Book Review: How Can I Help You by Laura Sims

How Can I Help You is a “compulsive and unforgettable novel” of razor-sharp suspense about two local librarians whose lives become dangerously intertwined. Read on for Doreen Sheridan's review!

Margo Finch has left her old life in the rearview mirror. Once a nurse who cared deeply for her patients, she’s now a library assistant – not that anyone can tell the difference between her and the town of Carlyle’s actual librarians. Working in a library is significantly different from her old job, and different too from the libraries of her youth. Shushing patrons is frowned upon, her boss tells her, as modern libraries seek to be a gathering place for the communities they serve.

Since Margo is as adaptable as she is competent, she quickly puts aside her old ideas and learns how to become the perfect library employee. Her unflappability makes her the go-to person when her co-workers aren’t sure how to handle a difficult patron. She’s had a lot of experience remaining calm under pressure from her hospital work, after all:

[C]haos could erupt from the heart of this quiet, too; suddenly I’d find myself standing by a patient’s bedside as commotion descended: hurried footsteps, shouted directions. I stayed calm, soothing the forehead or hands of a struggling one, shushing them gently, steadily handing this or that to the doctor while keeping my eyes locked on the terrified eyes. I’d show them my shining face and my beatific smile and they clung to it, hung their souls onto it, and sometimes they gripped my arms with their wasted claws and literally held me, and I let them. They needed me. I was their living, breathing saint: their nurse.

Working in a library definitely isn’t the same, but Margo is happy enough with her life change. Until, that is, glamorous new hire Patricia Delmarco arrives to shake up the place.

Margo is instantly drawn to her newest co-worker, who reminds her of friends long ago left behind. Patricia feels a reciprocal attraction but is more standoffish. She has, after all, just abandoned her entire life in Chicago to come work in small town Carlyle. Reeling from her decision to close the door – or, perhaps more fittingly, drawer – on an important part of her existence, she’s leery of forming new connections. A strange incident in the library bathroom gives her a small but crucial insight into Margo’s past, however, sparking a closeness both women at once crave and fear.

Intrigued as well as well-armed with her master’s in library science, Patricia starts to investigate her new co-worker, pursuing Margo’s truth even as the two women begin to bond. She’s thus understandably horrified to discover that Margo is wanted for questioning in a string of hospital deaths. But she’s also intrigued, as a desire she thought she’d been able to snuff out slowly rekindles within her:

I have a story now–or a story has me. Without willing it, I see my character sketches and notes cohere around a central spine: Margo as a killer nurse, living a camouflaged life. Determined not to kill again, but tempted, so tempted sometimes.


She’s a character in a book. My book. And like that, I acknowledge it. I am writing a book. I don’t deny or shy away from it this time. I can’t. How can I deny a story like this? One with such power and potential momentum?


I don’t think for one moment, I should go turn her in. I should call the police. Or–I think it, but I bat it away.

Soon enough, the two women embark on a cat and mouse game, grappling with the truth as each sees it and trying to pry open each other’s secrets. When the tension becomes too high, someone else has to die. But that’s only the first murder, as Margo and Patricia head for a showdown that promises destruction, more death and, perhaps, a terrible form of rebirth.

How Can I Help You is a compelling take on the complicated relationship between author and muse, as well as the ethics of writing fiction. Told from the alternating viewpoints of Margo and Patricia, this book explores the power inherent in the acts of nursing both people and ideas. I only wish that more of each character’s backstories had been explored. Tantalizing hints are dropped throughout the novel, but deeper explanations would have really driven the impact home.

That said, this is an absorbing, fast read about the dark sides of care work and public service. If you’ve ever wanted a book that riffs with literary inventiveness on the “kill your darlings” advice often given to authors, then this suspenseful novel with an ending worthy of a horror story is definitely the read for you.

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