For more than three decades, Robin Cook has been writing novels that highlight nightmare scenarios in the medical practitioner world. From illegal medical experiments to psychopathic doctors, from organ-donor rackets to unauthorised genetic experiments, he’s done it all. In his new book, Charlatans, Cook now examines the relevance of the medical degree itself.
Noah Rothauser is a surgical resident at a prestigious Boston Hospital. He’s worked very hard to get here, and is confident of graduating as a qualified surgeon soon. But a patient dies during a routine surgery in spite of his best efforts, and the ensuing investigation brings him into contact with the anaesthesiologist on the same operation, Dr Ava London. Ava seems competent, and the mess up during the operation wasn’t her fault, so Noah defends her. But then another operation goes awry, and then another.
As the Chief Resident, Noah is responsible for presenting the summary report on all failed operations to the staff. He finds Ava tangentially involved in all three operations, but once again, decides she did her best under the circumstances. The interactions involved in these reports bring Noah and Ava into contact. He discovers that she is as committed to medicine as he is, and they begin an affair.
But Ava lives in a home that she could not have afforded on her salary — and she admits that she has a side job as a promoter for a nutritional supplements group. That industry is what pays her for the house and the luxurious lifestyle. In another aberration from the typical doctor profile, Ava is also an extremely active figure on social media — Facebook, Twitter, Instagram, the works. She runs multiple profiles on these networks, all feeding off each other.
Noah, for his part, is the typical doctor — reclusive and focused on his work. Unwittingly, he’s gotten into the crosshairs of a senior doctor at the hospital, who seems to think that Noah is sheltering Ava during professional enquiries of the botched operations. Noah thinks he’s doing the right thing by saving Ava, but somewhere along the line, doubt begins to creep in. Did Ava really do her job well during the botched operations? Why is every attempt to find out her past blocked? And who are the two toughs going around the country murdering people just for their social media activities?
It seems like a lot of material, doesn’t it? And it is. To Cook’s credit, he builds up each of these strands slowly and effectively. Instead of diving right into the thrills and spills, he takes the time to bring Noah alive for us, talking about his motivations, his dedication to his job, and the kind of role that a medical resident at one of the world’s top hospitals would play. Medical terminology flies thick and fast, each of the failed operations and their aftermath explained over dozens of pages.
Where things begin to fall apart is when it’s time to draw the sprawl of threads together. More than one of the interesting storylines are left unresolved, and the plot begins to focus on Ava and the truth behind her medical experience. Noah goes into the expected Robin-Cook-Medical-Detective mode, and investigates her hometown, schooling and college. The two toughs, who are revealed early on to be on Ava’s side, do everything they can to put Noah off. There’s no real climax here, essentially just an acceptance of what Ava is (not a simple villain, if you were wondering that), and how she is a product of the times.
Charlatans is, at one level, about the clash of the traditional rites of passage for the medical profession and the new world of instant expertise. On another, it’s about how social media is taking the place of real interaction and turning us into selective show-offs.
The one thing it isn’t, however, is a well -structured thriller. It’s one thing to leave supplementary threads open — there are several, including the multiple botched operations and the rift with the senior doctor. But it’s another thing entirely to just take the main story of Ava’s past up to a big reveal: “Oh, so THIS was what the mystery was all about!”, and then essentially let Noah decide on what to do with it as the climax. The reveal and Noah’s decision are condensed into the last maybe 30 pages, along with hasty conclusions of everything else.
As a novel of ideas, and as a vehicle of a new viewpoint towards the medical profession, Charlatans is a good read. As a means of entertainment, it is somewhat unsatisfying and inconclusive. Read at your own risk.
Charlatan
Robin Cook
Pan Macmillan
2017, pp 400
Rs 299