So Professional

Which is more binding: the Hippocratic Oath or the Pledge of Allegiance?

Let me tell you about Marshall Goldberg's The Karamanov Equations. Surprisingly deep, the central conflict in the story is protaganist-surgeon Nick Sten's struggle between the Hippocratic Oath and the Pledge of Allegiance, even though you probably already know how that will turn out. The story takes place in the early 1970s, switching between Moscow (presumably), Wisconsin, and Paris. The Russians are about six months away from developing an impenetrable shield against any kind of guided missile (rendering all arms reduction negotiations pointless), but they've put all their eggs in one basket: Nikolai Pavlevitch Karamanov. The Central Committee freaks out when they learn that Karamanov has a clot in his carotid arteries--yes, both. To make matters worse, the clot is located just high enough on the neck that conventional clot removal would only kill him.

Enter Nick Sten. Dr. Sten has developed gas endarterectomy, which basically functions like a power wash. It can reach clots in arteries that no other method can, but the record is something like 8 survivors of 20 procedures. The Russians, desperate for their defense system, give Dr. Sten a call and ask him, through a ruse, to save Karamanov. The CIA catches wind of it and reminds him of his patriotic duty: to kill Karamanov on the operating table. Adding to the emotional mix is the fact that Sten's wife thinks he's leaving her for an old Parisian love from the Korean War.

As a political science major, I am always wary when novels enter the fray of politics, but this story was plausible. Goldberg reinforces the humanity of all sides (except, hehe, the French) and didn't get too carried away with the not-too-subtle message that doctors are more humane than Cold War government agents. The relationships between the various actors worked out decently and relatively unpredictably. The book closed well, with most of the important strings tied up.

In sum--I recommend it as reading to give you pause.