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As the year 2020 approached its close, I wanted to read a fast-paced novel to round-off my reading for the year. Perhaps a detective novel, a spy classic, some sci-fi, or a thriller. After exploring different new authors, I copped out and settled for a time-tested one in Michael Crichton. To be pedantic, this novel is not by Crichton but by Jeffrey Hudson, a pseudonym under which Crichton wrote his early novels while still studying at Harvard Medical School. He had also used another pseudonym, John Lange, in some of his other works during this period. Crichton was twenty-five when he wrote this book. It is not a techno-thriller like his later novels. I would call it a detective novel in the classical style, but with no professional detective working on the case. Instead, a pathologist does the sleuth work because the case needs expertise in medicine. The driving theme is abortion, and the associated social and moral hypocrisies in keeping it illegal. Seeds of all the brilliance Crichton showed later are visible in this initial effort.
Crichton sets the story in the Lincoln Hospital, Boston, where all action takes place in a frenzied week in October between Monday and Friday. The police arrest Dr. Arthur Lee, obstetrician and part-time abortionist at the Lincoln, on Monday morning. They charge him with causing the death of a young girl while aborting her baby, which is illegal. It so happens that the girl was Karen Randall, the daughter of Josh Randall. It is bad luck for Dr. Lee because Randall descends from a historical medical family that the Boston medical scene viewed as akin to royalty. Dr, John Berry is Art Lee’s close friend at the Lincoln and believes that his friend is innocent. He sets about to investigate the case to prove Lee’s innocence. Berry thinks that Lee was not the abortionist. Besides, Lee is Chinese American and Berry believes that the influential Randall family has picked him as a fall guy to cover up for someone else who has done the deed. Berry gets busy tracking what happened the previous night at the Lincoln and chasing the people involved in the case. He finds that Karen was not the nice girl that her family portrayed her to be and that she hated her father and stepmother. Besides, she used drugs and had two abortions already in her life as a teenager. Berry even suspects that Karen was not pregnant when she died, based on pathological evidence. His detective work leads him to Karen’s uncle and doctor, Peter Randall, as the one who operated on her. Berry doubts that Peter would have done the botched operation because he believes that Peter was too good a surgeon and also because he likes and trusts Peter. Investigating further, he stumbles on more players who had a role in the case. The story reaches a climax amidst the drama of a pursuit through the dark alleys of downtown Boston and some stabbing and bloodletting. The novel ends on a cheerful note for Art Lee and John Berry. However, the solution to the mystery is rather underwhelming.
As we would expect, the novel is replete with medical details on abortion, pathology, and surgery. The author explains them in the narrative and footnotes and appendixes. However, they are in the right proportion with the mystery element and do not swamp the non-medical reader with jargon. The novel is fast-paced and keeps the suspense till the end. The book has seven appendixes in which Crichton explores some thorny medical and social issues relating to abortion and morality. The analysis of abortion is substantive, and the author advances six arguments for and against abortion. One of them deserves elaboration here.
The argument for abortion is that it is safe, easy, and cheap, and hence, there can be no practical objection to legalizing the termination of pregnancy. The counterargument to this is that abortion carries a small, finite risk of mortality. In the 1960s, a million illegal abortions happened in the US every year. Out of this, 5000 cases resulted in death. This means illegal abortions had a death rate of 500 per 100,000. In contrast, hospital abortions had a death rate of only 0-18 per 100,000. So, illegal abortions were twenty-five times more dangerous than they had to be. Besides, a hospital abortion was only 10 to 16% as dangerous as a hospital delivery of babies. This means it was safer to abort a child than to carry it to term! With all these numbers in favor of legalizing abortion, why was it still illegal in the US? Crichton concludes that the crux of this issue is what he calls the ‘Death Threshold’. According to him, the US had a ‘Death Threshold’ of 30000 in the sixties. This was the number of Americans who died of automobile accidents each year. People accepted this as a fact of life and tolerable in the larger interests of society. To rouse the community to act, the number of abortion deaths had to be significantly higher than 30000. Then society will act out of fear and guilt. Through the voice of Arthur Lee, Crichton says that the number of illegal abortion deaths has to be about 50000 a year for lawyers and doctors to take action.
