Sunday, January 17, 2010

The Alphabet in Crime Fiction - The Nightmare Factor by Thomas N. Scortia and Frank M. Robinson

When many people think of medical thrillers, they think of Robin Cook. That makes sense, too, given Cook’s success and popularity. Even before Cook achieved his phenomenal popularity, though, there were medical thrillers. One of them, Thomas N. Scortia and Frank M. Robinson’s The Nightmare Factor, is my choice for this week’s “stop” - the letter "N" - on the alphabet in crime fiction community meme’s journey through the alphabet. Thanks to Kerrie at Mysteries in Paradise for guiding us on our perilous way through all of these crimes : ).

The Nightmare Factor, published in 1978, is the story of Dr. Calvin Doohan, a Scottish transplant to San Francisco. As the novel opens, Doohan works with the World Health Organization (WHO); he was recruited to the organization after the death of his wife, Elizabeth, and was forever changed by the years he spent working in Bangladesh. Now, he’s working on a study of the spread of disease through rats when Dr. Raphael Espinosa, who originally recruited Doohan, asks him to join a WHO watchdog committee on genetic research. Doohan, who has a much more sanguine perspective on genetic research, refuses. The next morning, though, all thoughts of joining Espinosa’s committee are wiped from Doohan's mind as he learns of a disturbing number of cases of a virulent, flu-like illness in the San Francisco area. He volunteers his services to the local Public Health Department, and before he knows it, he’s witness to an ever-increasing number of cases. Each case seems to end in death, and as the number of deaths rise, so does the local panic level.

Soon, the Centers for Disease Control (CDC) sends in field investigator Dr. Suzanne Synge to help isolate the cause of the illness. She and Doohan begin to work together to find commonalities among the cases. As they look through the case histories and interview some of the patients, they find that most of the cases can be traced to people who attended a convention at the Hotel Cordoba. Before long, the CDC, the Public Health Department and the Army Chemical Corps, led by Major Lawrence Hanson, have a stake in the investigation of this strange outbreak.

Their investigation is complicated by several factors. One of them is infighting among the various groups. Major Hanson, for instance, trusts no-one, especially not Doohan. In fact, Hanson is convinced that the outbreak may have been deliberately caused by a hostile nation, and may have military significance. So Hanson does his best to take control of every aspect of the investigation, cutting off Doohan’s and Synge’s access to vital witnesses, records and information.

Doohan’s search for answers is also complicated by his developing relationship with Suzanne Synge. The two begin a passionate affair, but at the same time, Doohan feels that Synge is holding something back. Still, he’s attracted to her, and her help is vital if he’s going to figure out what’s behind the deaths.

Another complication is that it soon becomes clear that the outbreak was deliberately caused. In fact, as Doohan slowly puts together the pieces of the puzzle, he realizes that this virus was synthesized, not natural. It’s not long before Doohan realizes that some very malevolent forces are aligned against him. One force is Hanson and his military team, who do everything possible to hamper Doohan, including trying to have him deported. Another, more dangerous force, is the enemy who started the outbreak. Doohan doesn’t know whether that force is another country or one person or group. What he does know is that someone is desperate to prevent anyone from knowing how and why the victims really died. As he gets closer and closer to the truth, Doohan becomes more and more of a target. So does anyone else who knows anything about the virus. Before the investigation is complete, three of Doohan’s friends are murdered because of what they know.

Despite all of the forces arrayed against him, Doohan manages to get the clues he needs to find out what caused the virus and how and why it was spread. He also gets help from some unexpected sources, including British Intelligence. What Doohan discovers, though, is that he’s in the middle of what amounts to a war for the truth about the deaths. He also learns, almost too late, that he’s become a valuable commodity, since he now has important knowledge. British Intelligence wants what Doohan knows for security purposes; so does the U.S. government/military. So does the group responsible for the creation of the virus. With his life at risk, and several forces competing for him, Doohan manages to isolate the cause of the virus and tries to warn the WHO about the infection. That’s when he’s captured…

There are several compelling aspects of The Nightmare Factor. One of them is the topic – genetic manipulation. Genetic manipulation is highly controversial, and laden with all sorts of ethical implications. Scortia and Robinson dealt with those implications years before they became what we now call “current events.” Yet, the novel doesn’t really preach. For instance, early in the novel, there’s a conversation between Doohan and Espinosa about the value of such research; Espinosa wants to limit it, while Doohan’s more optimistic. The controversy is laid out, but it’s done within the context of the story, so the conversation doesn’t feel like a sermon. Even later, as Doohan realizes the extent to which genetic manipulation can go horribly wrong, the novel focuses on the mystery and on the suspense as Doohan tries to outwit his enemies. The ethical issues are addressed, but they’re not the main point of the story.

Another absorbing element to this novel is the characterization. Calvin Doohan, for instance, comes across as a whole person, marred by life, but not a stock “wounded” character. He’s likable, and it’s easy to cheer for him as he peels away the layers of secrets to get to the truth about the deaths. We feel for as he finds out that most of the people he thought he could trust are not the people he thinks they are. At the same time, he’s no perfect hero. He’s moody, impatient, sometimes gruff, and puts several of his friends in mortal danger.

The other characters are similarly interesting. We discover, as the novel evolves, that they’re all more than they seem on the surface. In fact, it’s that process of discovering who the characters really are that’s as engrossing as anything else in the novel. Even when we find out who’s responsible for the virus, and who participated in the crime, we almost understand their motivations – almost. At the very least, Scortia and Robinson don’t paint these characters as stock “bad guys.”

