Abstract
The author of this impressive 400 page novel, as readers of this journal will know, was for much of her career a leading light of the clinical negligence scene at the London bar. She has achieved the difficult feat here of producing a thoroughly engrossing account, in what some might have thought would be arid territory, a clinical trial of a new drug, attended, as I imagine most of them are in real life, by enervating commercial and medical considerations.
The novel is promoted as a “medico-legal thriller”. The literal-minded might be disposed to jib a little at that description, saying that for a thriller there is a decided lack of violent deaths and villains but the author has, in my view, created a really gripping account of a large and important clinical trial that, through misjudgement or actions bordering on malfeasance, could go horribly wrong. No spoilers are offered here!
While it is true to say there is no actual violence in the piece it is all the more realistic and convincing for that. At the same time there is at least one character who gives way to their personal desires beyond what is appropriate while another seems willing to sacrifice personal virtue at all or any times to secure otherwise confidential information.
I have to say that I was impressed by what appeared to me to be the author’s in-depth understanding of the way in which clinical trials are conducted and the way in which one might go wrong. I myself was to an extent involved with clinical negligence while practising at the bar, yet I would have had no notion at all how to write such a clear exposition as we get from this book.
The cast is huge, and yet all characters are well differentiated one from the other. The focus of the clinical trial is on a new drug that is supposed to lead to weight reduction in a relatively short time and without any substantive contrary effects. When problems appear to arise, one is drawn into the anxiety of all the participants, both managerial, medical and at patient level, as to whether the trial is still able to proceed unimpeded.
We are introduced in depth to the structure and research aspects of a trial, to the company and its affiliates undertaking the trial, to the personnel of the company at managerial, medical and lower levels, to their connections to allies in associated companies in the USA, where there is the need to keep the FDA happy. Also to a whole range of the “guinea pigs” who, in varying stages of anxiety or gratitude, are happy to ingest the otherwise untested drugs, either because they need the money or because they genuinely wish to lose weight, or a combination of both.
As I have said, it is quite a tour de force that what might have seemed something of a dry subject for a “thriller” comes out convincingly with all guns firing and draws the reader unfailingly into the whole shenanigans.
Highly to be recommended.