Ischaemic by Andrew Cahill-Lloyd is a dark, twisty thriller that jumps between a closeted truckie with a secret nightlife, a man blindsided by a DNA shock, and a homicide team chasing a string of killings. Joshua is introduced as a married interstate truck driver with “queer kink” and a taste for danger. Antony, meanwhile, gets DNA results that point to a same-age brother, and it flips his whole sense of self. As deaths stack up and detectives Webb and Tiernan work the case, pressure builds from every side. Then the personal hits the practical. Money goes missing through Antony’s own login, and later, he ends up donating a kidney to Joshua. The book barrels toward a final confrontation, a shooting, Joshua’s death, and Antony’s name being cleared.

The writing style is loud and visual. It often feels like a camera is parked in the corner of the room. I could see the lights, the sweat, the dread. I liked that pace. It kept me turning pages even when I wanted to mutter, “Mate, slow down.” The downside is that it can lean hard into big feelings and big setups. Sometimes it reads a bit stacked. One punch lands, then another, then another. Still, I respected the commitment. It swings for the fence. It does not do “subtle,” and that boldness can be a guilty pleasure.

What stuck with me was the mess of identity and control. Adoption. Shame. Desire. Family roles that rot from the inside. The kidney thread felt like the sharpest moral test in the whole book. Love versus obligation. Anger versus pity. It also goes into sexual harm and coercion, and that hit me in the gut. I had moments of real sympathy for characters, and then whiplash when the story shoved me somewhere darker. That push and pull felt intentional. It made the book feel mean at times, but also honest about how trauma can scramble people.

The wrap-up gives a sense of closure and a glimpse of healing later on, which I needed after all that intensity. I’d recommend this to readers who like gritty thrillers with family drama, queer themes, and a true-crime vibe. Bring a strong stomach. Expect explicit scenes and heavy topics. If you want a neat little mystery, nah. If you want a wild ride that punches hard and keeps punching, this one will do it.

Pages: 260 | ASIN : B0G94PTRGK