What do you think?
Rate this book
The Last Patient
Honorable mention in the 2025 Readers' Favorite book awards.
THE LAST PATIENT is a sweeping historical novel that captures one family’s struggle for love, survival, and identity under the grip of Communism in Romania. Spanning fifty years of political upheaval, this saga explores how ordinary lives are shaped—and sometimes shattered—by extraordinary times.
Kostea and Clara meet and fall in love shortly before World War II. As they get married, build careers, and raise a son, the world around them changes rapidly—and often violently. From the two-bedroom apartment they are “patriotically” forced to share with another family, to Bucharest’s rampant food shortages, Romania’s Cold War history plays out in their day-to-day lives.
Kostea, a charming yet domineering surgeon, craves control in a place where party loyalists hold the reins of power. His pursuit of respect and authority threatens his promising medical career and his relationships at home, risking Clara’s love. While the temptation to break through the Iron Curtain is omnipresent, defection to the West comes with its own uncertainties. Ultimately, The Last Patient is a poignant exploration of the eternal tension between personal aspirations and love.
THE LAST PATIENT is a sweeping historical novel that captures one family’s struggle for love, survival, and identity under the grip of Communism in Romania. Spanning fifty years of political upheaval, this saga explores how ordinary lives are shaped—and sometimes shattered—by extraordinary times.
Kostea and Clara meet and fall in love shortly before World War II. As they get married, build careers, and raise a son, the world around them changes rapidly—and often violently. From the two-bedroom apartment they are “patriotically” forced to share with another family, to Bucharest’s rampant food shortages, Romania’s Cold War history plays out in their day-to-day lives.
Kostea, a charming yet domineering surgeon, craves control in a place where party loyalists hold the reins of power. His pursuit of respect and authority threatens his promising medical career and his relationships at home, risking Clara’s love. While the temptation to break through the Iron Curtain is omnipresent, defection to the West comes with its own uncertainties. Ultimately, The Last Patient is a poignant exploration of the eternal tension between personal aspirations and love.
377 pages, Kindle Edition
Published February 11, 2025
49 people are currently reading
66 people want to read
About the author
Tudor Alexander
8 books24 followersI was born in Bucharest in 1950 and moved to the United States in 1977. I hold a Master’s degree from the Polytechnic Institute of Bucharest and an MBA from the University of Connecticut. I live in Maryland with my wife, Viorica, and we have two adult children.
I started writing in high school, publishing many short stories in literary magazines. After the 1989 Romanian revolution, I began contributing to a Romanian literary weekly. I published several novels and short story collections in Romania, including The Runners, Smoke, Planet New York, One Morning and One Afternoon, and The Visitor.
I now write in both Romanian and English. My books feature immigrants yearning to escape their past and adapt to their new surroundings. Like myself, my characters are people who took a leap of faith to find political and intellectual freedom.
Planet New York and No Portrait in the Gilded Frame are available on Amazon. My recent (literary historical) novel, The Last Patient, was published by Boyle & Dalton in February 2025.
I started writing in high school, publishing many short stories in literary magazines. After the 1989 Romanian revolution, I began contributing to a Romanian literary weekly. I published several novels and short story collections in Romania, including The Runners, Smoke, Planet New York, One Morning and One Afternoon, and The Visitor.
I now write in both Romanian and English. My books feature immigrants yearning to escape their past and adapt to their new surroundings. Like myself, my characters are people who took a leap of faith to find political and intellectual freedom.
Planet New York and No Portrait in the Gilded Frame are available on Amazon. My recent (literary historical) novel, The Last Patient, was published by Boyle & Dalton in February 2025.
Ratings & Reviews
Friends & Following
Create a free account to discover what your friends think of this book!
Community Reviews
Displaying 1 - 25 of 25 reviews
September 23, 2025
"The Last Patient" is a story of family dynamics and relationships with love, loss, and the likes featuring a surgeon and his family in communist Romania. It also explores why some people decide to leave their country, despite their deep attachment and devotion to it. The characters were well-developed, with admirable qualities along with some flaws, that made them feel real and human. I think the narrative was very realistic and honest, and depicted the struggles of the characters as well as their strength during this regime, all while going about their day-to-day lives and experiencing the joys, sorrows, and difficult decisions that come with it.
Thank you to NetGalley and Boyle & Dalton for an ARC in exchange for an honest review.
Thank you to NetGalley and Boyle & Dalton for an ARC in exchange for an honest review.
February 22, 2025
Spanning a half century, "The Last Patient" is a beautifully detailed, absorbing account of the plight of a noted Romanian surgeon and his family under Communist rule. The result is a moving and timely reminder of why even those devoted to their homeland may choose to leave it.
