CLUBHOUSE: Review: “The Shapes of Wrath,” Medical Horror novel by Melissa Yi

OBIR: Occasional Biased and Ignorant Reviews reflecting this reader’s opinion.

THE SHAPES OF WRATH, Hope’s Seven Deadly Sins Thriller 1: Wrath – by Melissa Yi

Publisher: Olo Books in association with Windtree Press, Canada, February 2023

Cover Art – by Nancy Arksey


Hope is a first-year resident Doctor at University College Hospital in Montreal. Her goal is to learn and experience as much as she can to further her career. Unfortunately, someone on staff has a different career in mind, that of a serial killer.


This is, essentially, a medical-crime-mystery. I normally review Science fiction, fantasy, or horror genre works. Does this book fit?

I’d say so. For a couple of reasons. First, because Hope is sensitive to the presence of ghosts, and there is a ghost haunting the hospital who is very much involved with what’s going on there. Not a major character, mind you, but a ghost who serves as a handy device for incremental revelations concerning the killer, information made possible because of Hope’s acceptance of the ghost’s existence and her belief that understanding its purpose will help her unravel the facts behind the killing spree. Problem is most of Hope’s co-workers don’t share her sensitivity to ghosts, and every time she brings up the subject it renders her less valid in their eyes as a credible “investigator” of events. This, in turn, leads to self-doubts on her part, contributing to her emotional turmoil. In short, the ghost is an ideal minor character in a mystery, one who both helps and hinders the revelatory process, and thus aids the growing tension and suspense.

Second, this novel fits because it is definitely a horror story, a tale of medical betrayal confirming the subconscious fears of just about everybody who spends any time in a hospital. It used to be said, a long time ago, that “Hospitals are where you go to die.” The advent of anaesthesia, germ theory, and modern vaccines, medicines and technology has done much to dispel the dread associated with hospital stays. Modern surgeons are thought of, even taken for granted as, miracle workers. People have visions of efficient, well-scrubbed staff in the shiny operating rooms who know exactly what they are doing. No matter how badly bunged up you are, the expert medical staff will be able to put you back together such that life will eventually get back to normal or close to it. Only the most extreme cases cannot be salvaged. Statistically quite true, compared to a century ago.

However, Covid has taken the lustre out of this vision. Here, in Nanaimo, the Regional General hospital remains overcrowded, with many minor surgeries put on hold, and the staff, short in numbers because of Covid, run ragged with the never-ending rush of patients. In a sense, the medical staff ARE miracle workers, coping as best they can despite long hours and limited means. They perform magnificently. The public nevertheless has the uneasy feeling things are stretched perilously close to the breaking point and they’re not far wrong. More doctors are needed. More money. More facilities. But times are hard and politicians… well, politicians.

Point is faith in the medical system is not what it used to be. An endless spate of modern TV shows may have contributed to this. On the one hand, unusual cases are presented, mysteries in themselves, usually resolved by teamwork by individuals dedicated to moving heaven and earth to get what they want despite the sluggish resistance of an entrenched establishment. Very optimistic. Then again, villains can surface anywhere, in administration, among the patients, even within the ranks of the professionals. This all has to do with the needs of drama, of course, which often makes for suspenseful shows that some viewers find quite addictive. But I’m sure it leaves a worm burrowing away at the base of everyone’s thoughts about hospital stays. Could there be a villain among the staff treating me?

Worst of all, occasionally there is in real life. I’m 71 years old. I’m aging. If I wind up in a hospital for a prolonged stay, or in a care home, how do I know one of the staff isn’t one of these monsters who delights in killing off old people one by one, usually with the excuse, when caught, that they were doing their victims a favour? There’s a wide variety of motives, ranging from petty dislike for patients who annoy them to pleasure in the feelings of empowerment murdering the helpless provides. Rationalization is very much a major tool for evil. And you never know who is evil. Psychopaths and sociopaths are everywhere.

For example, a few years ago I was lying on an operating table at a hospital in Vancouver waiting for a heart ablation procedure to begin. The operation staff, while making final preparations, were discussing a Doctor back east who had murdered his wife. Turns out the staff all knew him, had worked with him, and all were agreed he was a great guy everyone had admired and enjoyed knowing. Their summation was more or less “Gee, you never can tell what people are capable of.” Yep. I agree.

