Fever By Robin Cook. Also by Robin Cook. VECTOR TOXIN INVASION. CHROMOSOME 6. CONTAGION ACCEPTABLE RISK FATAL CURE TERMINAL . Fever is a novel by Robin Cook and is in the category of medical thriller. Author, Robin Cook Create a book · Download as PDF · Printable version. Synopsis. Doctor Charles Martel turned to research when his wife died of cancer and he wanted to know why. Then his world is shattered for the second time.
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Doctor and author Robin Cook is widely credited with introducing the word ' medical' to the thriller genre, and decades after the publication of his Most of the Robin Cook novels are medical thrillers. I, being a huge fan of his writings, have almost all of his books in PDF or e-book format. You can mail me. DOWNLOAD PDF Review of Fever, by Robin Cook. AN INTRODUCTION TO THE MEDICAL THRILLER: FEVER AND FATAL CURE Robin Cook's fifth and .
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Views Read Edit View history. Always carefully researched, the subjects of Cook's medical thrillers offer his readers much to ponder. Because he characteristically uses the technical terminology employed by members of the medical profession, his books are also instructive, providing his reading audience with an authentic vision of the world of contemporary medicine. His father, Edgar Lee Cook, was a commercial artist and businessman.
His mother, Audrey Koons Cook, has apparently been a particularly significant figure in Cook's life—he appreciatively dedicated both Outbreak and Harmful Intent to her. Robin Cook has an older brother, Lee, and a younger sister, Laurie. Mortal Fear is dedicated to Cook's siblings with a heartfelt expression of his esteem and affection. As a young child, the winsome Robin Cook modeled toddler's fashions, but his first great enthusiasm was for archaeology, the subject he knowledgeably explores in his third work of fiction, Sphinx.
As its title indicates, he was especially fascinated by the wonders of ancient Egypt, and as a youth regularly visited the mummy rooms of Manhattan's Metropolitan Museum—where he was, in fact, inspired to commit to memory the names of the rulers of all the Egyptian dynasties. This early interest in the lore of Egypt has remained a lifelong passion, one that 4 Robin Cook indeed received expression in the only one of Cook's seventeen novels to date that is not set within the world of medicine.
Readers of his books will readily note that Robin Cook's first and third novels are anomalous in respect to the rest of his fiction. The largely autobiographical first book, The Year of the Intern, is not a thriller, and Sphinx, which is unquestionably a suspense novel one that even features a double conspiracy plot , is not a medical thriller. Appearing in the wake of the popular success and critical acclaim that attended the publication of his second novel, Coma, Sphinx spent seven weeks on the bestseller list and was also adapted for the screen.
The movie, in whose production Cook took no part at all, was not the success that the movie version of Coma had been, and reviews of the novel itself were decidedly mixed. It is quite apparent that, after writing Coma, Cook used his newly acquired facility with the suspense genre to write a novel that paid homage to his fascination with mysteries of the past. After experimenting, however, with a thriller that featured black market intrigue in the smuggling of Egyptian antiquities, Cook chose to return to his fictional exploration of a variety of medical issues, and it is this specialized focus that has come to distinguish his work within the body of contemporary suspense literature.
Sphinx's plot is an intricate one, providing room for Cook to play with standard conventions of the suspense novel, and the book is of general interest to his readers in two other noteworthy respects. In the figure of its central character, Erica Baron, it offers an example of a strong female protagonist, and in its "lovingly detailed and sensuous descriptions of Cairo, Luxor, and Egypt's holy places" Aldridge, 36 , it captures an atmosphere of place that can be favorably compared with the realistic effects that the writer characteristically achieves in his representations of hospital settings.
Sphinx's ingenious plot, based on the notion that the undisturbed tomb of another Egyptian ruler, Seti I, actually lies hidden beneath the familiar tomb of King Tutankhamen, proved to be of timely interest to many readers, for the book was published around the time artifacts from Tutankhamen's tomb were on exhibition in the United States.
Although his obsession with archaeology predated his interest in medicine, the latter passion also emerged early in Robin Cook's life. Indeed, it was at age fifteen, after he had witnessed a football injury at Leonia High School, that he determined that he would become a doctor. Cook graduated from Connecticut's Wesleyan University with a B. Cook's summer job during his years at Columbia was a particularly interesting one: While Cook found his university experiences at Wesleyan immensely stimulating, he has frequently criticized the ways advanced medical education is organized, believing that medical schools have "a tendency to stay in the past" Grossmann, The critique of medicine that is sounded throughout his literary career therefore first began to take shape while he was still a medical student.
In Cook became a surgical resident at Queen's Hospital in Honolulu, Hawaii; he remained at this post until , later using his own experiences there as the inspiration for his first book, the insightful study of the institution of medical residency entitled The Year of the Intern. Deeply disturbed by the exhausting regimen of residency or internship, as it was then called , and thoughtfully concerned about the ways this form of apprenticeship might in fact be counterproductive as a tool for training doctors, Cook felt compelled to find a way to express his thoughts on the subject.
The opportunity arose during his stint in the U. Navy, where he served from to eventually becoming lieutenant commander. Asked by an interviewer for Contemporary Authors hereafter cited as CA whether he had ever given thought to writing a novel before seizing the opportunity he enjoyed aboard the submarine, Cook acknowledged that he had wanted to begin writing while he was still in medical school, but that he had not had time. Then, the opportunity presented itself, and, as Cook said, "I didn't really know if I was going to be able to write one, but I assumed that I w a s " CA, Although this first book, published when Cook returned to civilian life, was very well received, it did not enjoy as wide a circulation as he had hoped.
