New York City, 1983. Bellevue Hospital — a thousand beds, eight hundred employees, the oldest public hospital in America.
James Morrow is thirty-two years old, two years into his internal medicine residency, and the owner of a single cigarette he always keeps in his pocket without ever lighting it. He quit smoking on October first. He hasn't yet quit wanting one.
One night, staring at the green glow of an IBM terminal, James notices something that doesn't add up: the number of oncology diagnoses in his ward has doubled in three months. Twenty-four patients in one quarter, against eleven in the previous one. His attending physician, Richard Kellner, dismisses the data with two words: natural variance.
James doesn't stop looking.
What he finds over the months that follow — in the archives, in the hospital basement, in his own blood — is not evil in any dramatic sense. It is not a monster. It is something harder to fight: a system. A group of intelligent, respectable people, with gold nameplates outside their offices, who have found a way to turn illness into a supply chain. Patients selected by insurance profile. Drugs from a single supplier. No autopsy on any of the seven dead.
And an air that smells of nothing, but that in time makes the blood stop working.
As the system closes in around him — a psychiatric diagnosis, involuntary confinement, the threat of electroconvulsive therapy that would erase everything he knows — James has one ally outside the hospital: Sara Connelly, a journalist at the Village Voice, who understands that truth without documentation is just an opinion, and that the opinion of a resident in conflict with his attending is worth exactly that.
She also knows how to go and get the proof herself.
A medical thriller set in 1980s New York, in the tradition of Robin Cook and Michael Crichton. A story about two people who keep looking when it would be much easier to stop.
