For a medical thriller, The Last Surgeon is light on scenes involving the practice of medicine. One of the main characters is a surgeon suffering from PTSD (after being one of only two survivors of a suicide attack that killed the rest of his unit in Afghanistan), and it is interesting to read about how he and the other veterans with the condition seek to cope with it. It is only late in the novel, however, that the fact that one man’s medical history is key to all the various subplots becomes apparent.
What there is a lot of is suspense, hints at a conspiracy connected to some very high-placed government officials, and a variety of ways people can be killed in such a way that it doesn’t look like murder. I found myself hoping that unbalanced individuals who might be tempted to murder would not read this book, or else that the creative murder ideas used in the book were already well-known or else too difficult to pull off as successfully as Franz Koller does it.
I would have liked to see more exploration of the moral ramifications of whether the ends justify the means. When the bad guys do it (cooperating with a known terrorist to save American lives – at least according to the mastermind behind the conspiracy), it’s clearly wrong. But when the good guys do it (using a teenage computer hacker to violate the privacy of patient medical records), it’s necessary to stop the bad guys, and the ethical implications are pretty much glossed over.
On the whole I enjoyed the book, as the mystery and suspense overrode any dissatisfaction with whatever flaws the book has. But the most memorable – and surprising – aspect of the book for me was that I found myself glad when the psychopathic serial killer was himself killed in a manner he would gladly have inflicted on others.
Most of the time, while I want the good guys to win, I am bothered by descriptions of painful death, regardless of how much the bad guy may deserve it. I remember once sitting in a movie theater when the audience erupted in applause as the villain burned to death, and feeling very uncomfortable both with the grisly sight and my obviously different reaction from those around me.
I’m not sure if this time the difference was that the killer had shown he had not a shred of real humanity (he compared himself to an animal, that kills because that’s simply what it does), or because his string of crimes was just so horrible. Another book I read recently brought up the quote “The death of one man is a tragedy, the death of millions is a statistic” (attributed to Joseph Stalin but primary source is unclear). Each of several deaths in this novel is the death of one man (or woman), and they never add up to (or down to) mere statistics. Whatever the reason, I was surprised to find myself saying, as the killer’s fate became clear, “Good – he had it coming.”