Cook had a message he wanted to deliver in fact, in , the year following the publication of The Year of the Intern, he summarized its sentiments in "My Turn," Newsweek's regular guest opinion column , and he now needed to find a way to appeal to a broader reading audience. Readers of The Year of the Intern had certainly included people with a specialized interest in the practice of medicine it was recom- 6 Robin Cook mended reading for both established doctors and doctors-to-be , but Cook was determined to write a novel that would catch the eye of the general public.
With this ambition in mind, he set out to discover the secrets of successful popular fiction. Hoping to produce a best-seller himself, he spent six months in reading and analyzing best-sellers over one hundred of them, in fact. Cook's reading suggested to him that the mystery-thriller genre would be likely to "capture the interest of the largest number of people" World Authors, , and he therefore decided to write one, drawing upon his own special expertise through the use of a medical setting.
The result of Cook's efforts was Coma, a best-seller that was also made into a successful motion picture. Having successfully published his first novel, he was unaware, until he wrote Coma, of how truly difficult it generally is to break into the highly competitive popular market.
In fact, reflecting upon the earlier publication of The Year of the Intern, he commented to Health magazine's John Grossmann: I thought you simply wrote a book, sent it in, three weeks later it was in the bookstores, people ran and bought it, and then you went on the Johnny Carson show.
I was very lucky" Grossmann, If Cook was lucky with The Year of the Intern, by the time he was ready to seek a publisher for Coma he had found a narrative formula that was probably guaranteed to win him success. His setting was marvelously authentic, his subject matter explosive, and, as Charles J. Keffer of Best Sellers observed, "I do not think anyone can beat the suspense and the story line developed throughout this novel.
It is so close to the truth that one has to reinvestigate the title page to be sure that it really did say 'A novel by Robin Cook' " Contemporary Literary Criticism, Coma found readers of the thriller genre ready to embrace the possibilities of medical intrigue. Before he was drafted into the navy, Cook had served his medical internship in general surgery.
When he returned to civilian life, he decided to specialize in eye surgery, and therefore took up a residency in ophthalmology at the Massachusetts Eye and Ear Infirmary an institution affiliated with Harvard Medical School.
Cook was a resident there from to When his residency was completed, he opened a private practice near Boston and also joined the teaching staff at Mas- The Life of Robin Cook 7 sachusetts Eye and Ear. Later, when he decided to commit more time to writing, he took a leave of absence from his Harvard teaching appointment. Readers might be interested to note that two of Cook's villainous doctors, Outbreak's Ralph Hempston and Blindsight's Jordan Scheffield, are themselves ophthalmologists.
Additionally, the medicine of the eye is featured in a couple of Cook's thriller plots. Blindsight's central action is concerned with the great demand for cornea transplants, and, in Mortal Fear, where unsuspecting victims are administered a dose of a sinister "death hormone," the deadly substance is cunningly introduced into patients' bodies through the mucous membrane of their eyes. In Cook's most recent novel, Contagion, the central character is an opthalmologist who has been driven from private practice by a profitoriented medical corporation.
Remarkably, Robin Cook wrote his second, third, and fourth novels while both maintaining his private practice and serving on the staff at the Massachusetts Eye and Ear Infirmary. Cook acknowledges that he writes rapidly The Year of the Intern and Coma were reputedly drafted in six weeks and Sphinx in ninety days , but it is also likely that the disciplined habits he acquired while studying and practicing medicine have in fact served him well as a writer.
When asked by an interviewer for Contemporary Authors whether it was difficult to establish a writing routine while practicing medicine full time, Cook answered that in his experience the two activities seemed to complement one another.
Writing is just the opposite. You're sitting in your own room surrounded by your own objects, by yourself, for protracted periods of time. In a way I think the two things are compatible" CA, After the publication of Brain Cook decided to take an extended leave of absence from the active practice of medicine, and it now appears that he no longer intends to return to his original occupation.
He has busied himself in the meantime with the prodigious task of researching and writing thirteen additional medical thrillers, and he remains an outspoken advocate for medical reform.
Cook's reading habits and longtime interest in all manner of medical issues keep him well abreast of new developments in his field, and he 8 Robin Cook delights in opportunities to speculate about future trends in his profession.
Indeed, in a interview for Omni, Cook had some startling predictions to make: Although we're going to see dramatic improvements in transplantation during the next ten or fifteen years, genetic manipulation is going to make organ transplants seem terribly old-fashioned. It will also cause most of modern medicine, perhaps even doctors, to become obsolete. The real physicians, in fact, will likely be genetic engineers.
I also believe that viruses are going to be useful in the genetic-engineering revolution. We're going to see a change in our perception of viruses. We'll no longer view them as some sort of inimical enemy. They may be much more helpful than we realize.
Bryant, 22 These intriguing predictions notwithstanding, Cook knows that issues surrounding organ transplants, viruses, and genetic engineering all lend themselves to suspenseful treatment in the hands of the writer of medical thrillers, and thus takes up these matters in Coma, Outbreak, and Mutation. He also has some thoughtful observations to make about cancer treatment, a subject he explores in both Fever and Terminal.
As he told John Grossmann, "I think the major problem in cancer research is the system: The drug firms want the cure for cancer to be a white powder they can patent. I think the solution will come through prevention and an immunological approach, which are less likely to have that kind of economic impact. This is where I'd like to see the research concentrated" Grossmann, Besides keeping up with developments within his field and conceiving plots for chilling thrillers, Cook enjoys refurbishing and decorating houses or apartments.
His current interest in architecture and decor is in fact given expression in a recent novel, Acceptable Risk. There his protagonist discovers that she too is fascinated by old buildings and by the creative challenges inherent in tackling problems of renovation and artful decoration. When he is not busy pursuing one of his many creative inclinations, Cook enjoys playing tennis, skiing, or organizing a pickup game of basketball at Columbia University's medical school gym which is now called the Robin Cook Gymnasium in honor of the benefactor who ar- The Life of Robin Cook 9 ranged for its complete renovation.
