Reviews
Praise for The Last Patient
Laurie Devine, bestselling author of “Nile,” “Kronos,” and other “Devine Saga” historical novels
A fascinating, deep dive behind the Iron Curtain in Romania, “The Last Patient” is a multi-generational family saga that confronts everyday struggles for love, survival, and identity under the grip of Eastern Bloc Communism. Its core story chronicles an opportunistic doctor’s uphill climb for a bigger piece of the relatively meager socialist pie in Bucharest—a bigger apartment, status jobs, foreign vacations, and ongoing do-or-die opportunities to defect to the West. What is a triumph for author Tudor Alexander is his realistic portrayal of characters—the bombastic patriarch Kostea, his long-suffering wife Clara, their son and assorted in-laws uncles and cousins—who seem so familiar and endearing that often painful concepts like party loyalty and food shortages matter less than its culture of deeply loving family ties and traditions.
J. Wynn Rousuck, author of Please Write: A Novel in Letters and award-winning Theater Critic at WYPR, Baltimore’s NPR Affiliate
The Last Patient is a beautifully written, absorbing account of one family’s life in Romania under Communism. Focusing on the father, a noted surgeon, this novel/memoir shows the forces that drive even those who love their homeland to leave it and start their lives over. A moving story populated with rigorously delineated characters, The Last Patient is an especially important book now, when immigration to the United States is increasingly misunderstood.
Lauren Goodsmith, Founder, Intercultural Counseling Connection; author, The Children of Mauritania, The Path of the Sun
Tudor Alexander's “The Last Patient” offers a vivid, often poignant portrait of one family enduring and emerging from the dark period of Ceausescu’s regime. At once intimate and sweeping in scope, the novel evokes the specifics of time and place through deeply atmospheric prose and dialogue that rings utterly true. With both clarity and compassion, Alexander depicts the dreams and desires, strengths and frailties of each of his characters. As they navigate the convolutions of Communist rule and the even greater complexities of the heart, they variously cling to and relinquish hopes and expectations, and make tenuous deals with others, and with themselves.
Review by Kate Robinson, US Review of Books
"What was an immigrant then, but a person with his legs in two countries and his heart riven?"
Alex Duvan, publishing as Tudor Alexander, penned this timely tribute to his Romanian parents and grandparents as a sensitive and honestly wrought historical family drama. The biographical novel covers nearly five decades in the life of Kostea Bardu, a Romanian surgeon. The story turns full circle, starting from the moment Clara Bardu, Kostea’s wife, goes into labor with their son Toddy near the outset of Kostea’s career in Russian-controlled Bucharest until he tends to his final patient, once again Clara, as she negotiates the ravages of cancer in the United States.
The emotionally poignant plot juxtaposes chapters devoted to Kostea with chapters devoted to Clara, who is also an accomplished physician, and with chapters starring the couple’s son Toddy, Clara’s mother, and Kostea’s mother. The family deals with many hardships during their years in Romania, especially during the Russian occupation from 1944–1954. While Kostea is often tempted to defect to the West as opportunities arise, he instead toes the line and nurtures the private and political connections necessary to protect his close-knit family and polish his social standing in Bucharest. A big fish in a little pond, Kostea is often unaware of how his temperament affects others while his achievements and his ego expand beyond his empathy for his family and friends.
Alexander’s portrayal of the proud, misogynistic man is memorable, and his quiet but articulate prose supports the character-driven, literary ambiance. The author seems at his best while delivering the ever-increasing tension marking the years before Kostea nearly loses all he’s worked for during a midlife crisis. Love and loyalty, loss and resilience, and the drive for survival at all costs make this novel a celebratory reminder of the humanity present in every nation and culture around the globe.
RECOMMENDED by the US Review
MWBR
The Last Patient opens with a 1993 Maryland setting in which wife and mother Clara lays dying, her husband Kostea and son Toddy caring for her in her final hours. The main story embraces Clara and Kostea’s past, however, with the first chapter returning to 1950s Bucharest and elsewhere, which is experiencing political turmoil and the raise of the proletariat.
The dangerous environment has been building for a good while, Dr. Kostea Bardu notes, with the contagion of political repression now infecting people they know:
“...we are small potatoes, but it doesn’t matter. What started at the top extends now to everybody. Simply put, it’s terror.”
In this past, Clara is nine months pregnant, still working as an intern in the hospital as she awaits their first child. A rap on the door brings more bad news on the cusp of her welcomed first child:
“Comrade Bardu, your apartment has been subdivided,” the policeman informed Kostea, handing him an authorization with the emblem of the precinct. “These are Comrades Sorin and Marta Ionescu, and their five-year-old son, Radu. Your second bedroom was assigned to them, with access to your kitchen and bathroom.”