May 9, 2025
I was immediately taken with the main characters, especially the FMC (female main character), they’re instantly put into an uncomfortable situation which anyone would find egregious which helps you bond with them almost instantly. No matter what you’re on their side and I feel like this molds you for how the rest of the story plays out. Three pages in and you know you’d ride or die for them (her) it’s the 3 of you against the rest of the world. Although fictional, these characters go through very human, normal day to day issues. They react how you might react, nothing is out of scope or beyond the ways of life. Even any day to day conflict that occurs between characters, be it through work or family, is not overly dramatized or world ending. It is so very human. All together it makes for a really pleasing reading experience, you already feel familiar with the story, it just fits into your life perfectly.
There is a divide between the female and male experience, although subtle at times, it is clear that there are two different experiences that the book flicks between. I think this is where my devotion to the FMC comes from, the emotional labour workload that lands on her plate is relatable to me even though decades span us. The men get to gather and drink and gamble with gentlemanly club vibes, whereas the women either stay at home and tend to the house and the family, or work and then go home to tend to the house and family. The family friends are friends of the husbands more than they are the wifes. Of course this is natural for the time, and is written to show that rather than to make a political point or even be malicious by reducing the power of a woman.
I have fear over women written by men, I’ve been burnt so many times before. But Alexander kept me safe. The FMC isn’t written as an air headed fool, she is intelligent, she has her own agency and she is so strong. The foundation of the family, supporting everyone as the plot plays out. Even as time moves through the book she is the character you look to, to manage the change or to understand the dynamics and even the emotions of the family as a whole. There’s the relationship between her husband and her, her son and her and her mother and her. But then also she is responsible for the relationships between her husband and her son and her husband and her mother. She takes on the entire emotional baggage of the family and always tries to come up with the best solution whilst also still being her own independent person.
The challenges she faces with her husband are heart breaking, soul destroying, and getting the tissues ready tough. My heart still hurts thinking of her story arc and I don’t think that would be the case for any other author. Alexander put his knowledge, his experience and his own family into this book and you can feel it through every piece of dialogue or thought.
As you make your way through the book you’re told play by plays of every choice the MMC makes. I’m not sure if it’s character development or if it’s my opinion of the character changing with each reveal of his choice. Either way I actually really enjoy it, with everything being fact rather than inferred you know exactly where you stand and exactly who the people are that you’re reading about.
Narration
This book might just be my favourite for its narrative voice. It flows beautifully with Alexander’s choice to use the inner monologue of characters in 3rd person. It just keeps you engaged and hooked on reading the book. The cadence of the narration almost makes it impossible to put the book down, it just flows so neatly into your brain. I can’t quite put into words how the writing style suits me so well, it’s almost like it’s itching my brain in the right places. I wish my school textbooks were narrated like this, I would have done much better at school!
As we read, we jump through time, an offering into the backstory of the characters, an insight to why they are like they are now, their traumas and trysts. I think it’s a great way to add more depth to the characters and it shows how times have changed with different wars, hardships and ways of life. It’s very methodical in structure and you can really tell how well every aspect has been planned out. This is a master at work, it is so obvious that Alexander has dedicated their life to writing.
In conclusion, this was a wonderful book to read, it was captivating and enchanting. A raw take on real history with an intrinsic human connection.
There is a divide between the female and male experience, although subtle at times, it is clear that there are two different experiences that the book flicks between. I think this is where my devotion to the FMC comes from, the emotional labour workload that lands on her plate is relatable to me even though decades span us. The men get to gather and drink and gamble with gentlemanly club vibes, whereas the women either stay at home and tend to the house and the family, or work and then go home to tend to the house and family. The family friends are friends of the husbands more than they are the wifes. Of course this is natural for the time, and is written to show that rather than to make a political point or even be malicious by reducing the power of a woman.
I have fear over women written by men, I’ve been burnt so many times before. But Alexander kept me safe. The FMC isn’t written as an air headed fool, she is intelligent, she has her own agency and she is so strong. The foundation of the family, supporting everyone as the plot plays out. Even as time moves through the book she is the character you look to, to manage the change or to understand the dynamics and even the emotions of the family as a whole. There’s the relationship between her husband and her, her son and her and her mother and her. But then also she is responsible for the relationships between her husband and her son and her husband and her mother. She takes on the entire emotional baggage of the family and always tries to come up with the best solution whilst also still being her own independent person.
