A Case of Need

by Michael Crichton, Jeffery Hudson

Written as Jeffery Hudson in 1968.
A Case of Need is Michael Crichton's award-winning debut novel, written shortly after he completed his medical internship. Set against the ever-building pressure and pace of a large Boston medical center, the tensions flare-and explode-when a surgical operation tragically ends in death, raising countless questions. Was it accidental malpractice? A violation of the Hippocratic oath? Or cold-blooded murder?

Genres: Fiction, Mystery, Thriller, Medical, Mystery Thriller, Suspense, Science Fiction

319 pages, Kindle Edition

First published January 1, 1968

About the author

Michael Crichton (1942-2008) was one of the most successful novelists of his generation, admired for his meticulous scientific research and fast-paced narrative. He graduated summa cum laude and earned his MD from Harvard Medical School in 1969. His first novel, Odds On (1966), was written under the pseudonym John Lange and was followed by seven more Lange novels. He also wrote as Michael Douglas and Jeffery Hudson. His novel A Case of Need won the Edgar Award in 1969. Popular throughout the world, he has sold more than 200 million books. His novels have been translated into thirty-eight languages, and thirteen have been made into films.

Michael Crichton died of lymphoma in 2008. He was 66 years old.

Reviews

[Dr. Appu Sasidharan (Dasfill) · Rating 2 out of 5]

The name Michael Crichton always brings mixed responses to my mind. He was a brilliant medical student who received his MD from Harvard Medical School. I loved a few of his novels like The Andromeda Strain, Jurassic Park and Congo, while I hated some of his books like the State of Fear. His opinion about global warming in that book was so acrimonious that he got severe backlash from people from all walks of life from almost all corners of the world. This medical thriller is one of his earliest novels that he wrote under the pseudonym Jeffrey Hudson (a dwarf who lived in the court of England in the 17th century).

What I learned from this book
1) Can we say that the past is the past?
The author tells us how most of us are linked to the past. I have a slightly different opinion here, though. I truly believe that the past is the past. We should never repent too much over lost things and opportunities. The only thing we should be careful about is that the ghosts of the past shouldn't haunt our present or future.

"We are all tied to the past, individually and collectively. The past shows through in the very structure of our bones, the distribution of our hair, and the coloring of our skin, as well as the way we walk, stand, eat, dress—and think."

2) Boston
The author says that Boston has the best prison cells in the USA. Boston is mentioned to have one of the worst traffic in America. Boston has the best hospitals in the USA. The author says that almost every parent in Boston at that time wished their children to study either Medicine or Law.

"Actually, Boston has some of the nicest cells in America. They have to: lots of famous people have spent time in those cells. Mayors, public officials, people like that. You can't expect a man to run a decent campaign for reelection if he's in a lousy cell, can you?"

3) Rebellious children and their parents
The relation between rebellious children and their parents is one important topic discussed in this book

"A rebellious child chooses the weak point of its parent with unfailing uncanny accuracy and precedes to exploit it. When the punishment comes, it must be in terms of the same weak point. It must all fit together. If someone asks you a question in French, you must answer in french. ”

My favourite three lines from this book

“Once you gulp carbon down, either as cigarette smoke or city dirt, your body never gets rid of it. It just stays in your lungs.”

"Morality must keep up with technology because if a person is faced with the choice of being moral and dead or immoral and alive, they'll choose life every time."

“Most doctors when they receive a call from other doctors follow a ritual pattern. first, they ask how you are, then how your work is, then how your family is."

What could have been better?
This book was published in 1968. But it is still difficult to agree with many problems in this book even after considering the time-period. The way the novel started by calling all the heart surgeons bast**** was ludicrous. The manner in which the author mentions the differences between the clinicians and the researchers makes it more problematic. To make matters worse, one character was calling women as creatures and patients as dirty unscientific things.