Kostea paled. Haltingly, Clara had followed him, and he heard her breathing behind him. He turned and pointed at her rounded belly. “There must be a mistake. We need the space. We’re expecting a baby.”
The policeman shrugged. “I’m merely executing an order. You know there is an acute housing shortage after the war. All of us make sacrifices.”
By now it should be evident that Tudor Alexander pays close attention to the juxtaposition of personal and political climate, bringing characters to life that are experiencing the blows of decisions they no longer make for themselves, which are imposed upon them from above.
Their assertive, demanding new “roommates” introduce further adversity and struggle to the young couples’ lives, illustrating the divide that comes from Communist activists who are as passionate about their patriotic purpose as they are about their newfound rights under this repressive regime.
As Alexander unfolds this couple’s shifting world, uncertainty, changes, unreliable happinesses, and affairs emerge that further impact their lives and perspectives about relationships, faithfulness, and life under the hand of Ceaușescu.
Readers receive thought-provoking, realistic insights about this period of time and how people not only survived, but sometimes flourished (albeit in unpredictable ways) as they raised families, faced the usual concerns of aging and change, and forged new pathways of discovery and life against a political backdrop that was anything but kind.
As the decades unfold, shifting viewpoints between Clara and Kostea reinforce differences in ethics, values, and experience that inject intriguing, thought-provoking reflections for readers:
At the trailhead, the driver turned his truck around. “Happy trekking,” he said. “And enjoy the time with your son.”
The path led uphill through the forest. The air was velvety and fragrant, the light borrowing a green hue from the trees. Kostea walked ahead. As the incline increased, so did the distance between him and Clara.
From Toddy’s emigration and profuse letter-writing over a five-year period to Clara and Kostea’s dangerous decision to escape the culture and place they have long called home, Alexander weaves social, political, and personal struggle in a compelling manner.
Readers may think they’ll need prior familiarity with the politics and regime of the times—but they do not. The backdrop and history are intricately referred to and woven into a story that proves deeply compelling even to those who may know little Eastern European history or culture.
Libraries that choose The Last Patient for their collections will find it worthy of book club and reading group recommendation for its outstanding blend of personal and political reflection.
Given modern times and questions about survival, fascism, freedom, and life trajectory, The Last Patient is especially relevant, important reading that should be chosen and discussed by any thinking readers interested in past precedent, history, and future possibilities.
Clark Thomas Riley, author
The reality of the Cold War lives on in today’s culture. We ignore the lessons of that time at our peril. The Last Patient is a triumph of the resilience and persistence of the human spirit. We care about the characters in this rare glimpse into the world of Romania in the days of Nicolae Ceaușescu.
Shayna, May 28, 2025, five stars on Amazon
The Last Patient isn’t just a historical novel—it’s a deeply personal, emotional journey through one family’s life under Communism in Romania. I wasn’t sure what to expect going in, but wow, this book pulled me in fast. The writing is eloquent and honest, and the characters ring true, especially Kostea, who is flawed and frustrating in the way anyone with a complicated male figure in their life will understand.
The book spans decades, and you really feel the weight of time—how the big political shifts affect the small, everyday moments of regular people living through extraordinary times. It’s heartbreaking at times, but also filled with moments of resilience and hope.
If you like historical fiction that focuses more on people than just events, and stories that make you feel something, definitely give this one a shot. It’s the kind of book that lingers after the last page. Oh, and the cover design is complex and absolutely gorgeous.
Alicia M. Avery, May 7, 2025, five stars on Amazon
Beautifully written
The Last Patient is a vivid, absorbing account of life in Communist Romania, and the challenges faced by a family of medical doctors navigating social and personal complexities. The characters are exceptionally well developed, within a moving story of particular interest to those of us who have not known Romania during post WWII years. The reader learns about experiences/challenges faced by highly skilled professionals immigrating to the US. This book is an excellent and gripping read.
Craig David Singer, April 15, 2025, five stars on Amazon
You will love reading this book!
Alexander has crafted a masterful tale of family life in post-war Romania. Through effortless prose and richly drawn characters, we are immersed in a world of personal struggles and political intrigues that spans decades and continents. The last part of the book is a deeply moving portrait of aging and death. This is a beautifully written story, one that will stay with you long after you read the last page. Highly recommended.
