The Blood Doctor
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* Jenny Heathcote

The Blood Doctor Barbara Vine. London, UK: Penguin, 2003. ISBN-13: 978-0-14-100916-2. Price: £7.99. Pages: 480 (paperback) 

I came across this book through a display in the foyer of a local secondary school where I had been asked to lead a sex education lesson. The teachers were recommending books they had enjoyed and this was one of the science teacher's choices. The story is narrated by Martin Nander who is writing a biography of his great grandfather, Henry Nander. Henry was an expert on diseases of the blood and Physician-in-Ordinary to Queen Victoria, who rewarded him with a hereditary peerage. Martin, the current Lord Nander, is facing losing his vote (and the expenses that go with it!) as part of the recent reform of the House of Lords.

Martin is in his second marriage and his younger wife is becoming more and more desperate to have a baby, and suffers the misery of repeated hopes dashed by spontaneous abortion. Martin himself does not have any great desire to go through the baby phase again, already having an older teenage son. As someone who struggled with fertility problems years ago, but now the parent of grown-up children, I can easily sympathise with both sides! The book describes well his efforts to support his wife (particularly as their friends seem to be having babies effortlessly), without her realising his true feelings about parenthood. He becomes engrossed in researching his family tree, which helps to blot out the dilemmas of his family and working life.

The modern day Lord Nander gradually unearths dark secrets involving his ancestor's obsession with blood and he suspects that the surviving papers have been written to conceal something – but what? The only memorable quote from Henry's few appearances in the House of Lords was “control circumstances and do not allow them to control you”, which has chilling implications as the storyline unfolds. (Barbara Vine is a pen name of Ruth Rendell, the best-selling crime novelist, and all sorts of dead ends and red herrings are pursued as Martin tries to unravel the truth.)

I was fascinated by glimpses in Henry's diary of the effect that haemophilia had on the royal family – and its resultant spread to royal houses across Europe. Henry reflects on Queen Victoria's refusal to acknowledge the possibility that she might be a “conductor”' of the disease, but comes to the conclusion that telling her would do no good (either to her and no doubt to his own career!). The doctors of the time are working out the genetics – but have very little to offer in the way of treatment apart from applying ice packs to bruises, and there are a number of descriptions of the hideous lives and early deaths that came with severe untreated disease.

The story made me appreciate the major impact fertility and genetics have on people's lives – in Henry's time women had large numbers of children, many of whom succumbed to illness in early childhood. Genetic traits were often missed or, if suspected, shrouded in shame and deliberately covered up. Shame and secrecy are themes that run through this story, and keep resurfacing even in modern and supposedly more enlightened generations.

The story is interwoven with references to real people and historical events so that the boundary between fact and fiction is blurred. The descriptions of the rooms and corridors of the Houses of Parliament make you feel as if you've been there – richly drawn from the author's personal experience as a peer; even Margaret Thatcher gets a passing mention, taking tea! I really hoped that there would be a piece at the end to put it in context (there wasn't) but this was my only disappointment with the book. Perhaps it's time to rev up the computer for a bit of personal research…

I hope that the teacher's recommendation has encouraged some of her pupils to read this book – who knows, it might even inspire a future medic!