There is a subgenre of science fiction that is not generally recognized that -- to make up a word -- I will call xeno-anthropological science fiction. It is characterized by positing an extraterrestrial alien sentient species and then exploring the ramifications of its culture. Quite often the exploration is done by assuming misunderstandings between the aliens and humans. I tend to think these stories could be done better if the alien cultures were simply made to be human cultures. Geographically and historically there have been a large number of human cultures that have been radically different from one another and there have been many and varied conflicts generated by misunderstandings based on cultural assumptions. Without doubt there are also very many human cultures that could exist, but never have. The advantage of writing stories about these hypothetical human cultures is that the author would not have to worry about making up an anatomically and physiologically different alien species. As different as various human cultures may be they are still human and the author and the reader could share certain assumptions about them and that would lend to the story's verisimilitude. As varied as human culture might be it is still constrained by factors such as human psychology, anatomy, physiology and environment. If one is going to write about alien cultures it would be better if the alien culture was not within the parameters of what is possible for human culture. It is rare that those alien cultures are outside of human parameters though. That is another problem. Making space aliens just like humans except that they look different detracts from the verisimilitude too.
This book takes place in an interstellar hospital that takes on patients from many and varied alien species with many and varied alien cultures, so there are a lot of cultural ramifications to explore. Given the setting it would be a good opportunity to explore the ramifications of various alien physiologies and anatomies and some of that is done, but it is clear that the author is more interested in the anthropological implications. Despite the fact that I am generally not enthused by xeno-anthropological science fiction I did like this book. Yes, the alien cultures that were posited were generally within the human parameters, but the main thing that caused me to give it four stars rather than three is that not all of them were. Some of these cultural attitudes could not be held by any group of human beings because human beings are just not made that way. That became the most interesting part of the book.