Andrew Frank, Canada, March 20, 2025, five stars on Amazon
Truly moving read
A beautiful, raw, gritty, epic journey through life straddling two different worlds. A story of real love, warts and all at times, and family, with a backdrop of the Cold War and a window into a generation that left a rich life in Eastern Europe to move to the new world. This beautifully written book is an important tribute to the millions who left on this bittersweet journey, those who stayed and anyone else who wants an insight through this authentic voice. And a great story.
Peter Varadi, March 14, 2025, five stars on Goodreads
Love’s triumph over loss and pain
The Last Patient is a story of the triumph of love over loss and pain during some of the most challenging times of mid 20th century Romania. With words like, “It is wrong to grade pain, it is wrong to grade love…”, the author invites the reader to a gently guided journey in the times when “everyone wore invisible shackles”, “life was hard but never hopeless”, and people’s aspirations were as alive as always. The journey proposed by Tudor Alexander is endearing. There are no “good” and “bad” characters in the book; there are only complex characters, each with their own story, ethos, motivation, aspirations, and dignity. The Last Patient provides for truly immersive reading, in which the readers—equally those who had lived in those times and places, and those who have not— become part of the story. With the author’s creative maturity on display, The Last Patient claims its place on the map of accomplished contemporary novels.
Stela Bratescu, March 26, 2025, five stars on Amazon
First love, last patient
The novel is a mosaic of words, events and images which form the powerful portraits of a series of complex characters facing their destiny in a world cursed by history, but blessed with love, humour and joy of living.
The sudden irruption of smells and sounds of the nature in the narration has the same stunning effect as in Joseph Roth's unforgettable Radetzki March.
When in philosophical vein, the author creates striking sentences that force you to stop reading, think over his thoughts and try hard to memorize them.
Diana Z, March 3, 2025, five stars on Amazon
Compelling family saga
Through masterfully crafted dialogues and salient descriptions, this candid recount of a family's history draws the reader to partake in its complicated dynamics where the main character, the undisputed patriarch looms large despite his flaws. The decades of post WWII communist Romania are depicted in evocative stories of food and housing shortages, the subeconomy of influential people, and the ubiquitous anxiety of an oppressive regime. With compassion and humor, the author relates the story of emigrants who struggle through the loss of identity in the effort to build a new life. However, the family’s dramas transcend to a universal experience of love, friendship, trust, betrayal, pride, and resilience.
T. Llanso, April 10, 2025, five stars on Amazon
An exceptional book
A thoroughly enjoyable book about the Bardu family. The story spans decades, generations, and geography, from Romania to the Ukraine to the United States. The often-agitated, mercurial character of Kostea is especially interesting, as he labors as a doctor during the communist period in Romania and then struggles to find his way as an immigrant in the US. Highly recommended!
Andrei Roman, May 14, 2025, five stars on Amazon
A touching, heartfelt and exciting read
The Last Patient is the story of a charismatic, flawed but fascinating character navigating life in mid-to-late 20th century Romania. Buffeted by the winds of political upheavals over which he has no control, Kostea, a surgeon, strives to advance his career, build a good life for his family and remain loyal to his friends, while staying on the good side of the authorities that can take it all away in an instant. Can a love affair derail his best-laid plans? Does lust trump duty, or is it the other way around? Can you have it all - professionally, romantically, materially - or does something have to give? The author skillfully weaves these narrative strands into a touching, heartfelt and exciting read. Highly recommended!
Judith T, March 18, 2025, five stars on Amazon
Epic historical novel!
This is an epic historical novel that begins in Romania and spans over half a century. Kostea and Clara, both doctors, start their adult lives as WWII explodes around them. The shifting political status of the country is challenging and yet along with family and friends they live full lives, have a son, raise him with love and later face a hard separation as he moves to America. Reunited when they immigrate to the US, the final chapters are bittersweet with the happiness of living close to their son and grandchildren yet, missing their homeland, struggling with English and having to cope with unexpected illness. Absorbing read and well worth buying!
Stasia Roze, May 9, 2025, five stars on Goodreads
I was immediately taken with the main characters, especially the FMC (female main character), they’re instantly put into an uncomfortable situation which anyone would find egregious which helps you bond with them almost instantly. No matter what you’re on their side and I feel like this molds you for how the rest of the story plays out. Three pages in and you know you’d ride or die for them (her) it’s the 3 of you against the rest of the world. Although fictional, these characters go through very human, normal day to day issues. They react how you might react, nothing is out of scope or beyond the ways of life. Even any day to day conflict that occurs between characters, be it through work or family, is not overly dramatized or world ending. It is so very human. All together it makes for a really pleasing reading experience, you already feel familiar with the story, it just fits into your life perfectly.