Reading this novel fifty years after its publication gave me a window into the United States of the 1960s. There were four great moral questions involving the conduct of medical practice in the 1960s. Two of them were abortion and euthanasia, A third was the social responsibility of doctors to administer care to as many people as possible. A fourth concerned the definition of death. The definition of death became critical as doctors were doing organ transplants. So, it became necessary to define when a person is dead so they can harvest his organs.
Abortion was illegal in most of the US in the sixties. A million American women flew out of the country every year to have an elective abortion. Those who could not afford the plane fare often showed up, septic and bleeding, in hospital emergency rooms. There were illegal abortionists in every city. The medical profession pretended they did not exist.
The novel shows that the 1960s was more sexist than today. All the doctors in the novel are men. Women in hospitals are mostly nurses or secretaries or wives of doctors. Crichton brings out such sexism subtly by describing a party at a doctor’s home with “The wives clustered in a corner, talking babies; the doctors clustered into smaller groups, by the hospital or by specialty. It was a kind of occupational division.”
Sensitivity to minorities and race was a lot different from what we see today. It was acceptable to refer to African-Americans with the N-word of their race and to East Asians using their origin in the Orient. I noted even one pejorative use of the N-word as a curse by one character. For example, the author writes, “There are a lot of Chinese and Japanese men in medicine, and there are a lot of jokes about them—half-nervous jokes about their energy and their cleverness, their drive to succeed. It is precisely the jokes one hears about Jews”. However, political correctness seems to have existed in describing patients. For instance, a patient was not demented, but “disoriented” or “severely confused”; a patient does not lie, but “confabulates”; a patient is not stupid, but “obtunded.”
The novel contains many snippets of insight into the medical profession and Crichton’s views on the doctors and the profession throughout the book. In the 1960s, most pathologists had trouble buying life insurance. The insurance companies took one look at them and shuddered—constant exposure to tuberculosis, malignancies, and lethal infectious disease made them high risk.
Radiologists had the shortest lifespan of any medical specialist. The exact reasons were unknown, but the natural assumption was that the X-rays get to them. In the old days, radiologists used to stand in the same room as the patient when they took the films. A few years of that, and they’d soak up enough gamma to finish them. Then, too, in the old days, the film was less sensitive, and it took a whopping big dose to get a decent contrast exposure.
On doing medical research, Crichton says it is much better to discover a new disease than to find a cure for an old one. Your cure will get tested, disputed, and argued over for years, while a new disease would be readily and rapidly accepted.
The novel won the Edgar award a year after its publication. I found it an enjoyable, easy-to-read detective novel.
Crichton sets the story in the Lincoln Hospital, Boston, where all action takes place in a frenzied week in October between Monday and Friday. The police arrest Dr. Arthur Lee, obstetrician and part-time abortionist at the Lincoln, on Monday morning. They charge him with causing the death of a young girl while aborting her baby, which is illegal. It so happens that the girl was Karen Randall, the daughter of Josh Randall. It is bad luck for Dr. Lee because Randall descends from a historical medical family that the Boston medical scene viewed as akin to royalty. Dr, John Berry is Art Lee’s close friend at the Lincoln and believes that his friend is innocent. He sets about to investigate the case to prove Lee’s innocence. Berry thinks that Lee was not the abortionist. Besides, Lee is Chinese American and Berry believes that the influential Randall family has picked him as a fall guy to cover up for someone else who has done the deed. Berry gets busy tracking what happened the previous night at the Lincoln and chasing the people involved in the case. He finds that Karen was not the nice girl that her family portrayed her to be and that she hated her father and stepmother. Besides, she used drugs and had two abortions already in her life as a teenager. Berry even suspects that Karen was not pregnant when she died, based on pathological evidence. His detective work leads him to Karen’s uncle and doctor, Peter Randall, as the one who operated on her. Berry doubts that Peter would have done the botched operation because he believes that Peter was too good a surgeon and also because he likes and trusts Peter. Investigating further, he stumbles on more players who had a role in the case. The story reaches a climax amidst the drama of a pursuit through the dark alleys of downtown Boston and some stabbing and bloodletting. The novel ends on a cheerful note for Art Lee and John Berry. However, the solution to the mystery is rather underwhelming.
