A solid, satisfying science-fiction story you haven't heard before. There's a lot to like about "Saint Elspeth," from its relatively original setup and premise, to the copious scientific details on display in its science fiction, to the generally unpredictable way its narrative unfolds despite relying on a few tried-and-true tropes of the genre. There are some great moments of development and growth that occur, particularly among the younger characters, but I was also pleasantly surprised to find many of the older folks portrayed as being capable of the same, and more than simplistic stereotypes only serving as plot devices, which can often be a weak point in such tales.
Honestly, I don't have many complaints about the experience. There were a few, what I'd call, rough edges, here and there but given the length and complexity of the work, and the many things it does extremely well, I found them very easy to ignore or overlook when they occasionally occurred.
It's also worth noting that, being written by an actual emergency-room physician, all the descriptions of medical procedures and the associated minutia of running a makeshift hospital in a far-from-ideal situation made for some of the most interesting and compelling aspects of the read. That's not to say that any of the other elements were particularly lacking but there was a distinct punch and authenticity to the way everything involving the practice of medicine was delivered that really stood out to me.
Bottom line: If you're looking for a dense yet accessible science-fiction book to immerse yourself in that has a great deal to offer beyond what's typical, "Saint Elspeth" is an excellent choice in my estimation.