I am a person who believes that Nurses deserve equal recognition like doctors in our hospitals. The ascendancy shown by doctors in this book is preposterous. The Nurses are treated like sex toys by the doctors. It seems like infidelity is the standard norm in the doctor's family life. Racism is also seen in a high amount in this book. We can see the N-word told by a couple of characters in this book. African Americans are referred to as black meat. Asian doctors are referred to as gadget-oriented orientals. The fact that it is written by a doctor makes the situation even worse. There are indeed doctors with lousy personality traits, just like people in every profession. But that doesn't give the author the liberty to extrapolate that behavior to every doctor and generalize that behavior. Mr.Crichton knew the ramifications of the absurd stuff he was writing, which might be one of the reasons why he was forced to write this novel under a pseudonym

The writing style and plot of this book are actually good. But all the problems mentioned above robbed away the entertainment factor altogether from it and made it a painful read. We can argue that this is a work of fiction and the author had the freedom to write whatever he wanted. But I still felt it was too much for an ordinary reader like me to digest.

Rating
2/5 The plot and the authors writing skills will give you an interesting read. But everything else about this book was a big let down.

[Claudia · Rating 4 out of 5]

Crichton's first published book. PUblished when he was 26. Oh, the envy. You can really see his medical training here, as well as the unavoidable road to his eventual creation of ER.
I'm a sucker for a book that I'll learn something from and this one has footnotes and appendices for further medical background and explanations. There is a good look into the behind the scenes of a hospital.

The plot revolves around the issue of abortion in the late sixties. I'm guesstimating at the year because it is actually never mentioned, but you can surmise it from the description of settings and details thrown in. In a time when abortion is illegal, a doctor is arrested for the death resulting from an abortion that is being pinned on him. His good friend and doctor, who also happened to study a bit of law before jumping to medicine, decides to investigate, and takes us on a ride through medical clues, family secrets, racial prejudices, and professional protocols.

I just can't believe it's the first thing he ever wrote.

[Nikki · Rating 4 out of 5]

1968. I was in college near Boston. One of my housemates, a girl I didn't know well, was pregnant. Her roommate learned that the ex-boyfriend and father, a pre-med student, was planning to perform an amateur abortion. This was 5 years before Roe v. Wade. My housemates, all urban people, were galvanized into action, calling friends and even their mothers to locate a safe abortionist. I really had nothing to contribute except hand-wringing. The girl eventually decided to have the baby, and I think it was given up for adoption as I seem to recall she was back in school during my senior year.
The following year, in summer, I found a room in an off-campus house. One of my flatmates had taken some time off from school the previous year. It turned out she had had a legal abortion at one of the best hospitals in Boston. You could get one if a panel of three doctors agreed that it was necessary for your health, and mental health counted. Unfortunately something had gone wrong, and she would now be unable to bear children. Since the abortion took place in a hospital, she didn't die.

For these reasons and a few other stories from women I've known, I was interested immediately in A CASE OF NEED when, looking it up in the library catalog, I saw the tracing "Abortion - Fiction." (I was going to read it anyway as part of my Edgar-winners project.) I brought the book home and started reading it right away. I'm going to give it a rating four stars, because the story certainly pulled me along. But for my tired old eyes, I would have finished it in one sitting.

Why not five stars -- which was evidently the consensus of the Edgar committee? One reason is that there were some definite plot holes. I can't really describe them for fear of spoilers, but since the story centers around doctors and others performing illegal abortions, I will point out that the three-doctor panel option existed at the time of the book, and is not mentioned. There are several more, which I'm sure any of you who read the book will spot.

Another reason is Hudson/Crichton's annoying practice of using medical jargon and abbreviations and then FOOTNOTING them! Yes, footnotes in a mystery thriller! I realize that this book preceded /Chicago Hope/ and /ER/, which made us all so conversant with hospital talk, but after all, it did follow /Dr. Kildare /and /Ben Casey/! I haven't read any of Crichton's other books, so I trust this was just a matter of youthful inexperience. I've read many books set in milieus unfamiliar to me, and nearly all the authors have been able to explain unfamiliar terms without resorting to footnotes. Talk about taking the reader out of the story!

The third reason I have for withholding the fifth star is the evident misogyny of the narrator/protagonist and, I fear, of the author himself. Maybe it's just me, but the way the protagonist interacts with his wife, the nurses, and the other women who come into the story suggested to me that he really didn't believe women were people. Perhaps I'm being unduly harsh and perhaps my view is skewed by having read that Crichton has been married 5 times. I will accept correction if someone believes differently. The character of the narrator is problematic in some other ways as well, again, I can't really explain that without spoilers.

