Book Review: Little Falls

Reviewed by Warren Maxwell

A dark comedy about modern society’s existential crises—with some eerily effective solutions

“This world is filled with people who walk around like they have it all figured out. They’re mostly mediocre losers blessed with an undeserved confidence. I have never been a part of this club, but for the first time in my life I feel as if I have a plan.”

Caught in the shadow of his father’s legacy as an awe-inspiring physician, Edward Teak is the reluctant CEO of Little Falls Hospital. With the institution well past its golden years, Teak finds himself chaperoning it into decline as the town of Little Falls is swallowed up by opioids, chronic illnesses, and a general malaise. 

Juggling the impossible tasks of turning his hospital around, satisfying his social-media crazed, stay-at-home wife Sam, looking after their delinquent children, and visiting his mother at the nursing home where she has taken to calling him Jeff for reasons that only her Alzheimers can explain, Edward is barely hanging on. 

That is, until he hatches a plan that will pull Little Falls Hospital back from the brink long enough for Edward to sell it and turn a retirement-sized profit. Locked in his office where he avoids the poor and sick who fill his bankrupt hospital, Edward draws up a list of names—the most delinquent, money draining patients in his hospital—and resolves to kill them. Enlisting the help of shady characters, Edward careens through his makeshift plan.

“I can sense that I am a step closer to something that resembles happiness. I am not the monster. The system is the monster—an unrelenting beast that devours us one painful bite at a time. That is, if you let it.”

Neither sociopathic or altogether normal, Edward Teak narrates with an inauspicious voice that seems pulled directly from one of Gogol’s stories of minor bureaucrats. Ordinary and peculiar, charismatic and pathetic, he is a fascinating study in opposites. When the novel begins, Edward is both hoping and dreading the prospect of being fired. 

However, during the anticipated phone call, the hospital board merely reiterates its faith in him and intention to retain him until he either saves Little Falls Hospital or goes down with it. Oscillating between rage and despair, Edward feels no relief. In his eyes, such quotidian moments appear as grand twists of fate, complicating and darkening the obvious humor of his helplessness. He dreams of being fired but can’t quit. One way or another, this is a story in which life is always at stake.

The novel tracks Edward’s life up until the moment in which murder suddenly seems reasonable, necessary even, if he intends to save a hospital and ensure his own future security. Morality is the ultimate punchline, a malnourished, otherworldly concept in the world of Little Falls. Here, the poor, the chronically ill, the drug-addicted, and the elderly are all coconspirators in a plot to put hospitals out of business, making Edward’s unrelentingly practical, rationalized approach to killing them both magnetic and deeply unnerving.

Through sarcasm and sly plot twists, the story places its sights squarely on the most egregious, unbelievable aspects of modern medicine. But Edward is not the inevitable result of a broken system—this book doesn’t stoop to such preaching. Instead, he’s a peculiar person in his own right, lazy, vicious, easy to please, a doting son, a neglectful father, a continually fascinating puzzle that drives the novel. Every character and setting provokes paragraphs of copious description from him, but somehow his wife and children always hover on the edge of the story. This says volumes about Edward’s inner life, but also leaves an unsatisfying gap in his universe. Perhaps this is fitting, for Little Falls tells the story of a world out of balance.

Traversing the darkest corners of modern life, Little Falls spins a thought-provoking, laugh-inducing, utterly discomforting yarn that will grip you for hours.

---

Thank you for reading Warren Maxwell’s book review of Little Falls by Will Werner! If you liked what you read, please spend some more time with us at the links below.