There’s plenty of action in the novel, too. The pace is fast enough to keep the reader turning pages, and the authors have several plot twists and surprises in store. In fact, in some ways, The Nightmare Factor is reminiscent of a “cliffhanger,” where the hero goes from danger to danger. The Nightmare Factor isn’t a light novel, and it’s not for those who enjoy quiet cozies. For the thriller enthusiast and the science enthusiast, though, I recommend it. To me, it’s an engaging forerunner of the modern medical thriller.


  1. This sounds like an interesting story that could resemble problems people are facing nowdays with the new flu going around. Sometimes its good to step away from the cozy mysteries and this sounds like the perfect one for that.

  2. Mason - It's so interesting to me that Scortia and Robinson were addressing some of the same issues we face today - over 30 years ago. I think you'll like it, actually. It's not a fun, light read, but it does keep you guessing, and it's got lots of layers.

  3. Thanks for this contribution Margot. I'm reading a book on my Kindle that may interest you too.: UR by Stephen King.- initial setting is in a college English faculty.
    After a mild mannered college professor orders a Kindle, he is met with a pink Kindle that downloads books not only from, but from Urs. Each of the more than 10 million Urs seem to represent a different reality where authors have written different books. Ever wanted to read the unpublished Hemingway book, or six Poe novels? King explores the possibilities and in the process makes every literary mind jealous.
    Not sure if it is available as an "ordinary" book - it is a novella

  4. I do like a medical thriller but it's so hard to find a good one - I've put this one on my library list. Thanks Margo.

  5. I used to read every medical thriller that came out but they started to make me nervous when I saw patients. ;0)
    Our pathology teacher at university had been a Junior Home Office Pathologist on the Christie/Evans 10 Rillington Place murders. He would have petrie dishes of plague and cholera on the desk and ask us to pass them round. That certainly improved our manual dexterity!

  6. Kerrie - Thanks for that recommendation! I'm going to have to look for that one because you're so right - it interests me a lot. You "had" me as soon as you mentioned it's about a college professor who finds a source for so many different kinds of books : ). I appreciate it.

    Bernadette - It *is* hard to find a good medical thriller, isn't it? Many of them preach, or they're too implausible, or the characters are far too flat. One thing I like about this one is the focus on the plot and characters. And no worries about the "t." You have no idea how often I've written comments and posts, only to find out later I left words and letters out.

    Norman - Your pathology teacher sounds like a fascinating person, and I'll bet he kept everyone's attention! How interesting that he was in on the Christie/Evans murders - I'll bet that was as interesting to you as his pathology lectures were. I know what you mean, too, about medical thrillers making one nervous. Robin Cook's Toxin was almost enough to put me right off meat forever.

  7. Great post, Margot (as usual!). I am trying to work out if I have read this book or not, as it seems very familiar from your review. Did they make a movie of it? (Maybe Outbreak with Dustin Hoffman?) If so, I liked it a lot.

    I agree, I love medical thrillers but have been a bit disappointed in those I've read. I often enjoy Michael Palmer, who is in the Robin Cook mould. There was a time when I always got Palmer's books out of the library, but I stopped a few years ago when I thought he was getting a bit predictable. I read a recent one about the president's physician on a plane last year which I quite liked, and thanks to you I have got his latest to read.

    I did like Stephen King when I was in my 20s (eg The Stand, Salem's Lot) but I think he really went off. I recently attempted to read Cell, having had a break from him for many years, but was very disappointed and stopped half way through. It was just the usual formula, more interested in blood and gore than a plot, and so poorly written as to be embarrassing. (Very similar to The Stand, actually- post plague USA - but highly derivative.)

    I suppose there is a vogue now for pathology thrillers, eg Cornwell, Reichs, Slaughter and Simon Beckett. I wish, however, we could go back to the hospital setting without being 100 per cent predictable!

  8. Maxine - I could not agree with you more!!! Too many hospital/medical/pathology thrillers are predictable and derivative. Or they're out to see how much gore and terror they can cram into 300 pages. No plot - just gore. When I first read The Nightmare Factor several years ago, I was afraid it was going to be like that, but it isn't. It's a little awkward in places - I wont' lie - but it is a much better read than some of what's out there now.

    I'm so glad you have Palmer's latest; I like some of his stuff very much, and he was really quite gracious to me; I always think it's so very special when people who've "made it" are gracious to us "unknowns" ; ).

    As far as Dustin Hoffman and Rene Russo in Outbreak, I think that was supposed to be loosely based on Robin Cook's novel of the same name. The two are not really all that similar at all, though. The protagoniost focus is different, and that's just the beginning. Both are good, but they are very different. I almost wish they had different names.

    I don't think The Nightmare Factor has ever been filmed (although I'm quite willing to be shown up on that if someone knows of a film version.

  9. Thanks, Margot! Now I know that there are two different books (I think I've read that Robin Cook one) I will go for the one you have reviewed here, as it does sound good!

  10. Glad to put in my two cents worth, Maxine : ). Especially if it means I get to use my otherwise-useless store of strange crimefic trivia.. ; )

  11. "Crime fic trivia" is meat and drink to some of us, Margot ;-)
    (The google captcha word for this comment is "dying".)

  12. LOL!! Oh, that is *funny!* Thanks for sharing, Maxine :)