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The explosive and controversial debut novel by a major new voice in fiction Meet Tristan Hart, a brilliant young man of means. The year is 1751, and at the age of twenty he leaves home to study medicine at the great hospital of St. Thomas in London. It will be a momentous year for the intellectually ambitious Mr. Hart, who, in addition to being a student of Locke and Descartes and a promising young physician, is also, alas, psychotic. He is obsessed with the nature of pain and medically preventing it, but—equally strong and much harder to control—is his obsession with causing it. Desperate to understand his deviant desires before they are his undoing, he uses the new tools of the age—reason and science and skepticism—to plumb the depths of his own dark mind.



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