Being an avid reader who has worked in child protection, I approached this book with great interest. It concerns a suspected case of Munchausen by proxy, with the diagnosis made on a Jewish family by a black female doctor. The stress on race/ethnicity is pervasive throughout the book, sometimes seeming gratuitous. (When two characters are shown to their restaurant table, the waitress is described as "sway-bottomed Asian." When the doctor, Darlene Stokes, hurries to an elevator, it is "past a tragedy-struck white family who talked in sniveling whispers," and who are never mentioned before or after.)
Divergences from the main plot are quite long and detailed to the point of irrelevance, such as in the recounting of Darlene's college days. The author seems incapable of telescoping his vision of her background to keep the story moving for the reader. This occurs also with the early life of Darlene's mother, the work experiences of the child's father (Josh Goldin), and the background of the family's sleazy lawyer. Oddly, the background on the alleged child abuser (the child's mother, Dori Goldin) seems rather sketchy in terms of explaining her behavior.
Though obviously much work was done on this book, errors/implausibilities seem rather frequent. Darlene's mother indicates that she only had sex once with Darlene's father, in 1966. Yet later the author proclaims that Darlene was born on March 1, 1968 (?). Darlene receives a 6-year scholarship for med school yet, going by the dates, first becomes a resident 13 years later, with her husband loafing at home the whole time on an allowance from his father. Darlene's father, who has a long criminal record, is released from prison just in time to become a factor in her credibility, and also to inexplicably thwart a robbery. Late in the book, Josh just happens to run into Darlene at a store, conveniently providing a forum for their conflict.
Having worked in child protection, I was particularly thrown by what happened at the court hearing (which is not yet the book's climax). The state agency (CPS) all but disappears in favor of the hospital and its lawyer, such that the Goldins' lawyer, who plants news stories attacking Darlene, wins the day mostly by threatening the hospital's reputation. The hospital backs down, never calling Darlene to testify, and strong evidence found by CPS is somehow never presented. In reality, this would never happen. The state agency bears primary responsibility for getting the case to court, where government lawyers are its primary advocates, sometimes with an additional attorney for the child. The reporting doctor testifies or his/her findings presented, as is all relevant evidence from caseworkers, police, etc. The process cannot simply be steamrolled by an aggressive lawyer, no matter how many tabloid stories he plants.
Weaknesses in the main story may be what invited the lengthy divergences, with unnecessary scenes, characters, and details. A scene at the foster home, for example, primarily depicts the foster mother, but her husband or boyfriend emerges from the shower just in time for a description of his glistening body parts. We also receive a detailed description of an insipid art project he is leaving to display. Even in the aftermath of the hearing, on pages 382-3, new characters are being detailed who have no part in the rest of the book.
This novel deals with an interesting and complicated subject, and the writing is fairly good, but I found it generally disappointing for the reasons given above.
