To protest the inequalities of the US healthcare system, every nurse in the US is going on strike for twenty-four hours. Robbi Hartford, representative of the ADWON movement, is presenting her case to a hostile Senate. Except she’s not Robbi Hartford RN, or even Robbi Hartford, and as events move towards a set strike date, things become even more involved. And dangerous.

The first few pages explain the situation clearly enough, bait the hook, and hook the reader. I salute the author for facing straight up to the fact this strike means people will die e.g. those requiring round the clock care, and for the nurses’ pushback: if the nurses have a moral duty to provide care, then politicians have a moral duty to ensure people can access it.

From that opening it jumps back seven months, and then alternates between Robbi and Lola’s stories as it approaches the present day. I will be honest, I found the nursing side of it more gripping than the intrigue, as it nicely sets up what drives them to the ADWON project, e.g. watching people with cancer be turned away because they can’t cover a co-pay and metrics taking priority over patient care. By about halfway through I was hooked. I’d lost track of who was impersonating who by this point, and the mix of body and online doubles, but I just wanted to see how this would play out.

The politics are right upfront, and may offend some as it tackles the US healthcare system, not an uncontroversial topic. While the UK system is brought up, it isn’t shown as the answer to everything (it’s not: see issues like the post code lottery) which is actually a nice touch. The other ethical problem some readers may have is the initially involuntary identity theft the story revolves around.

It flows nicely, and is well presented and nicely laid out. I can’t fault the formatting – if there were problems I was too engrossed to notice which is a good sign. The characters come across distinctly, even in the supporting cast, and there were some genuinely touching and upsetting moments. “The David Pledge” deserves its own mention, but no spoilers here – read the book to find out. I was slightly disappointed by the ending, but on consideration there was really no other way it could end.

Overall it is a gripping read, sometimes genuinely emotional, and a good blend of healthcare and realism and the political intrigue of the US government. It is innovative enough to be unpredictable, and might be good for anyone from political thriller readers to medical drama fans.