Medical thriller that takes us through some odd twists and turns.

Matt Rutledge, a doctor in his home town in West Virginia, has it in for the Belinda Coal and Coke Company. His father lost his life in a mine accident, and his new wife lost her life to a strange cancer. He believes the mining company is responsible for both deaths because of their callous health and safety violations. Unfortunately, he has not been able to provide adequate proof of their wrongdoings so nothing has been done.

Meanwhile, Ellen, a fit and active 60-something, heads for Belinda to pursue some cases of vaccine testing that took place there ten years before. And Nikki, a medical examiner in Boston, heads for Belinda to bury her close friend, who had developed a strange disease.

In part because of the local sheriff, the three ultimately meet and find common ground. Ellen is part of a group that is working for more transparency and testing time for vaccines. Nikki is interested in finding the cause of her friend's illness. Matt is pursuing the mining company.

And meanwhile, the president and his wife are counting on the rollout of a supervaccine to secure his second term. Ellen is uncomfortable with the vaccine from what she knows about it but doesn't know of any specific part of it that is harmful. However, she has questions about one of the included vaccines.

So there are Big Interests involved. They take the form of smaller interests, essentially thugs. And things go out of control toward the end.

I was uncomfortable with the anti-vaccine aspects of this novel. However, the author, being a doctor, has proceeded with caution in this respect. Ultimately his characters are looking for more time, more study, and are not necessarily anti-vaccine. Which makes them different from many I have encountered. Even so, Palmer states as if it's proven that vaccines sometimes cause autism along with other serious conditions. His character, Ellen, mentions the many studies on "both sides" of the issue and asks who knows what is true. I think most doctors know.

Ellen also feels not enough studies have been done, particularly because there have not been double-blind studies. Many many studies have been done that are rigorous and long-lasting. IT is not true that these medications have gone on the shelf without adequate study. It is odd that Ellen's group wants double-blind studies to assure themselves of the safety of vaccines, yet the members believe in anecdotal evidence, the worst kind.

I'll get off my soapbox at this point but had to register my concern about this topic. ( )

I don't remember reading any Michael Palmer's ever before. This one was a good story told well. ( )

Matt Rutledge is a small town doctor in Belinda, WV. He believes the local mining company is causing illness and death (such as his wife's and father's), and is looking real hard for the reason to get the mine shut down. Not a real popular idea amongst the folks in town.
Ellen Kroft is a retired school teacher who believes that a new vaccine that's being introduced nationwide (endorsed by the First Lady) is deadly. Nikki Solari, a coroner from Massachusetts, is in the town of Belinda to attend her best friend's funeral, when an attempt is made on her life. It seems she might have received some suspicious information about her best friend's death, and somebody wants that information at any cost.

The book can very well be reality in today's society. It is sad and scary, but it is extremely well written and gives the reader something very real to consider regarding a very real and dangerous situation. ( )

This was fun, fast and entertaining - just right for a vacation read. The science seemed very plausible to me. ( )

Overall, it was a good 'story'...trying to link what everyone thought were three random medical issues, despite the fact that these three cases were located in different parts of the country. It started out really interesting...how can a case of paranoid patients with neurofibromas (one in W. Virginia and the other in Boston) be linked to a pregnant woman in Chicago who thought she had the flu, but ended up with a fever and diarrhea that caused bleeding from every part of her body? What I like about Mr. Palmer is his ability to explain medical procedures and and healthcare policies with ease. what I don't like about him is his tendency to ramble on and on seemingly going nowhere with his explanations. This book (the paperback) was 509 pages! The story should have ended around page 321...it dragged on unnecessarily. It was a REAL struggle to finish it. I plowed through because I was ready to connect the dots. He seemed to add incidents just to make it a bit more convoluted to throw us off, but it only served to make things more boring. I don't know if I can recommend it unless you are truly fascinated by environmental issues (toxic dumps, coal mines) and vaccine-related illnesses and the supposed connection to autism and other similar diseases. The first Michael Palmer book I read was A Heartbeat Away and I really enjoyed it so I set out to read all of his books. Fatal was my second book and I think I need to take a quick break and read something more fast-paced before I dive back into the rest of his books. ( )