The prolog reads like it belongs to a different book as it takes place in space in the future and the rest of the novel takes place in a satirical version of a hospital in present-day China.

There are a couple hilarious moments. Our narrator Yang Wei gets sick from drinking water. He’s taken to the hospital by hotel staff. One of them takes out his wallet and bribes the doctor on his behalf. They even offer to take his blood tests for him!

It’s reminiscent of Kafka’s The Trial, but instead of a surreal vision of a corrupt legal system, it’s a surreal vision of a corrupt hospital. He criticizes hospitals for having long lines. Some patients wait so long cobwebs form on them. There aren’t enough beds for all the patients, so they have to take turns using them.

In this hospital, they perform interventions and surgeries without the patient’s consent. The hospital is not sanitary. It’s covered in filth. There’s even a phlegm waterfall.

The main criticism of the hospital is how greedy doctors are. Some doctors are said to stop mid-surgery to demand more money and leave the patient opened up if they don’t pay. Doctors are compared to gods and bribing them is like making an offering at a shrine. They convince perfectly healthy people that they’re sick, and in fact believe everyone is sick. The hospital bill includes a bathroom surcharge, a hospital construction fee, a fuel surcharge, an elevator fee, a fire safety fee, etc. If you can’t pay, you can take out a loan. The hospital’s interest rates are only slightly higher than the bank’s!

Some people stay in the hospital their entire lives, their genes being edited while they’re still in their mother’s womb. Gene therapy changes Yang’s genes so much, he’s no longer related to his family and as a result, can’t remember them.

I like when he points out that the tube that delivers food to our stomach and the tube the delivers oxygen to our lungs intersecting is a terrible design flaw.

Yang tries to escape, but discovers that he can’t escape because the whole world is a hospital. He starts having a conversation with a voice inside his head which might be his illness or his soul or something else. At one point, he wonders if the United States actually exists or not.

Sex is considered a form of therapy, but it isn’t pleasurable the way they do it. Yang fantasizes about his daughter which is pretty icky. He also has a relationship with an underage girl to give us more ick.

There isn’t a lot of plot or character development. The central mystery of the novel is Yang trying to find out if doctors die and how. Most of the book is just a description of the hospital. This is fun in small doses, but it got tedious for me and I almost didn’t finish it.