Hospital horrors

In his autobiography Only the Paranoid Survive, Intel’s former CEO Andy Grove narrates how the company became the world’s largest chip-maker by constantly looking over its shoulder for new emerging threats. Over the last four decades, Robin Cook has created a genre of medical-mystery thrillers where the friendly neighbourhood hospital turns out to be a dangerous place where only paranoid patients live longer.

A doctor who did his post-graduate training at Harvard before serving on a submarine in the US Navy, Cook draws on this experience to create medical-thriller fantasies in his novels.

In Host, Cook adapts for the second decade of the 21st century the formula which saw his first major novel Coma rated as the number-one thriller of 1977 by The New York Times. In Coma, an attractive young third-year medical student Susan Wheeler learns that two healthy patients at the Boston hospital where she is training have gone into a persistent vegetative state while undergoing routine surgery due to anaesthesia complications, though the medical probability of this happening is one in 100,000. Susan discovers that the oxygen-line in the operating room has been deliberately tampered with to induce carbon-monoxide poisoning. She and her fellow-student Mark Bellows find that the brain-dead bodies are being taken to the nearby Jefferson Institute and kept alive to meet the black-market demand for organs. The villain is the hospital’s chief of surgery, Howard Stark.

Click forward to Cook’s 2015 bestseller Host where the attractive young fourth-year student Lynn Peirce recommends that her boyfriend Carl Vandermeer have the torn ligament in his knee operated on at the Mason-Dixon University Medical Center where she is studying. During a routine surgery, Carl suddenly goes into a coma from extensive laminar necrosis or brain-death. Lynn learns that two other healthy patients had recently undergone routine surgery at the same hospital and had also gone into a coma following anaesthesia complications. Which takes the hospital’s major-complication rate for anaesthesia for healthy patients to three in 5,000, roughly 120 times the normal rate! Lynn’s queries evoke a frightening response. A thug threatens to kill her if she doesn’t stop asking awkward questions.

The brain-dead body of Carl is moved into the on-campus Shapiro Institute without any financial burden to the patient’s family, thanks to the “philanthropy” of the Russian plutocrat Boris Rusnak who has taken over the multinational Sidereal Pharmaceuticals, which has a controlling stake in Middleton Healthcare which runs a chain of hospitals, including the one attached to Lynn’s university. The Sidereal-funded Shapiro Institute has the latest computerised, automated systems to keep alive brain-dead bodies for any period of time.

At the dead of night, Lynn and her fellow-student Michael Pender break into the Shapiro Institute and discover that the bodies of the brain-dead patients are being used to produce monoclonal antibody drugs or biologics which are far more cost-effective than the synthesised variety when it comes to combating cancer. The local villain is the hospital’s chief of anaesthesia Benton Rhodes who follows instructions, without knowing that he is acting on the orders of Rusnak. Host is the globalised version of Coma and feeds into the prevailing phobia of all things foreign.     

However, his medical-mystery thrillers are much more than just Cooked-up potboiler-fantasies — pun intended. Through his novels, which have sold nearly 400 million copies, worldwide, Cook has raised awareness of the flaws in an American medical care system which is supposed to be based on market forces.

In one of his Facebook posts, Cook notes that “The problem is there are little or no market forces in healthcare, and the stakeholders — drug companies, hospitals, medical device makers, medical labs, health insurance companies and even providers (for a time but no longer) — were and are hell-bent on maximising profits. Ergo, we have the highest healthcare costs in the world even though we score particularly low in the usual gauges of the effectiveness of healthcare, such as life span and infant mortality... The reason I started writing fiction was to make people understand medical issues.”

Truth, as the saying goes, is stranger than fiction, even of the medical mystery-thriller genre, with Obamacare becoming a key issue in the 2016 US presidential contest between the Republicans and the Democrats.