Published January 7, 2009
Reviewed May 17, 2009
When you look at mainstream television and wade past the slew of reality shows and generic comedies, scripted drama tends to be dominated by two genres. First is the criminal world, represented by epic series like “The Sopranos” or “Law and Order”-style procedurals; and second is the medical field, headed by the “ER” juggernaut and a slew of comedic dramas such as “House” or “Grey’s Anatomy.” Both series have their own distinct traits but also share common threads: overly tense environments, a heavy dose of gallows humor and a professional lingo that takes a few episodes to understand.
Despite the similarities between and popularity of both genres, the two rarely come together – which is a mistake, if Josh Bazell’s first novel “Beat the Reaper” is any indication. A mix of “ER” and “A History of Violence,” casting a hitman in the role of a downtrodden medical resident, “Beat the Reaper” is a book with a distinctive voice, an educated grasp of its subject matter and a talent for delivering some truly shocking scenes.
The hitman in question is Pietro “Bearclaw” Brnwa, alias “Peter Brown” – a contract killer for a New York crime family who has been placed in witness protection and now works agonizingly brutal graveyard shifts at Manhattan Catholic. At the start of one of these shifts, he finds out a terminal cancer patient not only recognizes him, but has contacted a friend to put the word out in the event of his death. With the patient about to go under the knife, Brnwa has to feverishly find a way to keep him alive – while at the same time dealing with every other demand an understaffed hospital encompasses.
Obviously there’s a big difference between the Hippocratic oath and murder for hire, but Bazell does a surprisingly solid job of melding the two. The story, told in first-person present tense, shows how Brnwa’s mind processes the situation from a medical standpoint, such as when he downs mugger with brutal efficiency and goes through the anatomy of breaking the elbow. It’s a wry, cynical voice reminiscent of Edward Norton’s narration in “Fight Club,” and it drives the story on through his narration and a variety of wry footnotes rattling off medical facts and legalese.
Brnwa makes for an interesting character, but it’s the hospital he operates in that commands your attention. Bazell, who holds both an MD and an English literature degree, has stocked the book full of details that could only be known by someone operating in the healthcare trenches. Readers will learn how residents function during obscenely long shifts (stimulants procured from drug reps, Milk of Magnesia poured over cold cereal), see just how sexist an oncologist can be in the operating room and how a doctor can tell how old you are at first glance. All of these asides are offered in the same cynical and resigned tone, resembling the narration for “Scrubs” as read by Mel Gibson.
The medical terminology is so well mastered that the mob sections – flashbacks filling every other chapter – regularly come up short. There’s a fair share of gratuitous violence and commentary on the state of America’s legal system, but many of the characters depicted lack the realism and personality of the hospital residents. A few scenes are simply over-the-top even in the book’s context and there are also one or two unnecessary plot twists – one in particular involving the background of Pietro’s grandparents – that feel like Bazell is reaching for impact.
And reaching isn’t something he needs to, as the book is ripe with truly disturbing scenes. Beyond the burnout and apathy of the general hospital staff, Manhattan Catholic is rife with events that require a strong constitution to even witness. Syringes of unidentifiable contents, legs that swell up with blood for unknown reasons and clearly unsanitary surgical equipment all populate the area, and give Brnwa more immediate concerns than mafia shooters. The last few chapters are particularly macabre, with a trapped Brnwa once again falling back on medical school to create the most wincingly painful improvised weapon in literature.
While the book is a bit too eager to set up a sequel – the epilogue chapter is almost ham-handed in presenting plot threads – the majority of the volume is so well done that its continuation is encouraged. “Beat the Reaper” is entertaining and fast-paced, a thinking man’s suspense novel with enough of the real world in it to make readers even more uncomfortable about their next visit to the hospital.