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This dark but inventive medical thriller plops readers into the final episode from the rollercoaster life of J.D. Brewster, a medical student with a flair for drama and a penchant for revenge. Already saddled with a depressive malady that leaves him at odds with his colleagues and friends, due partly to the rigors of early 1980s medical school training, Brewster seems to attract misfortune. He crosses paths with Mumbo Jamar Apoo, a felonious black criminal who renders him sterile by smashing his remaining testicle in a brutal attack during a carjacking. This event closely follows an attempted murder and car chase by a cartel in Mexico after Brewster volunteers to work in a free clinic. In a triple whammy, Brewster soon loses his fiancé to a cluster of avoidable medical problems he is unaware of but that many in his circle of medical acquaintances blame him for not treating. Thus festers Brewster’s angry embrace of what is known in his Texas medical school as the “clinical justice system.”
The story settings make vivid the Texas and New Mexico countrysides and cultures. The prose is rich with authentic medical terminology, and the tale is populated with bright-minded, colorful characters that range from the eccentric to the downright deviant. If anything, the characters’ voices sometimes sound overly similar since almost all speak with great clarity and a large vocabulary, even those who would typically be less mentally and linguistically well-endowed. The restless, driving pace of the novel closely matches the protagonist’s and antagonists’ somewhat manic and self-absorbed approaches to life. While Brewster is preparing to fulfill a life of service to others, he is still locked into the prison of his mind and emotions, as is Apoo, whose life of abuse toward others leaves a trail of destruction that may surely destroy him too. While the dismaying racism of both men is difficult to witness, they are, at least, both equally racist and offensively entertaining in the manner of an Archie Bunker rather than the black brute caricature style. Fortunately, the tale spins in a kaleidoscopic tumble with several quirky subplots that release the reader from the hard edges of Brewster’s obsessive seething about Apoo and his crime sprees. At times the story arc takes on an almost magical realist bent, so bizarre and imaginative is the flow of the plot and subplot.
This novel is definitely not a straightforward medical drama but enters the realm of dark, quirky satire that examines saving life versus taking life. It also carries an underlying political thread straight out of the ultra-conservative side of Texas with Brewster’s bashing of liberal politics. In that sense, the story abandons the 1980s in those moments and jumps into twenty-first-century lingo before snapping back into its own era. The author employs some repetitive phrases to his advantage in a style reminiscent of Vonnegut, laced liberally with some Chuck Palahniuk grit and a good dose of Kerouac road- and word-tripping to boot. The many sexual references and romps throughout the tale are raw and comical but a natural fit for the carnival cast of characters and an audience who enjoys a testosterone-laden viewpoint.
Brewster continually struggles with his dark side, but the evocative heaviness is really not enough to stop him from engaging in spurious behavior. His seething anger over his misfortunes is not unique. In fact, some of his friends have also suffered at the hands of his nemesis, whose crime sprees and rank brutality have become an urban legend in Houston and, eventually, the nation. But Brewster’s friends seem less inclined to consume themselves in the flames of their anger, though who’s to say what karmic retribution will befall them all. Brewster seems to have little sense of the universality of hardship and obstacles and always looks to even the score, to his detriment. Ironically, despite Brewster’s propensity for trouble, he’s also the ultimate survivor, even if his sole companion throughout the remainder of his medical school training is his deceased fiance’s pet skunk. One wonders if the author’s medical school training was equally dramatic. Either way, it certainly gave Hill a gift for observing humanity in its highest and lowest forms.
RECOMMENDED by the US Review