Time of the Fourth Horseman

2.5 stars, Metaphorosis reviews

Summary
A hard working hospital doctor finds patients turning up with inexplicable illnesses, including, possibly, diseases long since eradicated.

Review
I remember Chelsea Quinn Yarbro as a name from the 70s and 80s, usually attached to fantasy novels that didn't every quite attract my interest. When I saw this book (probably for free) from Open Road, I thought I'd finally give her a try.

Unfortunately, this book is not the one to convert me. It's science fiction, so perhaps outside what I thought of as Yarbro's norm, but that's fine with me. And the writing is pretty good. However, many of the plot points just didn't seem credible, and I found my frustration mounting as the book went on and the issues were never addressed.

The base concept seemed workable – evil government decides to address resource limitation by killing people off, good doctor fights it off. However, a lot of the waypoints just seemed pulled out of thin air. The villains have the hero fired and threaten to blackball her, clearly with government support. She's under house arrest. Yet, from early on, part of her solution is just to squat in landmark tourist attraction and provide medical services there. She and her cohort never seem to give much thought to a) maybe they can't just take over a house by saying so, and b) since the government has arrested them all (and they goes through some contortions to escape), maybe that some government won't be happy about them openly providing services in said house. There's a little bit of handwaving, but mostly it works out. They even talk about trying to get the hospital that fired them to take cases from them. It just didn't make any sense to me, and did not seem in any way credible.

I'm not a doctor, and I get the impression Yarbro isn't either. There's a lot of doctors ‘doing' things that are never specified. Mostly, though, I got the impression that this whole group of rebel doctors has gone to extraordinary lengths to ... provide palliative or hospice care. That is, diseases are rampant, and they have no way to treat them, so all their patients are just going to die. I don't want to knock the value of palliative care, which clearly has an important role to play, but this doesn't seem like the kind of solution to the crisis that the narrative prompts us to expect.

There are a host of other issues, including the role of the government, youth gangs, chiropractors (who come out well), middle aged doctors who nonetheless have experience with polio cases, etc. On the whole, though, I found the set up substantially lacking in credibility, and the problem worsening as I went along. The ending, meanwhile, felt like a rapid wrapup deserving quite a bit more development. For one thing, the doctors, having committed themselves and risked their lives to provide palliative care, very suddenly realize there's no point, and just give up. It undercuts the already shaky premise the story was building on.

On the whole, then, I can't recommend this due to poor credibility. And it hasn't made me keen to try other Yarbro books.