No need for pondering over sentences for days on stretch, no need to indulge into the magnificience of carefully etched out paragraphs, and absolutely no need of even imposing your version of the title or the left-ajar climax. Simply because thrillers have grave disregard for such linguistic frills, and why shouldn’t they? Detached from these arduous and cloggy formalities give them more than enough space to develop in all directions into an instantly stimulating and electrifying capsule that has you sweating, panting and breathless with each sentence. One of my all-time favourite medical thrillers, Critical Judgement, is all this and more.
Coming to the plot (ah! these obligatory fillings of a review), Critical Judgement tells the story of a surgeon (Abby) who leaves her job at a high-profile hospital in San Francisco only to move with her fiancee (Josh, who’s been sacked at his workplace) to a suburbian Californian town with a wilfully deceiving name--Patience. While Abby finds herself suddenly stepping into the shoes of the Head of the ER team of the Patience Regional Hospital, Josh finds an equally well-paid job at the town’s sole employer--which doubles up as the country’s foremost battery manufacturer, Colstar.
Trouble starts trickling in as Abby, much stressed from the explosive workload and responsibility, starts encountering patients with seemingly simple, but undiagnosible symptoms. In jest, Abby calls them NIWWs (No idea what’s wrong) until a violent incident in which a Colstar employee, Willie Cardoza, in a manic fit, zooms his 4x4 into a tennis court almost killing three old ladies. And this obscure insanity also seems to have caught up with other Colstar’s employees--Angela, (who’s turned into a self-multilator), Josh (who’s suddenly become maniacally ill and has threatened Abby physically) and Ethan Black (the son of a supremely influential Ezra Black, the financier of Colstar, who jumps off a high-storey building when visiting his psychiatrist). The outlandish fury and rage in these Colstar employees kindles Abby into investigating the cause of the eruption of these sudden cases, but she doesn’t have to go far as one of her colleagues, Dr. Lew Alvarez seems to have all the answers to her NIWWs and violent cases--cadmium spill from Colstar.
Running an Alliance against the Colstar, Lew and his small team, has infact been accusing Colstar of neglecting the health of Patience’s population and even forging laboratory results keeping the cadmium spill well under covers for years, but have been muted by the influential Big Daddies. As Abby becomes the crusader, she finds both her life and job in serious jeopardy, as she’s been penalised at every stage for her probing. Has Abby got the strength to outperform her enemies? How successful does she become in unraveling the mystery? Is it really the cadmium spill causing the mysterious illnesses? Is Colstar really the culprit?
What instantly separates Palmer from other thriller-jotters is his care for his book’s characters which infact feel so alive and kicking, that the book has an ineluctable cinematic ambience to it. This, and his graphic style of writing uplifts even the most mundane of sequences enlivening the reading experience thoroughly. Some of the sequences like the introductory defibrillation (unpleasantly graphic), Abby treating an eccentric Old Man Ives outside her neck-breaking schedule (deeply empathetic), the pretentious celebrity psychiatrist (inescapably comic), Abby’s decision to treat a killer rather than the killed (thrilling and true-to-bone), a claustrophobic patient recollection of her experience at MRI (stomach-churning) and the orgasmic end keeps afloat the belief of Palmer being a storyteller to vouch for.
The protagonist’s character, an ER doc, is on the predictable side of the fence as from the very premise you expect her to be the crusader, the saviour, the find-all-reveal-all belle and Palmer’s heroine, Abby fits in all these gloves, yet comes across convincing thanks to bountiful nuggets of vulnerability and conflict that’s thrown into her sketch. The third-person narration, though glues to Abby’s every move, every thought, surprisingly keeps the sentimentality-quotient close to neutral with extremes of alkaline and acidic emotions kept much at bay. Their pictorial descriptions consistently withstanding, Palmer populates his book with believable and distinguishable characters with equal success, even though the genre means that almost all the characters have a meagre life outside the incidents involving them.
The pace of the thriller is rocksteady and absolutely unwavering for if Palmer doesn’t have Abby stepping into the shoes of the investigator, we see her participating in some genuinely chilling ER histrionics or we might even find ourselves reading first person gruesome accounts of Colstar’s suddenly-venegeance-seeking employees. The surprise factor is 10 on 10 as the book’s so overgrown with unpredictable twists and turns that you might not realise you have actually skipped a day’s meal. More than justifying its ’’thriller’’ tag, since the catastrophe’s of a aesculapian core, even the ’’medical’’ prefix is more than suitable for this thumping 400 page fiction.
Testing of chemical weapons on innocent population, has indeed made to the headlines time and again, and with an appreciable amount of sensitivity with which the issue is dealt with, the author keeps the scare and seriousness much intact. The climactic showdown, swaying between wrenching unpredictability and hard-to-gulp unbelievability (the latter, solely visible in the fierceness of Abby which takes quite a huge leap to gallant levels of heroism) doesn’t try too hard to bring every thread of the plot to close, but the bemusing and horrifying epilogue more than makes up for that.
The author, being an M.D. himself has also instilled a decent degree of rawness in the ER histrionics, but let the seemingly honest and amazingly vivid sequence of events not blind you into believing that diagnosis at ER is always so fulfiling, well-defined, objective, active, glamorous and brimming, as the routine, repetitive and tiresome aspects get negligible prominence here (understandably so), and the fiction carries forward the legacy of painting a reasonably blushful picture of medicine in ER which had emerged with telly-tube’s babies like ER, Casualty and the likes. Its not gruesomely externally valid, but internally, the procedures and the few diagnoses made are masterfully written.
The bipolar reactions of the workforce (be it a nurse reluctant to treat a patient just because he’s the presumed criminal or Abby being unreasonably censured by her seniors for attending to that very criminal), the contamination running in the upper levels of hierarchy and the innocent dependence of the public on their doctors sears through with astonishing effect. However, since the author’s quite unapologetic about the generous sprinkling of medical terminology, I won’t really recommend it to the medically uninitiated or ignorant. The unobtrusive, simple language is a major plus though.
In all, Critical Judgement is a fantastic thriller, with dominant threads of the population being betrayed for their unflinching trust in the medics and venegeance acquiring phantasmagoric potency, sewn with perfection by the wilful and ferocious (if larger-than-life) Abby. As intoxicating, as the industrial toxicology at its helm, this memorable medical thriller begs to be read, and writing even a sentence more on it would give the plot away. Go read it and experience it for yourself.