The Hospital at the End of the World

by Justin C. Key

From the author of the acclaimed The World Wasn’t Ready for You comes a thrilling first novel, set in a near future where artificial intelligence runs the world, involving a young medical student who must unravel family secrets to uncover the truth of his father’s mysterious death.

In a time not so far from our own, society is run by a global AI system controlled by an all powerful corporation. The Shepherd Organization oversees every medical school in the country save one in New Orleans, the renegade Hippocrates which still insists on human-led medicine. It is the last choice school for an ambitious young New Yorker named Pok. But after his father—himself a physician—dies under mysterious circumstance that seems connected to “the shepherds” and their megalomaniacal young CEO, Pok finds himself on a quest for answers that leads right to Hippocrates. Once enrolled, he stumbles upon a further mystery: a strange illness is plaguing newcomers to New Orleans who grew up under shepherd rule. What is causing this fatal anomaly? And how does it relate to the mystery of Pok’s father’s death and his own mysterious past?

Genres: Science Fiction, Fiction, Dystopia, Mystery, Thriller, Audiobook, Speculative Fiction

400 pages, Hardcover

First published February 3, 2026

Reviews

[Danielle · Rating 2 out of 5]

DNF @ page 147

I had been looking forward to this for months, but unfortunately I haven't enjoyed this enough to finish it. Life is short and my TBR is massive, so unfortunately I'm letting this one go.

What worked for me:

The conversation about AI vs human medicine. I fall unashamedly on the human side, for context. So does this book. AI has it's uses and its place in medicine, but replacing humans outright is not the way to go, and I enjoyed Pok's gradual coming around to this way of thinking. I liked the reader being challenged by this question.

What didn't work for me:

Everything falls into place exceptionally easily for Pok. He immediately meets the sister of the single patient we are shown, who just happens to be able to expertly guide him to the one place he needs to go to. He has no credentials and no acceptance into the hospital, and yet is accepted regardless. The very first patient that is discussed in earshot of him just so happens to be the one singular person in the state that he is looking for, and he finds her on the ward with absolutely no difficulty whatsoever. He accesses the ward with a stolen ID card and faces zero repercussions.

???

It's just way too convenient for me. All of it. There is no challenge and everything simply falls into place for Pok.

At least the author got the presentation of PPP correct.

[Shannon · Rating 4 out of 5]

I don't normally rate or write reviews for the books I work on (I was part of the production team for the audiobook) but I really, genuinely liked this book. Pok is an engaging, well-written protagonist. He is a first-year medical student at the last hospital in the US that isn't run by AI, and as he grew up in AI-saturated NYC, he has to learn from the ground-floor up.

The tension between so-called traditional medicine and the AI algorithms that purport to always create the best outcomes possible is the spine of the story, and the narrative goes in some interesting directions I wasn't expecting. While some of the dilemmas facing Pok are definitely in the near-future speculative realm - how to treat the physical manifestations of tech withdrawal? - some are frightfully relevant to today's world, like how Black mothers face increased levels of maternal mortality. Key takes care not to let the themes overwhelm the characters. They are all richly drawn, even those we see only briefly.

[♡Heather✩Brown♡ · Rating 5 out of 5]

ARC✶REVIEW
#ad much love for my advance copy @harperbooks #partner
& @harperaudio #partner for the ALC

𝕋𝕙𝕖 ℍ𝕠𝕤𝕡𝕚𝕥𝕒𝕝 𝕒𝕥 𝕥𝕙𝕖 𝔼𝕟𝕕 𝕠𝕗 𝕥𝕙𝕖 𝕎𝕠𝕣𝕝𝕕
< @justinckey >
ʀᴇʟᴇᴀꜱᴇꜱ: ꜰᴇʙʀᴜᴀʀʏ 𝟥, 𝟤𝟢𝟤𝟨
ᴛʜʀɪʟʟᴇʀ | ꜱᴄɪ-ꜰɪ | ᴍʏꜱᴛᴇʀʏ

