This book is about suicide and assisted suicide, and that's what my review is about. I'm not very good at the sensitivity/tact side of things, and my own lack of personal knowledge of some aspects and biases in others may be unintentionally offensive; if so, please let me know and I'll pull the paragraph or review.~~
f you remove a small amount of external trappings, Dr. Death is basically a what-if story: what if Dr. Kevorkian had been hooked up and murdered by his own device? In the story, Kevorkian's name is changed to Mate, but practically everything else remains the same, from Kevorkian's ghoulish beginnings to his interest in being on the CBS show "60 Minutes."
I'm not sure how I feel about ripped-from-the-headlines plots (the term is used to describe Law&Order episodes, and if you've ever had cable in the U.S., you've seen Law&Order). While I disapprove of the lack of creativity, the laziness of story conception, such stories usually mean I end up trawling Wikipedia and Google Scholar, so for me it's very much a learning experience. In this particular instance, I had no idea that Kevorkian was such a nutcase.
This book is, at its core, a discussion of suicide and assisted suicide. Personally, I'm not sure how I feel about it. I live in the United States, where attempting suicide is not (despite the common belief) against the law, at least in most states. You can and will, however, be taken into protective custody and placed on a 72-hr hold, apparently because attempting suicide is an indication of insanity. It becomes an interesting issue in the abstract: we have the right to do terrible damage to ourselves, as long as we don't hurt others; how do we not have the right to take our own lives? Personally, I find the delineation between harm to self and harm to others absurd. Everything you do affects others, and suicide is one of the most effective ways to wound those around you. As someone who has had a friend go down that direction, I approve of the handling of this, and at least for depressed people, I see the rationale for the definition of "temporary insanity." I used to be Christian, and despite a doctrine that idealizes self-sacrifice even unto death, straight-out suicide is a capital-s Sin. I was taught that it is "the ultimate act of selfishness," and that anyone who committed suicide would burn in Hell for all eternity. I can see the pragmatism of this--burning in Hell for all eternity is enough to make you think at least twice--but my own family's history and the grand old tradition of not allowing suicides to be buried on consecrated ground led to one of my own complaints against the religion. I don't think people who are suicidal are necessarily selfish or vindictive; you get to the point where you don't believe your death will hurt anyone. Kellerman explores the complex facets of desperation and damage to others through the story of a woman with an undiagnosed disorder who goes to Dr. Mate and leaves behind a grieving family.
An even thornier issue is assisted suicide. This is currently a contentious issue around the world. In England, the brilliant novelist Terry Pratchett, who was diagnosed several years ago with early-onset Alzheimers', is actively campaigning for a patient's right to die with dignity. Yet, as Kellerman explores, it is indeed a slippery slope. Surely you have the right to not seek potentially life-saving treatment. So, then, do you have the right to choose a moment before the pain and suffering of a terminal illness is debilitating? But if so, then what about a non-terminal illness that you simply cannot cope with? Or what about acting as the caretaker of someone who is incapable of making such a decision but would be "better off dead?" As Kevorkian himself said, "What difference does it make if someone is terminal? We are all terminal." I know where I see the line--terminal illness, your own decision, in concert with family--but I also see why many countries go for the far firmer line of "no."
To add to this complexity is Dr Kevorkian ("Dr Mate") himself. In both the novel and apparently in real life, Kevorkian comes across as something far too close to a sociopath, a publicity hound, an individual who utterly lacks respect for life. In the novel, Dr Mate started out by watching patients when they died and writing articles on his observations; in real life, Kevorkian was thrilled by the reinstating of the death penalty and wanted to use convicted criminals for medical experimentation and organ harvesting. He played around with transfusing the blood of the recently deceased. His "assists" never come off as about the patient--they seemed to be fascination with death, love of publicity, the danger, the control. To put a long story short, he was a sick fuck, and the potential damage that a person like that could do with any leeway in the law is probably related to many states' strong stance against assisted suicide. Perhaps assisted suicide is too frightening to contemplate; how can we ever ensure that the people involved don't have mixed motivations and that undue influence is not being exerted? I don't know.
I know I've spent the whole review writing out the random thoughts that have been churning through me as I absorbed the book. There really was a plot, and it was pretty good, if a little disjointed and contrived. Kellerman himself is a psychologist, and the psychology/counseling aspects felt real to me. I also liked the stability of Alex Delaware's life; unlike the eternally isolated Harry Bosch, Delaware is happily married and has an amicable relationship with the local police. I personally found this a far more enjoyable situation than the standard angst and isolation. Unlike Tempe Brennan, Delaware doesn't tend to sneer and despise the people he meets, which came as a welcome relief. At its core, though, the book delves into the issue of suicide and assisted suicide, and I got the impression that Kellerman is as torn and conflicted as most of his readers. I love that he presented multiple viewpoints rather than try to hammer home one particular stance, and, ripped from the headlines or not, the book made me think.