Science Fiction is at its best when the futuristic or other-worldly setting is merely the stage for a story about larger issues and meaningful relationships. Transference is an excellent example. The story is about how one person can make a difference against all odds, the impact of the stratification of society, the immorality of the rich accumulating wealth by walking on the bent backs of the poor, and the philosophical conundrum of whether the end can justify the means. It’s also a story about love and lust and deception and guilt and honor. After buying into the premise, the reader can forget about the setting and the tech and get lost in the narrative. Mr. Patterson achieves that level with a compelling story and solid writing. This first installment of what he’s calling “the Narrator” series, sets the bar high for part two.

                Nick, the protagonist, is at the lowest level of society in “the city.” He’s a sicko – someone who sells his body and takes on sickness from another person. This is accomplished through a mysterious “box” that has the power to transfer one person’s maladies into the body of another, leaving the transferor healthy and potentially killing the transferee. If the sicko survives the disease, he has some money, but still exists in the lowest rung of this self-contained civilization. In the lower level, life is hard, food is scarce and manufactured, conditions are challenging, and nobody lives a long life. In the upper levels (a kind of reverse-Inferno where the higher you go, the better your life is), the conditions are progressively easier. At the highest level, it’s a kind of paradise, but populated by spiteful, petty, politicians. (Dante would be proud.) When Nick survives a nasty cancer and finds himself flush with cash, he decides he wants to change the system.

                The key to societal change is to destroy the technology behind “the box” and force the rich to bear their own diseases and the consequences of their opulence. To accomplish this, Nick must infiltrate high society and gain access to the halls of medicine. He doesn’t know where the tech resides, or what it will look like, or how to kill it, or how well-guarded it will be. He only knows that this is his quest. (Cervantes would also be proud.) After undergoing a physical make-over (with the help of a doctor whose syphilis Nick had twice handled for him), Nick impersonates Allan, the son of a wealthy family from the second-highest level. To succeed, he must deceive Allan’s former girlfriend, who lives in the top level, which causes Nick/Allan some internal conflict – causing pain in support of a greater good. But he is convinced that the end here justifies any means. (Machiavelli would be laughing his ass off.) And there are other radical forces, including a terrorist organization willing to kill hundreds of aristocrats, also with the same objective as Nick/Allan.

                The story unfolds with brilliant detail, full of emotion and intrigue. There is also a fair amount of action, a little romance, and many friendships and acts of kindness. The pacing is terrific and the pages turn easily leading to the twists and betrayals that precede the exciting and unexpected conclusion.

                Without spoiling your read, the final assault on the medical citadel feels a bit like the final levels of a video game and somewhat detracts from the more tempered vibe of the first 90 percent of the book. The ultimate reveal and conclusion is not the best part of the book, and although it certainly sets up the sequel(s) (C.S. Lewis appreciates the homage), I would have preferred less explicit exposition and more ambiguity that Nick will need to deal with in the next book. That’s a minor quibble, however, at the end of a book that I very much enjoyed and fully recommend for all readers, whether science fiction fans or not.