In this debut novel, a steely CEO sets out to close a struggling hospital, but things don’t go as planned.
When Stella Savage starts her new post as the chief executive of London’s Royal Infirmary, she has one goal in mind: “secretly ensuring the demise of the hospital.” That’s easier said than done, it turns out, as she discovers that the institution’s motley crew of doctors and nurses isn’t going to be as easy to control as she anticipated. On top of that, an anonymous whistleblower claims that he has evidence of incorrect diagnoses—and he’s sending body parts of deceased patients to family members that seem to prove it. Things go from bad to worse when a mysterious gastrointestinal ailment breaks out among the hospital’s patients and staff. Is it evidence of the staff’s incompetence or a deliberate act of poisoning? McIntosh, himself a physician, isn’t afraid to show the dark underbelly of the medical field. The doctors at the Royal Infirmary and its sister hospital, St. Andrews, are a mixed bag—some nobly committed to helping patients, others vain and venal, and almost all with personal lives worthy of a soap opera. Consulting physician William Judd, for instance, is one of the noble ones, which initially puts him at odds with Savage’s cost-cutting ways. But as crises pile up, each character realizes that they must work together for the good of everyone. McIntosh lays the drama on a bit too thick at times, and a few twists strain credulity, particularly a bumbling act of vengeance that leads to a key plot point. Aside from Savage, the book’s villains are so broadly and cartoonishly drawn they’re difficult to take seriously. Far more compelling is Judd, a well-intentioned doctor struggling to deal with situations beyond his control, who serves as the novel’s moral center. American readers may also be a bit baffled by unfamiliar hospital terms and details about the United Kingdom’s National Health Service. However, the general messages about managing bureaucracy and providing adequate patient care are universal.
An entertaining, if sometimes-troubling, look at the chaotic reality of a modern health care system.