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Blending a witch’s brew of weird science and unbridled greed, Cook’s (Cell, 2014, etc.) newest medical thriller will boost the blood pressure of anyone facing hospitalization.

Lynn Peirce and Michael Pender are fourth-year medical students at Mason-Dixon University Medical Center, part of Middleton Healthcare conglomerate. With graduation coming, Michael is Boston-bound and Lynn is anticipating an engagement ring from lawyer Carl Vandermeer. Then Carl is hospitalized for knee surgery. He comes out of the operation comatose and in a persistent vegetative state. Serendipitously, the Shapiro Institute, a "state-of-the-art-facility" for PVS patients, is nearby. It’s an affiliate of Sidereal Pharmaceuticals, a high-tech drug manufacturer owned by a reclusive Russian billionaire. Risking expulsion from medical school and violating HIPAA privacy standards, Lynn and Michael learn that Shapiro’s true purpose is far more nefarious than providing "automation, computerization, and control of infection" for PVS patients. Affordable Care Act aside, Cook’s formula—greed and medicine are a lousy combination—still works. As one character notes, "even the so-called nonprofit hospitals are money mills in disguise." Cook’s other villain is an easy target—international pharmaceutical corporations, the sort that spend more on advertising than research. That leads to motive: "biologics, or drugs made by living systems," are a multibillion-dollar market, and Shapiro has a way to make them cheap and quick. Add esoteric terminology—hybridomas, gammopathy, doll’s eye reflex—plus Russian ex–special forces assassins, and the action ramps up from threats and coercion to rape and murder. Lynn is an anemic protagonist, while Michael, an African-American athlete and scholar from a poor family, is better sketched but verging on cliché. The bad guys are off-the-shelf Villains 'R' Us, but the Shapiro Institute, where the Mission Impossible final chase scene takes place, is sci-fi nightmare material.

Essentially a rewrite of Cook’s first blockbuster, Coma (1977), plugging in big pharma and amoral Russian oligarchs as 21st-century villains.