Sardonic, often harrowing look at the American way of life- support by a writer so thoroughly in control it's hard to believe this is a first novel. A stunning debut. Dr. Werner Ernst, the type who knows (and prefers to ignore) an ethical dilemma when he sees one, would rather be reading great books and chasing women than working all night as second-year resident on an intensive care unit. Constantly exhausted, what he most desires is sleep--as unattainable for him as death is for the hopeless (but well-insured) cases on life-support. Against a nightmarish high-tech backdrop, burned-out staff members exchange insults, refer to patients by bed numbers (never names), and sometimes perform acts of secret compassion. Meanwhile, terminal patients have eschatological hallucinations; Bed Five's self- involved daughter sets out to seduce the more-than-willing Werner and--raising questions of her real motive--asks him to block a procedure that may prolong her comatose father's life. Dooling's unflinching portrayal of suffering, dehumanization, and modern medical technique is almost unbearably painful to read but near impossible to put down. Cruel exaggerations don't detract from authenticity: details--whether about hospitals, lawsuits, or fashion models' makeup--are stunningly accurate. In lesser hands, the climactic scene--a conversation with a nun--might have seemed forced, but the metaphysical undercurrents that are skillfully evoked throughout the novel make it work. A powerhouse for those strong enough in spirit and constitution to read it.