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First Aide Medicine
By Nicholaus Patnaude
Reviewed by Travis Fortney
First Aide Medicine, the debut novel from Nicholaus Patnaude out now from Emergency Press, starts off promisingly, albeit with an italicized prologue that's a bit jarring to the eye. And the writing in the prologue is just, well, strange. For example: "Let the blood run down his sides faster than sweat so that we can be merry. Cut his life to a flame in a pinch as we await the Ghost Witch's commands in our parents attics and basements. Why'd you run into a dead man's arms, Karen?"
Which is fine. Mr. Patnaude has created an entertaining voice for his narrator, and he has a talent for rhythm. The prose moves. It might help that Medicine begins with a prologue, because the reader is willing to forgive a certain amount of weirdness, and by the time chapter one arrives the cadence of the writing is enough to carry us along.
There are a couple of sentences with internal rhymes early on--"Who was this girl alone so late at night in search of a faded cassette illusion to disembowel the clocks of time's intrusion?" and "My blood in the sky, my blood in the sea: carry me beyond the black mirror so that I may reach thee."-- which felt so aberrant yet somehow appropriate that I hoped they would continue.
The confidence of the writing--coupled with an endless stream of over-the-top blood and guts imagery, the sense of unreality, the early reveal that the narrator's girlfriend Karen is dead by suicide, and our realization that this flustered, red-faced-with-spittle-flying style of storytelling represents the narrator's attempt to cope with and move beyond that tragedy--are enough to carry us through the first third or so of the story.
Alas, there are problems. There's no plot. In the "real" part of the book, nothing happens--in fact, no character has a speaking part other than the narrator. In the nightmare world, the action is impossible to follow. We can't nail down a time-line for the narrator's relationship with the elusive Karen, nor can we get anything like a complete picture of what that relationship was like. For a while, a series of flashbacks seems to be moving in chronological order toward some conflict, but we're soon forced to give up the hope that anything in this story will make sense, ever. Also, the possibility that Karen was murdered is raised and then dropped. During her suicide she was decapitated, but that's never explained. Also, the constant onslaught of violent imagery--though inventive in parts--gets very repetitive. You could essentially choose any paragraph of this book at random, read it three or four hundred times in a row, add a few maggots coming out of eyeballs (if you've miraculously chosen one of the paragraphs with no maggots coming out of eyeballs), add a few decapitated birds, and you'd have pretty good feel for what the book is without actually reading it.
Also, this is at least the third or fourth debut with a "suicidal" narrator that I've read this year (though it feels like the hundredth). I just don't believe there's a good way to have your narrator contemplate suicide. Mr. Patnaude does an inventive job of it by having his narrator swim in the ocean with a razor blade in his pocket, hoping to attract sharks by cutting himself. But the problem is that the suicidal thoughts don't lead to any kind of action or move the story forward in any way. Unless the suicidal thoughts make him actually do something, a suicidal narrator is just a boring cliche.
I don't want to get too negative about this one though, and patient readers who are a looking for a gory, voice-driven novel might find much to love here. If Mr. Patnaude develops the plotting and character development skills to allow his voice to inhabit a deserving story, he will be a writer to watch.
Out of 10: 6.5