There is a divide between the female and male experience, although subtle at times, it is clear that there are two different experiences that the book flicks between. I think this is where my devotion to the FMC comes from, the emotional labour workload that lands on her plate is relatable to me even though decades span us. The men get to gather and drink and gamble with gentlemanly club vibes, whereas the women either stay at home and tend to the house and the family, or work and then go home to tend to the house and family. The family friends are friends of the husbands more than they are the wifes. Of course this is natural for the time, and is written to show that rather than to make a political point or even be malicious by reducing the power of a woman.
I have fear over women written by men, I’ve been burnt so many times before. But Alexander kept me safe. The FMC isn’t written as an air headed fool, she is intelligent, she has her own agency and she is so strong. The foundation of the family, supporting everyone as the plot plays out. Even as time moves through the book she is the character you look to, to manage the change or to understand the dynamics and even the emotions of the family as a whole. There’s the relationship between her husband and her, her son and her and her mother and her. But then also she is responsible for the relationships between her husband and her son and her husband and her mother. She takes on the entire emotional baggage of the family and always tries to come up with the best solution whilst also still being her own independent person.
The challenges she faces with her husband are heart breaking, soul destroying, and getting the tissues ready tough. My heart still hurts thinking of her story arc and I don’t think that would be the case for any other author. Alexander put his knowledge, his experience and his own family into this book and you can feel it through every piece of dialogue or thought.
As you make your way through the book you’re told play by plays of every choice the MMC makes. I’m not sure if it’s character development or if it’s my opinion of the character changing with each reveal of his choice. Either way I actually really enjoy it, with everything being fact rather than inferred you know exactly where you stand and exactly who the people are that you’re reading about.
Narration
This book might just be my favourite for its narrative voice. It flows beautifully with Alexander’s choice to use the inner monologue of characters in 3rd person. It just keeps you engaged and hooked on reading the book. The cadence of the narration almost makes it impossible to put the book down, it just flows so neatly into your brain. I can’t quite put into words how the writing style suits me so well, it’s almost like it’s itching my brain in the right places. I wish my school textbooks were narrated like this, I would have done much better at school!
As we read, we jump through time, an offering into the backstory of the characters, an insight to why they are like they are now, their traumas and trysts. I think it’s a great way to add more depth to the characters and it shows how times have changed with different wars, hardships and ways of life. It’s very methodical in structure and you can really tell how well every aspect has been planned out. This is a master at work, it is so obvious that Alexander has dedicated their life to writing.
In conclusion, this was a wonderful book to read, it was captivating and enchanting. A raw take on real history with an intrinsic human connection.
Mark Jacobson, March 17, 2025, five stars on Goodreads
The Last Patient is one of the most heartfelt, personal novels I've read in a very long time. Just like the people in my own family, the characters are alternately endearing and aggravating, loveable and detestable. Alexander brings them to life in every exchange and I came to understand all their strengths, weaknesses, loves, and hates as well as what things tenaciously hold them together as a family and a community.
Alexander's prose is extraordinarily well crafted without feeling the least bit pretentious. You hear his characters' varied voices in the dialog and you are allowed to discover their inner lives without the author trying to describe them.
This is a book I am going to recommend to all my friends who love a good, solid read by The Last Patient talented story teller.
Louanne, May 26, 2025, four stars on Goodreads
"The last patient" est une fiction qui s'ouvre en 1950, en Roumanie alors que la guerre est achevée depuis 5 ans ; le pays est le théâtre d'autres exactions passées sous silence, plus souterraines. L' ère du communisme pollue de ses ramifications multiples, les citoyens désormais contraints de partager leur propre logement avec des inconnus commis d'office.
Adhérer au parti communiste roumain devient alors l'unique alternative afin de ne pas subir la suspicion croissante et l'arrestation.
Le climat politique est abordé de façon réaliste, inclus au cœur d'une intrigue où le héros - médecin chevronné - se débat au milieu d'une pluralité de choix existentiel dont, celui, majeur, concerne la sécurité de son épouse et son enfant.
1960/1970 les décrit exposés dans une Roumanie en pleine mutation et en rupture d'avec la domination soviétique jusqu'alors omniprésente, et ce, dix ans après le soulèvement hongrois.
La haine des russes façonne le peuple, qui s'oppose depuis, vigoureusement au parti instauré par le fanatique oppresseur Ceausescu. C'est la fin de l'ère du communisme, relatée dans toute sa déchéance.
Un récit profondément humain, qui dénonce les mensonges de la propagande communiste avec gravité et vérité, et d'un pays qui se bat pour sauvegarder sa dignité, instrument de sa liberté.
Une œuvre poignante à lire !
This review was written for LibraryThing Early Reviewers.