Basketball, as it turns out, is also an interest that Cook has found means to incorporate in his fiction. In a truly fascinating way, his perceptive study of the social conventions that inform playground basketball in New York's inner city plays an important role in Contagion, his latest thriller.
Twice married, Cook has no children. His first wife was a young Scandinavian woman whom he had met while working with Jacques Cousteau in Europe. They were married in and divorced only a few months later. A relationship that "was more romantic than practical" Jennes, 65 , as Cook later revealed to Gail Jennes, it came to an end just before he was drafted. In Cook married Barbara Ellen Mougin, an actress and model who served as the inspiration for his characterization of Denise Sanger, a central figure in his fourth novel, Brain.
An end to this marriage, which was apparently a very happy one for several years, is seemingly signaled on the acknowledgments page of Mortal Fear, where Cook thanks the many friends who offered him support during "difficult" times.
To date, two of Robin Cook's novels, Coma and Sphinx, have been made into large screen motion pictures, and three others, Mortal Fear, Outbreak renamed Virus , and Terminal have been specifically produced for television audiences. His fiction has been translated into Spanish, and many of his books are available on audiocassettes. Cook, a widely recognized figure within the contemporary literary scene, serves on The American Heritage College Dictionary's select Usage Panel.
The novel is thus passionately earnest, indeed polemical, in its tone, and it is clear that when Cook wrote it, he had hopes that his poignant account of the ways the internship experience works to demoralize and harden idealistic young doctors might excite members of his profession to institute a change.
Cook was, in this respect, somewhat disappointed, for although he was invited to be a keynote speaker at a subsequent conference on medical education, the book "didn't cause any particular movement to look into these things" CA, In Cook's opinion, the medical internship unfortu- 10 Robin Cook nately remains a "kind of a hazing year" CA, Later on in his writing career, when he chose to master the possibilities of the suspense genre, Cook found a very different means to voice an expose.
Dedicated to "the ideal of medicine we all held the year we entered medical school," Cook's first novel recounts the disillusioning experiences of one Dr. Peters interestingly, a first name is never offered , intern at a community teaching hospital in Hawaii. It is the only one of Cook's seventeen novels to date to employ a first person narrative voice.
The central character generally called the protagonist addresses the reader with an intimacy that is appropriate to the story he has to tell. The novel, which begins on the fifteenth day of Dr. Peters's internship, is divided into three sections that correspond to the different medical rotations that comprise the surgical intern's hospital assignments over the course of a year.
Thus the first section, "General Surgery," relates Peters's initial experiences as an acting physician. The second section, called "Emergency Room," begins on the nd day of his internship, and the third section, "General Surgery: Private Teaching Service," takes up Peters's story on his th day of service.
A concluding section, "Leaving," summarizes Dr. Peters's feelings on the th day, as he happily passes his responsibilities on to another beginning intern, the eager and idealistic Dr. And thus, as the book's ending suggests, the grueling, exhausting, and enervating cycle of medical internship will begin anew. The question that hangs in the air almost seems to answer itself: Straus, after his year of internship has passed, emerge with his hopes and his high ideals intact?
The Year of the Intern marks Cook's first use of the episodic structure of plot development that he employs with such notable success within his suspense fiction. In this first novel, where plot is mainly a recounting of a series of unrelated events events that Cook describes as "a synthesis of my own experiences and those of my fellow interns" [TYOTI, 2] , there is admittedly little occasion for the writer to demonstrate the skill that will later be his hallmark.
Nonetheless, the story convincingly portrays the gradual transformation of an empathetic young doctor into something of a cynic, and in the closing pages of the book this change is emphatically registered upon the reader through Cook's use of a shrewd plotting device: This time, however, he places Dr. Peters in the position of detached observer of an event that less than a year earlier he had himself experienced with a great deal of pain and confusion.
By the end of his internship, Dr. Peters has forgotten the im- The Life of Robin Cook 11 mense trepidation he had felt the first time he "had been faced with the sole responsibility for pronouncing death" TYOTI, 5.
Readers are first introduced to Dr. Peters as he is summoned in the middle of the night to confirm the death of an elderly patient. Although Peters has obviously witnessed death before, he has never before been responsible for making the "judgment call" 5.
Stricken by the burden of this new responsibility and uncertain of what he should do, Dr. Peters wavers: I took out my stethoscope slowly, postponing the decision, and finally settled the pieces into my ears while I held the diaphragm on the old man's heart. I couldn't hear the heart—yet couldn't I, almost?
Muffled and far away? My overheated imagination kept giving me the vital, normal beat of life. And then I realized it was my own heart echoing in my ears. Pulling the stethoscope away, I tried again for pulses, at the wrists, groin, and neck.
All was quiet, yet an eerie feeling said he was alive, that he was going to wake up and I was going to be a fool. How could he be dead when I had talked with him a few hours ago?
I hated being where I was. Who was I to say whether he was alive or dead? Who was I? He must now call the next of kin, and this presents him with a new set of anxieties, as he tries to determine what he should say: Not sure even yet that the man is really and truly dead, Peters fights the urge to go back and check the pulse once again.
This poignant and sympathetically comical scene—wherein the young doctor confronts mortality and most reluctantly admits it, awkwardly yielding to its horrendous finality—is echoed in the concluding chapter. On this occasion the experience is Dr. Straus's, and Peters's re- 12 Robin Cook sponse takes a measure of the changes he has undergone in his year as intern. Peters is packing his belongings when Straus phones him: About eighty-five years old. I didn't say anything, expecting to be told more about the problem.
