When the resources of a strained medical system reach critically low levels, one doctor bypasses ethical concerns to act—creating a sophisticated network that saves lives but which also threatens to destroy his career.

When doctors inform Tom Bradshaw that his 12-year-old son, Link, is having a heart attack, he turns incredulous. But the relative stability Link experiences after his initial episode is soon offset by a flurry of negative test results, each of which seems to illuminate more parts of an increasingly threatening outlook. Born with a congenital heart defect, Link is in need of that most precarious of operations: a heart transplant. He finds himself navigating not only hospitals, complex prognoses and more tests, but the lingering grief he feels for his mother, who perished in an auto accident a year prior. Still, he manages to make friends with Marty, a cancer patient, who launches a spying operation that unwittingly discovers the dilemma on which the novel hinges: Dr. Kenneth Bernholtz, a family friend of the Bradshaws’, has been pilfering organs from dead patients in an exasperated attempt to perfect a technology that preserves harvested organs longer than usual. Several races against time ensue as Link’s family struggles to procure him a working heart, Marty tries to determine her fate amid rounds of chemo treatment, and Dr. Bernholtz endeavors to forestall the collapse of his covert operation, which violates official procedures, in an attempt to coordinate more crucial transplantations. Rendered in snappy prose, the narrative nonetheless unfolds at a consistent pace; the dialogue is mostly fresh, the characters, sensitive and realistic. The novel’s climax, which pivots on the tension between patients’ rights and the medical community’s task of saving lives, highlights the profound moral ambiguity and emotional tumult of this still highly relevant issue in bioethics. Bernholtz, committed to his cause to a fault, provides a moving case study in the limits of compassion.

A compelling medical drama, written in taut prose, that addresses with tact, humor, poignancy and sophistication the question of what individuals in desperate circumstances owe to each other.