Viral is Robin Cook's 38th medical thriller and it is my favorite from among all of his books. The ending was unexpected and extremely satisfying that I am tempted to begin rereading it ASAP.

The main character, Brian Murphy, and his wife and child travel to Cape Cod for a two week vacation. When wife Emma begins to get flu-like symptoms, they cut their vacation short and return to New York City after one week. On the drive home, Emma begins to convulse. When the family reaches their local hospital Emma is given a room in the ICU area. She is diagnosed with eastern equine encephalitis, a/k/a EEE. It is a rare and highly lethal mosquito-borne viral disease that she probably caught during one of their barbeques on the coast. To make matters worse, Brian and Emma's daughter Juliette begins to exhibit alarming physical and behavioral symptoms too. Emma's hospital stay is rather expensive. When Brian receives a $221,000 bill that his insurer refuses to pay, citing dubious clauses in their health insurance policy, he decides to get to the bottom of the hospital's predatory billing practices.

My love of the story is based on my own experience with encephalitis when I was 8 years old and my 35 year history dealing with insurance companies after a catastrophic injury in a car accident. The author gives us the basics on encephalitis, the treatment and etiology of which has changed drastically since I had it 55 years ago. I ended up googling it and discovered even more information that was geared to my experiences over all these years. Cook is known for writing the etiology of whatever disease he writes about in his books. It becomes part of the plot action. Naturally, I was drawn to this particular story.

The writing was superb. The pace was super fast because Brian needed to save the lives of his wife and child. The reader doesn't know how things will turn out, just that there is a sense of urgency. Brian had to fight this battle on three fronts: the disease, the insurer and the hospital. I believe this alone will connect with every reader. All Americans have been put through the ringer with medical matters. The ending was quite different from what we have seen from Cook in the past. I won't elaborate, but I loved it!

Another aspect to the plot is how asian mosquitos came to be located on the U. S. eastern coast. This mosquito has a distinct look: 2 white dots on its wings. Climate change is the reason that this type of mosquito traveled from the tropics, where it is normally located, to the eastern coast of the United States. Later on in the story, the reader sees that this particular mosquito is somewhere else on the planet. I don't want to be a spoiler so I will leave it at that.

The hospital setting was where much of the action took place. Cook shows us what we are all familiar with: hours long waits in the emergency room, seemingly uncaring staff, and, of course, the nasty billing department who call you nonstop trying to collect. The plot goes into hospital billing practices that I was not aware of. It has made me determined to check my bills in the future now that I know how this system works.

I thought the characters were sympathetic. We don't know much about Emma because she becomes ill early in the story. Daughter Juliette is four-years-old and cries constantly. She is catered to quite a bit. I can certainly feel for Brian. Having been through his circumstances more than once in my life, I felt his pain. His emotions ran high throughout the entire story. Although Brian is a problem solver by nature, he just cannot penetrate the medical system to resolve his issues. His line of thinking is insightful for anyone new to this experience. There are 4 other characters of note. His mother, mother-in-law, business assistant and a new friend named Jeanne all help him steer through the mess that healthcare is today. Jeanne, in particular, becomes a major part of the story. She is a child psychologist who lost her husband a year ago via the same situation that Brian now finds himself in.

Viral will make you read your insurance policy and search for medical billing advocates. I loved it and rate it 5 out of 5 stars. ( )

Fast moving---hour by hour and day by day! Robin Cook certainly knows how to grab your attention and of course this book, like so many of his, is SO very current. Very, very readable! ( )

This book is a rollercoaster ride for sure as you progress from the initial chapters through the main part of the book but seems to loose steam towards the ending. Yes there is a great deal of repetition of themes and some dubious logic like after one death related to a an obscure and relatively unknown virus when another close family member experiences symptoms no-one thinks to check to check/test for the same deadly virus when they were both exposed to the same threat? Character buildup was pretty good and you are pulled into the lives and tragedies seamlessly. Overall not the best Robin Cook book but provides and interesting read particularly against the backdrop of the Wuhan/Corona virus pandemic and all the effect that has come with living and working under the restrictions that it has brought. Having had a hospital stay during this period I know first hand the impact it had had on the nursing staff in particular who bear the brunt of the additional workload that is required and are most at risk due to exposure to the virus. If you are looking for a story about a wide spread pandemic this is not it. I felt that the ending was a little rushed and under done and could have benefitted from a few more twists and turns as it played out pretty much as expected. ( )

It breaks my heart to say this, but this book was just not up to par. I know that Dr. Cook is very devoted to the state of healthcare in this country, and this book does a wonderful job pointing out that our healthcare sucks. But he does so over and over and over ad nauseam. I mean talking about beating a dead horse.

It did do one good thing to get me off of my butt and make sure we had decent insurance (not short-term health insurance), and our local hospital was not part of a chain.

DR. Cook did a great job setting this story up during the Covid pandemic, but changing the danger to EEE (Eastern equine encephalitis ) and explaining why climate change is making our parts of the world so ripe for this virus.

The story in itself was eye-roll-worthy and obvious to the reader, especially as you get into the book and the conclusion...well, what can I say. I guess an eye for an eye?

*ARC provided by the publisher, the author, and ATTL/Edelweiss. ( )