In the tradition of The Lovely Bones, Krista Tibbs’s novel The Neurology of Angels deals with the hard topic of adolescent death while remaining at its heart a story about love and hope. Extremely timely, The Neurology of Angels also manages to pose thoughtful, lingering questions about our healthcare system.
In this engaging story, three families struggle with the ramifications of serious health conditions and possible pharmacological treatments. Galen Douglas is a neuroscientist who endangers the future happiness of his current family to develop a cure for the type of stroke that killed his former fiancé. Eddy Parker, Galen’s college roommate and almost-brother-in-law, enters politics when his own daughter suffers the same type of stroke that claimed his sister. His political agenda is driven by the fact that the cost of her medicine nearly bankrupts the family. Elizabeth Rose, a pharmaceutical industry lawyer, campaigns and saves for a cure for her daughter’s rare brain disorder.
The cost of research, government regulation, evolving politics, market-based economics and company policy all play a part in deciding which diseases - and thus which children - will be treated and which will die. A minor character, Patricia Chen, represents the crucial role of Federal Drug Administration officials in determining treatment for terminal illnesses and the cost of such treatments. Chen is devastated after her first drug approval results in an unforeseen death, leading her to become ultra-cautious, pushing for increased safety measures before any drug can be tested on chronically ill children - inadvertently causing death yet again.
As Tibbs aptly shows with her intersecting stories, the characters are motivated by love and strive to do the right thing. After Eddy’s legislation to lower drug prices ends up having far-reaching and disastrous consequences, he asks himself
“How could all these voices and choices be moral and legitimate and correct at the same time? His head was spinning, and he didn’t know which way was right.”
Galen puts it even more succinctly: “So you’re saying there’s no win-win here.” He goes on to point out that pharmaceutical company investors expect one thing, while customers relying on their medications expect another, and those waiting for a cure, yet another. And, if his company should go under, everyone loses.
Tibbs is well-informed about her subject matter, having degrees in neuroscience and business as well as a wealth of experience in political theatres and research. Bringing the divergent views to life in characters who grow and intersect effectively as the plot develops is clearly the work of a skilled writer.
The author also does an outstanding job representing the adolescents Abigail, Sera and Lexi. Although Sera and Lexi are best friends and Sera is terminally ill, Lexi voices common teenage jealousies while Sera is preoccupied with typical concerns such as whether to have sex with her boyfriend.
The only place this novel falls short is when Tibbs seems to be lecturing about the various ramifications of our society’s healthcare structure. Too simplistic at times when comparing the healthcare system to running a cookie and lemonade stand, The Neurology of Angels does offer an interesting concept about prepurchasing healthcare by bidding off skills. While accruing healthcare reserves this way would certainly help manage copays not covered by insurance (and fund research), I don’t see how this could truly impact a family’s ability to handle the staggering cost of a chronic, life-threatening disease. But don’t let this prevent you from enjoying this satisfying fast-read.