Today's links
Justin Key's "The Hospital at the End Of the World" (permalink)
Justin C. Key is one of the most exciting new science fiction writers of this decade and today, Harpercollins publishes his debut novel, The Hospital at the End of the World:
https://www.harpercollins.com/products/the-hospital-at-the-end-of-the-world-justin-c-key?variant=43822999928866
I've followed Key's work for more than a decade, ever since I met him as a student while teaching at the Clarion West writers' workshop in Seattle. At the time, Key impressed me – a standout writer in a year full of standouts – and I wasn't surprised in the least when Harpercollins published a collection of his afrofuturist/Black horror stories, The World Wasn't Ready For You, in 2023:
https://pluralistic.net/2023/09/19/justin-c-key/#clarion-west-2015
This is virtually unheard of. Major genre publishers generally don't publish short story collections at all, let alone short story collections by writers who haven't already established themselves as novelists. The exceptions are rare as hell, and they're names to conjure with: Ted Chiang, say, or Kelly Link:
https://pluralistic.net/2024/02/13/the-kissing-song/#wrack-and-roll
But anyone who read World Wasn't Ready immediately understood why Key's work qualified him for an exception to this iron law of publishing. Key is an MD and a practicing psychiatrist, and he combines keen insights into personal relations and human frailty with a wild imagination, deep compassion, and enviable prose chops.
Hospital at the End of the World is Key's first novel, and it's terrific. Set in a not-so-distant future in which an AI-driven health monopolist called The Shepherd Organization controls much of the lives of everyday Americans, Hospital follows Pok, a young New Yorker who dreams of becoming an MD. Pok's father is also a doctor, famous for his empathic, human-centric methods and his scientific theories about the role that "essence" (a psychospiritual connection between doctors and patients) plays in clinical settings.
The story opens with Pok hotly anticipating an acceptance letter from The Shepherd Organization, and the beginning of his new life as a medical student. But when word arrives, Pok learns that he has been rejected from every medical school in the TSO orbit. In desperate confusion, he works with shadowy hackers in a bid to learn why his impeccable application and his top grades resulted in this total rejection. That's when he learns that someone had sabotaged his application and falsified his grades, and, not long thereafter, he learns that the saboteur was his father.
To make things worse, Pok's father has fallen grievously ill – so ill, in fact, that he ends up in a Shepherd Organization hospital, despite his deep enmity for TSO and its AI-driven practice of medicine. Pok doesn't accompany his father, though – he has secured a chance to sit a make-up exam in a desperate bid to get into med school. By the time he is finished with his exam, though, he learns that his father has died, and all that is left of him is an AI-powered chatbot that is delivered to Pok's apartment along with a warning to flee, because he is in terrible danger from the Shepherd Organization.
Thus begins Pok's tale as he goes underground in a ubiquitous AI surveillance dystopia, seeking sanctuary in New Orleans, hoping to make it to the Hippocrates, the last holdout from America's AI-based medicine and surveillance dystopia. Pok's father learned to practice medicine at Hippocrates, and had urged Pok to study there, even securing a full-ride scholarship for him. But Pok had no interest in the mystical, squishy, sentimental ethos of the Hippocrates, and had been determined to practice the Shepherd Organization's rigorous, cold, data-driven form of medicine.
Now, Pok has no choice. Hitchhiking, hopping freight cars, falling into company with other fugitives, Pok makes his way to New Orleans, a city guarded by tall towers that radiate energy that dampens both the punishing weather events that would otherwise drown the city and the data signals by which the Shepherd Organization tracks and controls the American people.
This is the book's second act, a medical technothriller that sees Pok as an untrusted outsider in the freshman class at Hippocrates med school, amidst a strange and alarming plague that has sickened the other refugees from TSO America who have taken up residence in New Orleans. Pok has to navigate factions within the med school and in New Orleans society, even as he throws himself into the meat grinder of med school and unravels the secrets of his father and his own birth.
