Mutant - Hardcover

Clement, Peter

Hardcover

ISBN 10: 0345443373 ISBN 13: 9780345443373

Publisher: Ballantine Books, 2001

Synopsis

Former ER doctor Peter Clement blends electrifying human drama with the suspense of top-notch medical thrillers. Now, in an all-too-plausible story that could have been torn from today's headlines, Clement has written his most gripping, utterly chilling novel to date.

On an isolated stretch of moonlit highway in Oahu, a woman cradles her dying son in her arms. Though a physician, she cannot staunch the flow of foamy blood from his body. In the days that follow, an autopsy draws a shocking conclusion: the boy, his lungs filled with blood, died of a disease previously found only in birds.

On the other side of the globe, a burned-out ER doctor repeats to himself over and over: Physician, heal thyself. For Dr. Richard Steele, a near fatal heart attack in the middle of his own hospital was the last warning he needed. Now Steele is being recruited into a movement to examine the hazards of genetically modified foods, a job that takes him to an explosive conference in Hawaii.

Spearheaded by a charismatic female doctor, the anti-bioengineering movement is gathering steam. While a powerful company is using genetic breakthroughs to create new, disease-resistant super crops, activists warn that new DNA strains will wreak havoc on the environment. But no one suspects that the controversy is masking a far more frightening human threat.

From the war-torn Middle East to an insulated laboratory in New York, from murder in a French cathedral to an act of terrifying violence at a remote Hawaii farm, a horrific plot is set in motion. With genetic researching opening new doors, one man has realized that altered strains of DNA cannot only change the make up of plant life--they can create the deadliest weapon of mass destruction ever unleashed upon the world.

About this title

About the Author

Peter Clement, M.D., is a physician who headed an emergency room at a major metropolitan hospital and now maintains a private practice. He is also the author of Lethal Practice, Death Rounds, and The Procedure. He is married to a physician and has two sons.

From the Inside Flap

ctor Peter Clement blends electrifying human drama with the suspense of top-notch medical thrillers. Now, in an all-too-plausible story that could have been torn from today's headlines, Clement has written his most gripping, utterly chilling novel to date.<br><br>On an isolated stretch of moonlit highway in Oahu, a woman cradles her dying son in her arms. Though a physician, she cannot staunch the flow of foamy blood from his body. In the days that follow, an autopsy draws a shocking conclusion: the boy, his lungs filled with blood, died of a disease previously found only in birds. <br><br>On the other side of the globe, a burned-out ER doctor repeats to himself over and over: Physician, heal thyself. For Dr. Richard Steele, a near fatal heart attack in the middle of his own hospital was the last warning he needed. Now Steele is being recruited into a movement to examine the hazards of genetically modified foods, a job that takes him to an explosive conference in Hawaii.<br><br>Spear

Reviews

From the Machiavellian imagination of a physician/author of three paperback-original medical thrillers (The Procedure, etc.) comes this debut hardcover, mirroring today's headlines with its story of a world at the mercy of malevolent biogenetic engineers. Unfortunately, however, melodramatic, juvenile comic-book characterization, artless overwriting and distracting, tedious repetition curse the novel from page one. Following a particularly stressful day, veteran New York City ER physician Richard Steele a widower with a 15-year-old son suffers a near-fatal heart attack, totally oblivious that his karma is inexorably intertwined with a biogenetic accident that occurred 13 months before on the island of Oahu, Hawaii. At almost the same moment in nearby White Plains, Dr. Kathleen Sullivan a sort of postmodern Naderesque spokesperson for public radio's Environment Watch is delivering a prophecy of doom to media gathered at a press conference held by Agrenomics International, a mega-international corporation involved in genetic research. Three months later, Steele and Sullivan meet up at an environmental conference in Hawaii, where Sullivan makes a nocturnal foray to a chicken farm where she believes experiments in mutant viruses are being carried out, and is beset by armed gunmen. Meanwhile, Steele beds the mom of an infant victim of the mutant virus, then witnesses her suicide. Star-fated, Sullivan and Steele become allies and lovers. Clement's tale is technically astute, if plagued with unnecessary detail, but his emotionally na‹ve characters and pulpy crafting leave him drifting in the choppy wake of medical suspense queen Tess Gerritsen, much less that of Robin Cook. (July)Forecast: It's doubtful whether readers will make the leap to hardcover with Clement most will likely wait for the paperback. Meanwhile, negative word of mouth could cause Ballantine to regret the unusual money-back guarantee they are offering purchasers of the hardcover edition.

Copyright 2001 Cahners Business Information, Inc.

