We have a new and compelling protagonist in British crime fiction: police surgeon Harry Kent, an attractive, capable man who more than fills the role of a tortured sleuthing doctor. Addicted to amphetamine pills, Harry is conflicted, myopic, and brilliant, respected by his colleagues at the local A&E. He’s tormented by his time as a soldier in Afghanistan when his best friend, James Lahiri, saved his life and their loyal commander, Peter Tammas, suffered a fatal injury that left him a quadriplegic. Deep into the story, Harry finds himself drawn to DI Francis Noble of Southwark CID, who like Harry comes across as a rebellious, angry outsider. Weighing especially on Harry’s mind is his fracturing friendship with James, a friendship that hangs by a thread after it is revealed that Harry once slept with James’ wife.

But there is a case to solve, and it’s a complex one. Solomon Idris, a 17-year-old gang member, is holding customers hostage in a chicken shop on Wyndham Road. Intent to carry out some kind of vendetta, Idris demands to see the BBC and a lawyer. He also tells the police he’s doing it for some girl called Keisha. Idris’s health is failing from suspected pneumonia, maybe even tuberculosis. Harry’s own heart races with a familiar feeling. Charged with finding out what is wrong with the boy, it is up to Harry to try to defuse the tense situation--until a gunshot cuts through the cold, night air. Shots are fired, and Harry’s earpiece explodes to life. It’s a chaotic scene as Idris’s body leaks crimson blood against the white floor tiles of the chicken shop.

With Idris in hospital clinging to life, Harry and James try to save the boy. Noble is anxious to know if Idris is going to live, and she’s frustrated that there’s no chance of the boy waking up any time soon. This resuscitation of a young male gunshot victim is only the first event in a series of revelations that will bring back uncomfortable associations for Harry and James. As Harry’s mind wanders around the caverns of a dying teenager’s self-hatred, he visits Peter, confiding to his friend about “the poisoned chalice” of police work. Peter’s words--“we each have a deep hollow inside us”--echo deep inside Harry’s psyche.

Noble and her team begin doing the rounds, relying on information drip-fed from suspect to suspect until a picture begins to emerge: a string of cases where suspected sexual offenders are somehow tied to the Saviour Project, an inner-city group that helps gang members rehabilitate and re-build their lives. The Project has the kind of members expressly authorized to deal with the problems of homelessness and violence. Keisha Best, Idris’s girlfriend, was thought to have suicided by stepping in front of a train while high on drugs. The clues all point to some sort of vigilante conspiracy involving the Saviour Project and members of the hospital staff, members that Harry knows very well.

From the Southwark to The Docklands, to the London Eye where the City’s gleaming new skyscrapers create a majestic sense of place, to the deceptively helpful members of the Saviour Project, McCarthy strafes his story with a constant sense of danger: Idris’s second brush with death; Harry and Noble’s passionate affair; the threats to Harry, and later to James; and Harry’s efforts to find out the identity of a young girl called Zara who was found unconscious with no identification on her. Harry tells Noble that Zara has never regained enough cognitive function to respond to anyone.

Harry understands where Noble is coming from. The Met has their man, even though he’s currently comatose and under police guard. Nobody cares about Idris. He’s a criminal, “a nobody from the estates,” who probably would have ended up in prison eventually even if he hadn’t started waving his gun about. Part of what makes Harry such a compelling character is his tiresome fight for Idris, this fragile, emaciated figure whose hard look strikes Harry to the core. In the course of the unfolding case, Harry must also deal with the fallout from James. In one pivotal scene, we see Lahiri angry and scared, and Harry a broken, paranoid and unfaithful man ready to accuse his best friend of murder.

The Hollow Men isn’t anything new, but it’s solid and tense with attractive-sounding people swanning around London. What really sets the story apart is how McCarthy uses his medical expertise to freshen up what is rather generic plot. As the threads of the tale are tied up, old animosities surface and a beloved character is horrifically murdered. Throughout, Harry (and Noble) remain spirited and tough-minded as they realize that only they hold the key to the identity of Idris’s ruthless killer, a man consumed by the choices he’s made, the temptations he’s given into, and whose deviant desires seem to have eaten him up in the shadow of an inevitable death.