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2.98 AVERAGE
2.98 AVERAGE
dark
fast-paced
If I thought the previous books were bad, this made me re-consider. This is so appallingly bad that nothing will resuscitate it. It really doesn't help this novel's cause that it's set in clinical trials and having worked in clinical trials for over a decade, I do not have the words to describe just how ridiculous this novel is. You can take it for granted that there is the usual masochistic men who like beating the shit out of women for no real reason (a prostitute gets beaten near to death because she looks like our plucky research nurse) and said plucky nurse nearly getting herself killed at the hands of said men with over the top violence.
So let's get onto the meat of this review. The reasons this book went beyond being just bad and became a catastrophic chain of issues that is beyond any redemption. Let's move onto the plot. And most importantly, clinical trials. Bone Dry has our Gina and her boyfriend moved to a remote Nevada hospital, one which hosts patients taking part in a clinical trial. The trial is in a new 'miracle' dementia drug which technically works, however also has catastrophic side effects that the pharma company and the doctor in charge are determined to cover up because big bucks and all that jazz.
The problem with this is that it's all so ridiculously over the top that it's a) nonsensical, b) nobody is stupid enough to try it and c) WE HAVE REGULATIONS AND INSPECTIONS AND ALL THAT JAZZ. Oh, and d) post marketing surveillance exists (the author even bloody mentions it and conveniently ignores the implications) and believe you me, this shit would be picked up in a heartbeat and the company screwed seven ways sideways. You don't believe me? Let's go into details. We like details. Details are what makes the world go round.
The side effects for this drug that does indeed cure dementia are severe, horrifying, affect at least 10% of the patient population and are completely unmissable. This drug somehow accelerates just about every age related disease and co-morbidity you can think of - cardiovascular, respiratory, blindness, arthritis and those are just the patients we are introduced to. The symptoms progress rapidly and without any other logical cause despite having been otherwise controlled pre-trial. Patients with years to live are now in crippling pain or completely disabled and dependent on other life saving drugs and serious pain relief.
Yet despite patients seeing other health care professionals, nobody else seems to put two and two together or even report this as a possible issue - I work with sites; every one of my sites would be reporting this as a potential SUSAR and if I didn't escalate accordingly, the regulatory body would be on my ass. The company downplays the reactions in the patient notes and removes the individuals to this remote Nevada hospital/prison. So not only is there zero oversight of AE reporting, we're expected to swallow that the families just forget about their elderly relatives, not chasing the lack of contact. Lamb explains this by using the fact that the patients are burdens, but whilst that might work for one or two, it doesn't cover the systemic treatment here.
But that isn't the only reason why this is so bloody stupid. I mentioned post marketing surveillance earlier, otherwise known as Phase IV trials. This covers when a drug has been approved for medical use and begins being prescribed; there are processes in place to continue looking for side effect, particularly rare side effects that weren't caught in the smaller trial patient groups. So what do you think would happen when this drug hits the market and GP's everywhere notice that a significant proportion of their patients have rapidly escalating co-morbidities that were controlled before the new drug?
I can get behind the fact that drug companies are after the bottom line and to eke out whatever profit they can. I cannot get behind the fact that they'd be this damn stupid about it. This is something that would ruin them. The lawsuits, the loss of public trust, dear Lord it would be a financial, PR and legal nightmare straight from hell. There is no way they would try and hide the side effects, because the severity is too severe and the well would run dry in the three to five months it took the first patients to start showing symptoms. GP's would escalate, hospitals would escalate, the mess would explode and the entire damn company would go bump.
There are other issues; the consent forms apparently give consent for the hospital to cremate the bodies after death. This is nonsense. I've spent over a decade in clinical trials and I have never seen any consent form that gives rights after the patient has died, let alone body disposal. It's so irregular that the Regulatory Bodies would be asking what the bloody hell you're thinking and it's not as if you can say 'well, we want to kill them off and harvest their brains if they don't react well and need to be able to hide the evidence'.
Essentially, this has all the flaws of the previous novels but it's ten times worse because it's clearly written by somebody with no understanding of how clinical trials actually work. The author may have been a trauma nurse, but has no knowledge of the pharmacovigilence involved in any trial, how adverse events are documented and reported, and therefore of the fact that it isn't something you can just sweep under the carpet and hope for the best.
So let's get onto the meat of this review. The reasons this book went beyond being just bad and became a catastrophic chain of issues that is beyond any redemption. Let's move onto the plot. And most importantly, clinical trials. Bone Dry has our Gina and her boyfriend moved to a remote Nevada hospital, one which hosts patients taking part in a clinical trial. The trial is in a new 'miracle' dementia drug which technically works, however also has catastrophic side effects that the pharma company and the doctor in charge are determined to cover up because big bucks and all that jazz.
