First-timer Josh Bazell’s novel Beat the Reaper is an unusual medical crime thriller — which is to say its protagonist, Dr. Peter Brown, is not just a doctor. He’s also a notorious criminal.

The novel opens with Brown, an overworked, sleep-deprived intern at “Manhattan’s worst hospital,” being mugged by a lone gunman. The mugger starts having second thoughts right away. Probably he should have known better than to try to rob someone with a bad attitude and a thorough knowledge of human anatomy. What he couldn’t possibly have known, however, is that Dr. Peter Brown is actually Pietro “Bearclaw” Brnwa, former mob assassin, recently having completed medical school while enrolled in the federal witness protection program. As it turns out, what this mugger really needs isn’t money. He needs to go to the emergency room — he just doesn’t know it yet.

But Dr. Brown has a surprise waiting for him, too. A cancer patient at the hospital turns out to be an acquaintance from Brown’s former life, with ties to the mobsters who would surely kill him if they knew where to find him. With a phone call, the patient discloses Brown’s secret to an accomplice, with instructions to tip off the mobsters only in the event of his death. If the patient dies, so does Brown.

The plot unfolds from there, weaving present-day events with the lurid story of Brown’s past. We learn how he came involved with the mob and how he fell from grace, and about a series of increasingly dangerous and distasteful jobs in between. And in the present day, we watch as Brown tries to extricate himself from his predicament amid the chaos and insanity of a major metropolitan hospital.

Bazell’s style is pure pulp. This is not a book for anyone who’s bothered by profanity, and certainly not for anyone who can’t handle gallows humor. The sentences come fast and furious, everywhere punctuated by Brown’s dry sarcasm. This style is, of course, something of a crime-novel cliché; but Bazell, himself an intern at UCSF, manages to suffuse it with enough genuine style and wit — not to mention curious asides about the often-unpalatable world of modern medicine — to hold our attention. And where some crime novels are content to stick strictly to formula, offering only laconic banalities disguised as grim truths, Beat the Reaper never shies away from utter, wild-eyed absurdity, particularly in its pleasingly grotesque conclusion. Clever and occasionally hilarious, this is a novel that suggests that nothing in this world should really be taken seriously — not even life and death.

Beat the Reaper is a fast read — if you bring it on vacation, expect to finish it before you leave the plane — but if you enjoy it, know that Bazell has already promised us more of Dr. Brown’s adventures in future installments. I’m usually annoyed by this kind of thing. To me, it suggests a lazy author looking for commercial success, rather than one who is genuinely interested in good writing. But Beat the Reaper was entertaining enough that I may give the next one a try. If Bazell can keep up the pace and doesn’t run out of ideas, he could have an original and enjoyable series in the making.