The challenges she faces with her husband are heart breaking, soul destroying, and getting the tissues ready tough. My heart still hurts thinking of her story arc and I don’t think that would be the case for any other author. Alexander put his knowledge, his experience and his own family into this book and you can feel it through every piece of dialogue or thought.
As you make your way through the book you’re told play by plays of every choice the MMC makes. I’m not sure if it’s character development or if it’s my opinion of the character changing with each reveal of his choice. Either way I actually really enjoy it, with everything being fact rather than inferred you know exactly where you stand and exactly who the people are that you’re reading about.
Narration
This book might just be my favourite for its narrative voice. It flows beautifully with Alexander’s choice to use the inner monologue of characters in 3rd person. It just keeps you engaged and hooked on reading the book. The cadence of the narration almost makes it impossible to put the book down, it just flows so neatly into your brain. I can’t quite put into words how the writing style suits me so well, it’s almost like it’s itching my brain in the right places. I wish my school textbooks were narrated like this, I would have done much better at school!
As we read, we jump through time, an offering into the backstory of the characters, an insight to why they are like they are now, their traumas and trysts. I think it’s a great way to add more depth to the characters and it shows how times have changed with different wars, hardships and ways of life. It’s very methodical in structure and you can really tell how well every aspect has been planned out. This is a master at work, it is so obvious that Alexander has dedicated their life to writing.
In conclusion, this was a wonderful book to read, it was captivating and enchanting. A raw take on real history with an intrinsic human connection.
March 23, 2025
I enjoyed the book as a window and slice of life of a few decades in Eastern Europe. As expected, it’s slightly dark, or twilit at least. The characters are real and very human.
February 28, 2025
Though immensely interesting as to living conditions in Romania behind the Iron Curtain, this novel focuses on family relationships. This overwhelmed the storyline because of Kostea's powerful personality. I really disliked this egocentric, selfish and know-it-all man! His behaviour was totally unacceptable and it greatly saddened and angered me to see all the damage he caused his family in the name of love. I found it interesting to read about the social conditions (though Kostea's family had money, so it probably didn't reflect the general population). I never knew about bribery being the expected currency (what happened if you didn't have money and needed medical care?). I particularly enjoyed the descriptions of the Romanian countryside. It did sound lovely. A good novel about family dynamics.
I received a digital copy of this novel from NetGalley and I have voluntarily written an honest review.
I received a digital copy of this novel from NetGalley and I have voluntarily written an honest review.
June 11, 2025
Fantastic! I would recommend this novel - it is a well-written and interesting.
October 31, 2025
Tudor Alexander’s remarkable novel, The Last Patient, blends fiction with reality. While the scenes and episodes are created, the characters are modeled after the author’s family and other real people in his life, and the places put you in his native, repressive Romania before he immigrated to the United States in 1977, giving a unique authenticity to the novel. In the author’s notes Alexander says his goal, which he accomplished, was to depict the society of his youth as “a sweeping tale of the history, love, and survival of these people I cherished.” And what richly complex lives he portrays within the chilling account of the dictatorial government he experienced. In addition to the compelling, human story, the novel left me with a timely, worth-while warning of the possibility of our own repressive government in these threatening times. But this powerful novel is not limited to politics. Universal issues of love and lust in a meaningful marriage, passions and adjustments of being a father and grandfather, ambition and drive for professional excellence, dealing with the absence of justice, coping with personal vulnerability, regret and forgiveness, including one’s own trespasses, the difficulties of immigration, assimilation, and identity, and the sadness and inevitability of death are all woven together. Alexander ends with the positive message that love, family and relationships overcome hardships along the way, reminding me of the ultimate values to remember. I recommend reading the novel for a richly meaningful and lasting experience.
May 26, 2025
"The last patient" est une fiction qui s'ouvre en 1950, en Roumanie alors que la guerre est achevée depuis 5 ans ; le pays est le théâtre d'autres exactions passées sous silence, plus souterraines. L' ère du communisme pollue de ses ramifications multiples, les citoyens désormais contraints de partager leur propre logement avec des inconnus commis d'office.
Adhérer au parti communiste roumain devient alors l'unique alternative afin de ne pas subir la suspicion croissante et l'arrestation.
Le climat politique est abordé de façon réaliste, inclus au cœur d'une intrigue où le héros - médecin chevronné - se débat au milieu d'une pluralité de choix existentiel dont, celui, majeur, concerne la sécurité de son épouse et son enfant.
1960/1970 les décrit exposés dans une Roumanie en pleine mutation et en rupture d'avec la domination soviétique jusqu'alors omniprésente, et ce, dix ans après le soulèvement hongrois.