To be fair, I'm still impressed that Crichton wrote a book this good while studying at Harvard Medical School. In spite of some very dated attitudes, it's still worth reading.

[Miloš · Rating 4 out of 5]

I really liked it. Fast paced, interesting and with unexpected turn at the end. Little unrealistic that one doctor can go around and does what John Berry did, and that's the only reason for my 4 stars review.

[Deacon Tom F. (Recovering from a big heart attack) · Rating 4 out of 5]

Good Story

I enjoyed this book however it was not one of my favorite novels by Michael Crichton. It seems to run on a bit in the beginning without really knowing where it was going.

However, the last quarter of the book was fast paced and exciting.

Recommend

[Bridgett · Rating 3 out of 5]

This book was originally published in 1968.

As a long-time member of the medical profession, I found the medical information fascinating. So much change in just a few short decades. I didn't need the footnotes, but to me, they came across as less informative and more arrogant. Instead of the footnotes, why not just use the appropriate words within the story? We get it, you were a doctor...you know the lingo.

The publishing date of this novel is also a bit confusing to me, as this was the era of women's liberation. You'd never know it based on these writings...the male characters are so sexist, it's dismaying. Even the main protagonist, Dr. John Berry, spent more than a little time looking at women's bottoms, and discussing how most physical issues suffered by women are either related to menstruation or a psychological issue. That was NOT fun to read.

There is a great deal of fascinating information about abortions, and what it was like for women (and the doctors who performed them), prior to their legalization in 1973.

Overall, I found this book to be pretty dry, lacking in drama, and with a cast of so many characters, it's hard to keep them all straight.

**2.5 stars**

[Ahtims · Rating 4 out of 5]

After a long time read a medical thriller.....
And enjoyed it....

This is the story of a pathologist who fights for.his ObGyn friend who is prosecuted for the alleged abortion leading to uterine trauma, exsanguination and finally, death due to penicillin anaphylaxis shock of a young , rich, well connected female who is surrounded by prominent doctor relatives.
The pathologist is an upright doctor who fights for justice to his friend, Lee, who denies having performed that particular abortion.
Slowly, the complicated threads of the case untangle. .. and finally the culprit is identified.
There were a couple of minor inaccuracies...
And something that was left unexplained in the book.

These two facts, coupled with the fact that the ending was sort of an anticlimax, made me deduct a star from the initial five star book.

why I chose this?
Started this for a weekend challenge on medical theme, along with 'the good doctor" to complete the requisite 300 pages that I'd pledged myself to read.

[Erth · Rating 5 out of 5]

Michael Crichton has the rare ability to produce stimulating fast-paced fiction mixed with intelligent technical description. The book is a whodunit centered around an abortion that may or may not have been preformed. A good fast paced read.

[Angie · Rating 2 out of 5]

Got this free on kindle and can see why. Michael Chriton's first novel is a dated medical thriller dealing with the death of a young girl by an illegal abortion (the book was written in 1969). Thoroughly unlikable narrator, way too many characters and medical jargon, and a convoluted and confusing plot. Obviously his writing improved with age as demonstrated in his later novels like Disclosure and Rising Sun.

[Ilana · Rating 4 out of 5]

Overall a very enjoyable read. For me it was a fantastic insight into the behaviours and attitudes of the time. The beginnings of black people emerging into a predominately white society, the role of women, views on coloured immigrants, the climate of the time, the attitudes towards abortion. A fantastic picture of the time was painted.

I was happy to note that even the protagonist was imperfect in his ways and it came through naturally, not as if it had been added for flavour. All characters were really brought to life, through their descriptions.

The beginning was a little difficult to get into with regards to the many footnotes (some I felt were helpful, but some broke my concentration as they provided added information that could have been explained in the story itself or done away with. However, the story really took off as any good mystery should.

I appreciate Michael Crichton's ability to portray characters for all they are, just as they are (comes through in Jurassic Park and The Lost World too) - very observant of the human condition and that resonates with me personally. One of the reasons I've enjoyed this and the other books of his I've read.

[Kevin McGinn · Rating 5 out of 5]

I really enjoyed this book!!!

