Fatal Cure

Leaving their urban hospital for a modern medical facility in Bartlet, Vermont, Doctors Angela and David Wilson begin to notice puzzling details in the deaths of several terminal patients there. 250,000 first printing. $125,000 ad/promo. Lit Guild & Doubleday Main. Mystery Guild Alt.

If Cook's skills as a writer were as finely tuned as his sense of timing, his 14th medical thriller (after Terminal ) would be a lot more rewarding. Current political events guarantee that a suspense novel centering on health care management will be topical and at least potentially fascinating. Unfortunately, stock characters, stilted dialogue and improbable heroes and villains make for difficult reading here. Idealistic young doctors David and Angela Wilson take positions at a state-of-the-art medical center in a small Vermont town partly because they see it as an ideal spot for their daughter, who suffers from cystic fibrosis. But the town is not as idyllic as it seems, and the hospital is in a desperate financial bind due primarily to its contract with a local HMO, David's new employer. Worse still, patients are dying unexpectedly almost daily, and no one seems to care very much. The deaths are not normal, of course, and astute readers will quickly determine who is behind them, why and--most likely--how. Cook raises troubling questions about the conflicts between medical and financial priorities in managed care (albeit in a somewhat distorted fashion), but it's difficult to get emotionally involved in a scenario as improbable as this one. Literary Guild and Doubleday Book Club main selection; Mystery Guild alternate; Reader's Digest Condensed Book.
Copyright 1993 Reed Business Information, Inc.

Just when you thought it was safe to go back in the hospital, the king of medical malfeasance (Terminal, 1993, etc., etc.) shows why managed care makes life equally dangerous for idealistic doctors and their patients. Eager to flee the urban blight of Boston, budding pathologist Angela Wilson and her internist husband David are ripe for job offers from Bartlet Community Hospital, nestled in the bucolic hills of Vermont. They won't have to lock the doors on their sumptuous new house; their precocious daughter Nikki, who suffers from cystic fibrosis, will be able to have a dog; and together they'll be making over $125,000 a year (!). But there's trouble in paradise: Angela's paternal boss is a crude lecher; David is constantly under pressure from Charles Kelley, the scalawag regional manager of the monopolistic local HMO, to cut costs to the bone; the corpse of their dream house's former owner, a cranky retired hospital administrator who shot off his mouth too much, is walled up in their basement; Angela is attacked by a rapist who's obviously employed by the hospital; and, scariest of all, an awful lot of people with either terminal illnesses or life- insurance policies in favor of Bartlet are checking into the hospital but failing to check out. The HMO refuses to underwrite the costs of autopsies (are they covering up something, or just being obsessively stingy?); the apathetic, incompetent local lawmen are no more help; the old-boy administrators laugh at Angela's claims of sexual harassment and show her the door; and David, who's obviously never read a Robin Cook novel, surveys their tribulations with the sage comment: ``We might have lost our jobs, but as long as Nikki is okay we'll manage.'' Written with Cook's usual complete lack of interest in language and character--two administrators arise from frenzied rutting to a detailed discussion of cost-containment--but so canny in joining his trademark medical paranoia to his audience's likely alarm about draconian cutbacks under managed care that you can expect sales to go through the roof. Watch your back, Hillary Clinton. (Literary Guild Dual Selection for March) -- Copyright ©1993, Kirkus Associates, LP. All rights reserved.

You'd think that by now even the protagonists in a Robin Cook medical thriller would know that the last thing they should do is go to the hospital. But here they are again, checking in as if they didn't know and pretty promptly checking out--of life, that is. Orthopedic surgery patients at Bartlet Community Hospital in Vermont are the initial victims. Later, after espoused docs Angela and David Wilson come to work for the hospital and for the super-powerful HMO, Comprehensive Medical Vermont, David's oncology patients start buying the farm. What's going on? Well, it's obvious early on that hospital and HMO are more concerned about the bottom line than patient care, and several of the dead provided for the hospital in their wills. It takes little time to put two and two together and figure out who the killer is. After that, Cook's wooden dialogue and shallow characterizations may have many fast-forwarding to the end, a tepid takeoff of the Silence of the Lambs' conclusion. The author's message--watch out for managed competition!--comes through loud and clear, though; an argument on the point, however, might have made even staunch Cook fans happier than this rather soporific performance. Ray Olson