Thomas M. Disch has always been a brazen, demanding, endlessly inventive writer a realist with a penchant for the macabre, a satirist who refuses to type or flatten his characters, a literary stylist who can outdo any dime-a-word hack at breakneck pacing and big-scene bravura. His new novel, The M.D., is a pitiless fairy tale and a Faustian pastiche, a (doomed) family chronicle, and a crackerjack medical thriller.
''Over the years most doctors become more cold-blooded than generals. It's the training: cutting up cadavers, learning to operate all the chemical switches for pleasure and pain, poking about in open wounds, being the first to know the worst. You succumb to the fascination.'' Billy Michaels is just 6 a schoolboy in St. Paul, in 1973 when he succumbs, after finding a caduceus, the winged and serpent-twined ancient symbol of the medical profession.
The boy is convinced that it's a Christmas gift from Mercury, the Roman god of magic and science and, indeed, it may well be. Then again, it may not: It's possible that Mercury is just a product of his supercharged imagination, fueled by a glance at his older stepbrother's homework assignment. (Billy is a precocious reader, and Disch is a devilishly clever narrator!)
But whether supernaturally fortified or psychically charged, the caduceus works; it's a magic wand with the energy to charm or to curse, to reward or to punish, to bestow good health or to engender disease. All it takes is will, and some doggerel verse.
Is that a seductive premise, or what? And, in short order, it becomes as morally subversive as a Hitchcock movie. When Billy gets even with the neighborhood bullies by putting the whammy on a handful of candy bars and making their teeth fall out it's hard not to grin. They deserved it, right? When he causes his vain and nasty grandmother to lose all her hair during a shampoo at the local beauty parlor (''One touch of this leafless twig/Will make you bald as Porky Pig''), that's just good old slapstick fun isn't it? And when he cures his stepmother of alcoholism and his stepsister of anorexia, when he guarantees perfect health to every member of his family, and even (what a guy!) when he protects the elm trees in his front yard from blight how wonderful! Wouldn't it be great to have caducei of our own? Absolutely!
But then, right in the midst of this so-perfect pipe dream, when we're most enjoying ourselves, Disch sneaks up from behind and hits us with the sheer monstrousness, and the true meaning, of his tale that the power of life and death, the ''hinge of all power,'' is the hinge, too, of all corruption. As Billy's boyhood magic pranks turn into adolescent maliciousness and then to adult evil as cavities and baldness give way to cancers and strokes, and finally, to global plague The M.D. fully, and brilliantly, earns its subtitle: a horror story. A