“The Hospital at the End of the World,” by Justin C. Key, Harper, 400 pages.
Book critics rarely, if ever, write about book covers. That task, perhaps, is the domain of designers, artists and publicists. It’s what’s between the covers that matters. But the cover might be the best place to start when reviewing Justin C. Key’s debut novel, “The Hospital at the End of the World,” an Afrofuturist medical thriller set in a dystopian New Orleans.
On the cover, drones hover menacingly over a mist-shrouded hospital complex that, in turn, rises menacingly above the tree-lined avenue of a nondescript downtown district. It’s a slick bit of photographic collage work that, with a few minutes of online sleuthing, easily reveals its source materials.
That downtown scene is taken from an aerial photo of Racine, Wisconsin, a lovely city, I hear, but an odd aesthetic choice for a New Orleans-set novel. And that mist-menaced hospital, that’s the Walter Reed National Military Medical Center in Bethesda, Maryland — an imposing superstructure, for sure, but what’s creepier than the present-day limestone and steel tomb that is our historically beloved but now defunct Charity Hospital?
Open the pages of “The Hospital at the End of the World,” and readers will likewise find a completely unrecognizable New Orleans. Key’s novel takes place sometime in the near future, where the city remains a final, untouched frontier in a techno-capitalist world subjugated by the soul-crushing omnipresence of artificial intelligence and the cruelty of the plutocrats who make it so.
When the book’s hero, a medical student from New York named Pok Morning, arrives in the Crescent City to begin his training, he finds a place devoid of the AI tools he has taken for granted — technology not dissimilar to what exists today: AR glasses, autonomous cars, robot pets, delivery drones and omnipresent glass screens. Key’s future world has advanced some, mostly in regards to the medical field, where doctors work as little more than assistants to their AI overlords.
Much of this technology rests in the hands of Odysseus Shepherd, a one-dimensional villain drawn with the distinctive musk of a certain American oligarch, who seeks to rein in Pok, due to a long-standing beef between their fathers, while making sheep out of the techno-phobic people down in New Orleans.
The city’s resolutely analog values have ironically made it a utopia.
The local Hippocrates Medical Center, where Pok performs his medical studies, has erased racial disparities in maternal health and mortality rates. (Today, in real life h, Black women are up to four times more likely to die from pregnancy-related causes than White women.)
There’s more good news! Contrary to the actual decades-long trend, the city’s population is steadily growing. Enough to support several newspapers! (Though it’s unconfirmed whether The Times-Picayune still exists.) Confusingly, despite New Orleans’s low-tech bona fides, spires located throughout the city create an electromagnetic field that both weaken hurricanes and disable AI.
Unfortunately, New Orleans is doubly unrecognizable in these pages because Key apparently lacks any knowledge of the city he writes about. I have never read a locally set book with more cringeworthy errors. Almond and apple trees do not grow here. Hurricane season does not start in the fall, and we do not eat crawfish in the high heat of summer. There is no University Avenue streetcar, and Mid-City is not home — I can’t believe I’m writing this — to Bourbon Street.
Author Justin C. Key
Amina Touray
Perhaps the future has rewritten New Orleans’s climate and geography, or this is a simple case of careless research.
This is too bad. The California-based Key, who is also a practicing psychiatrist, shows promise. A handful of body horror-tinged tales in his 2023 collection of speculative fiction, “The World Wasn’t Ready for You,” are good enough to make Stephen King scream. His new novel attempts to ask era-defining questions about the role of AI technology in our lives and our bodies.
But ultimately, “The Hospital at the End of the World” will leave readers, especially those who know and love the city where Key has chosen to set his story, with other questions.
Why do so many writers and artists insist on treating New Orleans as an attractive set-piece, rather than a real place, a living and breathing city? When will New Orleans stop being treated as a backward-looking outpost, a city lost in time, instead of the dynamic and progressive place that it is and has long been? And does anyone on this planet really not know that Bourbon Street is in the French Quarter?
Mirroring its cut-and-paste cover, this novel does not portray New Orleans, has nothing to say about New Orleans, and lacks any emotional insight into what makes New Orleans and its people unlike any other in the world.
At the end of this long novel, Odysseus and Pok eventually meet up for their inevitable showdown. New Orleans initially strikes Odysseus as “a curiosity,” Key writes, “an unknown.”
The villain sneers: “I expected NOLA” — yes, groan, NOLA! — “to be more original.”
Much the same can be said for this book.
Rien Fertel is the author of four books, including, most recently, “Brown Pelican.”