The Children's Hospital

Mercy Ward

Many novelists set themselves the task of confronting the world's ills in their fiction. Fewer attempt to actually cure them, as Chris Adrian does in his second novel, The Children's Hospital, a sprawling and impassioned morality tale in which a catastrophe of biblical scale wipes out nearly all life, human and otherwise, on Earth. Adrian has an impressive CV for a young writer: The author of a critically acclaimed debut novel, Gob's Grief, and short fiction that has appeared in the New Yorker and the Paris Review, he's also a pediatrician now studying at Harvard Divinity School. All of these experiences bear fruit in The Children's Hospital, though that fruit may be a specialized taste, more durian or rambutan than apple or plum.

After a brief prologue spoken by an angel, we're thrust into the middle of a children's delivery room where Jemma Claflin, a third-year medical student, assists at yet another difficult birth. Outside, "lightning arched overhead and showed her a vast parking lot, empty except for a few dozen dead cars stranded in water up to their headlights." Inside, Jemma hurries from the birth of a "gruesome baby...so unique that she was her very own syndrome." Jemma is in a rush to meet her lover, Rob, another med student; they have wild sex in a locked room. Timing is everything, even -- especially -- at the end of the world: Moments after they make love, the hospital is rocked from its foundations and a voice announces:

"Creatures, I am the preserving angel. Fear not, I will keep you. Fear not, I will protect you. Fear not, you will bide with me. Fear not, I will carry you into the new world."

The first half of this novel is superb. Adrian's account of the medical staff's day-to-day battles -- with disease, with each other, with the demanding parents of their young patients -- is gripping and intensely humane, despite the frank and often horrific descriptions of the disorders that brought these children to the hospital in the first place. The exhausted workers stumble zombie-like through their rounds and tend to the sickest children whenever they hear "the soft tinkling bell of the code bell, and the angel's calm alarum: 'A child is dying.'"

The irony, of course, is that their jobs aren't much different from the way they were before the flood (which everyone calls "the Thing"). The mediating angels helpfully provide replicators that produce any food or comfort item the humans desire. But not even angels, it seems, can cure cancer or insert an IV into a wizened neonate's arm.

The stressed-out, winsomely pragmatic Jemma is at the center of the novel's huge cast of characters, mortal and semi-divine. She's death-haunted: Her beloved brother was a suicide and is now himself an angelic figure; their father died of lung cancer; their mother self-immolates in a house fire; Jemma's first love expires in a car crash. Is Rob doomed, too? Is everything bad really her fault? A lot of women feel this way but, given the circumstances, it's hard to argue with her.

Jemma isn't just the book's palpitating, tell-tale heart. She's also its gravid, symbol-laden vessel. Pregnant with Rob's child -- someone's child, anyway, or Something's -- she develops miraculous powers of healing. These eventually explode in an extraordinary extended sequence, a literary tour-de-force in which Jemma weaves together broken synapses, inflates collapsed lungs and burns away all the diseases and disorders of the sick children -- the harrowing of the hospital, or Thing Two, as it's quickly named.

But Adrian's carefully calibrated balance between the miraculous and the mundane begins to wobble in his depiction of the post-Thing Two world. The novel's baggy structure can't support the symbolic weight of all those angels and miracle children, who take center stage as the hospital's mortal, adult staff begins to sicken. There are haunting set pieces in the latter pages, but Adrian kills off much of the tension along with his flawed but riveting medical personnel.

Still, despite its weaknesses, The Children's Hospital establishes Chris Adrian as a remarkable American fabulist in the tradition of Melvin Jules Bukiet and Tony Kushner, writers who define and confront the terrifying moral choices of a new century. In what may be a terminally sick world, it's good to have a doctor in the house.

Elizabeth Hand's collection Saffron & Brimstone: Strange Stories has just been published.

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