Fresh Meat: A Fatal Debt by John Gapper

John Gapper, A Fatal DebtA Fatal Debt by John Gapper is a psychological thriller set in the world of high finance (available June 26, 2012).

Ben Cowper, an attending psychiatrist at the prestigious New York–Episcopal Hospital, is stunned to learn the identity of the emergency patient he’s just been assigned to treat: Harry Shapiro, a Wall Street colossus and one of Episcopal’s most prominent donors.

The initial description of this book reminded me of an older anime called Monster, but aside from the idea of a well-meaning doctor’s life being drastically altered by a decision he makes about a rich patient in the ER, they are very different, though equally gripping, psychological thrillers.

Gapper grabs you right away with the strange question of man’s sanity, or lack thereof:

He briefly stood there glaring before sitting opposite me. It was a lovely morning and the sun was casting a square of light on the floor. There were many worse places to get stranded—an airport, a police station—but his reaction was typical of people who woke up in a secure ward after being persuaded to sign in. They found themselves locked up, with sharp objects removed for safety, needing to ask permission for anything, and they went crazy if they weren’t in that condition already. I glanced at Harry’s notes. There was little there but a scrip for Klonopin, a longer-lasting tranquilizer than the Ativan I’d given out in the ER. His mental status had not been fully assessed, and he hadn’t been interviewed about his history or started on antidepressants. The only psych he’d talked to at length remained me, on Friday night.

“How have you been sleeping?” I said.

“I want to leave,” he repeated slowly, as if I hadn’t listened the first time. I found it hard to hold his intense gaze.

Letting him go means being responsible for his behavior, should he hurt himself or someone else. Forcing him to stay might cost the hospital a new cancer wing. Either could cost him his job, but Cowper feels pressured to sign Harry’s release.

Which we, as crime readers, just know won’t turn out well.

After the recent Wall Street crash, a lot of people would love to get back at the banks. Harry Shapiro has his own reasons for wanting revenge. Once the top man at a financial giant he’d resurrected, he found himself discarded after a merger that caused massive losses. While most of us have to settle for complaining online or camping in parks, Harry Shapiro has the means, motive, and a shiny new alibi courtesy of Dr. Ben Cowper. Which is how he ends up arrested for murdering his successor.

Ben doesn’t want to investigate anything. Like most of us, he wishes he could have stood up to his boss when he’d had the chance and avoided everything that followed. Except that wasn’t his only mistake and once they start piling up, he realizes he’s going to have to get to the bottom of Harry’s actions to clear his own name.

It was a bright June day, with all of the city’s monuments shining in the sun, and I stood for a few minutes gathering my thoughts on the paved section of Pennsylvania Avenue, where the tourists massed in groups next to the White House railings. I was at the edge of the strip opposite the eight Greek columns of the Treasury, its granite façade drab and gray next to its iridescent neighbor.

I’d arrived early, having caught the early train out of New York, and I pulled a dollar bill from my pocket to look at it. On it were the crumpled face of George Washington, the Treasury seal in green, and Tom Henderson’s scrawled signature. To the left, over the B on the Federal Reserve Bank of New York seal was a promise in uppercase letters: THIS NOTE IS LEGAL TENDER FOR ALL DEBTS, PUBLIC AND PRIVATE. I’d come to ask about a fatal debt.

The setting of this book is the land of the 1% and, in all honesty, I’m usually put off by books set in the wealth-and-privilege arena. That said, I had no problem liking this book because its heart isn’t in the shiny décor and Gulfstream aircraft. Ben Cowper might come from an upper middle-class world, but he’s a guy who acknowledges he sees as many mental health problems traveling to work as he sees once he’s there.

He’s a guy who loves the wrong woman and can’t make himself love the right one. He’s a guy who really just wants to drop the whole mess in his lawyer’s lap, but believes enough in promises and oaths that he can’t bring himself to do it. He admits he picked his field for one of the reasons so many suspect—that is, to put names to all his own childhood dramas. In other words, he’s believably flawed and as uncomfortable in the world of the super-rich as most of us would be. 

A Fatal Debt isn’t really a medical thriller, despite all the doctors in its cast. It’s not completely a financial thriller, either, though it delves into the banking crisis that led to C-SPAN coverage and bailouts. The stakes are high, but they’re personal stakes. Dr. Cowper faces lawsuits and backlash that could end his career and one person who might want to end his life. It’s a fun, suspenseful read that pits an intrepid young doctor against evil bankers. And, really, don’t we all want someone to fight the evil bankers?


Neliza Drew is a tofu-eating teacher and erratic reader with a soft spot for crime fiction. She lives in the heat and humidity of southern Florida with three cats and her adorable hubby. She listens to way too much music, writes often, and spends too much time on Twitter (@nelizadrew).

Read all posts by Neliza Drew on Criminal Element.

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