Straus's breathing could be heard on the other end of the line, but he apparently had nothing to add. TYOTI, As the telephone conversation continues, punctuated with many hesitations on Straus's end, it becomes quite apparent to the reader though not to Peters that Straus is suffering uncertainties very similar to those that earlier confounded Peters.
Straus does not know what to say to the family or how to handle the necessary paperwork. Indeed, he seems to need someone else to confirm the death, but Peters refuses to help him out. Thus Straus is left to undergo alone the intern's traditional rites of initiation, and Peters, for whom a full-fledged "medical practice was at last within sight" TYOTI, wonders whether he should download a Mercedes or a Porsche.
He knows that the Cadillac is a favorite car with surgeons, but this conspicuous status symbol is not—at least not yet— quite to his taste. Offering the first of Robin Cook's highly authentic depictions of life within a hospital setting, The Year of the Intern examines hospital politics, outlining the hierarchical order that defines staff members' relations to one another.
It emphasizes the competition that exists among the interns—all striving to catch the attention of the hospital's most important doctors. It portrays occasional incompetence in medicine, often the result at least in cases involving interns of exhaustion or confusion. The novel takes a measure of the psychological wear and tear that naturally occurs when people witness others' suffering or death, and it even notes the various physical discomforts that are a doctor's lot: The hospital setting brings with it associated problems, those of dealing with drug companies or handling insurance claims.
All of these details and others debates, for instance, about the relative advantages and disadvantages of Medicare are significant to Cook, who is interested in capturing as realistic a portrait as possible of both the intern's typical experience and the general flavor of hospital life. Before submitting his manuscript for publication, he asked eight other young The Life of Robin Cook 13 doctors to read it and confirm his observations.
Indeed, for the reader who is curious about the inner workings of the medical profession, The Year of the Intern provides an excellent introduction. Gail Jennes describes the work as the "rather sour tale of the harsh life led by doctors in training" Jennes, 65 , but World Authors notes the book's importance, claiming that "it can be seen as part of a growing protest against the processes of depersonalization built into medical training" World Authors, The persistence of effect of such books is remarkable, because we are driven not only to continue reading this one but also to watch for the next one by the same author.
While he acknowledges that "a book may have any one of several features that make it hard to put down style, ideology, informational content, humor ," he sees the use of suspense as one of the strongest of these features. The terms "suspense" and "thriller" are perhaps most commonly used to denote specific categories of popular formula fiction.
While the terms can be used interchangeably—as they frequently are in this study—to designate the kinds of stories that are built upon the tension evoked by the presence of a terrifying danger, they can also be used to define particular subgenres of popular fiction.
In this technical application, "suspense" refers to the plot wherein an innocent character is somehow threatened, and "thriller" to a plot's use of a conspiracy motif wherein 16 Robin Cook the very fabric of the social structure is threatened by the schemes of evildoers.
Because Robin Cook draws upon both these plotting strategies—often, in fact, intermingling the two—the distinction is not particularly useful in reference to his work. Additionally, "suspense" and "thriller" are terms sometimes used to characterize certain subgenres of the mystery novel.
The mystery, a popular fiction genre featuring a story that recounts the solution of a crime generally murder , obviously employs strategies designed to evoke suspense; when the mystery is combined, however, with features of the suspense novel, or with the conspiracy plot of the thriller, the mystery connoisseur is afforded an opportunity to make useful distinctions among the various kinds of mystery plots.
Because Robin Cook's suspenseful stories generally include instances of murder, elements of the mystery genre are significant in his work. Interestingly, however, murder is itself usually incidental to the kind of suspense that lies at the center of his plots, and his novels cannot therefore be classified as purely mystery fiction.
Indeed, Cook's medical thrillers are often quite generally categorized as special instances of the mystery-suspense genre. Cook's idiosyncratic contribution to popular suspense fiction is, of course, his unsettling use of the worlds of medicine and medical research as the sites for the assorted nefarious schemes envisioned in his work.
The extraordinary authenticity with which he realizes the details of his settings cannot but contribute to the jarring effect his novels produce on readers who are necessarily horrified by the scenarios offered in his plots. That criminal activity of the most devious order might occur within the hallowed halls of medicine unquestionably serves to jolt readers out of complacent assumptions they might hold about the medical profession.
As one reviewer notes: It is important to Cook to be able to relay information about the moral and social issues in the medical profession to the general public through his stories" Contemporary Authors, New Revision Series, Or, as Joseph McLellan observes in the Washington Post, "What makes you start reading Cook, at least since his spectacular success with Coma, is the expectation of horror and of a glimpse behind the scenes at the medical establishment" McLellan, C4.
Because setting and theme are thus intrinsic to the suspenseful effects Cook achieves within his work, the generic label that most appro- Robin Cook's Medical Thrillers 17 priately defines his fiction is one that acknowledges these crucial elements: Dating from the s, when the family story paper a publication printed in newspaper format first began to flourish, the thriller genre has been a popular one with American reading audiences.
Featuring serial fiction that offered "romance with some kind of exotic setting, episodes of threat to a helpless heroine from lawless brigands or pirates or the like, fates worse than death, separations of families and lovers, scenes oozing with sentiment, and the distribution of just deserts followed by a grand reunion at the close" Panek, 10 , the family story paper excited general interest in intrigue and suspense.
Following the success enjoyed by family story papers, inexpensive pamphlets called mystery and misery stories began to appear in large American cities. Dropping the exotic settings used by family story papers, the mysteries and miseries replaced them with "the sensational background of the corrupt city" Panek, Crime, of course, was an important feature of corruption within the city and thus grew to play an important role in emerging thriller fiction.
