Spotless

Everybody lies to their doctor. The body never does.

Every morning at seven, the ward must be spotless.

Elisa Valli irons her uniform at a hundred and ninety degrees, counts twenty-three steps to the pharmacy - never twenty-two, never twenty-four - and recites the protocol like scripture. In a ward that smells of tired flesh and surrender, she is the only one who sees the dirt. And the only one willing to remove it.

She is hungry. But she needs something that won't soil her as she digests it, and perhaps nothing like that exists.

Around her are the patients: an old man who believes he is Napoleon, a dying Scotsman, and a soaking-wet white horse that no protocol can classify. And there is Dr. Christian Sarti, the new director, who answers her in Latin and looks at her like a riddle he is desperate to solve. In her memory: the Little One, a tower of colored blocks collapsing, the first notes of Für Elise playing again and again.

Then the medical records stop adding up.

Spotless is a psychological horror novel told in a voice that is sharp, clinical, ferocious, and at times darkly funny. It is a story about purity as obsession, food as a weapon, and care as a form of power. And about the one question that follows you from the first page to the last:

Which side of the desk are you reading from?

For adult readers. Contains explicit violence, including the abuse and death of a child, cannibalism, eating disorders, suicide, and psychiatric restraint.