I don't know where to begin with what I found wrong with this book. I think one of the biggest reasons this book bothers me is that the author spent a lot of time exploring the torture itself - the victims' pain, the implements used, and details of the injuries without sufficiently exploring the psychological and emotional impact of torture on the victims and the perpetrator. Sure, Kosciusko has nightmares and assuages his guilt feelings by drinking, but it wasn't enough to convince me that he was truly suffering any inner emotional turmoil. It seemed to me as if one moment he was a dedicated medical professional and the next he was torturing victims and getting a thrill out of it. The transition in character was not realistic and, to me, Kosciusko lacked depth and complexity. Perhaps I would have been able to stomach this book better if the author showed more of Kosciusko's human side.
Sadly, I abandoned the book just 50 pages before the end.