Fiction Reviews

A Case of Need

(1968) Michael Crichton [as Jeffrey Hudson], pub, 0.25p, pbk, pp?. ISBN ?

Way, way back, before the days of Jurassic Park and ER, before even The Andromeda Strain, there was a medical student named Michael Crichton. To pay his way through college, the young Crichton wrote a series of quickie thrillers. Most of them were written only to vanish in a blaze of obscurity. However, one of these novels, A Case of Need - written under the pseudonym Jeffery Hudson - caused a minor stir in the late 1960's. This book, with a new foreword, has just been published in the UK.

It's the 1960's, and abortion is still illegal in the USA. Despite this, a doctor in one of Boston's largest hospitals is still performing the operation. His colleagues are willing to turn a blind eye, because they would rather a woman came to a qualified doctor than to some back-street abortionist. However, things get out of hand when the daughter of one of Boston's oldest families dies of a botched abortion. The finger of blame is pointed at Dr. Lee, and everyone seems to accept this. After all, not only is he an abortionist, he is an Asian - almost a crime in itself amongst the Bostonian WASPs.

The case seems pretty cut and dried, but hospital pathologist John Berry doesn't buy it. Lee is too good a doctor to make the kind of mistakes that happened in this operation. Besides, everyone seems so sure about it. Berry starts to dig a little deeper and comes up against racists, religious fundamentalists and Old Money. Despite the fact that his career and his very life are threatened, Berry will not stop until he has discovered the truth.

Like a lot of Crichton's work, this novel is a fast read. So the characters probably are not drawn as well as they could be, but the sheer energy of the plot carries the reader along. There's a wealth of medical information in here, and appendices that deal with some of the ethical issues raised in the book.

In America today, anti-abortionists are using murder to stop abortions. Despite this (and I wonder what effect this will have on his sales in America) Crichton comes out on the pro-choice side. He points out in the book that a woman is more likely to die from giving birth than from an abortion.

This book probably is not to everyone's taste. After all, it is not a straight SF novel. But it certainly has science elements in it, and I think it has a few interesting things to say about medicine in America.

As a footnote, I am interested to notice that Crichton and his fellow American doctor/author Robin Cook are both very unhappy with the way in which medicine in the States has been turned into a business. For them, this means the end of care and a drive for profits at any cost. I can't help thinking that with the slow death of the NHS in this country, we may soon be facing a similar system.

Jason Jarvis

Editorial note: A Case of Need won the 1969 Edgar Award for Best Novel.

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