Monday, November 29, 2021

REVIEW: A Case of Need (book) by Michael Crichton writing as Jeffery Hudson

A Case of Need is a medical thriller originally published in 1968. I checked my copy out from the library.


Dr. John Berry, a pathologist, is interrupted at work by a call from his wife: Dr. Arthur Lee, an obstetrician friend of theirs, is in jail. John goes to see him and finds out what happened. Karen Randall, the daughter of a wealthy family, was brought into a hospital by her mother after an illegal abortion, bleeding profusely. She died, and Karen's mother claimed that Dr. Lee had done the abortion. Although he tells John that he did indeed speak to Karen, he hadn't performed the abortion - in fact, he'd turned her away, telling her that, at four months, she was too far along and he couldn't do it. She'd seemed to accept this and left, but clearly she'd gone to someone else instead.

Unfortunately, Dr. Lee makes a good scapegoat. He's half Chinese, so racism is a factor, and it won't take much work to uncover that he does, in fact, perform abortions (and people like John and other doctors helped him hide it). It won't matter to anyone but John and Dr. Lee's wife that he didn't perform this particular abortion. John figures that if he doesn't try to find out the truth, no one will.

This is one of the works on Rep. Matt Krause's list of books he wanted banned from Texas schools. It caught my eye for several reasons - the author, how old it was, and overall how odd it was to see it on the list. From what I can tell, it isn't YA fiction and was never marketed as such, although that's not to say it wouldn't appeal to teens. Still, if a school library has this in their collection, I'm guessing it's a pretty good indicator that they're sorely in need of funds for new books.

Anyway, it's pretty obvious that it ended up on the list because of its frank discussion of abortion. It even includes an appendix that lays out the arguments for and against abortion, at the time this book was written, and it's clear that Crichton considered the former to be stronger and more convincing than the latter. However, it's also clear that Rep. Krause didn't read all the books he included in his list, because one could argue that the text itself had anti-abortion aspects in the way Karen was written and John's surprising inability to explain the word "abortionist" to Dr. Lee's young son in a way that didn't make it sound like a terrible thing.

The story had a very noir feel to it. It was written in first person, from John's POV, and I often found myself thinking that he read like an old school detective who happened to know a lot of medical jargon. There was even a scene in which he followed a guy around for a bit, like some kind of private investigator. And a surprising number of people talked to him and told him everything he needed to know, even though literally no one was required to tell him anything.

The mystery was extremely convoluted and confusing - I kept forgetting who everyone was, since the primary identifying characteristic of most of them was that they were male doctors. While it kept my attention, it didn't come together in a satisfying way in the end. I was left with a bunch of questions about details that were never fully addressed. I'm still not sure if I missed something, or if Crichton really did just opt not to explain the various odd details that John kept coming across and puzzling over. I finished this feeling like I'd read maybe 95% of a book, as though the chapter that was supposed to tie everything together was left out.

This wasn't necessarily a horrible reading experience, but it did come across as extremely dated. The casual racism grated on my nerves, and it was amazing how few women had speaking roles considering this was a book dealing with an issue that primarily affects women. I did appreciate that it dealt with abortion almost entirely from a medical perspective, although the revelations about Karen possibly undermined that somewhat. Characters' opinions on abortion weren't always clear, but one thing the book never wavered on was the safety factor: abortions performed by trained doctors in medical facilities are safer than both amateur abortions and giving birth.

In case this wasn't already clear: This book is absolutely not for anyone who has phobias about going to the doctor, and not just because of the graphic descriptions of what happened to Karen. Pretty much all of the doctors were horrible in some way - arrogant, misogynistic, sleazy, etc. It's one thing to know intellectually that doctors are imperfect and human like everyone else, and another thing entirely to have all the ugliness on-page.


Various footnotes throughout explaining some of the medical jargon. Also, six appendices: "Delicatessen Pathologists" (explains why some pathologists describe diseased organs as though they were food), "Cops and Doctors" (why doctors don't trust police), "Battlefields and Barberpoles" (the link between surgery and war), "Abbreviations," "Whites" (medical uniforms), "Arguments on Abortion," and "Medical Morals."

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