As well as finding reading non-fiction medical books and watching medical documentaries fascinating, I thoroughly enjoy reading novels with a medical theme and watching medical dramas on television. However, due to my extensive personal experience as a patient throughout my lifetime, I’ve always found it easy to pick holes in the medical accuracy when the writer hasn’t done their research thoroughly. That’s why I found it so refreshing to read Tiffany Schmidt’s YA thriller Hold Me Like a Breath, because she clearly has done her research well.
Like its protagonist Penelope Landlow—whose family is involved in the black market for organ transplants—I suffer from the rare autoimmune condition idiopathic thrombocytopaenic purpura, often abbreviated to ITP. I’d never read a book featuring a character with this little-known condition before, so was intrigued and apprehensive to see how accurately it would be portrayed. I was pleasantly surprised. The technical details of ITP and how it affects Penelope in her day to day life were very accurate, even the platelet counts! This may not sound important, but when you have routine blood tests and understand all the figures, there’s nothing more frustrating than hearing numbers plucked out of thin air in a novel or on television. I think the only obvious medical inaccuracy I spotted was when two distinct types of treatment (immunoglobulin infusions and platelet transfusions) were referred to as being the same.
The author kept Penelope’s ITP at the forefront of her mind and even when developing the plot still remembered to include little details about how it might affect Penelope, such as having to be very careful regarding physical contact and movement due to the risk of bruising. I don’t need to take such extreme caution personally, so I wonder if that was exaggerated to make a more dramatic story. The author also mentioned being able to draw on the character’s skin when her platelet counts were especially low. I’ve never experienced this myself, but don’t know enough about other people’s experiences with this condition to know if it would be possible in some cases or not.
I liked the humour that popped up sometimes regarding Penelope’s condition, such as her brother referring to it as “idiot pathetic” rather than “idiopathic,” because I know from experience how finding humour in bleak situations can make them easier to cope with. This seemed well balanced with Penelope’s understandable negative thoughts and frustrations towards her own body letting her down. I could relate to Penelope’s thoughts about survival and being “more than my illness.” Penelope can come across as younger than her seventeen years, but I know from personal experience that when you’ve grown up with a serious health condition, you often have to miss out on the normal things that your peers experience, and you’re left feeling less mature in comparison. I liked the way the author mentioned Penelope’s longing to be able to participate in activities, such as attending school, that other teenagers her age would—I could relate to that, too.
I thought it slightly odd how Penelope was able to identify the cause of each individual bruise so accurately—I personally can’t remember what caused most of mine, but that may well be linked to my poor memory and lack of co-ordination! When I had daily blood tests, like Penelope, I struggled with the extreme bruising each individual blood test produced, but this never seemed to be a problem for Penelope—that may be a small detail that the author overlooked. I liked the inclusion of other symptoms as well as the obvious bruising, such as nosebleeds and petechiae, but felt the dangers of potential external and internal bleeding and brain bleeds were mostly glossed over, with just a couple of mentions throughout the whole novel, compared to countless ones regarding bruises. I thought it was very honest of the author to say in the acknowledgements, after thanking the doctors and patients who helped her research, “If there are any mistakes in the way I depict Penny’s experiences with ITP, they are entirely my fault and I apologize.”
Due to having received a lifesaving multi-visceral transplant eight years ago, the “black market for organ transplants” aspect of the novel intrigued me. I was really pleased to see that the author treated such a sensitive topic with respect. However, transplants were presented as being almost an easy option and a complete cure, whereas in reality it tends to be a bit more complicated than that.
As far as the rest of the novel goes, I loved the author’s use of description, especially the imaginative similes and metaphors she employed to make Penelope’s physical world and emotions come to life. I found the story a bit slow to get going, but once it did, I was gripped and am now eagerly anticipating the next novel in this series.
In conclusion, I’m very impressed with the effort the author has put into creating an accurate portrayal of ITP. I’d recommend this book to anyone who is interested in learning more about the condition or just wants to read a good YA thriller.
