LITTLE FALLS

Werner tells the story of a man’s nefarious scheme to sell a hospital in this debut novel.

Edward Teak serves as the CEO of a failing hospital in the depressed town of Little Falls. He hates his job—he can’t stand the sight of blood—and only accepted it in a misguided attempt to live up to the memory of his deceased father, a beloved Little Falls physician. Edward would like nothing better than to bail on the entire enterprise and move his family back to the city. The opportunity comes when a national for-profit health care chain expresses interest in acquiring the hospital, but only if Edward can somehow improve its bottom line. It seems impossible, until Edward comes up with an idea: He simply needs to eliminate a few of the hospital’s “High Cost Patients.” As Edward explains, “The ‘High-Cost Patient’ is to the American hospital what norovirus is to the cruise ship industry. These patients are sicker than most, often poorer than most, and chock-full of pre-existing conditions. When they land on your hospital doorstep you might as well start writing a check and auctioning off the furniture.” Edward draws up a list of the five costliest cases and starts brainstorming ways he might hurry their exit from the hospital system. But how far is he willing to go to help them on their way? Werner imbues Edward with a comical misanthropy, which the character directs at himself and the rest of society in equal measure. “This world is filled with people who walk around like they have it all figured out,” Edward opines at one point. “They’re mostly mediocre losers blessed with an undeserved confidence. I have never been a part of this club, but for the first time in my life I feel as if I have a plan.” The book is over 450 pages long and would be stronger at half that length. Even so, Werner unspools a captivating (if slow-moving) ambulance crash, one that will hold the reader’s attention for a long time.

A demented, often funny satire of American health care.