On the Ravine

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From the bestselling, Giller Prize-winning author of Bloodletting & Miraculous Cures comes an exquisitely crafted novel, piercing in its urgency and breathtaking in its intimacy, about the devastating experience of addiction.

In his downtown Toronto condo, Dr. Chen awakens to the sound of streetcars below, but it is not the early morning traffic that keeps him from sleep. News banners run across his phone: Fentanyl Crisis; Toxic Drug Supply; Record Number of Deaths. From behind the headlines, on the same screen, glow the faces of his patients, the faces of the what-ifs: What if he had done more, or less? Or something different? Would they still be alive?

Claire is a violinist; she feels at one with her music, taking flight in its melody, free in its movement. But now she rises and falls with the opioids in her system, becoming increasingly reckless. After two overdoses in twenty-four hours, she sits in the blue light of her computer, searching a notice board for recommendations: my doctor saved my life; my doctor is just another dealer. And then another message catches her attention, about Chen’s clinic: be a guinea pig—why not get paid to take it?

When Claire’s life intersects with Chen’s, the doctor is drawn ever more deeply into the complexities of the doctor-patient relationship, the implication and meaning of his intention to treat. Chen must confront just how far he would go to save a life. 

Combining the depth of his experience as a physician with the brilliance of his literary talent, Vincent Lam creates a world electric in its precision, radiant in its detail. On the Ravine is a gripping novel of profound emotional force, a soaring achievement from a singular voice in Canadian fiction.Longlisted for the 2023 Toronto Book Award

“A small miracle. . . . With sharp precision . . . [On the Ravine] offers a compelling narrative on the purgatory of addiction. . . . Lam recreates the entire roller coaster in intimate detail, and leaves his reader shivering.” —Ian Brown, The Globe and Mail

“The best writers are born this way. It comes from the brain and the body; we’ll never understand this level of talent; it can’t be taught.” —Heather Mallick, The Toronto Star

“[On the Ravine is] a thought-provoking, wise, and compassionate novel on a subject of philosophical, as well as medical, import.” —The Sydney Morning Herald

Praise for Vincent Lam:

“Emotionally complex and layered, with a preternaturally surefooted negotiation of the human mind and heart, Lam’s insanely gripping book is also illuminated by shafts of radiant, beautiful prose. Like all great fiction, it is both the absolute truth and a vehicle for taking us to a place we’ve never been before. Read it.” —TIME on Bloodletting & Miraculous Cures

“It’s that street-level view of a story we’re more accustomed to viewing in panorama that ultimately makes Lam’s novel so effective and affecting. In stages so subtle they’re scarcely noticeable until he’s got you fully in his grip, Lam combines elements of historical fiction, political thriller and domestic drama to present one of the twentieth century’s defining stories in a whole new way.” —Montreal Gazette on The Headmaster’s WagerVINCENT LAM’s first book, Bloodletting & Miraculous Cures, won the 2006 Scotiabank Giller Prize, and was adapted for television and broadcast on HBO Canada. The Headmaster’s Wager, Dr. Lam’s first novel, was shortlisted for the 2012 Governor General’s Literary Award and the 2013 Commonwealth Book Prize. Dr. Lam is also the co-author of The Flu Pandemic and You, a non-fiction guide to influenza pandemics, which received a Special Recognition Award by the American Medical Writers’ Association in 2007. He served as executive editor and co-author of the textbook, Opioid Agonist Therapy: A Prescriber’s Guide to Treatment, published in 2022. In 2011, he published a biography of Tommy Douglas, “father of medicare,” for Penguin Canada’s Extraordinary Canadians Series. Dr. Lam is an emergency physician and addictions physician who lives in Toronto. He is the medical director of the Coderix Medical Clinic.US

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