The Bottom Line: A truly important medical thriller about the role of AI in life-or-death decision-making. Highly recommended.
In the tradition of Robert Harris’ classic thriller The Fear Index, and Arthur C. Clark’s 2001: A Space Odyssey, JL Lycette’s novel about the perils of flawed, uncontrollable artificial intelligence is an emotionally-charged, cautionary tale about the role of technology in modern medicine.
Chief Resident Hope Kestrel, a Seattle surgeon working in the PRIMA (Prognostic Intelligent Medical Algorithms) program, couldn’t be more personally or professionally invested in her mission. PRIMA promises to free patients and doctors from painstaking choices about courses of treatment. “The algorithms are more trustworthy than people,” she tells her skeptical lab intern, Jacie Stone.
Professionally, Hope is committed to doing whatever it takes to maintain her top ranking within the program. Doing so will mean a prestigious faculty position with her own research lab. Personally, Hope has a curiously strong relationship with her mentor, Cecilia, who she fears disappointing, and success would mean spending more time with her.
And perhaps most importantly, Hope’s own mother died of cancer after an agonizing and unsuccessful treatment. She harbors a great deal of resentment and regret over how much she suffered despite the fact that there was no chance of a cure. The constant reminders surfaced in her day-to-day work make objectivity about PRIMA’s effectiveness – and just how much decision-making power it should be given – extremely daunting.
Lycette, herself a real-life physician, creates spectacular tension between Hope, Jacie and program director Dr. Marah Maddox. In Maddox, Lycette has created a workplace monster that somehow manages to be even scarier than the prospect of fully autonomous AI. Thanks to Lycette’s meticulous observations, everything about Maddox, from her perfume to her cryptic threats, seems truly sinister. And that’s before she reveals what the powerful researcher is really up to.
While Lycette’s novel about the threat of generational AI could not be more timely, the story’s realistic portrait of the humans seeking to control it is what makes it memorable.
