This week i continued on my quest to read more medical thrillers. I really enjoyed my first Michael Palmer book i read previously, so i decided to read one of his other books Fatal’.


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In Chicago, a pregnant cafeteria worker suffering nothing more malevolent than flulike symptoms begins hemorrhaging from every part of her body. In Boston, a brilliant musician, her face disfigured by an unknown disease, rapidly descends into a lethal paranoia. In Belinda, West Virginia, a miner suddenly goes berserk, causing a cave-in that kills two of his co-workers. Finding the link between these events could prove FATAL.

Five years ago, internist and emergency specialist Matt Rutledge returned to his West Virginia home to marry his high-school sweetheart and open a practice. He also had a score to settle. His father died while working for the Belinda Coal and Coke Company, and Matt swore to expose the mine’s health and safety violations.

When his beloved Ginny succumbed to an unusual cancer, his campaign became even more bitterly personal. Now Matt has identified two bizarre cases of what he has dubbed the Belinda Syndrome–caused, he is certain, by the mine’s careless disposal of toxic chemicals. All he needs is proof.

Meanwhile, two women, unknown to one another, are drawn inexorably to Belinda, into Matt’s life–and into mortal danger. Massachusetts coroner Nikki Solari comes to attend the funeral of her roommate, killed violently on a Boston street. Ellen Kroft, a retired schoolteacher from Maryland, seeks the remorseless killer who has threatened to destroy her and her family.Three strangers–Rutledge, Solari, and Kroft–each hold one piece of a puzzle they must solve, and solve quickly. If they don’t, it will be far more than just their own lives that are at risk.

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I did not enjoy Fatal as much as the other medical thrillers i have read. Something about the plot and the characters just did not click with me. The story focuses primarily on Dr. Matt Rutledge and his quest to expose the shady health and safety practices by the mine in his community- primarily the dumpling of toxic waste, which he believes had caused the illness of many people in his town and the death of his wife to cancer. He gets suspicious as a number of individuals have been found dead after behaving strangely and with neurofibrodomas on their face. Nikki Solari is a ME in Boston, and her best friend is killed with symptoms similar to Matt’s patients-but she is unaware of the connection until she returns to her best friends home town for her funeral. This happens to be the town of Belinda-where Matt and his uncle reside.

There is one finals main character that is added to this mix-Ellen Kroft. She is a retired teacher who became very vocal against vaccinations after her daughter ‘supposedly’ had a reaction to the vaccination she was given. She is on the board of a committee that has been meeting for many years to work towards the release of the Omnivax- a vaccination against the majority of the major diseases in our society.

Throughout the book we follow Matt and Ellen, with Nikki initially an by her self, but works with Matt for the second half of of the book. I was very curious to see how Ellen fit into the narrative and the plot arc of the whole book. While it was obvious to see Nikki and her involvement in the investigation, Ellen was initially painted as an ‘anti-vaxer’ trying to stop the distribution of the Omnivax. For the majority of the early parts of the book there is a lot of information given about vaccinations and the politics and debate about them. While i knew where the story was headed with Matt, Nikki and the mine i had no idea as to how vaccinations and Ellen fit into this story. The reveal as to how everything was connected was the highlight of the story, but that was the only saving grace of the book. While i loved his writing in The Patient i was disappointed in this book. Something was wrong- i think it was how the portrayal of the villains were accomplished. While the main villain in The Patient was constructed wonderfully, i must admit he might be one of my favourite villains i have read in the last 3 or 4 months, the thugs and corrupt officials in this story seemed like and afterthought. While the tie in between the vaccinations and Matt/Nikki was very interesting, the resolution with the mine and everything else that occurred in the story was just not enough.

And don’t get me started about the love scenes…with some weird dialogue and internal monologues.

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Nothing about the characters really stood out to me and made me like them-even the villains made me feel impartial. I wanted to hate the villains, or think they were genius or immoral, but nothing Palmer wrote throughout the text really showed anything like this. Matt is constructed as a nice guy, a bit of a different doctor with long hair and a tattoo, grieving over the death of his wife, his obsession with the mine really is the only thing about his character i can remember as i am writing this review. Jessie, the main character from The Patient,  liked video games, studied an engineering/robotics (something related) degree before going into medicine and really had some touching moments in the book where she discussed the reality of neurosurgery that lots of patients die and many are completely different people after the surgery. Nothing about Matt resonated with me from the book-i just felt he did not received enough characterisation or development in the book. He had one great moment in his relationship with the Sluccomb brothers, and his make-shift was to treat the gunshot wound Lewis had received.  Nikki was the same-she is an ME from Boston who had a close relationship with her friend who was killed, and her investigation from this led her to cross paths with Matt. Her love of music that stemmed from her friendship with her roommate was the main character moment in the book.

I neither like or disliked Ellen. I though she was dedicated to finding out the truth about the vaccination and stood up to the man who blackmailed her and threatened her family. Her relationship with her old friend Rudy was a minor part of the book. I think the problem i had with Ellen is her strong stance against vaccinations, while i understand that some of her concerns are reasonable and her scientific investigations credible, as a strong believer in vaccinations (a pathology graduate too) at times i just was a bit…annoyed at her. Though i must remember that she shares many of the same opinions on vaccinations as many people in the world.

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Fatal was a let down from Palmer for me. The Patient was an amazing piece of writing, and i can’t help but compare this book to it.

I wished he used the whole book to investigate and discuss vaccination and diseases. The mine plot was boring too me, and i wished there was a but of a pay off for that whole side of the story. If they looked more into Omnivax and the political, medical and ethical implications of its distribution this book may have been a bit more interesting. The characters may have had a chance to shine and actually develop- and maybe is he toned down the romance.

I have many more Palmer books on my to read list, and hopefully they live up to the expectations i have for his writing.

Let me know what ya’ll think? Do you find my reviews too long and rambling? It takes me ages to start a review but when i get writing words just tumble out. So let me know if you would like me to try to switch to a shorter formal or just condense everything 🙂


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