Review of Blame: A Novel

Biopolitical Times
Blame cover, which displays two mice traveling in a maze.

Because it is a central theme of this novel, it seems appropriate for me to start this review with my own “conflict of interest” – or as I prefer to see it, my “competing interest.” So I note that my parents and Tony's parents were friends when we were young children and though he and I were never friends, we were colleagues in adulthood insofar as we attended the same medical/human genetics meetings and conferences and kept in touch with our separate critiques of these issues, even discussing them, when we met.

Readers, therefore, can make their own assessments of my comments about Blame as to whether or not they are “fair” or even unbiased. Readers should also know that though I have a long history of writing and publishing book reviews, both in print and online, with only one exception these have been works of non-fiction; critiquing a novel is something I vowed not to do once the first was complete, but here I am....

Enough about me; the book is what is important here, and it is an important book – especially for those who are not trained in or otherwise familiar with human/medical genetics and the range of ethical, social, legal, and political issues raised by the applications of what is learned in a lab. It is a novel of fiction and a novel of science, often eerily portraying not only what is happening now but what is possibly very soon to come as new technologies are normalized, “monetized,” and enter “ordinary” medical practice.

Blame is fueled by these issues, with the characters propelled by the concerns raised and their own ambivalences about what is “right” and useful to do. It is a kind of hybrid book, combining an introduction into the intrigues of (and intriguing nature of) genetic research with a compelling story of (some) good people who go – and are led – astray. Thus, while the characters are well-limned, they can at times seem to represent an issue at least as much as appear to be fully-fleshed individuals.  

As a result, the reader may feel, as I did, deeply drawn to but still hungry to know more about the central figure and his wife, in order to better understand just why he (a solid scientist doing careful research) and she (a strong woman with feminist leanings) do what they do. Unfortunately, to provide details here would likely give more away what readers should better discover for themselves. 

Watching the characters who incarnate a range of roles (investigative journalist, African-American woman harmed in a commercially-funded clinical trial, university administrators and faculty, et al.) also affects us strongly on gut levels but can nevertheless sometimes seem forced to meet Holtzman's political agenda when the latter is given priority over the deep development of characters per se.  Why do some key players make the turns in behavior and in practices that they do? Hubris? Insecurity?  Money? Love? All are at play, and we don't necessarily need these all spelled out. Yet while it's very clear that the central characters do change, it might enrich the novel if the why of this was easier to sense without feeling that some turns are plot-driven to make a point. 

But despite these quibbles, no doubt the book is a page-turner and the reader is driven along.

There is also no doubt that Holtzman has a stand on the issues he raises, a stand I probably almost entirely share with regard to the evils of profit-driven science, the corruption of academia and corrosive effects on science (and people and relationships) that ensue, the hyped promises of predictive medicine, the dilution of fully informed consent, and the lingering oppression of societal racism. He brings all this, including their historical grounding, into the novel with clarity and expertise.  And accompanying all this are generally easily digested details of genome analysis, medical interventions, and other “science” matters. As background these are essential elements of Blame; however, when these are foregrounded, they risk becoming ersatz major “characters.” This, in turn, can make some of the fictional people simply potential “issue-bearers,” embodiments, that is – but possibly with bodies that are thinner-than-needed to fully satisfy a reader.

Because it is a challenge for a reviewer to talk of the actual “plot” of the book without revealing its  ending, and wanting not to spoil the experience for readers, I will only note that there is lots here to keep a reader engaged and turning pages, perhaps even in one sitting. Blame is properly titled; much and many bear this load in the novel's exploration of how genetic testing of asymptomatic people can reveal DNA patterns suggestive of the later appearance of highly undesired diseases (in this book Alzheimer); of how lucrative for companies it can be to patent these DNA segments/patterns for the commercial development of tests they can sell; etc. To this are added references to other sources of blame: past racist research, sexual harassment, spousal violence, the lifestyles of rich and privileged whites in the US, inadequate even lax regulations and laws related to genetics and genetic technologies in law and legal regulations....a full set of the blameworthy from which to choose.

This book is as important to read and then discuss with others to foster the important public input into  decision-making re how genetic technologies are developed, funded, used, provided, and governed, as it is to read simply for oneself: it will surely give everyone several hours of pleasurable page-turning. I hope these two “applications,” the collective and the private, will merge– and Blame will be an essential basis for this merging as science continues to seek ways to read our futures and to extend lives. While a work of fiction, Blame is definitely not science-fiction.

Abby Lippman has spent decades following developments in applied genetic and reproductive technologies. Her main interests as a feminist researcher, writer and activist center on women's health and the politics of health. She is also Professor Emerita in the Department of Epidemiology, Biostatistics and Occupational Health at McGill University.

Image via Cloud Splitter Press