I think I'd give this one a B-/3.5 stars(I REALLY wish half-stars were an option!) For those not familiar with the book, it's a thriller of sorts with a hero who was once a mob hitman and who is now an intern at a truly terrible hospital in New York. His past and present lives collide when he discovers one of his old mob acquaintances is a patient at the hospital, and the story centers on his struggle to save himself.The story is told from Peter Brown/Pietro Brnwa's point of view, and he has a very definite voice. He is sometimes crass and full of sarcastic humor, but there is something distinctly likable about him even as we learn he's done some awful things. I started off thinking I would really enjoy this book and it wasn't until I got to the middle that I really started to see the weaknesses.On the one hand, the author's twisted sense of humor appealed to me, and the portions of the book that were set in the present flowed well. It's a fast-paced story and even if it's somewhat improbable, one gets the feeling early on that it's supposed to be improbable. I wouldn't head into a book like this expecting realistic action any more than I would head into a James Bond flick expecting complete accuracy and realism. However, the book is structured so that the reader goes back and forth between Peter's present and his past as Pietro. And really, Pietro just didn't interest me as much. As a reader, I needed to know something of the narrator's past and what brought him to his current situation, but the world created in the flashbacks just wasn't as appealing as the present one and I found myself wishing I didn't have to spend so much time there. In addition, many of the flashbacks were timed so that they interrupted the present-day action just as it hit a point that had me on the edge of my seat wondering what would happen next.Lastly, I have no idea how accurate some of the medical info is in this book but since the author is a doctor, I'm going to guess there must be at least a little truth here. I do have to say that with the mentions of dirty equipment, staff negligence, and insurance games, I will never look at a hospital the same way again after reading this book!