[Cynthia · Rating 4 out of 5]

This was an easy read by an author who writes so logically that one can clearly follow the lead character as he investigates a crime allegedly committed by a professional colleague. This fictional story is also important on another front: there is data about the days before abortion was legal. The story gives the reader a birds’ eye view into the outcomes for women who have no other choice than to seek out a back alley abortionist. Not real pretty! Fortunately for Dr. Lee, he had a loyal friend on his side.

[Franco · Rating 4 out of 5]

This book would be classified under, “Medical Fiction” because it deals with medical surgeons, and doctors trying to unravel the mystery of the murder or suicide of Karen Randall. Dr. Lee a young pathologist is accused of an illegal abortion. Art Lee’s lawyer didn’t want to deal with the case so he abandoned him with no help. When John Berry heard about this crisis he came to help his friend and try to find the real story of the death of Karen Randall. As he finds later in the novel, the history of Karen he starts to get more into what he is against, because he found out that Karen disliked her stepmother and father, and that shows a small sign of murder from either one. Then as he goes to the University of Boston College, he meets doctor Werner who holds all of Karen’s medical files and this man is Karen’s uncle. Peter Randall (Karen’s dad) brings him for a “cup of tea” and says that he would not do this to his own girl and that he was with his wife that very same day the death occurred. John asks Peter were he could find her lost boyfriend and when he found him there is a gang war and he gets severely injured and in that very hospital room is Karen’s roommate with what they think a suicide attempt, he later goes to the crime scene, and there is a missing theme to Karen’s death.
I thought the writing of this book was very precise and wordy. He made the reader always on your toes and waiting for the suspense. I thought the strengths were that it was well written and well thought out however there was a weakness. This book was to long was 416 pages, and I thought that was to long for a plot like this and he extended it way to long. I choose this book because I am a huge fan of Michael Crichton’s novels and I wanted to explore something other than genetics.
I would compare this book to the Five Patients another one of Michael Crichton’s best sellers because of the medical theme. I connected to this book around the middle because, the Randall family was getting very suspicious and I thought it was the step mother that killed Karen. I would recommend this book to people that are interested in medical mysteries.
Words: 300

[Windie · Rating 4 out of 5]

This book started really well. There was a dead patient, a daughter of a famous doctor and a friend of the protagonist was accused doing the abortion that led to the death of the patient.
It was intriguing (though I am not sure that a layman could enjoy reading it uninterrupted without consulting google or dictionary) and the plot was built really well.
Half through the book, I have to admit that I couldn't put it down until I finished
My problem with this book is there was some unsolved mysteries (or maybe it is just me) at the end and there were so many characters that I constantly have to read it back and forth to figure out who is this person he's calling.
Overall, a solid book but not my favorite Michael Crichton's fiction (that award goes to either Sphere, State of Fear, or the Great Train Robbery).

[Jose Seco Sanz · Rating 5 out of 5]

Great book. I'm always amazed (and envious) when I see how young some of my favorite authors were when they wrote some books I have loved. I think Michael was 26 when he wrote this. It doesn't fit into my head that I could write like this when I was 26. I don't think I could write like this now.
Anyway, a good thriller, good pace, intriguing case, good research and explanations. To me, it feels like a bit of a trick, because I think the reader could never guess for sure who was the culprit.
Well, it's a pleasure to read Michael Crichton.

[Mary Ann · Rating 4 out of 5]

I've always liked Michael Crichton's novels, and I had missed this one. It was perhaps more interesting to me now than it would have been in 1968 when it was published in the pre-Roe v. Wade days of illegal abortion. It feels a little dated in spots; for example, the respectful word for African-Americans was still Negro. Otherwise, it's a good, fast-paced mystery with characteristic Crichton-esque twists and turns.

[Karl]

This Edgar Award winner that was filmed as the "The Carey Treatment" and starred James Coburn.

