Crossmatch: A moral mirror

by Santhushya Fernando

Blossoming somewhere between a Chinaman and a Jam Fruit Tree is a Lotus. An unusual place to bloom, but there it is, anyway, Crossmatch. Crossmatch is Carmel Miranda’s debut novel that won the Gratiaen Prize 2020. Here’s what isn’t there in Crossmatch: steamy sex, profanity, harsh political commentary, preaching, flowery similes, structured ‘tools of literary writing’, boring descriptions. Probably uninfected by formal literary training, Miranda writes a provocative story with the acumen of a skillful doctor documenting on a patient’s bedhead ticket with some hardcore suspense thrown in. Crossmatch, for its entire 261 pages is captivating in its heart race potential.

Is she for real?

About 20 pages into Crossmatch, I phoned a senior friend who has spent the better part of his life at the Faculty of Medicine and the National Hospital of Sri Lanka (NHSL). “Seriously, you had a colleague called Dr Carmel Miranda? She writes like a hawk observing it all- is this a real name?” He’s was entertained, and replied “Carmel Miranda is for real. She spoke very little, did very much. Never spoke an unnecessary word: serious, committed, all about the patient, precise, not attention seeking, you know, the kind of person you miss when they are not there”. Oh, so I figure. Like Lotus. In Crossmatch.

The plot

Lotus, the protagonist is a third year medical student at the Faculty of Medicine, University of Colombo. She’s requested to pay a social visit to a hospitalised patient by her aunt, as all aunts of all medical students do. Like all medical students up to their eyes in real or imaginary stress, Lotus, grudgingly obliges visiting Anil Kumara only to find him dead. Events take Lotus to Lionel, the NHSL mortuary attendant with one glass eye, who convinces her to safe keep the dead boy’s mobile phone wrapped in a newspaper. Something about the numbers in the phone that includes the namesake Lotus Hospital, the NHSL ENT unit number and the contents of the newspaper drives Lotus to dig in deep. She uncovers, quite accidentally, the dangerous underbelly of organ trafficking mafia, poverty, inequality and the heart wrenching plight of the poor in our so called free healthcare system. Was it an accident that killed Anil? If not, who then is the killer? Finally Lotus finds answers and also confronts a devastating personal truth about her umbilical linkage to the Lotus Hospital. Even at the helm of her shatter, Lotus retains her characteristic objectivity and dignity. Throughout Crossmatch Miranda displays a true gift at maintaining the fidelity to her characterisation in personality, lingo, and mannerism.

The moral mirror

If you have read the captivating Gratiaen winner Chinaman by Shehan Karunatilaka, you would know that one need not be a cricket fan to fall in love with that book. Miranda shows similar skill and humility in telling a “medical story” without medical jargon interfering with storytelling. She has labored well to tell a story about the holes of a medical system in effortless lay language. Never does she matronizingly “explain” medical terms down to the reader, weaving it all in, silkily.

Miranda holds a moral mirror on to our conscience with Crossmatch. It’s a grand mirror with one in center in front of which the reader is stands. That mirror is hinged with two mirrors on the side: the moral mirror of medical education and the moral mirror of medical practice. Both the hinged mirrors reflect unto the main mirror creating an ‘n’ number of reflections.

The moral mirror of medical education in Crossmatch touch on teaching via humiliation, linguism, unjust hierarchies, lack of cohesion in medical education, doctors past their medical fitness ‘expiry date’ continuing to practice medicine. But the beauty of Miranda’s moral mirror is that it does not discuss this in a malicious spirit. All is written with astounding tenderness and sensitivity towards human fallibility. It’s a mirror that every teacher must consider standing before.

The more serious moral mirror in Crossmatch is the territory that few would dare to tread: the kidney mafia, organ trafficking, bending the law, exploitation of the poor in kidney transplantation, lack of a transparent registry for organ donation, the legal and moral dilemma of compensation for organ donation. Importantly, this moral mirror in Crossmatch shines blindingly in our eye asking us questions: do you know what it means to be poor? The desolation beneath the label of poor? How many times do the rich donate kidneys to the poor? Is there ever a free lunch at a private hospital?

Our collective crime: poverty

Miranda reflects the moral mirrors on us for the sole purpose of telling her story. Her tender observations about how people live, talk, move, rationalize, love and sacrifice are all for the purpose of storytelling. Her power of observation is consistent across the slums of Wanathamulla to the bungalows down Rosmead place. After reading Crossmatch you cannot afford to be Sri Lankan and be divorced from the collective social crime called poverty that we all contribute to, by commission or omission. For poverty is the one crime that has the direct or indirect consent of society. The crisp humorful language, sharp precise observation, humane narration without judgment- all these make it a good read. Noteworthy is Miranda’s security as a writer who doesn’t feel the need to climb on top of her story.

Perhaps the only anti-climax of Crossmatch is its epilogue. In an uncharacteristic bout of a need to tie up too many ends, Miranda writes an epilogue reminiscent of last minute commentary over movie credits in a Hollywood or Bollywood movie stating how each character ended up happily. The last line of the main novel (prior to epilogue) “But that doesn’t stop me from dreaming “is disappointing and reminiscent more of a line out of a Hallmark card. Miranda could have written a killer last line. The epilogue takes her matter of fact story telling a bit too far and negotiates a mediocre “happily ever after” to a thought provoking , disturbing story meant to induce a bit of reader- insomnia.

Yes, Crossmatch makes us stand in front of a difficult moral mirror.

To Carmel Miranda I say: “You. Go. Girl!!!!”

(Dr Santhushya Fernando is a senior lecturer in Medical Humanities at the Faculty of Medicine, University of Colombo)