Moving from comfortable Virginia to Kenya to begin the nation’s first heart surgery programme sounds like a noble objective, but Dr Jace Rawlings is running away. He’s running away from a broken marriage, a possible affair and memory loss, and returning to the town where he grew up as a missionary kid, working at the hospital where his Dad was a doctor, and where he lost his faith and his twin sister. But this is Africa, and there are challenges in getting the programme started, not least in getting the equipment through customs. And once Jace undertakes the first operation, he finds a strange after-effect: his patient is giving him messages from beyond this dimension. And that’s not his only problem. Someone is out to end the heart surgery programme, and it looks as though he might be implicated in a death back in the US. I’ve read and enjoyed novels set in Africa and other exotic locations (particularly those by JM Windle). I’ve read and enjoyed medical dramas (by authors such as Candace Calvert and Hannah Alexander). I’ve read and enjoyed novels with a supernatural element (like The Widow of Saunders Creek or Illusion). And I’ve read and enjoyed several of Kraus’s previous books (including Perfect and the Claire McCall series), so I thought I would enjoy this. I did, but not as much as I expected. The opening of Open Heart was excellent, as Jace found himself thrown in jail, then refusing to pay the bribes to release his medical equipment. But as I progressed, it felt as though the novel was trying to be a supernatural thriller (with supernatural messages and a witch doctor), a medical thriller (the surgery) and a suspense novel (who wants to end the heart programme and why, the US element and the back story about Jace’s twin sister) all at the same time. It was too much, and I’m not sure it worked. But my big problem was Jace’s faith. While I could understand why he turned away from Christianity as a child, I didn’t see why he essentially faked faith throughout his adult life. He married another missionary kid, a strong Christian woman; he went to church, then he goes back to Africa to serve in a missionary hospital, yet he has no personal faith. (SPOILER: He then has a major change of heart at the end of the story, yet it came out of nowhere. It seemed convenient rather than heartfelt).And there were times when Open Heart was let down by the writing. I found that the technical dialogue that comes across quickly in a TV medical drama doesn’t work so well on the page. It sounded authentic, but it read like a foreign language. There were too many points of view, odd changes of tense, and some of the scenes had a repetitious sentence structure (like starting consecutive paragraphs with adverbs). And there’s a spelling mistake in the Amazon blurb (it’s maelstrom, not maeltsrom), which isn’t good. Overall, it could have been great, but it wasn’t. Thanks to David C Cook and NetGalley for providing a free ebook for review.