The main action in the novel begins when Dr. Rudolph Richter, the Los Angeles-based co-owner of the Richter Clinic, is mugged on his way home from his office one evening. The attack is frightening, but Richter isn’t badly hurt and he tries to put it behind him. The next day, though, he becomes seriously ill and shortly thereafter, he suddenly dies. Then, seven of the clinic’s patients die. Now it looks as though there is an outbreak of a very serious illness, and Los Angeles authorities ask for help from Atlanta’s Centers for Disease Control (CDC). The CDC sends Dr. Marissa Blumenthal from its Department of Virology, Special Pathogens Divisions, to Los Angeles to help isolate the pathogen that’s responsible for the outbreak. Blumenthal is looking forward to the chance to prove herself, especially to her boss Dr. Cyrill Dubchek. The CDC team begins its investigation and it’s soon clear that the victims have died from the highly contagious Ebola virus. Blumenthal and the team contain the disease and return to Atlanta. Then, five weeks later, there’s another outbreak, this time in St. Louis. Then there’s an outbreak in Phoenix. The more Blumenthal investigates, the more certain she becomes that the Ebola virus is being deliberately spread. All of the outbreaks begin at medical clinics, and the only fatalities seem to be clinic doctors and their patients.
Blumenthal investigates the connections among the medical clinics and the victims and discovers a dangerous conspiracy that involves politics, medicine – and a great deal of money. She tries to alert her bosses and colleagues at the CDC, but no-one wants to cause a public panic. Besides, she has very little evidence that the deaths were deliberately planned. Now Blumenthal is up against a highly toxic virus, her bosses, and an extremely dangerous group of people who are not afraid to kill. As she slowly finds the evidence she needs to save lives and salvage her own reputation, Blumenthal discovers that the closer she gets to the truth, the more danger she’s in, especially when she finds out that her own employer was likely the source of the deadly virus.
Since this is a medical thriller, one of the important and interesting elements in it is the information we learn about the way that pathogens are spread and how the medical community reacts to it. Readers go “behind the scenes” beginning with the prologue, in which the Ebola virus passes from its animal host to humans. We follow as the doctors at the various clinics and hospitals struggle to cope with a virulent illness and keep it from spreading, too. Several parts of the action take place in hospitals and clinics and this, too, gives the reader an “inside look” at medicine. And yet, the reader isn’t overburdened with medical minutiae or terminology.
Just as interesting is the “inside look” we get at one of the U.S.A.’s less-well-known federal agencies, the CDC. Admittedly, this book was published 24 years ago, and times and procedures have changed drastically. The availability of information on pathogens is ever more instant, and the CDC has kept pace. Modern technology and communication have also changed the CDC’s response protocol. Still, it’s clear that Cook “did his homework” while writing this novel and the story provides a fascinating look at the way the CDC responds to, isolates and combats pathogens and how important an agency focused on the public health really is. We also get a look at how the CDC works with local medical and civic authorities when there is a dangerous risk to public health. This insight into the CDC also gives a sobering perspective on how easily a highly contagious pathogen can wreak havoc on a community.
Although this is a medical thriller, the focus is really on the crimes taking place. So there are clues, suspects and plot twists and turns. There is a discussion of medical ethics, particularly as it relates to the effects of money and political power in the medical community. However, the ethical questions really take second place to Marissa Blumenthal’s search for the solution to the mystery. This is one of Cook’s earlier novels, and you could argue that there is a stark difference in this respect between his earlier work and more recent novels. This is not a novel created to explore a question of medical ethics. It’s a crime fiction novel in which medical ethics plays a role.
Outbreak is also a thriller. So the pacing and timing are fast and there is little break in the action. There’s also solid suspense, which Cook heightens in several ways. For example, there’s the matter of point of view. Most of the story is told from the point of view of Marissa Blumenthal, and we feel her growing fear as she gets closer to the truth. But some of the story is told from the point of view of the killer. This gives the effect of a game of “cat and mouse” without making the story melodramatic. And as Blumenthal realises just what she’s up against, there’s even more suspense as it becomes clear that someone in the CDC is involved in the murders. Although we know who “the enemy” is well before the end of the novel, there’s a strong thread of suspense as Blumenthal tries to convince her bosses of what’s going on and as she tries to stay one step ahead of the “bad guys.” The plot is plausible; we can imagine an outbreak starting in the way that this one does, and that adds to the suspense. So does the fact that there is a believable motive for the murders, rather than just a group of evil people who just, well, want to be evil.
This isn’t a character-driven novel; it’s a plot-and-suspense-driven novel. That said, though, the character of Marissa Blumenthal is appealing. She’s bright, clever and skilled. Yet, she’s also human. She’s not always right, and she makes some mistakes in judgement. She’s up against a dangerous enemy and she’s quite naturally afraid. She doesn’t take comic-book-hero-type risks, and she feels the panic anyone might feel being so close to such a deadly murder weapon. And although Blumenthal ends up risking her own life, the novel doesn’t come overly close to the “persecuted heroine” trap into which so many recent novels have fallen (at least, in my own personal opinion it doesn’t). It’s not hard to cheer for her as she searches for the truth.
The story’s plausibility, combined with a likeable main character and solid pacing and time make this mystery a solid example of the medical thriller. But what’s your view? Have you read Outbreak? If you have, what elements do you see in it?
ps I have to admit I like this cover – there’s something “retro” about it…
An Interesting Factoid…
Don’t confuse this novel with the 1995 film of the same name starring Dustin Hoffman and Rene Russo. The film is (very, very) loosely based on the novel, and bears some similarities, but it’s a different story altogether. If you experience the novel and movie as separate stories, it’s certainly possible to enjoy both. But if you expect the two to tell the same story, you’ll be disappointed.