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The Hospital at the End of the World
Not yet published
Expected 3 Feb 26From the author of the acclaimed The World Wasn’t Ready for You comes a thrilling first novel, set in a near future where artificial intelligence runs the world, involving a young medical student who must unravel family secrets to uncover the truth of his father’s mysterious death.
In a time not so far from our own, society is run by a global AI system controlled by an all powerful corporation. The Shepherd Organization oversees every medical school in the country save one in New Orleans, the renegade Hippocrates which still insists on human-led medicine. It is the last choice school for an ambitious young New Yorker named Pok. But after his father—himself a physician—dies under mysterious circumstance that seems connected to “the shepherds” and their megalomaniacal young CEO, Pok finds himself on a quest for answers that leads right to Hippocrates. Once enrolled, he stumbles upon a further mystery: a strange illness is plaguing newcomers to New Orleans who grew up under shepherd rule. What is causing this fatal anomaly? And how does it relate to the mystery of Pok’s father’s death and his own mysterious past?
In a time not so far from our own, society is run by a global AI system controlled by an all powerful corporation. The Shepherd Organization oversees every medical school in the country save one in New Orleans, the renegade Hippocrates which still insists on human-led medicine. It is the last choice school for an ambitious young New Yorker named Pok. But after his father—himself a physician—dies under mysterious circumstance that seems connected to “the shepherds” and their megalomaniacal young CEO, Pok finds himself on a quest for answers that leads right to Hippocrates. Once enrolled, he stumbles upon a further mystery: a strange illness is plaguing newcomers to New Orleans who grew up under shepherd rule. What is causing this fatal anomaly? And how does it relate to the mystery of Pok’s father’s death and his own mysterious past?
400 pages, Hardcover
Expected publication February 3, 2026
6771 people want to read
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Displaying 1 - 5 of 5 reviews
January 17, 2026
ARC✶REVIEW
#ad much love for my advance copy @harperbooks #partner
& @harperaudio #partner for the ALC
𝕋𝕙𝕖 ℍ𝕠𝕤𝕡𝕚𝕥𝕒𝕝 𝕒𝕥 𝕥𝕙𝕖 𝔼𝕟𝕕 𝕠𝕗 𝕥𝕙𝕖 𝕎𝕠𝕣𝕝𝕕
< @justinckey >
ʀᴇʟᴇᴀꜱᴇꜱ: ꜰᴇʙʀᴜᴀʀʏ 𝟥, 𝟤𝟢𝟤𝟨
ᴛʜʀɪʟʟᴇʀ | ꜱᴄɪ-ꜰɪ | ᴍʏꜱᴛᴇʀʏ
NFTF - IYKYK
“𝙷𝚎𝚊𝚕𝚒𝚗𝚐 𝚒𝚜 𝚝𝚑𝚎 𝚒𝚗𝚝𝚎𝚛𝚜𝚎𝚌𝚝𝚒𝚘𝚗 𝚘𝚏 𝚜𝚌𝚒𝚎𝚗𝚌𝚎 𝚊𝚗𝚍 𝚊𝚛𝚝. 𝚆𝚒𝚝𝚑𝚘𝚞𝚝 𝚎𝚒𝚝𝚑𝚎𝚛, 𝚢𝚘𝚞 𝚊𝚛𝚎 𝚕𝚘𝚜𝚝. 𝚃𝚑𝚎 𝚙𝚊𝚝𝚒𝚎𝚗𝚝 𝚒𝚜 𝚕𝚘𝚜𝚝,” (p. 164-165).
This was such a fun and unique read. Holy crappers! I loved every second of it.
When Pok doesn’t get into any of the medical schools he applied to, he can’t accept this. So he hacks into the system to see what’s up. His info is all wrong - someone has changed everything. He was denied because he was sabotaged.
The world is run on AI. His father wants him to get away from AI doctoring people and help bring back patient-to-provider medicine. But there’s only one hospital left that isn’t run by AI. And now the Shepherd School of Medicine at MacArthur Hospital (who uses AI) wants to bring him onboard.
But Pok is given a warning to get out of New York, so he takes off heading to New Orleans. To the last hospital not depending on AI. Let the adventure begin.
🎧: Also followed along while listening to the audio and it’s a good audiobook. The narrator James Fouhey was perfect for this book and is easy to listen to. You can distinguish different characters and he just a fab voice actor.
Oh how I LOVED this book! As I was reading, I kept thinking surely this can’t possibly get any better, but it did! Such a fun, but also thought-provoking, read. From start to finish it was impossible to put down.
