Vincent Lam is Medical Director of Coderix Medical Clinic in Toronto. He has a depth of experience in emergency and addictions medicine and combines this with an award-winning literary style.

On the Ravine features Dr Chen, who puts extreme pressure on himself to solve drug problems. He runs a clinic in Toronto for drug users who overdose or need help to abstain. His compassion and care for his patients goes beyond scientific formulas. Some nights he wakes, opens his phone, and scrolls through the photos of the patients he’s lost. He calls them the ‘what-ifs’. What if he’d done things differently.

Twice a week he goes on an early bike ride delivering safe injection equipment to the homeless, anxious in case ‘the cops’ ask where he’s taking it. Fitzgerald, one of Chen’s co-workers, lives on the other side of a ravine where sneakers hang from trees. He’s a ‘trusted source’ who saves lives by providing predictable opioids, less potent and dangerous than the street drug of choice, fentanyl, which can stop people’s breathing.

Chen is chief investigator in trials for new drugs. Volunteers from his clinic receive methadone and get paid for being guinea pigs.

Claire, a talented violinist, who buys street drugs, becomes Chen’s patient. Her situation is desperate. The journey of her addiction is an enlightening experience. The sharp, engaging conversations between the characters are rich in tension and Chen’s philosophy is thought-provoking. Claire plays brilliantly when high on heroin, whereas after Chen’s drugs she’s still good but not incredible. Chen shares an appreciation for the violin’s capabilities and understands her dilemma.

Chen also faces a dilemma that challenges his integrity as a clinical scientist. As the leading investigator of a new drug trial ‘healing by forgetting’ – he clashes with the venture capitalists whose requirements of speculative investment are the opposite of proper medical research.

The suspense is whether Chen will keep his integrity and whether his treatment of Claire will succeed or if he will lose her like his other ‘what-ifs’. Chen is a gentle seeker of truth with a desire to give his patients back their lives.

A memorable, inspiring read of the power of addiction told with empathy and sensitivity.

Reviewed by Judith Grace