By the time the dime novel, prototype of modern paperbacks, appeared in the s, the thriller was a well established genre within popular literature. Interestingly, the first doctor to enjoy unqualified success when he turned his hand to writing suspense fiction was none other than Arthur Conan Doyle. In introducing Sherlock Holmes with his publication of A Study in Scarlet, Doyle began to emphasize the use of scientific method in pursuit of solving crimes. This move opened an interesting connection between suspense and the world of science, one that other writers were quick to exploit.
It might further be noted that in choosing a physician, Holmes's sidekick Dr. Watson, to serve as narrator for his stories, Doyle also established an early link between detection and the world of medicine. A contemporary of Doyle's, R. Austin Freeman, almost immediately followed this lead, also using a doctor as narrator within his suspense fiction. Although he is by no means the only contemporary writer of medical thrillers see, for example, Elizabeth Trembley's study of Michael Crichton's work, also published in this series , there is no doubt that Cook's name is the most readily recognizable among novelists in this somewhat specialized field.
Reasons for this are perhaps obvious: Cook is prolific over the past decade he has published a new book almost every year.
Cook has, in short, developed a reputation as a writer of those books you just can't put down. Robin Cook, however, has succeeded in creating an audience of his own, and many readers of popular fiction keep an alert eye open for his latest book.
Interestingly, it is highly likely that Cook's success in popularizing the medical thriller will have the effect of opening the field for other writers with similar interests. The degree to which Cook has in fact popularized the medical thriller should not go unremarked. Readers might not be aware that medical mysteries of one sort or another have been published for over one hundred years. One of the earliest writers interested in mixing medicine with mystery was British author Elizabeth Thomasina L.
Meade, whose fiction was published in the s. In spite of its relatively long history, the suspense novel now known as the medical thriller has really come of age during the two decades that have witnessed the publication of Robin Cook's fifteen popular thrillers.
If Cook's medical thriller can generally be seen as presenting an amalgamation of plotting strategies drawn from formulas recognizable within the suspense, thriller, and mystery genres, it should also be noted that much of his work intersects with yet another popular genre, namely, science fiction.
Particularly in the novels where Cook explores the domain of medical research, or in those that feature plots centered upon the use of some cutting-edge technology, the futuristic turn that is the hallmark of science fiction is readily apparent. While Cook is not, as he has more than once maintained, interested in writing science fiction per se, he does want to draw readers' attention to the possible implications of certain trends within medicine's use of scientific technology.
Serving as cautionary tales, the novels in which Cook speculates about the future directions of medical research envision worst-case scenarios that reflect the writer's characteristic wariness about any kind of science that is driven more by economic considerations than by a concern for the public good. In speculating about the future, Cook himself performs a special kind of public service: Cook's fiction has done much to demystify the arcane world of medical science.
In at least three of his medical thrillers, Godplayer, Mutation, and Acceptable Risk, Cook incorporates suspense strategies borrowed from the horror novel. Outbreak, whose plot features viral epidemics, could also plausibly be seen as an instance of the horror subgenre that Michael Wood has recently termed the "mutant-disaster story" [Wood, 54]. The horror novel, featuring a special kind of suspense that derives from the manifestation of hideous psychological or supernatural forces or events, is best exemplified in the work of another popular contemporary writer, Stephen King.
In Cook's fiction, the horrific emerges in the form of monstrous villains who inhabit the worlds of medicine or experimental research. Godplayer, a novel of psychological terror, features a psychopath whose egomaniacal tendencies are exacerbated by his important role as a leading surgeon. Tension in the novel mounts as other characters remain oblivious to the fact that there is a murderous monster in their midst.
In both Mutation and Acceptable Risk, monsters are the result of scientific experiments that go wrong: In all three books the presence of monsters turns the general effect of Cook's strategies for suspense in the direction of the horrific. Cook, who successfully established his reputation as leading writer of the medical thriller with the publication of Coma, his first truly gripping novel, continues to experiment with a variety of suspense strategies.
In one of his most recent books, Acceptable Risk, he plays with elements of the gothic, exploring questions about witchcraft, from both old and new perspectives. Readers who are fascinated by his ability to incorporate plotting strategies derived from a variety of genres should remember that, in teaching himself to write the popular novel, Cook carefully analyzed a large collection of best-selling novels.
Drawing inspiration from these, he finds a way to blend elements of suspense, mystery, science fiction, and horror. Dove offers useful insights about the characteristics of novels that readers just can't put down. Dove's understanding of the nature of suspense is based upon the pact he sees as existing between a reader and a writer. The writer, he believes, must actively involve the reader in the unfolding of a novel's action; the reader must, in other words, be brought to care about what happens next.
To establish a framework for his definition of suspense, Dove offers three statements of principle for use as guidelines to support his readings of specific texts.
These guidelines, which are applicable to an understanding of Robin Cook's success as writer of suspense fiction, are as follows: Suspense takes place only when the reader is involved in the story. Suspense is dependent to a far greater extent upon thrust than upon delay. The will to read on—that is, intensification of interest in what happens next, or suspense—is dependent to a greater degree upon what the reader has been told than upon what he wants to find out.
The more the reader knows without knowing everything , the more he wants to know. Dove, 4 Dove acknowledges that "the involvement of a reader naturally takes many forms" Dove, 4 , but one device that seems to work especially well for Robin Cook is his frequent use of a prologue to introduce his novels. This device, which Cook actually uses for a variety of different purposes to foreshadow events, to plant clues, to afford his readers a dramatic view of microscopic events taking place within the human body , has the effect of immediately plunging readers into the world of the novel.
