Perhaps the chief draw of any postapocalyptic spectacle is the vast opportunity for plunder; Chris Adrian's medical millenarianism, however, envisions a band of survivors rather indisposed to such distraction. The Children's Hospital imagines a genre-exploding eschaton where the chief residual vice is less indulgence than blinkered intensity: Its legatees are doctors, and come hell or high water—or, in this case, both—nothing will delay their rounds. Adrian's epic opens with a flood that drowns the planet under seven miles of water, and the only postdiluvial buoy is a floating pediatric hospital with its thousand-odd inhabitants.
The hospital's denizens are so preoccupied by the usual tasks before them—being sick, curing the sick (or attempting to), obsessing over the sick—that most of them hardly register the end of the world. When they fret, narcotic consolation is close by, though it's a matter of administering rather than digesting those drugs. "The kids are still sick, you know," reminds one nurse, echoing the book's chorus of health-care professionals. "Everything else may have changed, but that's still the same." Adrian, himself the recent graduate of a pediatric residency, has set his apocalypse in a hospital to allegorize an unreflective medical steadfastness. Hippocratic purposes seem so clear-cut, so self-justifying, it's easy for the author to press the physician into service as the standard-bearer of secular heroism. He casts his doctors as intellectuals who might witness Armageddon—and tend to its wounded—without bothering to wonder why it's happened.
The countervailing ministerial elements of The Children's Hospital come from a council of four angels: One records, one preserves, one accuses, and one destroys. The preserver inhabits the hospital as a literal deus ex machina, on board to comfort the anxious. She also engineers the book's sci-fi entertainments, including special "replicators" that fulfill most on-board wishes—for food, tools, and the like. The recording angel narrates the book; he slyly introduces himself as "neither a perfect angel nor a perfect witness," but nonetheless prepares "the book that would be scripture in the New World." The other two angels show up to complicate things.
The recording angel's stenographic energies are mostly devoted to tracing the steps of Jemma Claflin, a mediocre third-year medical student "training for a profession to which she felt no true calling, doing work she knew she could tolerate but never love." Her father, an imperious and distant surgeon to whom she felt she had much to prove, is dead, as is everyone else who was important to her: her adored older brother, Calvin, self-disemboweled at age seventeen, and her bitter and drunk depressive of a mother, self-immolated. Jemma's first love drunk-drove into a tree. (That lover's name, not incidentally, was Martin Marty, the first find in a silly book-long Easter egg hunt for Protestant theologians. Both Niebuhr brothers appear, and one supposes the name Calvin was not pulled from a hat. It's one of the very few places in this book that Adrian, who interrupted his medical career to enroll in divinity school, amuses only himself.)
The recorder tells four stories, which lend some structure to the book's mythic seaborne tarrying: the Book of Calvin, the Acts of Jemma, the Book of the King's Daughter, and a nameless metaseraphic commentary on the others, replete with angel bicker. The Book of Calvin thunders inscrutably in short gnomic passages; the voice of Jemma's dead brother offers a revelatory pastiche of mortifications and reckonings; and the Acts of Jemma presents vivid and remarkable set pieces, the book's loveliest chapters, from Jemma's unhappy childhood. In these scenes, beastly parents visit private ruin and shame upon their children. If the book offers a sincere hamartiology—the branch of theology devoted to taxonomies of sin—it is quietly intimate rather than blockily metaphysical: The gravest offenses are those that unhappy, narcissistic parents inflict on their children.
The Book of the King's Daughter tells the story of Jemma and the rest of the hospital's anxious guild: Rob, Jemma's blandly endearing boyfriend; the smarmy doctors Snood and Tiller, whose eviscerations of their residents provide some of the book's funnier moments; Vivian, Jemma's sexually voracious friend, who sets herself to cataloguing humanity's corruptions (from all-you-can-eat buffets to "the people who dress up dogs and children and take pictures for greeting cards"); and a fleet of sympathetic and lively sick children.
For the quick-paced first third of The Children's Hospital, hospital life proceeds in a shockingly normal vein: one emergency after another. Adrian contrasts lexicons of bodily and spiritual pathology to achieve an off-kilter motif: As the horrible fate of the world remains unfathomable, the medical banter grows desperately hermetic and precise. Jemma ends this charade of normalcy, however, when she gains magical powers and heals all seven hundred sick children in one awesome jag. From there, the hospital community is forced to look past triage toward creating the purposes of a new world; at least some of them will make it there.
The internal logic of The Children's Hospital is consistent and compelling enough to make the novel less outlandish than it must sound, but it's nevertheless the sort of book you want to reread slowly, then quickly, then slowly again, or maybe the opposite. Equal parts The Stand and Friedrich Schleiermacher, Adrian's saga makes good on its half-sincere promise of a new scripture: It seems likely to live on as a cult phenomenon, first among medical students and scattered theologians manqué, then among the breed of strange-epic hounds, and ultimately among their friends. This novel is a singular event: Massive, recondite, often electrifying, and just as often unwieldy, it will demand and inspire some gathering of attention.
Gideon Lewis-Kraus has written for the New York Times Book Review, the Oxford American, and The Believer.