New York: Penguin, (2013). First edition - The author's first novel, published only as a trade paperback in the US. "Meet Tristan Hart, a brilliant young man of means. The year is 1751, and at the age of twenty he leaves home to study medicine at the great hospital of St. Thomas in London. . . the intellectually ambitious Mr. Hart, in addition to being a student of Locke and Descartes and a promising young physician, is also, alas, psychotic. He is obsessed with the nature of pain and medically preventing it, but - equally strong and much harder to control - is his obsession with causing it." 547 pp. ISBN: 978-0143123828.