A device he uses to set the stage, as it were, the prologue instantly excites readers' curiosity. Joseph McLellan waxes poetic about the theme he finds embedded in Fever's prologue: Here the primary evil force is microscopic, a cancer cell, and the best section of the book is probably the first two pages where Cook describes the creation of that cell. He takes his "inside story" perspective to some kind of logical ultimate: We are inside the bone marrow of Michelle Martel, watching the carcinogenic molecules of benzene pour in "like a frenzied horde of barbarians descending into Rome.
But one is only damaged so that it begins to reproduce as cancer cells. No longer responsive to "the mysterious central control,. The reader of Fever thus begins the experience of reading with immediate engagement in the process that will shape the content of the story. In arguing his second point, that suspense depends more "upon thrust than upon delay," Dove takes issue with critics who hold the view that "the key to effective suspense lies in the number of obstacles a writer can place in the way of successful resolution, that is, in using the strategy of delay.
Robin Cook, indeed, is a master of the use of "surreptitious signals," generously distributing hints and clues as he unfolds his tightly woven plots. Almost ironically, it is the very fact that he so deeply involves the reader in the unraveling of his schemes that he is able to spring unexpected surprises as he does in Brain and in Harmful Intent that turn out, from the reader's perspective, to make perfect sense in the end. Dove's third point is the logical extension of his second principle.
As he observes, "One thing that keeps us interested in a story is our access to privileged information, whereby we know something that has been withheld from the characters themselves" 5. Cook shrewdly employs this principle, almost always granting his readers an angle of vision broader than that commanded by his characters.
Because so much of his suspense depends upon his readers' apprehension of the ways his protagonists or other characters have unknowingly become ensnared in dangerous circumstances, Cook must find means to provide his readers with information to which the characters are not privy.
The suspense of a scene of entrapment is enhanced when the reader can anticipate that the trap will indeed be sprung. The reader, who also perceives the impending crisis, sharply experiences the terrible sense of entrapment that is the lot of a character who sees clearly but cannot, for one reason or another, persuade others to accept her or his privileged form of knowledge.
In Godplayer, Cook uses this motif to dramatic effect. When his central character, Cassandra Kingsley, finally understands that her husband, who has murdered several other people, has also set his sights on her, her position is one of absolute helplessness.
Recovering from an eye operation, she lies in a hospital bed, blindfolded and sedated. Her requests to be transferred to another room are not honored because she has in fact already been moved twice. Her fears are dismissed as expressions of paranoia resulting from the operation itself or from the drugs she has been given. Horrifyingly, Cassandra Kingsley knows exactly what is going to happen, but she has no means to forestall it.
She is completely and certainly trapped. As Cassandra's name signals, she occupies the position held by the Cassandra of Homeric legend, the daughter of Priam who warns against acceptance of the Wooden Horse and who foresees that Troy will fall.
She is the character who possesses a knowledge that others cannot be brought to believe. Cook uses the motif he introduces in Godplayer in other novels as well, but often it is the reader who seems to hold the Cassandra position in respect to his plots.
In Outbreak, Mortal Fear, and Mutation, for example, it is the reader who must helplessly look on as central characters move closer and closer to a danger that the reader has already identified. Suspense, then, builds, while readers, mesmerized in horror, observe protagonists approaching the traps that certainly await them.
In Suspense in the Formula Story, Dove goes on to elaborate the nature of the pact that exists between readers and a successful writer of popular fiction. One important expression of this implicit agreement, he notes, can be seen in popular literature's use of genre formulas, or conventions. When readers choose to read in a particular genre, they meet with a writer on a common field of expectations. As Dove observes, it is "those accepted conventions of formula fiction, those proved, almost endlessly durable devices so familiar to the experienced reader," that initially Robin Cook's Medical Thrillers 23 "serve to establish a common ground between writer and reader, so that communication between them is facilitated" Dove, 6.
Those critics who complain that writing in the popular genres is too formulaic, have, Dove insists, entirely missed the point. Readers, who delight in finding the conventions they have expected to encounter, do not tire of the inevitable repetitions that are a given part of formula fiction.
While many of Cook's conventional ploys are derived from the suspense genre his chase scenes, his hired thugs or hitmen, his use of psychopathic maniacs , it is, as Joseph McLellan noted, the anticipation of horror, combined with a behind-the-scenes look at the medical establishment, that draw readers to his books.
His quite serious intentions of informing his reading public about the inner workings of the medical profession do not, happily, cancel out his playful side. Many of Cook's conventional chase scenes are presented tonguein-cheek; clearly the writer is exercising his imaginative faculties, looking to amuse his faithful readers with a variation they have never seen before.
The chase scene in Terminal is one such example. Exploiting a spy versus spy motif, Cook lines up sets of characters, each following someone else, until he has created a veritable parade of cars streaming across the expanses of central Florida. To add to the fun, Cook shows the vehicles all executing a U-turn, one after another.
In Harmful Intent he enjoys great sport with a minor character, a sometimes bad guy, sometimes good guy whose quirky mannerisms and great facility for being Johnny-on-the-spot finally endear him to the novel's readers.
In Acceptable Risk, where he whimsically transforms a whole passel of cocky, self-serving, and impatient researchers into grunting, snorting, firefearing brutes, the invitation is laid wide open for readers to join in his hilarity: Beginning with Coma and Sphinx, Cook demonstrates a keen interest in women's positions within the professional world.
Coma's Susan Wheeler and Sphinx's Erica Baron are the first of the many strong, resourceful women characters that Cook casts in the role of protagonist. Eight, which is to say nearly half, of Cook's seventeen novels to date feature female protagonists.