Professor of genetics Kathleen Sullivan and disaffected agricultural executive Bob Morgan occupy opposing positions on the politics and safety of insufficiently tested GMF (genetically modified food). Theirs isn't just a public relations spat, especially when Taiwanese bird flu and police departments in Asia, the U.S., and France get involved. The stakes are high, and dead bodies are not unusual. Sullivan is convinced that two agribusinesses are producing GMF and puts herself at risk to prove it. She and a faculty colleague, ER physician Richard Steele, join forces against the medical school administration and a prominent industry spokesman. Lurking in the background are Afghanis who, still upset over U.S. bombings in their homeland, try to spray the Ebola virus on New York City on the Fourth of July. Former ER physician Clement realistically projects the tension and challenge of the field in a fascinating novel of national and international commerce and betrayal. William Beatty
Copyright © American Library Association. All rights reserved

A former emergency room physician, now a private practitioner, Clement (The Procedure) here offers his fourth medical puzzler. This one centers on genetic engineering and its potential for devastation if not properly and morally controlled. ER physician Richard Steele joins geneticist Kathleen Sullivan, prominent among anti-bioengineering forces, in her investigation of the effects of genetically modified foods and genetic vectors that can cause diseases to cross the species barrier. Gradually, they unravel a complex web that spans the globe. After a young boy in Hawaii succumbs to an illness that previously affected only birds, the story line expands to include three corporate entities, which may be in collaboration toward a perilous goal. Richard and Kathleen find their lives in danger, and the threat of genetic weapons becomes increasingly real. This novel, which depicts a horrific and dramatic story, improves as it progresses and as the reader establishes a bond with the protagonists. However, the scientific information is presented in exceedingly complicated detail and is almost too much for a lay reader. Recommended for public librar-ies. Linda M.G. Katz, Florence A. Moore Lib. of Medicine, MCP Hahnemann Univ., Philadelphia
Copyright 2001 Reed Business Information, Inc.

Excerpt. © Reprinted by permission. All rights reserved.

Thirteen Months Later

New York City Hospital

Dr. Richard Steele found today’s shift his worst ever in ER. Of course, Mondays were always bad compared to the rest of his week. More people arrived in emergency with heart attacks and every other kind of medical crisis on that day—a fact he knew well as a twenty-year veteran and longtime chief of the department. But this Monday’s marathon seemed particularly hard, and all afternoon he felt a step behind.

One of the nurses slammed down the phone and sprinted toward the resuscitation room. “There’s a precode coming—a fifteen-year-old asthmatic!” she yelled over her shoulder the way a quarterback calls a play. Everyone within earshot leaped up to help her get ready, instantly understanding what would be demanded of them. Past an overflow of stretcher patients crammed into the corridor, they scrambled after her, briskly navigating the jumble of IV poles, bags, and lines that hung like webs from the ceiling.

As he watched them go, Steele knew that not only the protocols for running a respiratory arrest would be flashing automatically into their minds. The patient’s age would pump their adrenaline levels higher than usual. The prospect of losing someone so young always exacerbated the fear of failure in ER. It would be his job to make sure that the extra anxiety didn’t affect his team’s performance. At one time he accepted this added burden as simply another part of his role. These days he found himself dreading it. While his abilities as a resuscitator were as sharp as ever, his people skills had become nonexistent. “Put the MI who’s still in resus near the head of the line!” he called after them, making himself heard above the noise of a department already loud from overcrowding.

He grabbed the nearest receiver and punched in the numbers for the cardiac care unit. In no time two nurses raced back from the resuccitation room pushing a gurney that bore a frightened-looking elderly woman attached to an armada of portable monitors, intravenous tubes, and a tank of oxygen. By then he’d at least managed to bully the covering cardiologist into giving the woman a bed upstairs, where they could treat her heart attack properly. Years of cost-cutting had made such fights into another of his “routine” duties, but this time the argument left him feeling drained and sweaty.

A low rumble of protest broke out from those who were also waiting for beds when the nurses wheeled the woman past their convoy of stretchers and parked her at the front. “Christ, it’s warm in here,” he complained in an overloud voice to no one in particular, continuing to scribble his clinical notes in her chart. “Would someone call maintenance again and tell them to turn down the goddamned heat? It’s too bloody hot to work!”

One of the nearby clerks, already wearing a sweater, gave him a curious glance. The cardiac lady, despite being so sick, skewered her face into an expression of disapproval, pulled her covers up around her neck, and muttered loudly enough for everyone in the nursing station to hear, “I’m lucky to make it out of this zoo before I freeze to death.”

The ambulance attendants rushed in with a tall adolescent who had blue lips, a gray face, and such respiratory distress that beneath his open shirt the muscles between his ribs sucked inward each time he attempted to breathe. Even though they’d given him oxygen, he kept pulling off the mask, frantically rolling his eyes and straining his head in every direction, the way a man trapped in an airless chamber might cast about trying to find a final puff of breath.

As Steele followed the stretcher between the rows of patients lining the way, he huddled with his resident. “What’s your immediate course of action here?” he demanded.

“Albuterol, by aerosol, to dilate his bronchi?” she replied timidly.