Given that, even in the best case scenario “It’s only a scratch,” people deep down inside fear the worst, this novel has a guaranteed readership to target. I’m confident readers will want both their fears and their hopes catered to. Melissa does this with ease and confidence. No wonder, for she is a highly experienced emergency-care doctor with a plethora of experience to cherry pick details sufficient to her purpose. For example, a number of surgical procedures are described in exquisite, or perhaps I should say, excruciating detail. The reader’s response depends on how squeamish they are. This accomplishes two things: it makes the reader shudder, and also impresses by virtue of the sheer amount of technical knowledge the character possesses. Quite reassuring, that.

After all, people should never make the mistake of thinking that hospital staff share their viewpoint, i.e. an ignorant incomprehension of what’s happening to them. Trained and experienced medical personnel know what ails you or, at least, know how to go about finding out the source of the problem. Several times in the book Hope assesses the condition of a patient. Invariably, and I suspect true to life, the patient says “It hurts” and points to where it hurts, and hopes for the best. Meanwhile Hope is checking instrument readings, poking and prodding, and asking innocuous, seemingly irrelevant questions, all of which lead to an understanding of symptoms the patient isn’t even consciously aware of. In one case the evidence brings her to conclude that the patient’s stomach has “torted,” or twisted around. I nearly jumped out of my seat. I’ve heard bowels can get twisted and blocked, but I never in a million years suspected a stomach could do that. Good grief! As if I’m not hypochondriac enough already. Even more frightening, it’s not that uncommon, and there exists a standard procedure to reverse the problem, which Hope proceeds to arrange. Good to know. But scary!

Puts me in mind of the time my doctor (back when I had a doctor—same guy from 1967 to 2018—now I go to a medical clinic for a whomever-is-available doctor) sent me to St. Paul’s hospital because my lungs were shutting down. They tested me and concluded I was the carrier, the first person in North America, to possess the latest deadly flu from Asia (this is before Covid, long before). They shoved my hospital bed into a glass-walled room with an air filtration system big enough for a battleship and an alarm over the door that went off whenever it was opened. Six doctors in what looked like hazmat suits came in and stood at the foot of my bed staring at me. I stared back. Finally, one of them said “We think you might be a trifle contagious.” I believe my response was something along the lines of “No shit, Sherlock.”

Anyway, long story short, working their way down a long list of suspected causes they eventually stuck the Canada Arm down my throat and took samples from my lungs. Turned out the presence of bird antigens proved I was suffering a fatal allergic reaction to bird dander and the administration of a particular steroid put me on the road to recovery. They insisted on telling me I had come within twelve hours of dying. Needless to say, I’ve had to give up my dream of being a bird juggler.

Point is, if you are a mystery-genre addict, daydreaming about being a famous detective, become a nurse or a doctor. They solve mysteries every day, utilizing experience, training, and a holistic attention to the problem in search of telling details that will solve the identity of the culprit, be it a twisted stomach or a rare disorder. Examining physicians are thinking all the time they are examining you, running past a million scenarios you’ve never even heard of. This is why they often seem distant and uninvolved. They are listening to you, but with only part of their brain, the rest is functioning like a computer accepting or rejecting conclusions till they can come up with a genuine and accurate understanding of what you are complaining about. They’re not seeking to bond with you emotionally. They’re trying to figure out what’s wrong.

This is a far more complex task than most people realize. You may point to your big toe and say “It hurts.” You may think something must be done to your big toe to make it feel better. In fact it may be your toe has nothing to do with the actual problem. Possibly, say, a certain type of pinched nerve elsewhere in your body manifests only as pain in a big toe. So, the pain, otherwise inexplicable, is a sure sign of that particular problem. Back pains in general are notorious for this. Pain can go wherever nerves exist. Pain is not necessarily a clue as to the location of a given problem. This is why physicians or, at any rate, good physicians, never stop learning. Medical science knows far less about the human body than laymen assume, and something new comes to the attention of every doctor every day. It’s like crime solving; though many crimes and criminals are similar to the point of being predictable, in fact every case is unique, and you never know when the unexpected will occur. Same thing in medicine, which is why medical mysteries can be so fascinating.