And in Fever, Terminal, and Fatal Cure, im- 24 Robin Cook portant women characters work closely with male protagonists to resolve the novels' central conflicts. Although characterization is not one of Cook's particular strengths he generally prefers to present his character studies in vignettes that serve the larger purpose of plot development , his most fully developed characters are, speaking generally, his several female protagonists. Cook is sympathetically alert to the kinds of problems women meet in attempting to assume positions of equality to men when readers first meet Sphinx's Erica Baron she is being manhandled by a leering adolescent youth in the streets of Cairo , but his resilient women protagonists unfailingly fight back Erica turns around and slugs the offending youth, much to the approval of cheering onlookers in the crowded bazaar.
To elaborate a little on the question of characterization within the suspense genre, it is useful to reflect upon some insights offered by Thomas J.
Roberts in An Aesthetics of Junk Fiction. Noting that "readers and writers agree—too quickly, I think—that the people in paperback fiction are simply drawn," Roberts argues that "readers' interest in fictional characters" need not "depend upon their complexity" Indeed, because "role identities are fundamental social realities for urban humanity" 25 , this critic of the popular genres sees the strategy of characterizing fictional figures in terms of the roles they play within novels as a thoroughly appropriate one.
Robin Cook, occasionally criticized in reviews for his "simplistic" handling of characterization, is nevertheless greatly skilled at drawing characters who fill the roles envisioned by his own conceptions of institutional or social realities. Thus, "truth of character" Roberts, 26 for many of Cook's heroines and heroes can be found in the strikingly realistic roles they play within the worlds portrayed by the books.
Since the publication of the initial expose that he offered in his only nonthriller, The Year of the Intern, Cook has consistently sought to democratize knowledge of the specialized interests related to the medical profession. The only exception, noted earlier, is Sphinx—which nonetheless does expose a different set of special interests, those involving the illegal marketing of immensely valuable Egyptian antiquities.
All of Cook's major themes, his visions of entrapment and the victimization of innocent people, his Robin Cook's Medical Thrillers 25 scenarios of secrecy in research and the deadly secrecy of conspiracy, can be linked together by the recognition that in knowledge resides a power to confront the designs of special interests that do not serve the public good. Within Cook's novels, the villains who ruthlessly exploit others are invariably motivated by vanity or greed.
Central to Cook's concerns about recent changes in the field of medicine is his fear that its gradual transformation into a form of business enterprise leaves it vulnerable to the manipulations of people too strongly motivated by economic considerations. Where there is big money to be made, he suggests, greedy people will seek out opportunities to promote their special interests.
Part of Cook's purpose in writing thrilling tales of intrigue and suspense is to demonstrate for readers just where those interests lie. Thus, in exaggerating their dangers through his use of a conspiracy motif, he is able to inform his reading audience about trends within the complex social institution that is the object of his focus.
His presentation of ordinary people that is, patients as the victims of these trends speaks dramatically to readers who immediately recognize that they, too, as ordinary people, necessarily have a strong interest in understanding developments within the medical profession. One significant trend within the health care industry is the recent growth of subscription plans for medical services.
The emergence of health maintenance organizations HMOs has effected changes in the ways medicine is practiced, and Cook examines the implications of these changes from a couple of interesting angles.
When HMOs first began to claim a noticeable portion of the medical market in the s , some doctors in private practice began to worry that this new health care delivery system might jeopardize their own positions. In Outbreak Cook shows how the beginnings of a shift from a general reliance upon private practice to organized group practices created shock waves that reverberated throughout the medical profession. Basing his plot on an actual conspiracy by private physicians to discredit HMOs, Cook conceives of the wicked scenario wherein a cartel of private doctors arranges to eradicate certain self-funded clinics by unleashing upon them the dreaded Ebola virus.
In this Battle of the Titans, this clash between opposed economic interests within the medical profession, innocent victims lose their lives and the society in general is recklessly threatened with the danger of contagion. In Outbreak the arrogant assertion of the desires of greedy vested interests endangers the welfare of the public.
Outbreak's HMOs are themselves victimized by influential members of the traditional medical establishment, but Cook recognizes that, as busi- 26 Robin Cook ness entities, HMOs also have vested economic interests.
In Mortal Fear and Fatal Cure he turns his attention to these very interests, showing how it profits the HMO to keep its medical costs down. Obviously, an HMO's ability to operate is threatened if expenditures exceed the amount of money its membership brings in. One way to keep costs down is to somehow avoid handling those patients who require unusually expensive treatment, and the hospital administrators depicted in these novels devise fiendish plots to realize this end.
In Mortal Fear, middle-aged patients who engage in health-threatening personal habits excessive drinking, smoking, overeating, etc. In Fatal Cure another costly group of patients, those who suffer from such chronic illnesses as cystic fibrosis, are irradiated in a hideous hospital bed specially installed by the Board of Directors. In these plots that feature "rationed medicine" by design, the economic interests of the health care industry once again override the medical interests of the public, and innocent people are victimized.
Cook exposes the strong self-interests of the pharmaceutical industry in Mindbend. In an utterly extravagant plot, one that features a scenario wherein Arolen Drugs attempts to gain control of the entire medical profession by "bending" doctor's minds, Cook cleverly uses a strategy of exaggeration to acquaint readers with the very real kinds of power and influence that large pharmaceutical companies command.
Similarly, Harmful Intent reveals the special interests of the law as they apply to medical malpractice litigation, and both Vital Signs and Terminal focus on the emerging trend within specialized branches of medicine to mount attempts to corner a market. In Vital Signs an international conglomerate seeks to dominate the field of fertility clinics, and in Terminal a research center tries to gain an inside track on cancer treatment.
In all of these novels greedy malefactors advance their selfish causes by victimizing an innocent public. If medicine's alliance with business interests opens opportunities for the greedy, its traditional status as a privileged profession presents special temptations for the vain.
