Gone Before Goodbye

Gone Before Goodbye taps into the real-world rise of a global billionaire class and the corresponding growth of “concierge medicine,” a system where extreme wealth grants access to exclusive and often ethically ambiguous medical services. This phenomenon is embodied by the novel’s antagonist, the reclusive oligarch Oleg Ragoravich, who operates a secret, lavish medical facility called “The Vineyard” entirely outside of legal and ethical norms. This fictional world mirrors a reality where the ultra-rich fund private research and engage in “medical tourism” to circumvent regulations in their home countries. The novel’s organ-harvesting plotline, for instance, reflects a real global black market; the World Health Organization estimates thousands of kidneys are sold each year illegally to service this demand. The novel examines the intersection of organ trafficking and medical tourism, which, according to The International Journal of Travel Medicine and Global Health, “have their origins in global wealth inequality and poorly developed organ donation and transplantation service in many countries” (Flaherty, Gerard Thomas, et al. “Transplant Tourism and Organ Trafficking: Current Practices, Controversies and Solutions.” The International Journal of Travel Medicine and Global Health, 26 June 2021).  

Ragoravich’s pursuit of longevity is also grounded in actual scientific advancements. His focus on creating a superior artificial heart with the THUMPR7 device parallels real-world efforts like the development of the BiVACOR Total Artificial Heart, which the text also mentions. In the novel, Ragoravich’s immense fortune allows him to transform these cutting-edge technologies from tools of healing into instruments for his personal ambition. His liaison, Ivan Brovski, notes that Maggie’s suspended medical license makes her the “perfect” surgeon, illustrating a world where the wealthy seek practitioners who are, like them, unbound by conventional rules.