Marker (2005)

Robin Cook, master of the medical thriller, brings us another glimpse into modern medicine with Marker. While most of his works stand alone, he does have one continuing series which features a group of forensic pathologists that work in Manhattan for the Office of the City Medical Examiner, OCME. As the rest of the medical profession looks at our pathology colleagues as the "doctor's doctor" they can be intriguing characters indeed (As an aside, there's some truth to the saying- "surgery does the most, but knows the least, medicine knows more, but does less, and pathology knows the most, but they're always too late"). Anyway, Marker is the fourth novel in the series, and follows Vector.

A developing series of deaths is occurring at the nearby and fictitious Manhattan General Hospital. Our steadfast pathologists, Drs. Laurie Montgomery, and Jack Stapleton are on the job to figure out why younger, healthy patients are dying soon after surgery. They are at a loss to explain things, as they have no pathology on autopsy, their labs are normal, and their toxicology is negative. A mystery indeed! Set against this is Dr. Montgomery discovers that she is positive for the BRCA1 tumor marker, while her biological clock, at age 43, ticks away.

I'm kind of divided on this novel. On one hand, it is a very enjoyable read. The prose well written, and I had trouble putting it down once started. On the other hand, being a physician, and matching wits with the author who is similarly trained, I had most of this 500 page novel figured out by page 50. Seriously, there needed to be a few more twists along the way as I expected much of what followed.

Also, Cook has been "on leave" from his day job for many books now, and he needs to update some of his medical knowledge. For example, a PICC line would never be put in acutely in the OR for a fluid resuscitation on a bleeding patient as the catheter is too long, and the flow too slow. Also, the explanation about the EKG changes didn't make sense to me. High potassium causes flattened P waves and peaked T waves, and his explanation was rather confusing, and incorrect. Also, infertility rates I'm sure would go up after removing the tube and ovary (why the took the ovary too is beyond me as they only needed to do a salpingectomy without an oopherectomy) in a 40+ year old patient.

Medical details aside, unlike some of Cook's other novels, Marker is very well done. The characters are quite developed, and the descriptions are great. The plot moves along like a freight train, without a stop at a station. If you've been considering reading this author, this series is among the best of his work.

Overall Grade: A-

--Jonas