spirits.

It’s really hard to know where I fall on the recommendation spectrum with this book. On the one hand, it gets extra points for not indulging in a ridiculous adulterous affair between our two main protagonists. On the other hand, you have the unoriginally named secret terrorist organization called The Network, or the sudden change from past to present in the twentieth chapter which makes absolutely no sense and speaks of bad editing. I guess all I can say is that while I won’t go around singing its praises, I’d recommend everyone read it for themselves and find out, if only because it's the first medical thriller written by a Pakistani author that I know of.