One of the great strengths of this novel is that it presents the working viewpoint of medical staff as provided by accurate insider knowledge. This helps the reader understand that patients are not, when it comes down to the nitty-gritty, perceived as a bundle of neurosis seeking validation and compassion, but rather a collection of symptoms, often traumatic and life-threatening, which need to be understood as quickly as possible if the patient is to be saved. “They’re treating me like a piece of meat” is an oft-heard complaint. Well, of course, the immediate task is solving the conundrum of your shattered or enflamed body, some of it already possibly necrotic. They’re trying to prevent you from turning into a cadaver. Working on restoring your peace of mind comes later. First, they have to save your life.

Another strength, perhaps a bit of a surprise to many readers, is how human the characters are. By that I mean that many people have a tendency to view doctors and nurses in terms of stereotypes, as trained professionals determined to help people in need. Certainly, this is true as far as it goes. If asked to imagine the stresses these professionals face, fatigue and burn out come to mind, and sex. Weird, that, but there are plenty of movies, some of them smutty and some even pornographic, which put nurses in the same category as airline stewardesses or private secretaries as far as male fantasy is concerned. Not exactly a sound public persona, but it is the public that is at fault, not the individuals that are perceived as sexual objects. To put it another way, nurses and doctors tend to be thought of in rather simplistic, shallow terms.

Not in this book. Melissa is adept at portraying the banter between medical personnel, but also conversation and action revealing the complex and often competitive interaction as they seek to a) help their patients, b) meet their own expectations, c) maintain and even enhance their reputation with both their peers and their superiors, d) “get ahead” in their careers, and e) enjoy some kind of private life. This allows room for all sorts of failings and shenanigans the public doesn’t like to think about and is better off not knowing. Good source of realistic drama, though.

I haven’t touched on the characters in this book. They’re all different and all credible. The reader comes away feeling sorry for some of them. Not all manage to serve their own interests with any credit, but it is fair to say that all of them, like everyone else on the planet, are dedicated to serving themselves first and foremost. Hence many a moral and ethical dilemma in their minds. For some, this renders committing to exposing the bad guy difficult and potentially bad for their careers. Their responses to the crimes are varied. As a result, many plot complications ensue.

Another useful authorial device is that Hope is new to her residency and is still in the first stages of getting to know the people she is working with. This allows the reader to discover assorted truths and realities as she discovers them, which makes it easier to identify with her and her attempts to cope with an ever-accelerating situation growing more dangerous and intense with every shift on duty, or off duty for that matter.

Add to this the fact that the villain is identified very early in the book. It’s not a who-done-it sort of mystery. It’s more a case of will-he-get-away-with-it? The killer, who knows how to cover his tracks, is virtually impossible to expose. The tension and suspense revolve around finding an explanation for the killer’s motive, whether any evidence will stand up in a court of law, how far anybody is prepared to go when it comes to risking their careers, and mainly, who will die next? A sense of urgency combined with thwarted progress and extreme risk makes for tremendous tumult in the mind of Hope, given that she is attempting to get the goods on the guy in her spare time while carrying out her expected duties on shift, including working side-by-side with the suspect. Her worst fear is that the killer will get away with his crimes. Killers often do. Especially when they know how to game the system better than the gatekeepers.  It’s quite the conundrum.

There is a resolution, albeit one unexpected by the reader or, at least, by this reader. Nicely done. Nothing predictable about it. All in all, an immensely satisfying book I enjoyed reading for many reasons, perhaps most of all because of the ambience of authenticity pervading the plot and characters. Any writer can do research, but a writer who has lived the background and understands it thoroughly contributes so much more to the telling of the tale.


For anyone interested in the behind-the-scenes reality of hospital life, this book is a treat to read. Even better, as a glance at the title demonstrates, this is the first of a seven-part series. There is much to look forward to.

Check it out at:  < Shapes of Wrath >



Source: Auto Draft

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