BookBrowse Reviews Isolation Ward by Joshua Spanogle

BookBrowse:

A funny, smart and skilled writer at the beginning of what readers will hope is a long and prolific career. Medical Thriller

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From the book jacket: In an astounding debut, Spanogle takes us on an all-too-real race against time…as a young doctor enters the dark side of scientific research, desperate to stop a terrifying epidemic before it is too late…

In Baltimore's St. Raphael's Hospital, three newly admitted patients are among society's most helpless citizens: female residents of Baltimore's group homes for the mentally impaired, their bodies racked by a virus the likes of which no one at St. Raphael's has ever seen.

Dr. Nathaniel McCormick is one of the first on the scene. A young investigator from the Centers for Disease Control (CDC), Nate is paid to explore the bizarre, the exotic, and the baffling–from superviruses to bioterrorism. But as soon as Nate begins to investigate the lives and habits of the victims, he knows something is terribly wrong. Using all his skills as a medical detective, Nate soon zeroes in on the "vector" – the one person who had sexual contact with the first victims. And when that suspect is found murdered, Nate fears that the disease he's chasing may not be an act of nature, but of man.

Comment: Joshua Spanogle is currently a student at Stanford Medical School.  Most medical students graduate with a 4-year medical degree in five years having taken a year to do research, but Spanogle is set to graduate in six.  He spent his first additional year doing basic science research and orthopedic surgery; he's currently taking a second year in order to write his second novel (Flawless, due out in August).  More about Spanogle.

He wrote Isolation Ward, his first novel, in the summer between his first and second years, and spent the following 18 months editing it in spare moments.  It's set firmly within the medical thriller genre as defined by Robin Cook, with noir overtones (Spanogle cites Raymond Chandler, Dashiell Hammett and Raymond Carver as major influences).

The action moves at fever pitch, with beautiful women, a really, really nasty villain, lots of medical lingo and liberal amounts of gratuitous violence from which our protagonist recovers with miraculous speed. 

Having said that, there is more to Isolation Ward than many "page turners".  Spanogle's protagonist, Dr Nate McCormick, is a flawed, misanthropic character with a  shameful past, which together with the wide canvas of opportunities open to him as a member of the CDC gives the series the potential to run through many books!  In this opening book he's launched into the middle of a controversial plot rooted in the often substandard care of the mentally impaired; a story which is inspired by some real life events and Spanogle's own concern for society's most vulnerable - "At times, we dehumanize those with mental disabilities, and I wanted to present them as fully as I could --- with different needs and wants and, yes, sex lives."

Without giving away any plot spoilers, according to Spanogle, the group home is inspired by newspaper reports of a Baltimore institution; the idea of using patients in a persistent vegetative state as they are used in the book was proposed in a public forum by a surgeon; and the risks and rewards of xenotransplantation (transplanting cells, tissue or organs from one species to another) are all based on fact.

One of Spanogle's stated intentions is to educate as well as entertain so he has set out to make the science challenging but without going on ad nauseum - "Readers are very smart and discerning, and my responsibility to them is to present the science truthfully and rigorously, at least in a general sense."

As Publishers Weekly puts it, "medical thrillers have been rather sickly of late" - which is why it's particularly exciting to discover this "engrossing and intellectually wrought first novel".

This review was originally published in The BookBrowse Review in March 2006, and has been updated for the January 2007 edition. Click here to go to this issue.