This was an interesting novel which cast a light on a bit of history I didn’t know much about, the aftermath of WW2 in the Netherlands.

The book is set in 1961 and the two main characters are 30-year-old Isabel and Eva, a couple of years older, so both had been children during the war years. Isabel is paranoid and neurotic, living alone in a house on the east coast which her uncle purchased during the war for her mother and the children to live in after the death of her father; it has been promised to Louis, the older of her two brothers, on her uncle’s death. Her other brother Hendrik is in a relationship with a French man of mixed descent, two facts which are quietly not mentioned in the family. Eva is the latest in a long line of short-lived women Louis introduces to his siblings. Most of these girlfriends come to one dinner and are never seen again, and are generally despised by Isabel and Hendrik, but in spite of an awkward first meeting with the family Eva asks to stay with Isabel while Louis is away on business for a month.

The story builds slowly and menacingly. Isabel lovingly cares for the house and her mother’s favourite things including a set of dinnerware with a hare motif. She is shocked when Hendrik casually mentions that it wasn’t their mother’s at all but had come with the house, which had been bought fully furnished in 1942. She is discombobulated by Eva’s arrival, becoming convinced that Eva is stealing things. She becomes more and more anxious and uptight, and the atmosphere becomes increasingly claustrophobic, until a turning point comes when she is forced to acknowledge that her dislike of Eva is in fact underpinned by a fierce sexual attraction. For a while it feels as though the novel is just going to be a lesbian romance, but the final third takes another turn.

The shadow of the war looms large, even 15 years after its end, all the more present for the memories not really being confronted head on. A dimly remembered episode, when the family were visited just after the end of the war by a hysterical woman with her daughter demanding that her property should be returned, has long ramifications for the plot. I did see the final twist coming from very early on, which probably doesn’t matter since this isn’t a thriller, but it did make the middle third, the developing relationship between Isabel and Eva, feel too long. As obligatory queer subplots in contemporary novels go, this one fitted in better with the overall purpose than some others I’ve read, but I am getting to the point where it’s a device in historical novels that is making me a bit weary.

So, as is often the case with well researched first novels, I’m going to say that there is a lot in this one which is of great interest, and it’s written very well, but it needed to be a bit tighter I think. Worth reading though.

I found this book an great read and was extremely well written. The author's approach to discussing race and racism in relation to health and wellbeing was incredibly insightful and well-articulated. Unlike other books on race which are often more general, this one delved into the intricate connections between racism and health, offering a detailed exploration that I found to be quite compelling.

One chapter that particularly stood out to me was the one on environmental racism. It shed light on the profound impact of not only experiencing racism but also living under the constant threat of it on one's everyday life and overall health. If your body is constantly in fight or flight due to the threat of racism it is obvious going to have a detrimental affect on health and wellbeing.

While I did notice some generalisations in the text and some scientific studies used as examples have relatively small participant numbers, I appreciated the book's strong scientific foundation. The extensive bibliography also made it easy for me to delve deeper into the referenced studies.

The book also brought to my attention the issue of racial bias in medicine, illustrating how medical professionals often only encounter examples of conditions on lighter white skin. This systemic bias hinders the recognition and treatment of conditions in individuals with different skin tones, which was a perspective I hadn't fully considered before.

The author also emphasised the critical importance of data in addressing discrimination. This resonated with me, as I encounter similar challenges with data in my professional life. The book highlighted how the absence of accurate data not only hinders efforts to address discrimination but also affects various aspects of intersectionality. I was particularly struck by the discussion of the sensitive nature of medical data collection in some European countries, such as Germany, due to historical fears and valid concerns about privacy and misuse.

At times I did find that the book could be a little repetitive but overall, I thought it was, thoughtfully structured, and truly eye-opening for those who may not have firsthand experience with racism.

This book discussed the racial and ethnic health disparities in different countries. It looked at the link between racism and health harms,both systemic and interpersonal forms. Saying they both exist within medicine and health care.
I really liked the way the book discussed the research and gave people's relatable lived experiences throughout. It certainly made me think more deeply of my own experience with health care.

Having read Medical apartheid I was naturally drawn to Systemic by Layal Liverpool. Once again I was somewhat shocked by her challenging evidence which only served to highlight the systemic racism that still exists in diagnosis and medical treatment between races. I found the book accessible and easy to manage for the lay reader as well as those trained in the profession.

The continual stereotypical approach when dealing with black people and people of colour during COVID was particularly enlightening. For me it put a lot of doubts and questions into perspective. Liverpool does a great job in addressing this up to date event that shook the nation by demonstrating just how POC were treated as if their socio-economic situations played no part. For that I thank her.

The stories of those around the world proved also interesting and some of the cases resonated with me and I suspect this will be the case for many once the book is published.
Maybe some day the healthcare will be truly equal without prejudice.

Thank you NetGalley for giving me the opportunity to read this- highly recommend

Systemic is a nonfiction book by Layal Liverpool on Systemic racism and how racism in healthcare impacts black people and ethnic minorities. I would recommend this for readers of Under the Skin by Linda Villarosa and Medical Apartheid by Harriet Washington. Systemic is very up to date with statistics and information on COVID-19 and how racism impacted the pandemic. Liverpool has clearly done their research because this had real life perspectives of how people have been impacted by systematic racism and it even had celebrity examples like Serena Williams. If you are interested in this topic I think this is a great place to start. I am giving this 4 stars and the only reason it is not a 5 is because it wasn’t the most engaging but that’s my own personal issue. I definitely recommend this book and it is an important read.