Justin C. Key

"Not for the faint."

Speculative fiction looks at the possible direction of medical care.

In a near-future America, the Shepherd Organization has turned healthcare in to a cold, algorithmic commodity. AI dictates every diagnosis and treatment, leaving no room for human intervention or error. Pok, an aspiring medical student living in New York, has spent his life preparing to join this system alongside his father. When his applications to medical school are rejected, his world falls apart show more coinciding with his own father's sudden death.

Following a path his father had secretly set in motion, Pok flees the high tech surveillance of the North for New Orleans. The city, guarded by electromagnetic spires that block the Shepherd's reach, is home to Hippocrates, the last medical school on earth that still practices human led medicine. But that special place and sanctuary comes with a price. As Pok struggles through the grueling medical school training, he discovers a terrifying new plague -- the Grips -- that specifically targets those who have spent their lives under AI. As more become infected and die, Pok must accept his own purpose and realize all that he is capable of when the truth about his origin and past are revealed.

This plausible scenario was haunting and scary and I really enjoyed it. I love medical fiction, and this plunged deep into the big questions about what AI will do as it is increasingly integrated, or mandated, into our lives. Will human empathy and all the skills of a human physician be traded for an algorithm and efficiency. Who lives, who dies just a calculation. There is so much to think about within these pages and so it took me a lot longer to read this than a typical thriller of this type. It made me even more certain that restrictions and restraints need to be in place to prevent machine driven medical practice and care.

A huge question raised by the author deals with the ethical questions. Definitely a must read for fans of speculative fiction who want a story that feels both like a warning and a tribute to the people who still believe in the human side of healing.

I was able to listen to the audio book while also following along in the e-book ARC, both provided by the publishers. The narrator, James Fouhey, did a decent job, but it was a bit of a let down because he just didn't do women's voices well. As a result, the characters basically sounded the same without much differentiation. This production would definitely have benefited from a full cast, or at least a female voice. I always enjoy the immersive experience of listening and reading, and this would have been such a huge hit had the characters sounded more distinctly male or female. show less

Justin C. Key's "The Hospital at the End of the World," takes place in an America of the future that is controlled by an all-powerful entity, the Shepherd Organization. Its leaders use artificial intelligence to regulate people's lives. A young black man, Pok Morning, aspires to be a doctor like his father, Phelando. However, unlike his dad, Pok believes that AI enables physicians to provide highly efficient patient care. Phelando, on the other hand, runs a holistic private practice that show more relies heavily on human interaction. A sudden crisis sends Pok fleeing from New York City to the Hippocrates Medical Center in New Orleans, the one healthcare facility in the United States that shuns Ai. When he arrives at his destination, Pok enrolls in the hospital's medical school.

This dystopian novel has an imaginative premise. However, it is weighed down by a large and unwieldy cast of characters and a meandering and confusing plot. We sympathize with Pok's uphill battle to fit into an environment that is radically different from his home in New York, where AI is omnipresent. In addition, although he tries to meet his professors' and classmates' expectations, Pok is overwhelmed by his course-load and soon alienates both his teachers and his fellow students.

Our hero endures quite a few challenging and humiliating experiences as he tries to adjust to this unfamiliar setting. In addition, he discovers shocking secrets about his past that his father intentionally withheld from him. Worse still is Pok's growing realization that New Orleans is facing a serious threat from a malicious and dangerous enemy. It is too bad that the author fails to develop his intriguing premise more plausibly and coherently. Its subpar writing notwithstanding, "The Hospital at the End of the World" encourages us to wonder why governments are not doing more to protect their citizens from the potential consequences of artificial intelligence. show less

TOR with another original piece of short fiction. Justin C. Key’s “The Perfection of Theresa Watkins” is a story about race, sickness, and prisons in America. The turns in this story is how the prison systems change a person and not by rehabilitation but through the terrible mismanagement that they are widely known for. An exploration of mental illness by way of race through the lens of the political problems within the prison system. Justin C. Key explores the humanity that can be show more found in sweeping inhumane systems that we all live with. Very fine writing and Key truly cares for his characters. show less

I didn't get very far into this. I found myself arguing with so much of it that I stopped. It was a very un-nuanced AI vs. no-AI vision of the world.