- © 2007 Canadian Medical Association or its licensors
The Fifth Vial Michael Palmer St. Martin's Press; 2007 372 pp. $31.95 ISBN: 978-0-312-34351-4
As if we didn't have enough to worry about just watching the news, along comes Michael Palmer's 12th medical thriller to get us really stirred up. Never mind. From time to time, we need a heroic tale to make us glad we're still alive and to point out just how much worse things could be. Palmer is a master of this game. He blends his medical background with his storytelling instincts in a cauldron of international conspiracy, ethical disaster and human drama. No wonder his medical thrillers scamper up the bestseller lists.
![Figure](https://www.cmaj.ca/content/cmaj/177/12/1554/F1.medium.gif)
Here's his recipe for success: Start with a contemporary medical issue (in this case, the heartbreaking shortage of transplant organs), add a shadowy international corporation running blood-testing labs and a medical cabal with a difference, drop an unsuspecting hero and heroine into the dangerous brew, sprinkle with a touch of unlikely romance, and bring to a boil in Brazil. Palmer stirs well and the first thing you know, you've kissed your good night's sleep good-bye.
Palmer is passionate about the issue of organ shortages and uses the thriller to reflect his concerns. The story plays out with 3 protagonists who are unaware of each other and of the impoverished victims who have been selected because their blood samples have been tissue-typed as matches for wealthy and desperate recipients.
It's easy to care about the people in this book: not only the victims, with their unheard screams, but also the brilliant and dying medical researcher, Joe Anson. He is close to a breakthrough serum that could save millions of lives, yet is guarding the results from his funders: the Whitestone Foundation, a conglomerate that's a front for the Guardians of the Republic.
Aside from the saintly Anson, the key character to root for is Natalie Reyes, a flawed, obsessive resident, who will stand up to anybody, even when this is obviously a bad plan. This attitude, useful for the Olympic-level athlete she used to be, gets her tossed out of her emergency department rotation, and may cost her the surgical residency she covets. That chip on her shoulder gets larger after Reyes is attacked on the way to a medical conference in Rio de Janeiro, Brazil, and, as a result, loses a lung.
Meanwhile back in Chicago, Illinois, Ben Callahan, a failed private detective, seems to need a boot in the backside to get out of bed in the morning. He gets that metaphorical kick when he's hired by a medical anthropologist to investigate the death of a bone-marrow donor, unknown to any of the local hospitals. The likeable Callahan could use a dollop more flawed obsession as he is pulled reluctantly into this international conspiracy.
Reyes and Callahan will be called on to survive in intense and challenging conditions, tricky at the best of times, and nearly impossible as they both converge on the secret medical facility in a remote Brazilian community and use every strength they possess to save an unwilling victim. You will figure out early enough who is pulling the strings, but Palmer can still get your heart rate up during the darkest moments. Of course, you already know that a certain suspension of disbelief is required in any contest of lonely heroes against vast and organized evil. Suspend early, and Palmer will reward you with a lively and engaging adventure. One word of advice: you do not want your patients reading this book. They might never look at you the same way.
Footnotes
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Mary Jane Maffini is a part-president of the Crime Writers of Canada and the author of 3 mystery series. Her latest book is Too Hot to Handle.