What follows is a masterful and suspenseful work of science fiction informed by Key's own medical training and his keen sense of the human psyche. It's one part smart whodunnit, one part heist thriller, and one part revolutionary epic, and at its core is a profound series of provocations and thought experiments about the role that deep human connection and empathy play in medical care. It's a well-structured, well-paced sf novel that probes big, urgent contemporary themes while still engrossing the reader in the intimate human relations of its principals. A wonderful debut novel from a major new writer.`
Hey look at this (permalink)
Object permanence (permalink)
#20yrsago AOL/Yahoo: our email tax will make the net as good as the post office! https://www.nytimes.com/2006/02/05/technology/postage-is-due-for-companies-sending-email.html
#20yrsago Volunteers ferry 15k coconuts every day to Indian temple http://news.bbc.co.uk/2/hi/south_asia/4677320.stm
#15yrsago Wikileaks ACTA cables confirm it was a screwjob for the global poor https://arstechnica.com/tech-policy/2011/02/secret-us-cables-reveal-acta-was-far-too-secret/
#10yrsago Laura Poitrasâs Astro Noise: indispensable book and gallery show about mass surveillance https://www.wired.com/2016/02/snowdens-chronicler-reveals-her-own-life-under-surveillance/
#10yrsago How to prepare to join the Internet of the dead https://archive.org/details/Online_No_One_Knows_Youre_Dead
#10yrsago Who funds the âMillennials Risingâ Super PAC? Rich old men. https://web.archive.org/web/20160204223020/https://theintercept.com/2016/02/04/millennials-rising-super-pac-is-95-funded-by-old-men/
#10yrsago They promised us a debate over TPP, then they signed it without any debate https://www.techdirt.com/2016/02/03/countries-sign-tpp-whatever-happened-to-debate-we-were-promised-before-signing/
#5yrsago Stop the "Stop the Steal" steal https://pluralistic.net/2021/02/04/vote-machine-tankies/#ess
#5yrsago Organic fascism https://pluralistic.net/2021/02/04/vote-machine-tankies/#pastel-q
#5yrsago Ron Deibert's "Chasing Shadows" https://pluralistic.net/2025/02/04/citizen-lab/#nso-group
Upcoming appearances (permalink)
Recent appearances (permalink)
- "Canny Valley": A limited edition collection of the collages I create for Pluralistic, self-published, September 2025
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"Enshittification: Why Everything Suddenly Got Worse and What to Do About It," Farrar, Straus, Giroux, October 7 2025
https://us.macmillan.com/books/9780374619329/enshittification/
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"Picks and Shovels": a sequel to "Red Team Blues," about the heroic era of the PC, Tor Books (US), Head of Zeus (UK), February 2025 (https://us.macmillan.com/books/9781250865908/picksandshovels).
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"The Bezzle": a sequel to "Red Team Blues," about prison-tech and other grifts, Tor Books (US), Head of Zeus (UK), February 2024 (thebezzle.org).
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"The Lost Cause:" a solarpunk novel of hope in the climate emergency, Tor Books (US), Head of Zeus (UK), November 2023 (http://lost-cause.org).
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"The Internet Con": A nonfiction book about interoperability and Big Tech (Verso) September 2023 (http://seizethemeansofcomputation.org). Signed copies at Book Soup (https://www.booksoup.com/book/9781804291245).
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"Red Team Blues": "A grabby, compulsive thriller that will leave you knowing more about how the world works than you did before." Tor Books http://redteamblues.com.
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"Chokepoint Capitalism: How to Beat Big Tech, Tame Big Content, and Get Artists Paid, with Rebecca Giblin", on how to unrig the markets for creative labor, Beacon Press/Scribe 2022 https://chokepointcapitalism.com
- "Unauthorized Bread": a middle-grades graphic novel adapted from my novella about refugees, toasters and DRM, FirstSecond, 2026
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"Enshittification, Why Everything Suddenly Got Worse and What to Do About It" (the graphic novel), Firstsecond, 2026
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"The Memex Method," Farrar, Straus, Giroux, 2026
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"The Reverse-Centaur's Guide to AI," a short book about being a better AI critic, Farrar, Straus and Giroux, June 2026
Today's top sources:
Currently writing: "The Post-American Internet," a sequel to "Enshittification," about the better world the rest of us get to have now that Trump has torched America (1011 words today, 21655 total)
- "The Reverse Centaur's Guide to AI," a short book for Farrar, Straus and Giroux about being an effective AI critic. LEGAL REVIEW AND COPYEDIT COMPLETE.
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"The Post-American Internet," a short book about internet policy in the age of Trumpism. PLANNING.
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A Little Brother short story about DIY insulin PLANNING
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