"This gripping and heartfelt coming-of-age tale from debut novelist Key takes place in a near-future America dominated by an AI system . . . . The worldbuilding fascinates and Pok is a wonderfully believable protagonist acting from both good intentions and naive suppositions. Key should win plenty of new fans with this." -- Publishers Weekly
"In theory, AI has the potential to revolutionize health care by minimizing the potential for human error. Key's debut novel shows a concerningly realistic future if this path is chosen, solidifying his place as a strong voice of contemporary sf . . . . Pok's ethical and moral struggles with AI will resonate with those concerned with society's trajectory. For fans of Michael Crichton, Elizabeth Bear, and Annalee Newitz." -- Booklist
"A medical-minded dystopia with mystery elements that emphasizes the importance of human connection and equity for everyone in a world of artificial intelligence. For readers of Laila Lalami." ⎯ Library Journal

"The writing shows the author's rich imagination . . . . An enjoyable tale about AI's dark underbelly." ⎯ Kirkus Reviews

"The Hospital at the End of the World is the rare speculative novel that brings to life the world in which we already live. Justin C. Key has my full attention. His stunning debut deserves yours."-- LeVar Burton
"The Hospital at the End of the World is smart and brims with imagination, a novel both as big as the future and as intimate as a son's love for his father. Key is a rising star in Afrofuturism, artfully tending the path laid by Octavia E. Butler." ⎯ Tananarive Due, Los Angeles Book Prize and Bram Stoker Award winner, author of The Reformatory
"Justin C. Key writes with sharp-eyed intelligence, integrity, and an unbridled but humane imagination. The Hospital at the End of the World is the cyberpunk, anti-AI, anti-tech-fascism, medical mystery/thriller you need in your life right now. Don't miss it." - Paul Tremblay, New York Times bestselling author of Horror Movie and A Head Full of Ghosts
"A medical thriller, a family saga, a meditation on the practical value of human interaction, and a deep look into an imaginary future, Key's debut novel is smart, exciting, and full of heart. Highly recommended." - Karen Joy Fowler
"A vital book. Vital, by all of its definitions: essential, full of life, necessary. This is a near-future medical thriller that manages to celebrate humanity, caregivers, and humane-ness, while also asking important and relevant questions about the nature of medicine, the decisions we are ceding to algorithms, and the nuances of our increasingly unprivate lives. Since finishing it I keep looking for excuses to bring it up in conversation, if only to say, "You need to read this book." ⎯ Sarah Pinsker, Nebula and Hugo-winning author of We Are Satellites and A Song For A New Day
"The more you read Key the more layers he reveals. From sci-fi to horror to fantasy, he now turns his deft eye to techno-thriller. Key takes his first-hand expertise and takes careful aim at the medical industrial complex, technology, and examines what it means to be human. Thought-provoking as it is gripping, its complex worldbuilding and layered commentary speaks to a near future with words meant for today. Visionary, chilling, and pulse-pounding--like John Grisham meets Cory Doctorow--The Hospital at the End of the World is the medical thriller for the age of AI." - Maurice Broaddus, author of Sweep of Stars, Breath of Oblivion, and A City Dreaming

"The Hospital at the End of the World is a riveting med school thriller about dedicated young people learning the hard lessons of what it means to be a doctor. Justin C. Key puts human faces on the technological revolution we all are about to experience. This is why science fiction was invented!" -- James Patrick Kelly, winner of the Hugo, Nebula, and Locus awards

"A stunning, pulse-pounding, heart-hurting journey through an all-too-plausible nightmare future." -- Sam J. Miller, Nebula-Award-winning author of Blackfish City
"Key's stories exemplify [a] tight focus on interior experiences, zooming in on the intimate horrors wrought by fantastical technologies and events. The standout 'Spider King' features an unwitting participant in a twisted carceral experiment involving telekinetic arachnids. . . .`Afiya's Song, ' about an enslaved Black woman who inspires an uprising, cleverly complicates the magical Negro trope. . . . The intrusive public health system of `Wellness Check, ' the nightmarish interactive art of `Now You See Me' and the alien apartheid of the title story showcase an active imagination and a commitment to socially-minded speculative fiction." - New York Times Book Review on The World Wasn't Ready for You
"From the first sentence of the first story, I knew I was in the hands of a gifted storyteller. Each tale in this tightly woven collection has its own voice, which pairs with the narrative. The stories are by turns heartbreaking and terrifying." - Mary Robinette Kowal on The World Wasn't Ready for You
"One of many distinctive new Black American voices in the fantasy genre, Key shows throughout these eight stories the range and ingenuity of such grandmasters as Ray Bradbury, Robert Sheckley, and Theodore Sturgeon, with whom he also shares acute empathy for human vulnerability. . . . Key resolutely carries on the tradition of the modern SF writers who always found new and rueful ways of reminding readers that no matter how much technology changes, humanity, in its loneliness, folly, and constricted vision, somehow never does." - Kirkus Reviews (starred review) on The World Wasn't Ready for You

Publisher: Harper

Pub date: 2026-02-03

Length: 400 pages