La haine des russes façonne le peuple, qui s'oppose depuis, vigoureusement au parti instauré par le fanatique oppresseur Ceausescu. C'est la fin de l'ère du communisme, relatée dans toute sa déchéance.
Un récit profondément humain, qui dénonce les mensonges de la propagande communiste avec gravité et vérité, et d'un pays qui se bat pour sauvegarder sa dignité, instrument de sa liberté.
Une œuvre poignante à lire !
This review was written for LibraryThing Early Reviewers.
August 29, 2025
3.75⭐️
*I received a digital copy of this book through the LibraryThing Early Reviewers program in exchange for an honest review*
The Last Patient is an engrossing story that follows the Bardu family over 60 years in Communist Romania (didn’t realize until the author’s note that the story is actually based on events in his own family!). I really enjoyed learning about a part of Eastern Europe during a period of great transition that I knew little about prior to this book.
There was love, conflict, politics, grief, betrayal and character growth that had me engaged throughout the story, although I was very annoyed with Kostea at many points in the book.
I found a few parts dragged on and the book could perhaps have been a bit shorter. I also wish there had been more of Toddy and Clara’s perspectives as they were vastly different from Kostea in many ways.
Hoping the author releases his next book detailing events of his wife’s family soon!
*I received a digital copy of this book through the LibraryThing Early Reviewers program in exchange for an honest review*
The Last Patient is an engrossing story that follows the Bardu family over 60 years in Communist Romania (didn’t realize until the author’s note that the story is actually based on events in his own family!). I really enjoyed learning about a part of Eastern Europe during a period of great transition that I knew little about prior to this book.
There was love, conflict, politics, grief, betrayal and character growth that had me engaged throughout the story, although I was very annoyed with Kostea at many points in the book.
I found a few parts dragged on and the book could perhaps have been a bit shorter. I also wish there had been more of Toddy and Clara’s perspectives as they were vastly different from Kostea in many ways.
Hoping the author releases his next book detailing events of his wife’s family soon!
November 13, 2025
A multi-decade family saga set in Communist Romania from the 1950s to the 1990s following the Bardu family, doctor Kostea, his wife Clara and son Toddy, as they face the challenges and difficulties of living under a totalitarian regime. From an historical point of view, the book is both authentic and convincing. The details of daily life, and the strategies needed to not just survive but to thrive are well-conveyed, as is the slippery slope into amoral behaviour, a path which Kostea embarks on. Based on the author’s own family history, there’s a lot to find of interest here. But I found the writing style bland and mundane, with forced dialogue and superficial characterisation. The book failed to engage me and failed to involve me in the lives of the family. Not a bad book, by any means, but not a very good one, and one which would have benefited from some ruthless editing.
March 4, 2025
Through masterfully crafted dialogues and salient descriptions, this candid recount of a family's history draws the reader to partake in its complicated dynamics where Kostea, the undisputed patriarch looms large despite his flaws. The decades of post WWII communist Romania are depicted in evocative stories of food and housing shortages, the subeconomy of influential people, and the ubiquitous anxiety of an oppressive regime. With compassion and humor, the author relates the story of emigrants who struggle through the loss of identity in the effort to build a new life. However, the family’s dramas transcend to a universal experience of love, friendship, trust, betrayal, pride, and resilience.
April 21, 2025
Not for me.
Set mostly in Romania from 1950 onwards, this follows a hot-headed doctor through his adult life. The focus is on family dynamics, with a dash of infidelity, chauvinism, prejudice, corruption etc. I liked learning of the power of connections and “the party”, but the story had me wanting more. I was impatient with it, increasingly disliking the main character and wondering what the point of it was. I would learn at the end that it was the story of the author’s grandfather. The book would have been a DNF early on had I not won a free copy and felt obliged to persevere so that I could write a fair review. I ended up skimming from half-way onwards.
I won a free copy of this book (thanks to the author & publisher!) and am voluntarily providing an honest review.
Set mostly in Romania from 1950 onwards, this follows a hot-headed doctor through his adult life. The focus is on family dynamics, with a dash of infidelity, chauvinism, prejudice, corruption etc. I liked learning of the power of connections and “the party”, but the story had me wanting more. I was impatient with it, increasingly disliking the main character and wondering what the point of it was. I would learn at the end that it was the story of the author’s grandfather. The book would have been a DNF early on had I not won a free copy and felt obliged to persevere so that I could write a fair review. I ended up skimming from half-way onwards.
I won a free copy of this book (thanks to the author & publisher!) and am voluntarily providing an honest review.