“No! At least not first off. This guy’s bronchi are clamped so tight that he can’t inhale air, let alone medication. What are you going to do about that?”

“Give him IV steroids?” she said hopefully.

“Again, later. Right now you’re going to intubate him before he arrests on you.”

She flushed from the neck of her clinical jacket to the tips of her earlobes. “I’m sorry, Dr. Steele, I knew that. It’s just that you’re making me nervous—”

“Knowledge at the ready, Doctor, is the best and only antidote around here for being nervous,” he snapped. With a wave at the boy, he added, “And your apologizing for not having that knowledge isn’t exactly going to cut it with him!”

Her eyes welled up with tears.

Shit, he thought, what an asshole I’ve become! He hadn’t always been so impatient and sarcastic when he taught. The woman on the verge of weeping in front of him appeared young enough to be his daughter, and so far during her rotation she’d proved herself no better or worse than the thousand other novice doctors whom he’d guided through the shoals of ER over the years. With a pang of loss he remembered the heady days when he’d actually adored taking them under his wing and building their confidence. Teacher of the Year, they’d repeatedly voted him before he lost all capacity for the joy of it. Now the phrase made him wince: If any resident had said it of him over the past eighteen months it could only have been in sarcasm. He knew that the sole reason they still put up with him were the skills he could impart. A rotation under his temperamental watch had become known as a trial by fire—a passage to be endured and survived, and then joked about over beer—one of the horror stories that all training programs generate. But causing his charges to cry was a new low, even for him. And if he didn’t make it right with her, she could report him for it. Shit, she probably should, he thought, disgusted with himself. “So how do we do a crash induction?” he asked her a tad more gently.

“Administer IV midazolam for short-acting sedation, give an antifasciculation dose of pancuronium, then paralyze him with succinylcholine . . .”

The answers poured out of her now that he’d adopted a less frightening tone. As they hurried into the resuscitation room, he gladly let her talk. The brisk pace left him out of breath. Damn cigarettes, he thought, wondering if he’d ever regain the courage to quit.

The nurses converged around the teenager, plying him with pressure cuffs, stethoscopes, IV lines, and monitor leads.

“BP ninety over fifty. Pulse fifty-five.”

“O-two sat—eighty-seven.”

“Respirations labored at fifty; minimal air entry at the bases!”

As they measured his agony by the numbers and the resident ordered the meds she’d rattled off before, Steele moved to the head of the bed.

The boy’s eyes were blue rims around pupils wide with terror. He attempted to talk, but issued little more than a barely audible squeak.

“It’s okay, son,” the physician said gently, easily offering the professional comfort he so readily gave to frightened patients but withheld from others around him. With a pang of guilt, he thought of his own child, who was nearly the same age, to whom he’d repeatedly uttered those same words, but never with the conviction that he offered daily to strangers. “We’re going to sedate you and have you breathing right in no time. Just nod yes or shake your head no to my questions. Is your asthma usually this bad?”

The youth shook his head. No.

“Do you use your pumps regularly, the steroids as well as the bronchodilators?” If he’d been properly taught how to administer his medication and manage his problem, Steele knew, he’d understand the distinction. If not, he’d been poorly trained, and poor control would be his norm.

The youth nodded. Yes!

Various screens lit up around them, and beeping sounds filled the tiled echo chamber. Oxygen hissed out the side vents of the patient’s large green mask, which the nurses had substituted for the one he’d arrived with. Quick terse orders bounced around the room.

“. . . get his bloods . . .”

“. . . do an arterial gas . . .”

“. . . a portable chest film . . .”

Through the din Steele thought he heard a small wheezing sound emanating from the boy’s throat each time he breathed in as well as out. His own pulse rocketing, he announced, “He’s also got stridor!” That meant an obstructed upper airway as well as bronchospasm, and a big jump up in the league of trouble they were dealing with. Upper airway obstruction sometimes required a tracheotomy—the act of cutting a hole through the front of the windpipe. Even in the most skilled hands, as an emergency procedure it could be a tricky maneuver. “Were you stung?” Steele demanded, his mind leaping to the most common causes of such a severe reaction.

No.

“Do you have food allergies?”

The boy vigorously nodded.

“To nuts?” The most common culprit.

More head bobbing.

“You ate something with nuts?”

The boy immediately protested, shaking his head back and forth.

The trouble with nut allergies, Steele knew, is that people can ingest the allergen unknowingly when it’s ground up and used as flour in baked goods or added in minute pieces to salads or dips. He also knew that it didn’t matter anyway at this point how the nuts got into his patient. Having recognized the possibility of their ingestion, he quickly added a third enemy to the list of what they might be battling— anaphylactic shock, or the vascular collapse ...

Edition details

• Publisher: Ballantine Books
• Publication date: 2001
• Language: English
• ISBN 10: 0345443373
• ISBN 13: 9780345443373
• Binding: Hardcover
• Edition number: 1
• Number of pages: 336