[Victor Sonkin · Rating 4 out of 5]

Reread: the first novel by Michael Crichton, who is best known for Jurassic Park the movie (which was way, way inferior to JP the book) and ER, the ur-mother of today's TV show boom. A young girl dies in EW (=ER) from loss of blood, seemingly from a botched abortion (the setting seems to be mid-1960s Boston, and abortion is illegal — this is a world before Roe v. Wade (1973), and, certainly, a book that was one of the paving blocks toward it. The victim allegedly named Dr. Art Lee, who is American Chinese, as the abortionist. The situation is complicated by the fact that the girl, Karen Randall, comes from a prominent medical family: her father, her uncle, her brother are all reputable doctors. Dr. Lee is arrested and held in a police cell. The details of the case do not sit well with the narrator, Dr. John Berry, a friend of Lee's and a pathologist. The most delightful feature of this medical thriller is the constant underflow of medical information (the novel was actually one of the reasons for Crichton to ditch the medical profession and go into writing full time). It's not a great detective story — it is extremely hard to write one, harder than a thriller; but it's a decent thriller. It is also very instructive as regards the speed of change: apart from the abortion issue at the core of the story, black characters are exotic (and their exoticism is commented upon) and called Negroes. Same about Chinese, actually (and shortly before that, the Irish were in the same position).

[Gail · Rating 5 out of 5]

Exciting

A doctor is anxious to prove his colleague is innocent of killing a young girl in a botched abortion. As he tries to find who did the abortion many other medical professionals are implicated in this fantastic book with an unsuspected outcome. I recommend this book as a fascinating great read.

[Jenny · Rating 3 out of 5]

Meh- just an ok read. Interesting but not super thrilling.

[Augusta Whittemore · Rating 2 out of 5]

The story and the writing itself were phenomenal--however, it was published in 1968 and there's a lot of outdated statements that made the overall reading experience a bit uncomfortable ):

[Tucinkata · Rating 3 out of 5]

3.5

"Историческа истина е, че човек може да извърши нещо неправилно поради правилни причини. В този случай той губи. Или пък може да постъпи правилно поради неправилни причини. В този случай ще бъде герой."

[Barbara Radisavljevic · Rating 4 out of 5]

This is the first Michael Crichton book I've read, and I couldn't put it down. The pervading theme was the moral and ethical decisions doctors had to make concerning abortions -- performing them, knowingly not reporting (and, in fact, covering for)reputable doctors who performed them in hospital settings. This book was originally published under the name of Jeffery Hudson in 1968 when abortion was still illegal in the USA, and may have been intended to stir the public to legalize it. I personally am Pro-life.

I would not want to spoil the story for you if you haven't read it, but it revolves around a doctor who has performed abortions with the knowledge and even some behind the scenes help of other doctors on staff at his hospital. Dr. Lee is arrested when a patient is brought into the emergency room after a botched abortion and dies. Her step-mother tells the police that Dr. Lee did the abortion. His friend, Dr. John Berry in Pathology, determines to find the real abortionist when Lee says he did not do it. I will leave it there and let you follow along with Dr. Berry in his informal investigation.

[Deya Andreev · Rating 4 out of 5]

I still voice type my reviews so if this feels long it’s just me rambling into my phone at 9:14 PM.

The beginning of this book was way better than the second half which is weird because I feel like it’s usually the opposite. Because this was written in like the 70s every character just felt like a white man and it made it very confusing when they all had names like James and Lee and Arthur and Conaway.

this is not a bad book at all I feel like it’s not as controversial now as it may have been back in the day just because abortion is a lot more talked about but it was back then, but also I’m very pro-choice so I can see why this is a lot for someone who is pro life.

I think that this book did a good job making it not so political and more of like a mystery like a who done it?
I did feel like I was pushing through the second half and the ending did not shock me nor surprise me and it felt a little underwhelming for the tone of the rest of the book. if Goodreads gave half stars this would be 3 1/2 so I need that feature really soon.

[Jennifer · Rating 3 out of 5]

A Case of Need was Michael Crichton's first novel and it showed. The book was decent, but it lacked the polish of his later work. I was interested, but not engrossed and could have put it down and never missed finishing it. Forgettable.

[Darinda · Rating 2 out of 5]

This first novel by Michael Crichton failed to drawn me into the story. My least favorite of his books.