March 16, 2025
As somebody who lived until my teenage years in communist Romania under Ceausescu's dictatorship, then came to US later, I was very moved by the story of the family in this book, their struggles, successes and difficulties of making like-changing decisions. The characters are well-developed and although some have flaws, they all demonstrate humanity. I was also happy to see citations from Eminescu, the greatest romanian poet, throughout the book. Overall, an excellent book which I couldn't put down.
March 18, 2025
I have been reading and writing a lot of historical fiction recently and loved the way the auth0r was able to use his family story to create an engaging book about the trials and tribulations faced by late 20th century emigrants from Eastern Europe. Alexander captured how different people and personalities react to fear and threats to their freedom and the challenges of living through a variety of challenging situations. I enjoyed reading this story and recommed it. You will gain a much deeper understanding about the challenges of leaving one's home.
April 16, 2025
Alexander has crafted a masterful tale of family life in post-war Romania. Through effortless prose and richly drawn characters, we are immersed in a world of personal struggles and political intrigues that spans decades and continents. The last part of the book is a deeply moving portrait of aging and death. This is a beautifully written story, one that will stay with you long after you read the last page. Highly recommended.
March 6, 2025
This book was a very interesting look into Romania under Communism. The novel’s greatest strength lies in its richly drawn characters, whose resilience and vulnerabilities make them unforgettable. The Last Patient is more than just a historical novel; it is a tribute to those who lived through hardship yet found ways to persevere.
April 15, 2025
I was given a free copy of "The Last Patient" via LibraryThing. I lived in Romania briefly, so I am interested in stories about Romania. I'm glad I had the opportunity to read this book. It details the life and struggles of a family during the war and communism. It gives the reader insight into what life was like at that time. Anyone interested in history would enjoy this book. I did.
May 24, 2025
A story of life behind the Iron Curtain and one man’s struggles to provide for his family and friends, even to a fault. All the characters are well-developed, and the writing will keep you entertained through the night. A good historical read.
Thank you to Librarything.com and Boyle and Dalton Publishers for a copy of this book.
Thank you to Librarything.com and Boyle and Dalton Publishers for a copy of this book.
March 4, 2025
I particularly loved the honest humanity of the characters in this novel…how they wove so believably through their gripping, fascinating, and sometimes heartbreaking world. The read was a truly immersive experience.
March 12, 2025
Insightful and first-hand stories that speak to us about life under a communist regime. The stories become real through sensitive the description of the lives of his characters as they faced their struggles imposed on them by communism.
April 9, 2025
A compelling story of everyday life under communism and the challenges of migration. Enjoyed immersing myself in the lives of this vividly described family and their community. A great read!
July 23, 2025
Beautifully written. Not to be rapidly devoured but savored slowly to appreciate the well-crafted descriptions. Fine character development.
August 15, 2025
DNF…overly exaggerated characters. (the hero should have been wearing a cape!) i understand the concept of fiction, but the author took too many liberties.
March 14, 2025
The Last Patient is a story of the triumph of love over loss and pain during some of the most challenging times of mid 20th century Romania. With words like, “It is wrong to grade pain, it is wrong to grade love…”, the author invites the reader to a gently guided journey in the times when “everyone wore invisible shackles”, “life was hard but never hopeless”, and people’s aspirations were as alive as always. The journey proposed by Tudor Alexander is endearing. There are no “good” and “bad” characters in the book; there are only complex characters, each with their own story, ethos, motivation, aspirations, and dignity. The Last Patient provides for truly immersive reading, in which the readers—equally those who had lived in those times and places, and those who have not— become part of the story. With the author’s creative maturity on display, The Last Patient claims its place on the map of accomplished contemporary novels.
Peter Varadi
Peter Varadi
Read
September 3, 2025The Last Patient is one of the most heartfelt, personal novels I've read in a very long time. Just like the people in my own family, the characters are alternately endearing and aggravating, loveable and detestable. Alexander brings them to life in every exchange and I came to understand all their strengths, weaknesses, loves, and hates as well as what things tenaciously hold them together as a family and a community.
Alexander's prose is extraordinarily well crafted without feeling the least bit pretentious. You hear his characters' varied voices in the dialog and you are allowed to discover their inner lives without the author trying to describe them.
This is a book I am going to recommend to all my friends who love a good, solid read by aThe Last Patient talented story teller.
Alexander's prose is extraordinarily well crafted without feeling the least bit pretentious. You hear his characters' varied voices in the dialog and you are allowed to discover their inner lives without the author trying to describe them.
This is a book I am going to recommend to all my friends who love a good, solid read by aThe Last Patient talented story teller.
Displaying 1 - 25 of 25 reviews