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Virginia Nielsen's post-apocalyptic tale of family and survival, Maladies, shows empathy and deep understanding of its characters from the outset. Any reader interested in three-dimensional portrayals of credible people will find a lot to like in this brief book. Nielsen's primary character Sam, a young and resourceful woman, has her life upended in the aftermath of World War III beginning, an invasion of the United States mainland, and chemical attacks reducing much of the population into "hybrids" who murder indiscriminately and cannibalize other humans. Her responses to losing her mother and brother after her family leaves the mainland for the comparative safety of the sea are quite human and Nielsen builds on that central characterization throughout the book.
She keeps the story moving at a brisk pace from the beginning and doesn't waste the reader's time with needless sideshows. Maladies boast a small cast of characters and this limited dramatis personae makes things "easy" for her and readers alike to focus on creating strong relationships between the book's main characters. The setting for the story is limited, largely confined to a boat, but it doesn't work to the book's disadvantage. It is the first book in a prospective series and the shapeshifter laden climax for the book lays the groundwork for future volumes.
There is much to commend about Nielsen's Maladies. Despite writing in a defined genre full of conventions and traditions both literary and cinematic, she succeeds in crafting a narrative that relies on human connection and emotion far more than "gee-whiz" set pieces. It is a work you can consume in a single sitting and, undoubtedly, it will assume even greater contextual luster when she completes the series. This is entertaining genre fiction with some literary merit and, based on the book's dedication if nothing else, an obvious labor of love.