The Fifth Vial (original 2007; edition 2007)

The Fifth Vial is a medical thriller in the ’surely that couldn’t happen outside fiction…could it?’ vein. In what appear to be unrelated incidents a coroner in Florida finds recent surgery scars on the body of an unidentified man hit by a truck on the highway and a Boston detective is hired to investigate the situation. Medical student Natalie Reyes is suspended from duty and heads to Brazil to deliver a research paper and in Cameroon a brilliant doctor’s experimental drug is in danger of never reaching production due to his own health problems.

The characters here are all a little over the top but they’re fairly credible in the context of the story. The never-ending tragedies that befall Natalie do verge on far-fetched and I did start to wonder just how many more perilous situations one 35 year old woman could survive but you expect that kind of thing with these books and I was happy to go along for the ride. There’s more than one protagonist in this book and I enjoyed their different points of view and they way their parallel stories wound themselves together. I wasn’t overly fond of Natalie so it was nice to spend a chunk of time with different characters, especially fledgling detective Ben Callahan whom I did develop a soft spot for.

The plot is what you’d expect from this kind of thriller: lots of action and twists and revealing of things (and people) that are not as they first appear. It’s a pretty well-constructed example of the genre although the resolution is a little obvious and a couple of the plot devices seemed forced to me. Why would bad guys hire a complete stranger to be a flight attendant for a plane carrying only 6 passengers? Could they not get their own packets of peanuts rather than risk showing their entire evil empire to Joe Schmo? However, the book did keep me up past my bedtime which is a sure sign of a good story-telling.

I had just about given up on medical thrillers after reading the last couple of Robin Cook novels in which his insufferable moralising about the evils of modern health care administration overtook any pretence of story-telling. Happily though The Fifth Vial is a solid example of what the genre should be: an entertaining page turner that makes you wonder which parts might just be happening somewhere in the world right now.

My official rating for this one is 3.5 ( )

This is the first Michael Palmer book I've read. Knowing he wrote medical mysteries and being a huge fan of TV's "House," I figured I'd give him a try. The idea of black market organ transplants had potential, but got bogged down with the telling of the story, one-dimensional characters, and little mystery.

“The Fifth Vial” has three interrelated stories: med student Natalie Reyes is sent to a conference in Rio only to get abducted, shot, and have one of her lungs removed due to a bullet wound. Then there’s Ben Callahan, a low-level PI who gets asked to look into the disappearance of someone suspected of being killed for his bone marrow. Finally, there’s Joe Anson, a medical genius who’s being paid by Whitestone Pharmaceuticals to develop a potentially life-saving drug. But he must undergo a life-saving lung transplant due to an illness so he can complete his work and divulge all of the drug information to Whitestone.

Pretty early on, it’s clear who’s responsible for what happens to Natalie but we’re supposed to be shocked at the end. Then Ben, who seems like a pretty decent guy, goes way out of character to get himself on a plane to the “hospital” in Brazil where these transplants take place. (SPOILER: He doesn’t get in trouble for it either…guess the guy he abducted and locked in a storage shed for several days/weeks didn’t hold a grudge.)

One really cool, pretty much left-alone idea that comes along, however, is the fact that what Nat thought happened to her (abduction, getting shot) were memories implanted via a 3D virtual reality system. I think had that been a bigger part of the story, things might have been more interesting. I also think a debate between more reasonable characters on organ transplants would have served the reader better. We have already made up our minds about the characters before they go off on why organ transplants are good/bad. This is something Michael Crichton did very well in “State of Fear.” Characters offered very differing views of global warming, but if memory serves, they weren’t purely good/evil characters.

Overall, “The Fifth Vial” was pretty disappointing. ( )

This is pretty much in line with Michael Palmer's other books - pretty basic medical thriller with a twist at the end (not unexpected). A good, quick summer read. I like stories like this. It’s fiction but you believe it could actually happen. The science in the midst of the story is interesting and current. Some of the stories were told from separate points of view but it all came together in the end. Books that increase your paranoia are always fun to read, and this book did exactly that. After reading this, you will always pay attention to the color on the top of the blood vials from now on (watch out for the green ones). I greatly enjoyed this book. It was an excellent mix of adventure, puzzle-solving, romance (there is a little) and, of course, paranoia. I would recommend this to anyone who likes to solve mysteries and is interested in medical thrillers. ( )

The Fifth Vial written by Michael Palmer. I wasn't sure about this book when I started listening to it as an audiobook because I did not like the reader's female character voices and felt the twang in Ben’s, a main characters voice was artificial. However, as I continued to listen, I began to get caught up in the plot and connected with the characters. The plot and action made the voices less important but I would have enjoyed it more with a different reader.
Natalie Reyes a young medical resident has a terrible life threatening incident which changes her life and her aspirations to be an Olympic track star. She is pulled into a world of medical mystery and terror. From the sterile operating rooms in the United States to the green and lush jungles of Brazil, this novel is non-stop action and suspense. Ben Callahan is a private detective from Chicago who doubts his own worth and is not positive about his future. Natalie and Ben meet in a most unlikely way.
This book deals with the delicate issues surrounding legal and illegal donors and recipients of transplanted organs. The story line is filled with self-important men and women, selfless medical staff and greedy and self-proclaimed rulers known as the “Guardians” as the plot speeds through narrow alleys, down steep and dangerous cliffs and into the lives of doctors, military police and into small unknown villages.
I enjoyed this book and would have given it 3.5 stars, but it is closer to 4 and a worthwhile read. ( )

I have read other fiction about black market organ donors but Michael Palmer introduces a new twist in The Fifth vial. A group based on Plato's philosophy rationalizes that they are doing the honorable thing in saving those who have a lot to contribute to society (the upper caste if you will). This thriller definitely will keep you worrying when you have blood drawn and certainly opens up moral areas for discussion. It is troubling but well worth the read. ( )