NFTF - IYKYK

“𝙷𝚎𝚊𝚕𝚒𝚗𝚐 𝚒𝚜 𝚝𝚑𝚎 𝚒𝚗𝚝𝚎𝚛𝚜𝚎𝚌𝚝𝚒𝚘𝚗 𝚘𝚏 𝚜𝚌𝚒𝚎𝚗𝚌𝚎 𝚊𝚗𝚍 𝚊𝚛𝚝. 𝚆𝚒𝚝𝚑𝚘𝚞𝚝 𝚎𝚒𝚝𝚑𝚎𝚛, 𝚢𝚘𝚞 𝚊𝚛𝚎 𝚕𝚘𝚜𝚝. 𝚃𝚑𝚎 𝚙𝚊𝚝𝚒𝚎𝚗𝚝 𝚒𝚜 𝚕𝚘𝚜𝚝,” (p. 164-165).

This was such a fun and unique read. Holy crappers! I loved every second of it.

When Pok doesn’t get into any of the medical schools he applied to, he can’t accept this. So he hacks into the system to see what’s up. His info is all wrong - someone has changed everything. He was denied because he was sabotaged.

The world is run on AI. His father wants him to get away from AI doctoring people and help bring back patient-to-provider medicine. But there’s only one hospital left that isn’t run by AI. And now the Shepherd School of Medicine at MacArthur Hospital (who uses AI) wants to bring him onboard.

But Pok is given a warning to get out of New York, so he takes off heading to New Orleans. To the last hospital not depending on AI. Let the adventure begin.

🎧: Also followed along while listening to the audio and it’s a good audiobook. The narrator James Fouhey was perfect for this book and is easy to listen to. You can distinguish different characters and he just a fab voice actor.

Oh how I LOVED this book! As I was reading, I kept thinking surely this can’t possibly get any better, but it did! Such a fun, but also thought-provoking, read. From start to finish it was impossible to put down.

Set in New Orleans, this is as much an atmospheric thriller as it is literary - while still being fast-paced. It’s one of those rare books that balances it all perfectly. But there’s also some head-spinning parts that will take you by surprise.

In NOLA there lies a city hidden from the Shepherds, people fighting to keep the humanity in medicine. But there’s rumors that something much darker is happening there. Pok needs to figure out what is going on and do it fast. Humanity depends on it.

Loved Pok. He’s fighting with the worldview he grew up in, to how things used to be. He wants to help people and has no negative intentions, but still has much to learn. He isn’t secure in his abilities even though he knows everything they can teach, and the things they can’t teach.

Told in four parts - the seasons, summer, fall, winter, spring, and back to summer. Each is gripping and keeps you hooked. An easy 5 star read. I especially loved the schooling and testing chapters.

Mem
Skinning the pen*s song title LMAOOOOO
The librarian 😂😂
Sweating rot 😭


Explores the bias of AI
Grief
Betrayal
Humanity
Fighting back
Conspiracy
Secrets
Agendas
Communities

[Renee Godding · Rating 2 out of 5]

In hindsight, I should’ve DNF’ed this book at about the 40% mark, when I realized I wasn’t enjoying it/started to be mildly annoyed at times. Up until that point, I would’ve been inclined to give it an “objective” rating of 3-stars. there is a solidly average Chosen One Story in here, where Medical School stands in for Magical School. My dislikes were personal, and mostly related to my own background as an MD, which made the limited worldbuilding around the sci-fi/magical healing feel trite and cringy to me. Putting those aside, there was a fast-paced story in here with hints to raise real-world issues in the medical world (nepotism in medical education, the position of AI in medicine, and a drug-epidemic that’s a thinly veiled stand-in for the opioid crisis).