Among Cook's gallery of villains is a collection of doctors or medical researchers who also prey on the public in their endeavors to serve their own private ends. In the cases of Coma's Dr.
Howard Stark, Brain's Dr.
William Michaels, Godplayer's Dr. Working in secrecy, these characters do not stop at murder in their singular pursuit of their private ambitions and desires.
Cook's purpose in presenting villains of this sort is part of his general critique of the medical profession. As members of a socially honored occupation, doctors are, in his view, sometimes too conscious of their own importance. This is particularly true, he believes, of physicians engaged in scientific research: Researchers feel they're doing something so important that they don't have to be held to the same guidelines that other people are. In a way that's one of the general problems in medicine, researchers feeling that they're doing the most important thing of all and that it gives them a sort of license to do what they think is right.
They start making minor or major ethical decisions on their o w n. The ethical problems of dealing with this kind of thing are horrendous. CA, In plotting stories that depict the repercussions of doctors' or researchers' arrogance, Cook emphatically alerts readers to the existence of the ethical problems he has cited.
In Cook's conspiracy plots, where, as Joseph McLellan observes, "the horrific situation is one of helplessness in the face of a vast, impersonal and malevolent force" C4 , readers perceive that some awareness of contemporary cultural trends seemingly offers the only available means to address their possible implications. The malevolent force to which McLellan refers is, in Cook's vision, the very human evil that arises from vanity or greed; through the plots of his medical thrillers, Cook endeavors to impart knowledge of the present dangers of this evil.
Knowledge, he believes, is as important to the reader as it is to the characters in his books. Most of the protagonists of Cook's novels become entrapped because they lack some crucial piece of knowledge, and the innocent patients in the books are the victims of what they do not know and have no reason to suspect.
Cook sees the medical thriller as an ideal forum for educating people about developments within his profession because, as he states, "not only can fiction gain you a much larger audience than, say, if you wrote a serious essay about these problems, but you also get people to experience the emotional aspects of the problems and reach an understanding which they couldn't have otherwise, short of actually participating themselves" CA, For example, in both Fatal Cure and Terminal, two of his most recent novels, Cook experiments with form by introducing subplots to accompany the central action.
Designed to provide his readers with extra thrills and chills, the subplots function to reinforce the medical thriller's ties to a broader suspense genre. Fatal Cure's subplot features the menacing presence of a serial rapist who haunts Bartlet Community Hospital's parking lot. Heightening suspense by enhancing the aura of danger, Cook's subplots contribute to the nonstop action of his thrillers. In two of his most recent novels, Fatal Cure and Acceptable Risk, Cook introduces another and quite fascinating innovation.
Although the evildoers in Cook's fiction are not always brought to justice as in Fever, for example , in both of these recent books the plots ensure—in an altogether Dantesque fashion—that the villains are meted wonderfully appropriate punishments to redress their terrible crimes. Acceptable Risk's elitist researchers are transmuted into primitive beasts, and Fatal Cure's monstrous Board of Directors is irradiated by its own lethal bed.
Thus, as an old saw would have it, the Board must lie in the bed it has made. With these daringly whimsical flourishes, wherein fictional retribution is visited upon fictional malfeasance, Cook weaves a strand of surrealism into the fabric of his thrillers' plots. Although eleven years and certain innovations in technique separate Fever and Fatal Cure, the two novels do have much in common. Both books feature plots wherein protagonists find themselves pitted against the power held by the medical establishment, and both are set in rural communities, where local inhabitants are strongly protective of the business interests that support the regional economy.
Unlike any of Cook's other plots, those in these two novels are sharply focused on family life, for in Fever and Fatal Cure, the lives of the protagonists' children are in danger. Fever's protagonist, Dr. Charles Martel, is a researcher at the Weinburger Research Institute, a facility that specializes in developing treatments for cancer. Martel's special expertise lies in the area of immunology which, as Robin Cook actually believes, offers the best hope for Robin Cook's Medical Thrillers 29 finding a means to control the dreaded disease , but his job is in jeopardy because his research does not offer the promise of producing a patentable or marketable drug.
Martel, therefore, finds himself opposing the special interests of his company at a time when it is especially important that he preserve his job, for his young daughter Michelle has been stricken by leukemia.
Under pressure to change the direction of his research, Martel resists, largely because he firmly believes that his own line of inquiry offers the best chance of finding a cure for Michelle.
Michelle is undergoing traditional chemotherapy while her father races against the clock in his efforts to find a way to trigger an immune response within his child. Charles Martel is furthermore convinced that his daughter's leukemia the disease, in fact, that killed his first wife was brought on by the benzene that Recycle, Ltd.
Martel is himself viciously beaten and the members of his family are harassed by disapproving neighbors. Thus Charles Martel is a man beset, and the novel's theme of besiegement reaches its crescendo after he has, in a desperate effort to save her life, actually kidnapped his declining daughter from her hospital bed and boarded up his house. With his family united around him, and police and armed citizens surrounding his home, Martel applies his treatment to Michelle.
Fever nears its climax when Martel is brought to the recognition that his actions have endangered his entire family. A man manages to enter the house during the early morning hours descending from the attic , and when Martel apprehends him, and finds that he is armed with a Smith and Wesson. Checking his wallet, Martel finds a business card identifying the intruder as one Anthony Ferrullo, a security guard for Breur Chemical.
Knowing that Recycle, Ltd. Up until that moment he had felt that whatever risk he was taking in standing up against organized medical and industrial interests could 30 Robin Cook be resolved in a court of law. Anthony Ferrullo's presence suggested the risk was considerably more deadly.