Robin Cook - Fatal Cure

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From Publishers Weekly
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.
From Library Journal
Recent medical school graduates David and Angela Wilson find the perfect setting for both their careers and family in rural Bartlet, Vermont. Not even the recent suicide and disappearance of two other physicians dampen their enthusiasm as they begin their jobs and buy their dream house. David's confidence is soon shaken, however, as his patients begin dying-not from their terminal diseases but from a mysterious illness. The deaths, coupled with attacks in the hospital parking lot, give the Wilsons the uneasy feeling that Bartlet is not what it seems. When a gruesome discovery prompts the Wilsons to hire a private investigator, the lives of several patients-and they themselves-are in danger. Physician and writer Cook once again terrifies and intrigues with this realistic and intense-to-the-end thriller, which is enhanced by actor Barry Bostwick's remarkable range of voices. For most popular collections.

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"In very carefully targeted areas with carefully controlled doses," Angela said. "David's patients were getting uncontrolled full-body exposure."

"How was this radiation administered?" Bradley asked.

"An orthopedic bed was fitted with a heavily lead-shielded box," Angela said. "It was mounted under the bed and contained the source. The box had a remotely controlled window that was operated by a garage door opener with radio waves. Whenever the port was open the patient was irradiated through the bed. So were some of the nurses tending to these patients."

"And both of you saw this bed?" Bradley asked.

David and Angela nodded.

"After we found the source and shielded it as best we could," David explained, "I tried to figure out how my patients had been irradiated. I remembered that many of my patients had been in hospital beds that malfunctioned. They'd wound up being transferred to an orthopedic bed. So after we left the conference room we went looking for a special orthopedic bed. We found it in the maintenance shop."

"And now you contend that this bed was destroyed," Bradley said.

"The bed was never seen again after that night," Angela said.

"How could that have happened?" Bradley asked.

"The people responsible for the bed's use got rid of it," David said.

"And you believe the hospital executive committee was responsible?" Bradley said.

"At least some of them," David said. "Certainly the chairman of the board, the administrator, and the chief of the medical staff. We believe the operation was the brainchild of the chief of the medical staff. He was the only person who had the background necessary to dream up such a diabolical yet effective scheme. If they hadn't used it so often, it never would have been discovered."

"Regrettably, none of these people can defend themselves," Ed Bradley said. "I understand that all of them died of severe radiation sickness despite some heroic measures to save them."

"Unfortunately," David admitted.

"If they were so sick how could they have destroyed the bed?" Bradley asked.

"Unless the dose of radiation is so great that it is immediately lethal, there is a variable latent period before the onset of symptoms. In this case, there would have been plenty of time to get rid of the bed."

"Is there any way to substantiate these allegations?" Bradley asked.

"We both saw the bed," David said.

"Anything else?" Bradley asked.

"We found the source," Angela said.

"You found the source," Bradley said. "That's true. But it was in the conference room and not near any patients."

"Werner Van Slyke essentially confessed to us both," David said.

"Werner Van Slyke is the man you believe was the worker bee behind this operation," Bradley said.

"That's correct," David said. "He'd had nuclear technician training in the navy, so he knew something about handling radioactive materials."

"This is the same Werner Van Slyke who is schizophrenic and is now hospitalized with severe radiation sickness," Bradley said. "He's also the same Werner Van Slyke who's been in a psychotic state since the night the hospital executive committee got irradiated, who refuses to talk with anyone, and who is expected to die."

"He's the one," David admitted.

"Needless to say, he's hardly the most reliable corroborating witness," Bradley said. "Do you have any other proof?"

"I treated a number of nurses with mild radiation sickness," David said. "They had all been around my patients."

"But you thought that they had the flu at the time," Bradley said. "And there is no way to prove that they didn't."

"That's true," David admitted.

Bradley turned to Angela. "I understand you autopsied one of your husband's patients?" he asked.

Angela nodded.

"Did you suspect radiation sickness after the autopsy?" Bradley asked. "And if you didn't, why not?"

"I didn't because she'd died too quickly to manifest many of the symptoms that would have suggested radiation," Angela said. "She'd received so much radiation that it affected her central nervous system on a molecular level. If she'd had less radiation she might have lived long enough to develop ulceration of her digestive tract. Then I might have added radiation to the differential diagnosis."

"What I'm hearing is that neither of you has any hard evidence," Bradley said.

"I suppose that's true," David said reluctantly.

"Why haven't either of you been called to testify?" Bradley asked.

"We know there have been some civil suits," Angela said. "But all of them were quickly settled out of court. There have been no criminal charges."

"With the kind of accusations you've made it's incredible there have been no criminal charges," Ed Bradley said. "Why do you think there haven't been any?"

Angela and David looked at each other. Finally David spoke: "Basically we think there are two reasons. First, we think that everybody is afraid of this affair. If it all came out, it would probably shut the hospital, and that would be disastrous for the community. The hospital pumps a lot of money into the town, it employs a lot of people, and it serves the people medically. Secondly, there's the fact that in this case, the guilty, in a sense, have been punished. Van Slyke took care of that when he put the cobalt-60 cylinder on the conference table."

"That might explain why there hasn't been any local response," Bradley said. "But what about at the state level? What about the state's attorney?"

"Nationally, this episode cuts to the quick of the direction of health-care reform," Angela said. "If this story were to get out, people might begin to reevaluate their thinking on the route we seem to be taking. Good business decisions don't always equate with good medical decisions. Patient care is bound to suffer when the powers that be are too focused on the bottom line. Our experience at Bartlet Community Hospital may be an extreme example of medical bureaucrats run amok. Yet it happened. It could happen again."

"Rumor has it that you could profit from this matter," Bradley said.

David and Angela again exchanged nervous glances.

"We have been offered a large amount of money for a made-for-TV movie," David admitted.

"Are you going to take it?" Bradley asked.

"We haven't decided," David said.

"Are you tempted?"

"Of course we're tempted," Angela said. "We are buried under a mountain of debt from our medical training, and we own a house that we have not been able to sell in Bartlet, Vermont. In addition to that, our daughter has a medical condition and might develop special needs."

Ed Bradley smiled at Nikki who immediately smiled back. "I hear you were a hero in this affair," he said.

"I shot the shotgun at a man who was fighting with my mom," Nikki said. "But I hit the window instead."

Bradley chuckled. "I will certainly keep my distance from your mother," he said.

Everyone laughed.

"I'm sure you two are aware," Bradley said, resuming a more serious tone, "that there are people who contend that you have dreamed up this whole story to make the TV money and to get back at the hospital and HMO for firing you."

"I'm sure that those who don't want the true story out will do what they can to discredit us. But they really shouldn't blame the messenger for the bad news," Angela said.

"What about the series of rapes in the hospital parking lot?" Bradley asked. "Was that part of this plot?"

"No, they weren't," Angela said. "At one point we thought they were. So did the private investigator who lost his life investigating this episode with us. But we were wrong. The one indictment that has come out of this unfortunate episode is for Clyde Devonshire, an emergency-room nurse. DNA testing has proved he was responsible for at least two of the rapes."

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