Continuing through that second half however, made me realize that I can’t recommend this book on a purely story-based level either. A plot that relies entirely on convenience and unlikely events just “happening to our passive chosen protagonist. Melodramatic plot twists so contrived that they’d make a tele-novella blush. A resolution to the final conflict that felt fár to easy and unearned to be satisfying. And holy-mother-of-exposition, whý is everything plot-relevant explained to our protagonist through a longwinded monologue, rather than shown organically through the story?!
Even with all the grace I was willing to give this book, recognizing I might not have been the right audience for it, I still have only one conclusion to draw; this just wasn’t particularly well-written.

[Kelly Garman · Rating 3 out of 5]

While really timely and a very good premise, this was too slow, too dry, and too optimal.

[Angie Miale · Rating 4 out of 5]

I’ve never been afraid of AI taking over healthcare… until this book.

This is a sci-fi dystopian mystery set in a future where AI has essentially taken over healthcare—and not in a comforting way. The premise alone was enough to hook me: what happens when medicine is no longer led by humans, but by an algorithm-controlled monopoly?

We follow Pok, a med student with perfect credentials who somehow doesn’t get into any of the elite Shepard medical schools. Instead, he ends up at Hippocrates in New Orleans, a more traditional, old-school institution that resists AI-driven medicine. After the sudden death of his father (a doctor who also rejected AI healthcare), Pok is left trying to make sense of both his grief and the system he’s entering.

At school, he builds relationships, makes enemies, and gets entangled with a mysterious sponsor doctor—which is where the story leans more into its mystery elements.

I’ll be honest: this is a long book, and I definitely zoned out at times—especially during the more technical or scientific sections. When the story focused more on the characters and the central mystery, I was much more engaged and found it easier to follow.

That said, the ending really picked up and delivered a lot more excitement, which made the slower parts feel more worth it in hindsight.

Overall, I think this will really work for readers who enjoy dense dystopian fiction with a strong sci-fi edge.

⭐️⭐️⭐️⭐️ (3.5–4 range for me)

[Cari · Rating 5 out of 5]

**I received a copy of this book from Edelweiss**

Read on the plane down to Disney. I love everything Key writes, and this book was really up my alley. It's a dystopia set in a world where AI and tech controls everything people do. The main character, Pok, loses his father early in the book. Pok's dad leaves him a message saying to go to New Orleans. It's a rough trip, but eventually he makes it to the hospital there, where he becomes a student doctor. At Hippocrates, real medicine is practiced--there are no robots that will fix your broken leg or administer IVs. Pok learns about how to resist while also about his father's past. Loved this.

[Kat · Rating 3 out of 5]

The idea of this book is much more interesting than the execution.

The main character's ludicrously poor decision-making throughout doesn't really gel with his alleged intelligence and medical school worthiness. Many characters read as high schoolers and seem particularly prone to stupid decision making, immaturity and banal dialogue. Side characters are forgettable and entirely interchangeable on page. The pacing is inconsistent throughout.

Ultimately, this is just mid. There's nothing terribly wrong here but this just doesn't live up to the potential of the concept.

[Squirrel · Rating 1 out of 5]

This starts strong, interesting, good world building. But by Ch 6 the reader will find it not credible. And think, huh, do I really want to read 10 more chapters about a med-school wannabe hobbling around on broken leg. Yes, he did that for 10-20 miles, and somehow didn't stumble once, without even a crutch, and didn't make it worse. Or pass out from the pain. Alone. The day his father dies, at about age 56.

Not to miss that the father thinks to send a death notice of what to do, but in 22 years never once told his only son about the risks of the tech or how to find safe spaces... and what happened to the mother, again? Oh right, Disney format, there simply is no mother.

The tale quickly shifts to 'journey' mode, with more not credible coincidences, yet still engaging and entertaining. The sister of the very patient he just met takes him on, along the road. Come on! And the patient has 'disappeared' from the hospital...she was planning to travel to Louisiana anyway, she didn't have a means picked out, 9 months pregnant?

Not one other person in the rail yard even looks at a woman and young boy, clean with good haircuts, coming into the train yard? Again, all this with the broken leg... And he's managed to jump OFF a train, up into a boxcar, fall, hide, roll, and not even crack the magic jar of honey? It's perfectly intact? And the bounty hunters didn't take it? (Honey is very expensive in some areas...) A fun enough trip, yet not much for an adventure tale.

