April 20, 2019

Kanar’s `J Factor’ medical nightmare> Concocted world not one we want to see

THE J FACTOR, by Stephen Kanar, Bantam Books, 392 pages, paperback, $5.99.

In the not-too-distant future of “The J Factor,” a nightmare has finally become reality. A mega-HMO known as UNIMED has combined with IORC, a corporation specializing in donor organs for transplants, and they pretty much control the medical world.

In fact, IORC negotiates international treaties as if it were a sovereign nation, and dictates who has transplants, who provides them, and when and how they happen. The treaties specify that IORC can’t be sued — for any reason.

It’s not a world you’d want to live in.

The main characters, a promising young surgeon and a promising young lawyer, run afoul of IORC. When the doctor performs his first heart transplant as a result of an emergency, the only available organ is one previously used by IORC, a troublesome fact he learns too late.

It turns out the transplant is illegal because no UNIMED administrator reviewed the patient’s “justification factor” — or J factor, a complex of circumstances determining a person’s eligibility for organ transplants. The fact that the patient would have died without the transplant is immaterial, as the idealistic Dr. West discovers.

Meanwhile, a drunken IORC doctor has mowed down a smaller car with his Porsche, killing the other driver. The doctor can’t be bothered with the pesky police details afterward, and threatens an officer with having his J factor reduced — not an uncommon practice in this HMO-run world.

IORC attorneys are called in and promptly humiliate the promising young lawyer, Janette Compton, who has been assigned to represent the victim’s family.

West and attorney Compton meet and hit it off. Then West’s heart patient suddenly dies, which is a mystery to the doctor but not to the reader. Sensing something is fishy, West enlists Compton’s help in unearthing IORC’s dark secrets.

The truth about IORC’s organ-donor system, one of the few surprises available in the novel, is unethical, not to say gruesome. In trying to expose it and win truth and justice for all, especially for the family of the dead heart patient, the young doctor-lawyer duo scramble for their lives.

“The J Factor” has all the elements of a made-for-TV movie. Shootouts of indeterminate cause, exploding airplanes, a powerboat chase, good guys and bad guys — loyal friends, conscienceless administrators, a busty female incarnation of Steven Seagal, and a character who after being deceived, assaulted and shot at, gravely says of his assailant, “I don’t trust her.” The story’s outcome is never in doubt, and its action surfs headlong on sentences whose main goal seems to be to get to the next one.

Author Stephen Kanar, himself a lawyer, lives in Maine and Florida. His knowledge of medicine, airplanes and courts enters the narrative in passages that are in some ways the most interesting in the story. The courtroom scenes toward the end are the most fully imagined, both in terms of imagery and of the themes of social justice and administrative corruption the novel tries to illustrate.

“The J Factor” has the atmosphere of a 1960s shopping mall that somehow became a book. Fast readers who need something to keep them occupied on the beach will find it useful to duck into and out of. But like its fictive HMO-ruled world, it’s not a place they’ll want to live in for long.

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