The book takes place over three hours in an ER in the ominously named The City, with chapters broken up among many points of view and labeled with their exact time. It's going for an Arthur Hailey/James Michener-esque epic in a very short space, and it does succeed in capturing that type of feel.

The characters we follow include a college student who's hit by a stray bullet in a gang shootout, a gangster who shows up at the ER to finish off the guy he shot on purpose, and a high school student who crashes a motorcycle. The characters I cared the most about are interestingly both there not for medical reasons but to escape their homes: a teenage mother of twins at the end of her rope, and an eight-year-old neglected child there who brought her younger siblings with her because there's air conditioning and crayons.

The main characters are a pair of aspiring medical students volunteering at the ER, Seth and Diana. Seth is humorless and arrogant. Diana is insecure and sharp-tongued. The book had other problems but they were one of the biggest. I neither liked nor cared about either of them.

The book was written in 1997 and you can tell, in good, bad, and historically interesting ways. An HIV positive baby is going to die, period. The City is a complete urban hellscape where it's dangerous to go outside because you WILL get shot... which is actually true of America to some degree, but it's described in a very 1997 way.

Cooney goes well out of her way to not be racist about what is essentially a racist trope, and succeeds to some extent (she has a multiracial cast of all sorts of people) but accidentally shines light on exactly how racist that trope is. I kept being brought up short by her gangsters being white (or at least some of them are, I forget), because they're described in a way that is pretty much always reserved for teenage Black gangsters. Calling it the City was a mistake, IMO; just inventing a city with a name would have worked better. The allegorical name clashes with the realistic details and also adds to the sense of "cities are terrifying hellscapes filled with scary people of color" except Cooney clearly doesn't agree with that part so she kept everything but that, highlighting how completely nonsensical the trope is - it has literally no basis beyond racism.

I was hoping this would be along the lines of Flight #116 is Down! and it kind of is, but it's nowhere near as good. It's not a failure by any means - it wants to tell an exciting and informative story about what a big-city ER is like - but that's all it is. It's a perfectly fine example of what it is, but Flight #116 is Down! is above and beyond what it is.

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