There are safe transports and helpful advice at every single step. Then ... oh NO, this does not go THERE too! Sigh, the Prince-nepo baby/Chosen One trope, oh not that! Special treatment because of who daddy was, and he was just murdered and all, so sure, break ALL the rules, have 'special' knowledge while being remedial in the basics, and all is forgiven. YUCK.

By Chapter 14 reading becomes an effort. The outcome is so obvious the steps to get there would have to be engaging enough to keep the reader moving through. They'll find the sister and Baby Girl, or not. They clearly are not going to tackle the murder of MC's father, they're not going to fall in love, FMC will return to NYC or not. MC will become 'a doctor' and learn that human involvement is more valuable than AI decision-making. Likely without any really hard lessons.

There will be no significant repercussions from running away, from mistreating a broken leg. There will be no playing-out of 'paying forward' the assistance MC is receiving. In fact, its so flat that the reader quickly sees that the only reason the father didn't bring the MC "into the fold" with a short trip earlier in their lives, is to pave the way for this tale.

"Science Fiction" only in a paranoid application of existing technology. Calling a tablet a 'glass' is just rebranding, there is no innovation in what's described. Apps already track steps, diet, blood sugar, mental health states, heart rate, etc. Self-driving cars are already on the road in some cities, drones are actively used by military and civilians, 'black out' areas are already a reality across the country, the AI debate is active and thriving as AI is being released live across the world.

And that 'energy'/essence concept isn't even a little new! So many books on the topic of bio-energy transfer and effects - Bio-electronics, Bioelectromagnetics, 'Subtle Energy' Medicine, crystals, energy centers... this has been in the pop culture for at least 80 years, it was all the rage in Europe in the 1940s. Dr. Masaru Emoto (1943-2014) studied this in the 20th century, publishing "The Hidden Messages in Water" in 2004. Consistent with the entire Buddhist religion and Mindfulness concept.

"Amulets were banned by the Christian church in 355 AD" - which would only happen if they'd been used for power and strength and healing before that. They're mentioned as far back as the bible: https://www.crystalage.com/crystal_in...

Of course, believing someone can actually get three heart transplants is a real fantasy - three failures does NOT make a patient a priority for another 'try', at least not in the current world. The glaring lack of innovation or extrapolation makes this simply fiction, a YA-college level adventure story. A la Disney. With an overage 'kid'. No siblings, kill the parents first, other adult coming to threaten the young one, cute-friendly help along the way taking risks for the MC's benefit - for no objective reason, a map, a forbidden city, treasure at the end....

Definitely YA - instead of speaking with superiors, the MC steals, lies, manipulates. Steals drugs, steals a key, lies about whereabouts and motives. His childhood bff, who WORKED with the villain, understands him, has inside knowledge, is not only available, but AT the school. And MC doesn't share this info with people in charge. Why? So the YA theme can play out. (sigh)

And the errors! as well as details that are 'off'. The map turns out to be unnecessary. Which is convenient, as the bounty hunters took it - even though when last mentioned, it was in the MC's pocket, not the bag. And there is no reason the bounty hunter protects the MC, and that's never addressed.

In Ch 21, a young PATIENT is drawing blood from an older one? Risk of punctured vein, infection, cross-infection. PATIENTS are taking each others' blood pressure? Smart cuffs do that already. Probably meant to write 'student' but WHO missed this!? FAN fiction is better presented than this.

The Hippocrates Dean's area is 'reminiscent of Phelando's basement' - they had a 'basement' on the 4th floor of a hi-rise? (NO editor noticed this error?) And the mentor calls the basic trainings 'inconsequential' - drawing blood, privacy, cpr - wonder if the patients agree? Imagine having a doctor that doesn't care about your privacy - oh wait, that's kind of the norm, isn't it? The reason HIPAA legislation exists.

