A thrillingly entertaining novel from author Derek Dubois, Miss Diagnosis is a crime thriller that slowly devolves into a nightmare tale of modern science gone terribly awry.
Kate White is struggling to find her place as a soon-to-be doctor, constantly measuring herself against the others in her class, as well as her studly super-surgeon boyfriend. She undergoes quite the transformation as a character over the course of the novel, from a fumbling medical student with inexplicable and terrifying blackouts to a resilient protagonist with nerves, and a stomach, of steel.
The relationship she has with her partner Sean is an odd one; he is deeply unlikeable, leaning hard into negative stereotypes of the cocky, entitled, elitist doctor who treats those without an MD terribly. He feels archetypal in certain ways, and less developed than other characters such as Lien and Daniel. Similarly, Dr. Lucas has a familiar feel – a hard-nosed senior doctor who plays favorites – but her treatment of Kate feels close to unbelievable and cartoonishly cruel, despite her gradual softening.
Lien is Kate’s med school friend with a strange side gig, running clandestine deliveries for the secretive research facility at the heart of the teaching hospital, Davol Laboratory. The facility admittedly “skates on the bleeding edge” of DNA reassignment and stem cell research, but when Lien mysteriously disappears, no one suspects the lab as the monstrous cause.
As Kate continues to navigate the tests and trials of hands-on training, serious trauma from her past is re-triggered when a sadistic patient under lock and key attacks her at the hospital, revealing more about her fascinating character, mixed with the chilling and gruesome horror to follow. Seizing control of her own narrative, and finding a way to get her own revenge, Kate sneaks into the lab downstairs for a chemical cocktail, and plunges it into her attacker. What her spontaneous anger unleashes is a horror beyond imagination, a monster born from death, a genetic aberration that breaks out of containment, sending the final chapters of this book into a bloody, action-packed spiral.
The contemporary setting of the novel makes it feel timely and accessible; pop culture references to everything from Harvey Weinstein to the Theranos scandal remind readers that this wild story is very much set in the real world – a surprising but effective juxtaposition with the horror propelling the story forward. The pace is strong, and the chapters move quickly, without wasting time on plotlines that don’t develop, or secondary character arcs. The dialogue is cutting, pointed, and believable as well, from the speedy repartee on rounds with patients to the emotional tension between ex-lovers.
That said, the technical accuracy of the book leaves something to be desired – in even the first few chapters, grammatical and spelling errors set the tone for the read. There are also more dynamic moments that feel rushed, or lacking in emotion, including some of the goriest moments, which feel almost sterile in their descriptions, as if a stand-in for something to be expanded later. Even so, the momentum of this novel is undeniable; readers can see the violent climax coming, once they’re clued into the truth of Davol labs, but somehow it doesn’t ruin the surprise as the drama climbs to a dramatic close.
All told, Dubois has real skill as a storyteller, and a thoroughly dark imagination to make this genre-bending novel stand out.
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