In the grand tradition of fantasy books, we’ve got a system of [industry] similar to ours except with magic instead of science, with a handful of words that are misspelled, some that have alternate words, and some that are entirely new words for existing principles.
In this case, we’re talking about medicine and the practice/delivery thereof. In lieu of doctor, of course, we have healers. In lieu of medical school(s) we have The Academie. And in lieu of bacteria and virus, we have microvive and phantome, all of which now makes me realize that these funny words are sort of French?
More broadly, this is a book about doctor burnout in the post-COVID era. While the blurb is correct in that the book is about a final year med student killed/dead on the eve of their final licensing exams, it’s actually about five classmates who are all responding differently to the pressures of the draconian state and its control of the medical profession.
See, some 5-10 ish years ago, a phantome called the serrage flooded through the world. It doesn’t necessarily kill, but it leaves patients with inexplicable and painful after effects (like muscle spasms) that render them incapable of working. Healers tried to help but, understaffed and overwhelmed, many ended up infected themselves and unable to practice anymore despite loving patient care. Those who are left behind, and children who test for healing magic, are now required to train to become doctors and serve via a system of debt bonds. Failure to do so is a crime, and harming a Healer or med student is punished by death. That being said, there is a chronic shortage of Healers. Those who can try and escape the public system after their bond years are over (or because they come from money) into private medicine, causing even more strife with the general public, who used to respect Healers but now, by in large, distrust them and even believe that COVID the serrage might be a consequence of the use of healing magic.
Get it????
All of that is background noise to the murder of the top student of the year, whose body is found in the exam room of five of her classmates, all of whom are weeks away from graduating and have varying levels of enthusiasm for the idea. Some are utterly burnt out at school and ready to leave for easier pastures, some need to escape the city by any means necessary, and some are desperate to stay longer even if it means failing on purpose (and, therefore, failing the entire group–a little conceit that mostly solves the issue of forcing people to become doctors who don’t want to). We don’t know all their motivations or the complex web of interpersonal relationships they have with one another or society at large (everyone seems to have mostly healthy casual sex at a pretty healthy clip) (except for the frankly alarming amount of student/faculty harassment???). To complicate things further, the dead student seems to have known the top secret exam questions ahead of time and is sending them letters helping them through them, but conveniently spelled for secrecy such that they can’t tell the gendarmes* why her death wasn’t a pressure-driven suicide.
*yes okay I see it now
I found the book, on the whole, very interesting, and once I got to know the various characters (and their romantic entanglements) I was much more invested in their story and quest to solve the mystery. Lots of plot developments are forecast WAY in advance (oh, there’s a med student who really doesn’t like patient care /touching dead bodies traditionally causes revulsion? I bet you that med student will become a magical forensic pathologist!) but it doesn’t really take away from the main mystery, and I’ll cop to not immediately getting the answer despite it being solvable by the reader–hallmark of a good mystery. The biggest issue is that Marske is definitely trying to capture a lot of elements of our medical system and the absolute shit that was COVID and is the deterioration of medicine practice. Despite it all being systems we know very well, she ends up having to do a lot of ancillary world building orthogonal to both the mystery and interpersonal plots, which does sap some of the forward momentum and make the book drag at times.