One doctor calls the MC her 'apprentice' - to a patient. Imagine YOUR reaction as the patient, yeah. Not 'student', not 'mentee', 'apprentice'!

And gosh, in a city of hundreds of thousands, MC is delivered for transport to the only person he knows in the city. What a coincidence! It reads like the author didn't want to have to write another character. Why not allow the pair to bump into each other later?

Why would people in a hot humid climate be knitting? Weaving cloth or sewing, sure, but knitting? That's hot to work with and hot to wear. And the comment about 'bullfrogs' - does MC, immersed in technology, really know the calls of different frog species?

Did no one involved in publishing this, really NOT ONE PERSON, suggest researching the underlying facts, at least for the key points? This goes on and on about the scarceness, and limited energy to run the Spires. Except Louisiana is energy rich, and already actively converting to renewables, now, diving deep into solar power irl. n top of rich oil resources in the Gulf of Mexico, and being a major processing center for foreign oil. So the "State economy" would not be suffering - unless the sun dried up - energy just would not be scarce. Also wind under development, and active 2 nuclear plants, irl.

DO THE RESEARCH! It's not like one has to physically go to a library or write to the State. They do actually publish this info on the internet. For free. And there are non-tracking browsers if the paranoia is actually the author's.

If the State were having an "energy scarcity", the incredibly hot Louisiana sun dries fabric plenty fast. And why would an laundry-intense organization waste fuel to drive laundry elsewhere every day? Bring the facilities onsite, it's faster, and cost efficient.

This is one reason people write SF about other planets and other universes - they get to make up the parameters. But writing about the real world does suggest an obligation to accurate portray the reality the author borrows from.

The MC makes a big deal at feeling faint seeing his own blood. That's actually common, especially among males - the term is "Vasovagal Syncope". An entire TV series (Doc Martin) uses that as the background, its a running gag in tons of TV medical series ... but not ONE physician informs the MC of this? Its treated as something 'mysterious' and he tries treating it with ... ginger? He doesn't even look it up. That is NOT the behavior of a 'top medical student'.

More - he describes the "life cycles" area as having "women with uniformly large bellies". Isn't the author supposed to be a physician? Has he ever seen more than two pregnant women near each other? "Uniformly round"? Would he see all legs as 'the same' too?

Then, the narrator explains "each patient found balance in community and privacy." In a group ward? Well, that's a feat.

Why does the MC want to be a 'doctor' at all? Because Daddy was? The MC doesn't even ask about the woman who risked her safety to care for him, then he just assumes she's okay because he is?

The political plaints about birth terminations due to genetic factors ignores the scientific aspect. The strategy of choosing the strongest and best lines to reproduce is also ignored. No mention that if someone can have a healthy baby vs. reproducing a known defect, maybe the emotional and physical investment would be better served producing offspring with the potential to be fully healthy? It is the central argument in 'gene therapy' approaches, here corrupted into a political-only focus on race and age. The argument isn't 'don't reproduce', it says choose the healthier start.

The extrapolation is also erroneous. That is, lowering the birth rate short term to produce a healthier population pays forward. (cf. hemophilia and the European 'royalty'.) WHO would NOT choose healthy offspring?

Futuristic SF often assumes genetic engineering, for everything from 'beauty' to alterations for alternate environments, or a genetic shift due to environmental selection. Those are different stories, but the aspects aren't even hinted at here. The topic is introduced in such a biased fashion, it loses power, coming off as paranoid rather than rational.

This tale also introduces, then drops, the AI factor, until the predictable end. The MC is presented as a skilled hacker, yet doesn't even look for what's going on. Even though very early in the tale, multiple clues are dropped about how much of the 'villain' might be AI rather than biological human.

Wouldn't that be an interesting version, changing the AI, unexpected effects of that, the corporation's reaction, etc. But that is not this story. Too many elements the story introduces are not handled to reader satisfaction.

