Pietro Brnwa, nicknamed "The Bearclaw," has embraced change - a new name, a different occupation, and a regenerated outlook. Thanks to the Federal Witness Protection Program, Pietro, who was formerly employed as a hitman by a mafia-connected lawyer, is now Dr. Peter Brown, an intern in the Department of Internal Medicine at Manhattan Catholic Hospital. His career as an assassin was motivated by the desire to avenge the murder of the grandparents who raised him. As a physician, Dr. Brown is paying off a moral debt - doing good deeds to atone for previous acts of violence including killing people.

Unfortunately, life doesn't get any easier for the hit man-turned-physician. Trouble stalks him and finds him. Everyone he loves is lost. In addition to the death of his grandparents, Dr. Brown's girlfriend, Magdalene, is gunned down in a car. His former best friend, "Skinflick" is thrown out of a window of a six-story building, survives, and is later stabbed to death by Dr. Brown.

Life might have been easier if Dr. Brown had not been recognized by a mafia acquaintance named Nicholas LoBrutto who is a patient in Manhattan Catholic Hospital. LoBrutto has stomach cancer and threatens to squeal to Dr. Brown's former crime boss. If Dr. Brown cannot keep LoBrutto alive, the mafia will be notified where to find the physician and he will be eliminated. Dr. Brown assists during LoBrutto's surgery but the mobster experiences ventricular fibrillation postoperatively. Dr. Brown's two medical students mistakenly administer intravenous potassium and LoBrutto dies.

A group of thugs quickly infiltrate the hospital and it appears likely that Dr. Brown will be exterminated. He risks his life to prevent a young woman from having her leg amputated for an erroneous diagnosis. The thugs capture Dr. Brown and detain him in the blood bank freezer. He removes a piece of bone from his own lower leg (an autofibulectomy) to use as a weapon and proceeds to kill the entire gang of murderers. Dr. Brown is sure to be dismissed from Manhattan Catholic Hospital but realizes there is still much he hopes to accomplish as a physician. With some help from friends in the Witness Protection Program (and a likely sequel to this novel on the horizon), it's a good bet that Dr. Brown is not likely to retire his stethoscope (or firearms) anytime soon.


The novel offers up two careers that are complete opposites: hit man and doctor. One occupation is intent on destroying life. The other is dedicated to safeguarding health and preserving life. Yet there are similarities between the two professions. Both types of work demand composure and foresight. An understanding of human anatomy is a big advantage too. Physicians and assassins are acutely aware "how little it takes to kill someone." [p6]

Befitting his status as a medical resident, the author delivers a superb portrayal of life as a harried intern. Some of the humor and wisdom in this clever novel is provided in the form of footnotes such as, "Calling a code is what you do when you want to pretend you don't know someone's already dead." [p16] The narrator can be dead serious too especially when discussing why it is so hard to be a doctor: "The endless suffering and deaths of patients whose lives I was supposed to fix but couldn't, either because no one could or because I just wasn't good enough." [p274] Paradoxically, he hates being a doctor and he loves what he does.

Make no mistake - this novel is brutal and vulgar. It is also tough and hilarious. The manner in which the author handles concepts such as fate, survival, danger, decision making, mistakes, and love is exemplary. Dr. Peter Brown is a fascinating character, and the novel is destined to be a hit, especially with physicians-in-training.

Primary Source

Beat the Reaper


Little, Brown

Place Published

New York



Page Count