The Waiting Rooms by Eve Smith is apocalyptic, chilling and uncannily plausible. Its currency – it happens to be set 20 or so years after a pandemic – gives it a horrible urgency. It is a novel that encourages us to think about our response to the world around us. It gives us a dystopian vision that causes us to question what we should aim to preserve in our current society.

The premise is that a global antibiotic crisis causes the return of tuberculosis on a biblical scale. The overuse of antibiotics both by humans personally and in the food chain has led to strains of disease that cannot yet be stopped. Twenty years later, the effects have been devastating: no one is allowed antibiotics after their seventieth birthday. People count down the days until their seventieth – and not in a joyful way. A small scratch can provide a death warrant: the only medical treatment you can expect is a vial containing a fatal serum: a state-mandated assisted death. There has been a knock-on effect onto the everyday lives of the under-70s. Women die in childbirth. Going to the shops requires you to wear a mask; to go into a building you must be scanned for disease. This is the backdrop in which Kate, a health worker, starts the search for her birth mother. Flashbacks to pre-crisis South Africa tell us why someone else is looking for the mother, too.

Dystopian novels like this do a number of things. They present a character, a human, whether Winston Smith or Kate, trying to continue to be human among a paradigm that we readers would recognise as inhuman or alien. We think about what it means to be a human: whom to trust, how to love one another when to do so could be an act of rebellion against the state.

I used the phrase ‘uncannily plausible’: Smith shares evidence in support of her predictions, but whether she is right or not (and there are at least warning signs that she may be correct) is to miss the point. Thinking about how a future government might be untrustworthy is a way of inviting us to examine our current regime. There has been no shortage recently of new books trying to analyse the rise of autocrats and destructive politics and asking whether we are ambling into a post-democratic abyss. Smith is asking the same question. Importantly, she also demands that we consider the consequences of living in a connected world in which resources are held in nation states but diseases have no respect for national borders. On her side is a shocking serendipity with our current pandemic and discourse. During the week in which I read The Waiting Rooms with its clear critique of Big Food, the debate whether post-Brexit Britain should allow food produced to US standards on our shelves reopened.

Smith has no qualms about manipulating the reader. In order for us to understand that everything has changed, cellulite becomes deadly, books are replaced by sterile devices with touchscreens (*shudders*), the world’s oldest person is 94 and the King hasn’t sent a single telegram to a centurion. I’ll admit that I quite like it when authors do that: it’s a way of saying that they don’t trust that harrowing scenes involving the world’s poorest people are utterly relatable to their privileged readers – but that they won’t judge us for it.

Not a fun read, exactly. But it is a warm one. In Kate, Mark and Sasha we have a believable family whom we like and root for. We do want to know the story of the mysterious woman and how the story in South Africa leads to the crisis (for we quickly assume that it will). I am not always convinced by the relationship that starts in South Africa, certainly once the characters leave that country, but with that exception Smith gets us behind the characters, though I am not sure what to make of one of them and I would be interested to know whether it was the author’s intention to keep us guessing. That would certainly be consistent with the themes of trust that have permeated this book.

The Waiting Rooms is unmissable, terrifying and absolutely of this moment: it is an outstanding debut novel.

You can get The Waiting Rooms here (affiliate link)

Thanks to Orenda Books for the review copy.