The title promises excitement the tale does not deliver. NOT suspenseful, nor original, nor a 'thriller'. Don't see why the publisher marketed it this way, when the first section works as a reverse Huck Finn-type adventure, with the soft irony of the black man returning to the South for safe haven, along the anti-tech 'underground', literally on the railroad. As is, its setup to disappoint both SF and Thriller fans.

The writing style is more entry-level romance novel: 'the senior physician... had a long, flawless coat, long black hair with warm golden skin and the start of wrinkles...' Not significant to the scene or the story, so why is the coat being described like she is a dog? What makes her a 'senior physician', & are there junior physicians?

The descriptions throughout are not made meaningful for the reader. There's a sub-theme about hair and locs (dreadlocks), but the reader doesn't know why. There's no nostalgia or emotion shared about that, e.g. "dad's been caring for my locs since I was 10. It always made me feel special, like I matter" or "wish I had a mom/sister/brother to do this" or whatever. The action does not give the reader insight, so why is it included? What is the significance TO THE CHARACTER or the story?

And people keep making 'a gesture' - different ones. Why mention it if the author can't bother to describe it? This jars the reader out of the flow. Wouldn't an editor challenge these weak quirks?

Assuming the reader 'just knows' is entry-level writing. As is announcing instead of sharing. "Dr. Roberson was patient but firm and knowledgeable." If its important to the story, play out the important exchanges, don't editorialize. If skin shade, height, hairstyles of random background characters, matter, explain why. Too much of this reads like character notes for the author, or the likely hoped-for movie option.

The plot continues to annoy, even one-third of the way through. The MC goes out alone based on a setup by his supposed lap partners. THEY are going to study. Does Mr. New In Town do the same? Nah, he goes out alone. And is threatened overtly by ... a newspaper man. Like, the MC FORGOT there's a bounty on him? He wouldn't go out ALONE in NYC to a place he doesn't know. He knew enough to hide there.

So does he go straight back to the Dean, with whom he already has a relationship, and tell her about this? Does he tell his new Sponsor? Of course not, that would impede the c0nspiracy plot.

And when he does tell his sponsor, wait - SHE doesn't know that someone needing a drug will say ANYTHING to get it? Sure, the MC might not, but a teaching physician? And gosh, how did 'Jerry' know Kris was his bff? This MC doesn't have the survival skills, or reasoning, of a HS freshman.

And why is medical training run like the military? Does hyper-stressing students turn out the best practitioners? Sorry if the author went through the hazing, but modern medicine recognizes this is NOT the optimal path, and many are correcting it. Yet this 'top' school is the worst? First year students TREATING patients? Nightmare for everyone. An HOUR to admit 3 patients? That's just BAD procedure. The author makes the facility seem substandard at best. Why would any student be allowed in "the Vault" unescorted?

This is not written well enough to keep the reader engaged or caring. Interludes are simply philosophy lectures, pseudo-physics fantasy. Halfway through the author inserts political rants - which the readers of a 'science fiction thriller'-cum-YA adventure tale, didn't sign up for. Someone needed to establish that the author had the opportunity to write more than one book, on a variety of topics, and didn't need to try to shove every idea into the same single tome.

There is plenty of material, but the concepts are name-dropped rather than explored in this book. Too much is thrown in without adequate development. The line between book knowledge and real-world interaction is hinted at but never delved into. Naming a picture on a page is NOTHING like identifying a structure in a human body, but how does one really combine that learning? The reader will never know from this book, the answer is a useless 'just study'. 'Connect it to something.'

One 'student' has an apparently movable, flexible wheel chair - why not go into that a bit? A character has prosthetic legs but there's no revelations about how, or what methods or techniques might have achieved them. And the injury was to the spinal injury, so why are the actual legs prosthetic? Wouldn't just the nerves or the controls be augmented? This is so scattered.

The MC stays with a couple as a guest for one night, and days later offers someone ELSE he hasn't even met a job with them. That's a heck of a lot of familiarity for a single meeting. Presumptuous beyond all reason, wouldn't a college grad know better?

What's with the indoor garden, in a state overflowing with fertile ground and ideal growing cycles? Why is that important enough to build into the story?