The problem with this is that it's all so ridiculously over the top that it's a) nonsensical, b) nobody is stupid enough to try it and c) WE HAVE REGULATIONS AND INSPECTIONS AND ALL THAT JAZZ. Oh, and d) post marketing surveillance exists (the author even bloody mentions it and conveniently ignores the implications) and believe you me, this shit would be picked up in a heartbeat and the company screwed seven ways sideways. You don't believe me? Let's go into details. We like details. Details are what makes the world go round.
The side effects for this drug that does indeed cure dementia are severe, horrifying, affect at least 10% of the patient population and are completely unmissable. This drug somehow accelerates just about every age related disease and co-morbidity you can think of - cardiovascular, respiratory, blindness, arthritis and those are just the patients we are introduced to. The symptoms progress rapidly and without any other logical cause despite having been otherwise controlled pre-trial. Patients with years to live are now in crippling pain or completely disabled and dependent on other life saving drugs and serious pain relief.
Yet despite patients seeing other health care professionals, nobody else seems to put two and two together or even report this as a possible issue - I work with sites; every one of my sites would be reporting this as a potential SUSAR and if I didn't escalate accordingly, the regulatory body would be on my ass. The company downplays the reactions in the patient notes and removes the individuals to this remote Nevada hospital/prison. So not only is there zero oversight of AE reporting, we're expected to swallow that the families just forget about their elderly relatives, not chasing the lack of contact. Lamb explains this by using the fact that the patients are burdens, but whilst that might work for one or two, it doesn't cover the systemic treatment here.
But that isn't the only reason why this is so bloody stupid. I mentioned post marketing surveillance earlier, otherwise known as Phase IV trials. This covers when a drug has been approved for medical use and begins being prescribed; there are processes in place to continue looking for side effect, particularly rare side effects that weren't caught in the smaller trial patient groups. So what do you think would happen when this drug hits the market and GP's everywhere notice that a significant proportion of their patients have rapidly escalating co-morbidities that were controlled before the new drug?
I can get behind the fact that drug companies are after the bottom line and to eke out whatever profit they can. I cannot get behind the fact that they'd be this damn stupid about it. This is something that would ruin them. The lawsuits, the loss of public trust, dear Lord it would be a financial, PR and legal nightmare straight from hell. There is no way they would try and hide the side effects, because the severity is too severe and the well would run dry in the three to five months it took the first patients to start showing symptoms. GP's would escalate, hospitals would escalate, the mess would explode and the entire damn company would go bump.
There are other issues; the consent forms apparently give consent for the hospital to cremate the bodies after death. This is nonsense. I've spent over a decade in clinical trials and I have never seen any consent form that gives rights after the patient has died, let alone body disposal. It's so irregular that the Regulatory Bodies would be asking what the bloody hell you're thinking and it's not as if you can say 'well, we want to kill them off and harvest their brains if they don't react well and need to be able to hide the evidence'.
Essentially, this has all the flaws of the previous novels but it's ten times worse because it's clearly written by somebody with no understanding of how clinical trials actually work. The author may have been a trauma nurse, but has no knowledge of the pharmacovigilence involved in any trial, how adverse events are documented and reported, and therefore of the fact that it isn't something you can just sweep under the carpet and hope for the best.
Content Warnings
Graphic: Chronic illness, Sexual violence, Violence, Medical trauma
While the idea behind this is good and rather interesting the execution (excuse the pun) is not so great. There were times where the writing was really good, flowing well and without unnecessary grammar. But then there was so much that had extra unnecessary words, exclamation marks and clunky links that the story kind of stuttered and jolted along, not to mention the fact that I couldn't quite accept that this had gone on so long with nobody else doing anything (especially in this day and age when whistle blowing is so much easier and accepted). I also found the main characters somewhat annoying, they were just too lucky, nosey and on the ball. I prefer my heroes with a bit more grit and edge to them. Not a bad read but not one I'll be repeating any time soon.
the characters were not very engageable, very strange story too.
Only managed half the book
The writing isn't great and I couldn't force myself to finish amidst character inconsistencies, unbelievable plot lines, and weird side stories which felt like they were added in an attempt to flesh out a struggling story.
The writing isn't great and I couldn't force myself to finish amidst character inconsistencies, unbelievable plot lines, and weird side stories which felt like they were added in an attempt to flesh out a struggling story.