Because Vincent Lam broke Bloodletting and Miraculous Cures into twelve chapters - each with it's own characters and purpose, it was difficult to narrow it down to four significant points - or even find one for that matter.
As Dr. Fitzgerald seems to be the most important character throughout this book, and his relationship with Ming is one of the few things that is mentioned throughout the book, I considered Dr. Ming and Dr. Fitz' break-up to be fairly significant.
When the two of them break up we lose focus of the theme of the book. We are reminded that they are both people and not just doctors. It is also through this that we see character information emerge. The one gentle Ming has a sour attitude towards Fitz and ends up doing everything in her power to block him out of her life. She won't answer his calls, open his letters and eventually she changes her phone number.
Fitz on the other hand is literally crazy in love with Ming. He continually calls despite getting no answer. He writes to her non-stop, even when he gets no reply. When he is in Toronto for his university interview even after being ignored for so long he still shows up at her apartment and upon discovering she is not home, he breaks in to wait for her.
This part in the novel is also one of many conflicts. At this point, as the reader, you have only really been introduced to these two characters and the story has only been narrated through their perspective. This makes this conflict very important as it triggers the split in narrative and pulls focus to two different lives as opposed to two entwined ones. Once the character of Chen is introduced through conversation between Ming and Fitz, he gets to narrate the next chapter - sending the book in a whole new direction and pushing focus from the love of two doctors to the independent stories of other doctors and patients.
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