The nemesis broadcasts an interview, and everyone is shocked? Did the early 21st century not happen in this world iteration? Do the medical students have a major educational void in the area of electromagnetism, broadcasting, and 'airwaves'? etc.

Hoped this would get better, tighter, the varying threads would weave together, as the story progresses; it does the opposite. Past the halfway point, the MC starts learning about drugs and dependency. Yet instead of taking the opening to educate the reader about something useful, the author makes up a drug and conditions, and uses that to belabor points. Where's the value to the reader? If the reader has to slog through Socratic Q&A, why not impart actual useful knowledge?

The Dr. "walked the class through her physical exam" with a woman starting labor. The MC 'felt her would-be ... child kick against her belly ...' What the WHOLE CLASS is physically handling the one patient? Imagine being that patient, it does NOT ring true. One student, maybe two, but the whole class? Rescued animals aren't even treated that impersonally! And the whole apparent point, to tie in a memory from the MC's father - lest the reader forget this is the Special Nepo Baby - would have been more credible if the MC was simply observing. This makes it seem like the class is mobbing the poor patient, AND the MC is so selfish he's in his own head instead of relating to the patient and the current experience of a live being moving inside its mother.

Having a bad day? Go interrupt your friend AT his customer-service job. SELFISH much? And why isn't the friend, accepted to 8 schools, not rushed into Hippocrates also? Ah, because he's the method of revelation as well as murder. Lovely. Similarly, what makes the admitting clerk so interested in MC, when he doesn't bother to attend to her at all? Ah, plot movement.

Kept reading to find some valid point, an uphill slog. Good topics raised but cast aside for plot convenience. Not a good conspiracy story, not a fun thriller. Too much medical detail about made-up conditions. The tale misses that in creating a world, the reader deserves to be clued in on what's normal and what's reasonable. "A drink made for you" seems normal in the context. If its not, why didn't the MC catch it at the time? Why aren't the known engineered proteins screened out or killed before the carriers are allowed out of quarantine? Are the Hippocrates staff incompetent, or is it just plot convenience?

[Lawren M. Perry · Rating 3 out of 5]

At first, this book had me very interested but it lost me at the end. Great concept and writing.

[Michelle · Rating 2 out of 5]

IT JUST WENT ON AND ON WITH NO REAL PLOT.

[Lia Preyde]

Why do I trust tiktok

[Michael DeRose · Rating 3 out of 5]

Very interesting read

[madcrazyreviews · Rating 4 out of 5]

In the acknowledgements section of his debut novel THE HOSPITAL AT THE END OF THE WORLD, author Justin C Key says he started this book after his first year of medical school (2014). I first came across Key's work in the Black horror short story collection OUT THERE SCREAMING (his story "The Aesthete" was a highlight).

His first book has some growing pains, it feels a bit uneven, but it shows promise for the career to come, and it's also one of those books that gets better as it goes along. (No small feat.)

The book focuses on Pok Morning, a star student who has tested and interviewed so well he's a shoo-in for any medical school he wants. Except he gets a rejection letter from the top twelve universities. The one he does get accepted to is in New Orleans, and they're a bit backwards down there.

For starters, NOLA doesn't use any of the biological enhancements, technological advancements, or integrated medical AI that Pok is used to in New York. NOLA is old school – they actually believe in human interaction.

See, THE HOSPITAL AT THE END OF THE WORLD is set in an unspecified near-future, where AI delivers basically all healthcare services. This novel comes at the perfect time. We're all familiar with generative AI threatening Hollywood, but perhaps even more worrisome (to me, anyway) is how heavily involved AI is becoming in healthcare.

As Pok journeys further down the rabbit hole – why was his stellar application rejected? why is he being followed? what is it about New Orleans that makes it special? – we get to see Key shine. The second half of the book is hard to put down, and you love the twists and turns along the way. The first half is a bit bumpy and uneven, the medical school stuff in the middle needed a trim, but the book is nevertheless an enjoyable sci-fi medical thriller.

