A CASE OF NEED (1968) by Michael Crichton

Why doesn’t Michael Crichton (1942-2008) get more street cred as a crime writer? Is it because he was so commercially successful? Who needs respect when your books and movies make you a multimillionaire, right? But his absence from major genre histories – including those by Ashley, Murphy, Symons and DeAndrea – does seem odd when comparable big sellers like Jack Higgins and Forsyth for example are both present. Granted, many of Crichton’s books, like The Andromeda Strain and Jurassic Park, are SF but he wrote over a dozen mysteries and thrillers too – so what gives? To find out I’m looking at his early novels (now being reprinted as e-books) to see how they stand up – starting with A Case of Need, which won the Edgar in 1969.

I offer the following review as part of the 2013 Book to Movie Challenge at the Doing Dewey blog – for links to other participants’ reviews, click here; I also submit it as part of Patti Abbott’s Friday’s Forgotten Books meme over at her fab Pattinase blog.

“All surgeons are bastards …”

This was one of 10 books that Crichton published under various pseudonyms while still a medical student, so it’s not surprising that it has a hospital background. Crichton wrote in his spare time to help pay a few bills and also to ease his literary frustrations, cranking out paperback originals as by ‘John Lange’. A Case of Need though immediately stood out from his four previous potboilers and was the book that effectively marked his emergence as a popular author. After it won the Edgar for best novel in 1969 the movie

rights were soon snapped up (I’ll be reviewing the film version, The Carey Treatment, soon) and the author very quickly would become something of a pop culture phenomenon with the success of The Andromeda Strain. This medical thriller was not originally published under the ‘Lange’ pseudonym though but as by ‘Jeffrey Hudson’, the name of the celebrated ‘dwarf jester’ at the court of King Charles I who was alleged to be barely 19 inches tall. This seemed a good disguise to Crichton, who was an imposing 6 feet 9 inches tall and was looking to keep his writing activities a secret from his conservative tutors (‘Lange’ of course means ‘tall’ in German).

“Morality must keep up with technology …”

A Case of Need sets out to impress with its confidence – Crichton was barely 25 when he wrote it but there is a lot of showing off in this highly entertaining novel. It is set during a hectic Monday to Friday in October (Crichton liked to emphasise specific time frames for his stories) and the story is narrated in the first person with a precision and exactitude bordering on the pedantic. There is a morass of detail on display everywhere, with medical terminology constantly being explained via asides, footnotes and editorial intervention (my favourite has a note from the editor explaining how a paragraph with the three easy steps on how to manufacture LSD in our own home has been omitted from the original MS). On top of this are such

abstruse notions as the type of cars and number plates being used by the plainclothes cops in the Boston narcotics squad for instance – daft but fascinating. For all its exaggerated emphasis on facts and figures, the book boasts a strong plot, a bold theme and an unusual environment that does in fact reasonably allow its callow author plenty of scope to share his knowledge – indeed, there are dozens of footnotes for example and after the book is over Crichton provides several appendices to sound off on all sorts of topics. Set in the ‘Lincoln Hospital’ in Boston, this book tackled the hot topic of abortion in the years before the Roe v. Wade decision. Art Lee has been arrested for causing the death of a young girl who apparently wanted an abortion.

“You’re forgetting the way it works. J.D. is a big man. J.D. lost a daughter. There happens to be a convenient Chinaman in the neighborhood, who is known to do the nasty deed. A perfect situation”

His friend, pathologist John Berry, sets out to prove his innocence. This is for three reasons – firstly, because he is sure he is innocent since Lee is too good a surgeon to have botched the job so badly; secondly, because the girl was the daughter of a prominent medical family and he feels that Lee has simply been picked as the fall guy due to an old grudge; and three, because Lee actually does perform abortions but with Berry’s help so if the doctor is indicted, then most likely so will he. As Berry looks into the girl’s background he discovers that she hated her family, had been experimenting with drugs and, most peculiar of all, that the medical evidence suggests that she was not pregnant at the time of her death. So what caused all the blood loss? And why had she put on weight and had unexpected body hair growth too?

“… he said something very interesting: that one reason abortion remained illegal was because it was so safe”

The book does suffer from a surfeit of characters, even to the extent that when a villain is revealed in the final pages I had trouble remembering quite who he was. On the other hand what we get is a lively and very credible-seeming depiction of the medical community in Boston circa 1968 with all kinds of arcane medical information thrown in for free as we follow Berry’s investigation to its reasonably satisfying conclusion. There is some humour too (unusual in Crichton to be honest) while he ably resists the temptation to tie up all the loose ends at the end, respecting the seriousness of his theme even though the resolution ultimately proves to be linked to a secondary plot about drug smuggling. A really solid mystery that, 45 years later, is still current in its subject matter – no mean feat.
The Michael Crichton mysteries & thrillers:

• 1966 – Odds On as by ‘John Lange’
• 1967 – Scratch One as by ‘John Lange’
• 1968 – Easy Go [aka The Last Tomb) as by ‘John Lange’
• 1968 – A Case of Need as by ‘Jeffrey Hudson’
• 1969 – Zero Cool as by ‘John Lange’
• 1969 – The Venom Business as by ‘John Lange’
• 1970 – Dealing (co-written with Douglas Crichton) as by ‘Michael Douglas’
• 1970 – Drug of Choice [aka Overkill] as by ‘John Lange’
• 1970 – Grave Descend as by ‘John Lange’
• 1972 – Binary as by ‘John Lange’
• 1975 – The Great Train Robbery
• 1992 – Rising Sun
• 1994 – Disclosure
• 1996 – Airframe
• 2004 – State of Fear

A Case of Need was filmed by Blake Edwards as The Carey Treatment in 1972 starring James Coburn – a review of this fairly loose adaptation will follow shortly.

Open Road Media are republishing all ten of Crichton’s early potboilers from what they term his ‘Med School Years’ as e-books at the end of July. For further information, visit their homepage at: www.openroadmedia.com/michael-crichton

For those interested in find out more about Crichton’s life and work, they should visit his official homepage: www.michaelcrichton.net

***** (3 fedora tips out of 5)