Set in New Orleans, this is as much an atmospheric thriller as it is literary - while still being fast-paced. It’s one of those rare books that balances it all perfectly. But there’s also some head-spinning parts that will take you by surprise.
In NOLA there lies a city hidden from the Shepherds, people fighting to keep the humanity in medicine. But there’s rumors that something much darker is happening there. Pok needs to figure out what is going on and do it fast. Humanity depends on it.
Loved Pok. He’s fighting with the worldview he grew up in, to how things used to be. He wants to help people and has no negative intentions, but still has much to learn. He isn’t secure in his abilities even though he knows everything they can teach, and the things they can’t teach.
Told in four parts - the seasons, summer, fall, winter, spring, and back to summer. Each is gripping and keeps you hooked. An easy 5 star read. I especially loved the schooling and testing chapters.
Mem
Skinning the pen*s song title LMAOOOOO
The librarian 😂😂
Sweating rot 😭
Explores the bias of AI
Grief
Betrayal
Humanity
Fighting back
Conspiracy
Secrets
Agendas
Communities
#ad much love for my advance copy @harperbooks #partner
& @harperaudio #partner for the ALC
𝕋𝕙𝕖 ℍ𝕠𝕤𝕡𝕚𝕥𝕒𝕝 𝕒𝕥 𝕥𝕙𝕖 𝔼𝕟𝕕 𝕠𝕗 𝕥𝕙𝕖 𝕎𝕠𝕣𝕝𝕕
< @justinckey >
ʀᴇʟᴇᴀꜱᴇꜱ: ꜰᴇʙʀᴜᴀʀʏ 𝟥, 𝟤𝟢𝟤𝟨
ᴛʜʀɪʟʟᴇʀ | ꜱᴄɪ-ꜰɪ | ᴍʏꜱᴛᴇʀʏ
NFTF - IYKYK
“𝙷𝚎𝚊𝚕𝚒𝚗𝚐 𝚒𝚜 𝚝𝚑𝚎 𝚒𝚗𝚝𝚎𝚛𝚜𝚎𝚌𝚝𝚒𝚘𝚗 𝚘𝚏 𝚜𝚌𝚒𝚎𝚗𝚌𝚎 𝚊𝚗𝚍 𝚊𝚛𝚝. 𝚆𝚒𝚝𝚑𝚘𝚞𝚝 𝚎𝚒𝚝𝚑𝚎𝚛, 𝚢𝚘𝚞 𝚊𝚛𝚎 𝚕𝚘𝚜𝚝. 𝚃𝚑𝚎 𝚙𝚊𝚝𝚒𝚎𝚗𝚝 𝚒𝚜 𝚕𝚘𝚜𝚝,” (p. 164-165).
This was such a fun and unique read. Holy crappers! I loved every second of it.
When Pok doesn’t get into any of the medical schools he applied to, he can’t accept this. So he hacks into the system to see what’s up. His info is all wrong - someone has changed everything. He was denied because he was sabotaged.
The world is run on AI. His father wants him to get away from AI doctoring people and help bring back patient-to-provider medicine. But there’s only one hospital left that isn’t run by AI. And now the Shepherd School of Medicine at MacArthur Hospital (who uses AI) wants to bring him onboard.
But Pok is given a warning to get out of New York, so he takes off heading to New Orleans. To the last hospital not depending on AI. Let the adventure begin.
🎧: Also followed along while listening to the audio and it’s a good audiobook. The narrator James Fouhey was perfect for this book and is easy to listen to. You can distinguish different characters and he just a fab voice actor.
Oh how I LOVED this book! As I was reading, I kept thinking surely this can’t possibly get any better, but it did! Such a fun, but also thought-provoking, read. From start to finish it was impossible to put down.
Set in New Orleans, this is as much an atmospheric thriller as it is literary - while still being fast-paced. It’s one of those rare books that balances it all perfectly. But there’s also some head-spinning parts that will take you by surprise.
In NOLA there lies a city hidden from the Shepherds, people fighting to keep the humanity in medicine. But there’s rumors that something much darker is happening there. Pok needs to figure out what is going on and do it fast. Humanity depends on it.
Loved Pok. He’s fighting with the worldview he grew up in, to how things used to be. He wants to help people and has no negative intentions, but still has much to learn. He isn’t secure in his abilities even though he knows everything they can teach, and the things they can’t teach.
