Beat the Reaper by Josh Bazell

Flap copy from paperback:
"Dr. Peter Brown is an intern at Manhattan's worst hospital. He has a talent for medicine, a shift from hell, and a past he'd prefer to keep hidden. Pietro Brwna is a hit man for the mob, with a genius for violence, a well-earned fear of sharks, and an overly close relationship with the Federal Witness Protection Program. Nicolas LoBrutto is Dr. Brown's new patient, with three months to live and a very strange idea: that Peter Brown and Pietro Brwna might- just might- be the same person...

As goons, G-men, and death itself descend on the hospital, Dr. Brown must so whatever it takes to save his patients, himself, and his last shot at redemption. He just has to get through the next eight hours- and somehow beat the Reaper."

This book is a fast-paced, often terrifying ride, a literary marriage of House and the Sopranos. The main character is crude, frightening and cold-hearted, and yet he is one of the more appealing characters in the book! As the true story of his past unfolds, Peter/Pietro becomes a deeper, less stererotypical character (though no less terrifying). The dark humor and the sheer force and energy of the writing make this an excellent debut novel, though the language and the medicine are not for the faint-hearted! 4.5 stars.