Health scare

Of all the places in which a thriller strands you, the hospital is the only one you are likely to see in real life. It is easy to stay out of a gothic mansion or the underside of a bridge at night. But at some point most mortals will experience the gloom of white walls, a cold antiseptic smell, long corridors and unmarked, unexplained, forbidden doors.

In every other kind of scary book, an ambulance, an emergency room, and a white-coated duty doctor signal reassurance. In a medical thriller, the white coat is where the trouble begins. Those novels play on an authentic fear, a fear of medicine that for some is as stark as the fear of illness.

 

Robin Cook, ophthalmologist, wrote a number of medical thrillers, but with his first novel, Coma, published in 1978, he most effectively tapped into that fear. Coma starts out bloody, like all of Cook’s novels. His characters don’t just bleed, they haemorrhage or exsanguinate. The author tells us whether the blood was oxygenated or frothy, whether it came from the stomach or lungs, and how many pints it amounted to.

The gist is that several young and healthy patients fall into a coma after a minor D&C (dilation and curettage) or knee surgery. A medical student looks into one patient’s case because she happened to talk to him before he was anaesthetised, and she discovers the hospital is supplying organs for transplant to wealthy patients.

That was clearly much more shocking back in 1978, but what still makes our skin crawl is the way the comatose are stored in the novel, in a window-less building, hung on wires. The movie poster showed this unforgettable image.

In Mortal Fear, the Good Health Plan Clinic introduces a profitable executive check-up plan. Patients are usually given a clean bill of health and told to lose weight, quit smoking and drink less. But they drop dead about a month later, with the kind of organ deterioration doctors normally see in the very old.

(This happens in real life, too, but you don’t want my sarcastic asides on corporate hospitals and their checklist approach to health care.) It doesn’t take a detective to ask cui bono in this novel. The hospital cleans up, monetarily, and doesn’t have to spend its precious energy on chronic patients. Even if the hospital administrator did not appear in every scene dressed in black and red, you’d see she was driven by profit and loss. She merely pursues, with murderous efficiency, the corporate aims of the Good Health Plan Clinic.

It’s not just lust for money that makes a dangerous doctor, of course. Pure scientific curiosity can be just as lethal. Mutation is a predictable cautionary tale, a Frankenstein rerun. A quote from Mary Shelley sets the tone, and in case you didn’t get that, the mad scientist’s first name is Victor. It has its little frights. When Victor’s genetically modified baby opens his bright blue eyes, we are reminded of what Frankenstein saw when he bent over his just-electrified creature: “The dull yellow eye opened.”

Mutation barrels downward from there, but it will no doubt be reread when biotech firms announce tie-ups with infertility clinics.

Though Cook does not master the larger surprise element — the reader always knows who is really doing harm — his stories have twists enough to keep us on the hook.

But Coma was scary beyond the shocks. Was it because the New Jersey Supreme Court had just allowed doctors to pull the plug on Karen Quinlan? Comatose young women were on our minds. Before then, we knew life and we knew death. But when artificial life support became an issue, we talked, even in classrooms, about what it meant to exist in the in-between. To have a machine breathe for us, put nutrients into our bodies and flush toxins out. To sleep. Perchance to have a nightmare.

(Latha Anantharaman is a freelance writer and editor based in Palakkad)