Told in four parts - the seasons, summer, fall, winter, spring, and back to summer. Each is gripping and keeps you hooked. An easy 5 star read. I especially loved the schooling and testing chapters.
Mem
Skinning the pen*s song title LMAOOOOO
The librarian 😂😂
Sweating rot 😭
Explores the bias of AI
Grief
Betrayal
Humanity
Fighting back
Conspiracy
Secrets
Agendas
Communities
December 1, 2025
I don't normally rate or write reviews for the books I work on (I was part of the production team for the audiobook) but I really, genuinely liked this book. Pok is an engaging, well-written protagonist. He is a first-year medical student at the last hospital in the US that isn't run by AI, and as he grew up in AI-saturated NYC, he has to learn from the ground-floor up.
The tension between so-called traditional medicine and the AI algorithms that purport to always create the best outcomes possible is the spine of the story, and the narrative goes in some interesting directions I wasn't expecting. While some of the dilemmas facing Pok are definitely in the near-future speculative realm - how to treat the physical manifestations of tech withdrawal? - some are frightfully relevant to today's world, like how Black mothers face increased levels of maternal mortality. Key takes care not to let the themes overwhelm the characters. They are all richly drawn, even those we see only briefly.
The tension between so-called traditional medicine and the AI algorithms that purport to always create the best outcomes possible is the spine of the story, and the narrative goes in some interesting directions I wasn't expecting. While some of the dilemmas facing Pok are definitely in the near-future speculative realm - how to treat the physical manifestations of tech withdrawal? - some are frightfully relevant to today's world, like how Black mothers face increased levels of maternal mortality. Key takes care not to let the themes overwhelm the characters. They are all richly drawn, even those we see only briefly.
October 29, 2025
The Hospital at the End of the World is a gripping and unsettling journey into isolation, survival, and the fragility of humanity. Justin C. Key masterfully blends psychological suspense with elements of horror, creating a chilling atmosphere that lingers long after the last page.
The story’s setting—a remote, desolate hospital—is as much a character as the people who inhabit it, and Key’s attention to detail makes the environment vividly haunting. The characters are well-drawn and complex, each grappling with fear, desperation, and secrets, which adds layers to the tension and intrigue.
While the pacing occasionally slows, the build-up of suspense and the unexpected twists make the story compelling. Key’s writing style is immersive, keeping you on edge while exploring themes of isolation, morality, and human resilience.
Fans of psychological horror and dark thrillers will find this novel particularly satisfying. It’s eerie, thought-provoking, and unflinchingly intense—a story that reminds you just how thin the line between order and chaos can be.
The story’s setting—a remote, desolate hospital—is as much a character as the people who inhabit it, and Key’s attention to detail makes the environment vividly haunting. The characters are well-drawn and complex, each grappling with fear, desperation, and secrets, which adds layers to the tension and intrigue.
While the pacing occasionally slows, the build-up of suspense and the unexpected twists make the story compelling. Key’s writing style is immersive, keeping you on edge while exploring themes of isolation, morality, and human resilience.
Fans of psychological horror and dark thrillers will find this novel particularly satisfying. It’s eerie, thought-provoking, and unflinchingly intense—a story that reminds you just how thin the line between order and chaos can be.
November 4, 2025
**I received a copy of this book from Edelweiss**
Read on the plane down to Disney. I love everything Key writes, and this book was really up my alley. It's a dystopia set in a world where AI and tech controls everything people do. The main character, Pok, loses his father early in the book. Pok's dad leaves him a message saying to go to New Orleans. It's a rough trip, but eventually he makes it to the hospital there, where he becomes a student doctor. At Hippocrates, real medicine is practiced--there are no robots that will fix your broken leg or administer IVs. Pok learns about how to resist while also about his father's past. Loved this.
Read on the plane down to Disney. I love everything Key writes, and this book was really up my alley. It's a dystopia set in a world where AI and tech controls everything people do. The main character, Pok, loses his father early in the book. Pok's dad leaves him a message saying to go to New Orleans. It's a rough trip, but eventually he makes it to the hospital there, where he becomes a student doctor. At Hippocrates, real medicine is practiced--there are no robots that will fix your broken leg or administer IVs. Pok learns about how to resist while also about his father's past. Loved this.
January 15, 2026
**I received a copy of this book via Goodreads giveaway***. I would give this book 3.5 stars. The premise was interesting but felt it was a bit slow and maybe didn’t need to be as long as it was.
Displaying 1 - 5 of 5 reviews