Little Ivy Pettibone is born in west Texas with birth defects, accompanied by a wide intellect plus a genuine zest for life, all of which cause her to fight for all she’s worth upon entering the world. But this being the 1930s, the birthing doctor attempts to snuff her out, as was the practice back then when deformed, disabled “monsters” came along. However, infant Ivy refuses to go quietly, and circumstances conspire so that–instead of being pronounced dead, she is placed into her loving mother’s arms–a mother who sees her as precious and perfect despite the obvious handicaps. Ivy then becomes the backbone of John Albedo’s profusely rich novel NUTSHELL, reappearing every so often woven into the tales of other characters whose lives and realities readers are invited into.

One of those characters is Chase Callaway, the grandson of the famed doctor who initially tried to euthanize Ivy with his bare hands. Chase, whose innate talents might have led to a life of songwriting, also enters the medical field for practical reasons as an aide at a psychiatric institution. It is there that his path first crosses the irrepressible Ivy. With garbled speech and fingers still fused into flippers, the now orphaned Ivy has been receiving an ever-changing stream of professional diagnoses regarding her conditions which have caused her to barely escape being subjected to treatments such as lobotomy, a standard method of care used on psychiatric patients at the time. Unfortunately, whereas once Ivy’s disposition was often joyful, due to the various health care modalities she’s been subjected to–from electroshock to experiments in hydrotherapy and sleep deprivation to convulsive therapy, etc.–little by little this pint-sized wonder now exhibits fits of rage. Meanwhile, Chase isn’t having an easy time of it either as what he witnesses going on behind the scenes regarding patient care within the field of general surgery is hair-curdling. With professional ego and personality conflicts taking center stage, First Do No Harm to patients does not seem to be that much of a priority for many of the health care practitioners Chase encounters.

Classified as literary fiction, the genre seems too staid to contain John Albedo’s NUTSHELL, a thought-provoking, emotionally rattling and gut-wrenching book that will cause readers to question everything they once thought they knew about how the vast U.S. health care system ‘works.’

~C.S. Holmes for IndieReader