As we would expect, the novel is replete with medical details on abortion, pathology, and surgery. The author explains them in the narrative and footnotes and appendixes. However, they are in the right proportion with the mystery element and do not swamp the non-medical reader with jargon. The novel is fast-paced and keeps the suspense till the end. The book has seven appendixes in which Crichton explores some thorny medical and social issues relating to abortion and morality. The analysis of abortion is substantive, and the author advances six arguments for and against abortion. One of them deserves elaboration here.
The argument for abortion is that it is safe, easy, and cheap, and hence, there can be no practical objection to legalizing the termination of pregnancy. The counterargument to this is that abortion carries a small, finite risk of mortality. In the 1960s, a million illegal abortions happened in the US every year. Out of this, 5000 cases resulted in death. This means illegal abortions had a death rate of 500 per 100,000. In contrast, hospital abortions had a death rate of only 0-18 per 100,000. So, illegal abortions were twenty-five times more dangerous than they had to be. Besides, a hospital abortion was only 10 to 16% as dangerous as a hospital delivery of babies. This means it was safer to abort a child than to carry it to term! With all these numbers in favor of legalizing abortion, why was it still illegal in the US? Crichton concludes that the crux of this issue is what he calls the ‘Death Threshold’. According to him, the US had a ‘Death Threshold’ of 30000 in the sixties. This was the number of Americans who died of automobile accidents each year. People accepted this as a fact of life and tolerable in the larger interests of society. To rouse the community to act, the number of abortion deaths had to be significantly higher than 30000. Then society will act out of fear and guilt. Through the voice of Arthur Lee, Crichton says that the number of illegal abortion deaths has to be about 50000 a year for lawyers and doctors to take action.
Reading this novel fifty years after its publication gave me a window into the United States of the 1960s. There were four great moral questions involving the conduct of medical practice in the 1960s. Two of them were abortion and euthanasia, A third was the social responsibility of doctors to administer care to as many people as possible. A fourth concerned the definition of death. The definition of death became critical as doctors were doing organ transplants. So, it became necessary to define when a person is dead so they can harvest his organs.
Abortion was illegal in most of the US in the sixties. A million American women flew out of the country every year to have an elective abortion. Those who could not afford the plane fare often showed up, septic and bleeding, in hospital emergency rooms. There were illegal abortionists in every city. The medical profession pretended they did not exist.
The novel shows that the 1960s was more sexist than today. All the doctors in the novel are men. Women in hospitals are mostly nurses or secretaries or wives of doctors. Crichton brings out such sexism subtly by describing a party at a doctor’s home with “The wives clustered in a corner, talking babies; the doctors clustered into smaller groups, by the hospital or by specialty. It was a kind of occupational division.”
Sensitivity to minorities and race was a lot different from what we see today. It was acceptable to refer to African-Americans with the N-word of their race and to East Asians using their origin in the Orient. I noted even one pejorative use of the N-word as a curse by one character. For example, the author writes, “There are a lot of Chinese and Japanese men in medicine, and there are a lot of jokes about them—half-nervous jokes about their energy and their cleverness, their drive to succeed. It is precisely the jokes one hears about Jews”. However, political correctness seems to have existed in describing patients. For instance, a patient was not demented, but “disoriented” or “severely confused”; a patient does not lie, but “confabulates”; a patient is not stupid, but “obtunded.”
The novel contains many snippets of insight into the medical profession and Crichton’s views on the doctors and the profession throughout the book. In the 1960s, most pathologists had trouble buying life insurance. The insurance companies took one look at them and shuddered—constant exposure to tuberculosis, malignancies, and lethal infectious disease made them high risk.
Radiologists had the shortest lifespan of any medical specialist. The exact reasons were unknown, but the natural assumption was that the X-rays get to them. In the old days, radiologists used to stand in the same room as the patient when they took the films. A few years of that, and they’d soak up enough gamma to finish them. Then, too, in the old days, the film was less sensitive, and it took a whopping big dose to get a decent contrast exposure.
On doing medical research, Crichton says it is much better to discover a new disease than to find a cure for an old one. Your cure will get tested, disputed, and argued over for years, while a new disease would be readily and rapidly accepted.
The novel won the Edgar award a year after its publication. I found it an enjoyable, easy-to-read detective novel.