[Mary Canary · Rating 1 out of 5]

I'm spoiling this because it's garbage. Stop reading now if you want to read it.
Horrible. Okay, not terrible. It's Michael Crichton's first book, written circa 1967-69, prior to Roe v. Wade. It takes on illegal abortion.
Okay, I'm a biased reader. I'm ardently pro-life. But my dearly departed father-in-law practiced as an OB/GYN resident at Cook County, Chicago, pre Roe v. Wade. He made some of the same arguments these doctors make. And he lost young women to botched hangar abortions. So, I thought I would give it a try.
Holy misogyny. First of all, the docs performing the abortions talk about one patient with a first trimester rubella exposure to defend performing illegal abortions... And that's their case. Okay... That's one case that would certainly pull on one's convictions, right? Then every other abortion they talk about performing is on women who cheat on their husbands, take drugs, and OH THE HORROR, sleep with black men. THEN, the one doctor talks about how he isn't going to perform any more abortions on this one girl, because "she clearly wants to be a mother, she keeps getting pregnant". And he has no problem being the deciding factor if she deserves an abortion.
Uhhhhhhh. If there isn't anything wrong with abortion, why not let her have 50 of them? And if you perform them, why do you get to be the moral police?
Anyhoo, this gal dies in the first pages of the book from a botched abortion... Turns out she wasn't pregnant. Probably stopped menstruating and got FAT (5'4" AND SO PORKY AT 140 LBS) because of a pituitary tumor.
AND GUESS WHO KILLED HER? A nurse. They threw a nurse under the bus.
And the protagonist? You know why he HAD to get to the bottom of this? To get his friend out of jail. No one gave 2 $#!+$ about the dead girl. AND when he suspected another doctor, he didn't want to sully his good name. His friend? A known abortionist. He didn't care who really killed her. Just wanted his friend off. Oh. And he was complicit with the illegal abortions in their hospital. (deep sigh. Accompanied by eye roll)
Even if you are so absolutely pro-choice that you can hardly stand to read my stuff, you would hate this book. I kept reading out of twisted curiosity.
You're welcome. I took one for the team.

[John Mcconahey]

If you’re a doctor, you’ll probably love this book. After all, Crichton attended Harvard Medical School and is certainly knowledgeable of the medical practices and techniques in effect at the time of publication (1968). If you’re a determined layman, have a dictionary close at hand while you follow this plot. Just be aware, this isn’t a book for fast reading (if you really want to know what the terms that are used mean) and it's heavily footnoted and apendicized. But, don’t let that discourage you from enjoying this engrossing medical mystery.

The daughter of a prominent (and powerful) Boston physician dies from the after effects of a botched abortion and a pathologist’s closest friend, Dr. Art Lee, is arrested for murder. Thus begins the quest of who-REALLY-done-it, with Dr. John Berry seeming to be the only one willing to support his friend. It turns our there are a myriad of choices for suspects, many of whom are the dead girl's relatives. While there are no wild car chases or street shootouts, "A Case of Need" keeps you wondering about the conclusion. Give it a shot.

[Jay Pruitt · Rating 3 out of 5]

While entirely fictional, this short book by former medical-student-turned-novelist, Michael Crichton (under the pseudonym Jeffery Hudson), gives an interesting behind the scenes look at the medical profession. Not only do we catch a glimpse of the frantic and often heroic efforts of doctors and nurses to save lives, but we see that these "professionals" are humans with human frailties, drug addiction, adultery, egotism, etc. We also learn about the hidden business of abortion. Largely viewed from the "clinical" perspective of a pathologist (examining body tissue in hospital labs), we see the science of autopsies.

Although I enjoyed the eye opening discussion of the politics and processes of the hospital ecosystem, the book's storyline, written almost like a detective novel, was OK but nothing like many of Crichton's widely known masterpieces.

[Rebecca · Rating 3 out of 5]

A very fast paced medical thriller. Till the end I was sure of it being a 5 starrer or at least 4. The end well, besides being disappointing did not really sync with the rest of the story.

Dr Lee is accused of the death of a seventeen year old girl after an illegal abortion. She happens to be the daughter of a famous and arrogant cardiothoracic surgeon. So things are on the move and Dr John the narrator a friend of Dr Lee and a pathologist at the same hospital takes it up. There are many twists and turns enough to make the journey exciting... Very suited to the readathon theme Medical. Thanks Girish for the recommendation.