[Lauren · Rating 3 out of 5]

why tf did they integrate at the end

[Elizabeth Godfrey · Rating 2 out of 5]

Interesting concept for the book: what happens to our world and specifically, the practice of medicine, when AI takes over? I feel like this book started very strong, faces paced, and with enough intrigue to keep the reader engaged, but then lost the pace towards the middle and end. There were a number of minor characters that got a little mixed up and were hard to keep straight. The ending lost me a bit, it seemed like there were "twists" thrown in for no reason and it did not tie together well in the end.

[Jen C · Rating 3 out of 5]

**I received a copy of this book via Goodreads giveaway***. I would give this book 3.5 stars. The premise was interesting but felt it was a bit slow and maybe didn’t need to be as long as it was.

[Jessica · Rating 3 out of 5]

Started strong but kinda lost me in the middle. I feel like the book was trying to be everything (thriller, mystery, sci-fi, philosophy, and medical) all at once and ended up being a hodgepodge. Some fascinating ideas barely explored while all of the deep dives were in the shallow waters.

[Amy]

Yes: A book I borrowed from the library to try before I buy (tired buying hundreds books and hating half)

I read first ch or more -first 10-100 pages skim around at times. I read many of my GR friend’s reviews. This is what I did and didn’t like:

Ok wow this cover caught my attention!! I love HCP!

A medical drama / dystopian/ written by a doctor
Yes 🙌

Ch 1 was a little technical I was like eh I want more medical more end world …then ch 2 we meet his dad who’s an MD and I loved that! This was interesting.

The writing is good, easy, fun. This is a concern of mine as a nurse that ai is taking over. Curious how he writes this.

Amazon $24.00

[Reactor Magazine]

Justin C. Key's The Hospital at the End of the World explores healthcare in an AI-driven monopoly; Vanessa Armstrong reviews the balance of slow med school drama and tense techno-thriller.

[Jemily · Rating 4 out of 5]

This book gave me “Station Eleven” meets Harry Potter ambiance. I really enjoyed the dystopian feels with the whole medical school setting; very unique from anything I’ve read before.

[Michelle Osborn · Rating 5 out of 5]

This book did a really good job painting a picture of what the world could very well look like with AI having a hand in so many aspects of the world, especially the medical field.

[Tracy DeAndrea · Rating 3 out of 5]

The first 2/3 of the book moved way too slow. While the subject matter was relevant, the good parts came too late in the book and didn’t have the punch it needed.

[Misha · Rating 5 out of 5]

The Hospital at the End of the World by Justin C. Key is a science fiction debut about a world ravaged by climate change and controlled by the Shepherd Organization, a company embedding AI into all daily life. Pok is eager to follow his father’s footsteps in the medical field, but when his acceptances fall through and a nefarious plot against him and his father unfolds he flees to the anti-AI stronghold of New Orleans. This is a thrilling futuristic tale about technology and the future of humanity. Another major theme of the novel is how we may not understand our parents until they are gone, especially if there are secrets and stories they did not share before they died--and how reckoning with a legacy you may not have been aware of shapes your past and your future.

[Dianysaurusrex]

Ooof. Ok. Dnf-d shortly after updating.


It’s just too riddled with convenient plot devices and TELLING, not showing. Life’s too short.

[Paige Tuttle · Rating 2 out of 5]

Really wanted to love this one…started off intrigued. Great idea just didn’t come together for me

[Vanessa L · Rating 2 out of 5]

Interesting, but could have moved with significantly more pace.

[Kristine]

DNF at 60% - Started off strong but then I got bored and kept hoping it would get better, but decided to just not continue due to lack of interest.

[Thrish · Rating 3 out of 5]

The premise was so interesting and relevant (human vs. AI-led medicine) but by the end, the book was trying to fit the mold of a sci fi, a thriller, a family drama and the ending fell flat. Still enjoyed overall.

[Marly · Rating 2 out of 5]

Almost DNF.