Isolation Ward: A Novel of Medical Suspense (Nathaniel McCormick)

Even though I had packed a fair share of books on my recent roadtrip, my flight back from Orlando to Portland was lacking some mind-candy reading. I visited the airport book store and picked up Isolation Ward by Joshua Spanogle. This is an excellent first novel, and it made the trip back a whole lot shorter... Dr Nathaniel McCormick works for the Centers For Disease Control, and he's out in Baltimore when a strange virus outbreak occurs. The symptoms look like a cross between a flu and a hemorrhagic fever, and it's got a high mortality rate. Furthermore, it's only appearing in mentally handicapped individuals who reside at group homes. The medical tests are not finding anything currently in the books, but some old-fashioned legwork is showing a web of sexual partners with a single individual at the center. The harder McCormick pushes to question people and test the homes, the more interference he gets from high-powered officials. And when "patient zero" is found murdered, McCormick knows that there's a major cover-up taking place. He just doesn't know what it is or where the virus will show up next. Together with a prior love interest, he turns his sights on a biotech firm associated with the medical college he was thrown out of earlier in his life. Far too many of the people he visits end up dead shortly afterwards, and he's not quite sure if he'll discover his answers before they get to him also... Generally speaking, I cut new authors a little slack when it comes to their first published work. Writing a mainstream novel is not easy, and getting the pacing down usually comes with time. In this case, Spanogle cut to the head of the class. The depiction of a new virus threat seemed very realistic, as well as the constant questioning as to whether this was a bio-terrorist threat or just a new bug. It also showed that there are no easy answers when it comes to the detective work, and sometimes luck plays a more important role than skill. Just about the time you think you know where his story is going, there's a twist that takes you off in another direction. And although you think there are people in the story you can trust, each one has just a slight edge to them that makes you wonder if there's something that you don't yet know... A very good, entertaining read, and an excellent first effort... Spanogle will be an author I keep on my "must read" list...

I must say I had my doubts, since this is a new writer, kind of young, and, moreover, preoccupied with the challenging task of graduating from one of the most selective, and, by inference, probably one of the most rigorous, medical schools. But I was surprised at how expertly he writes. Kind of like a John Grisham of the medical world or like a modern Ed McBain with medical and scientific expertise. He shows a lot of artistic imagination for someone who has spent so much of his life with the science books and in the lab. There are all the elements in this to make it a successful debut: a good plot, conflicted and multidimensional characters, mystery, romance, action, fantasy, philosophy. It takes a rather mundane area of the country and transforms it into a place of intrigue, making you wonder what has the potential of lying or developing beneath the layers of even the most seemingtly unruffled surfaces if certain elements of human nature were to go unchecked. Spanogle is more descriptive than John Grisham in some of his novels. He is more like Ed McBain, aka Evan Hunter, but with more complexity and not as formulaic; I realize this statement may seem irreverent and even quite a stretch to McBain fans, because McBain is considered by many to be a master, so I apologize in advance. I guess I am saying a lot about Spanogle's first novel. I hope he writes many more.

There is, at the beginng a satisfying search for Casey, patient zero? In it, there is novel twist, I won't name it, but its good. Also a climatic escape that is novel. Plus you've got to hand it to the author for taking chances that aren't formula driven, and really work. The characterization of the protagonist, Dr. Nathaniel McCormick, is good, especially in his Forget-About-It Attitude Adjustments. The science is good. The medical terminology is good. All in all an entertaining ride that ends with one asking, "When is the next medical thiller going to hit the shelves?". And could he possibly have a few more of those fun novelties up his sleeve?

I read Robin Cook's "Vector" a few years back; I'm a fan of "Coma" but I'll tell you -- "Vector" was trash. Plot by the numbers, lame noble doc, a conspiracy that made the whole reading experience feel like a waste o time. I wrote off medical thrillers with that book. But Josh Spanogle has me coming around. "Isolation Ward" smuggles the strengths of classic hard-boiled crime fiction (a smart but bruised protagonist coming up from his own personal bottom) into the Michael Crichton-y genre of speculative medical horror. What works in this book is the fact that Nate McCormick, the C.D.C. doc, is a screw-up. The guy is deeply flawed, so that the story of the book is how a man puts his life back together while everybody around him is falling apart. Try reading the first chapter and see if you don't feel charmed by him. No doubt, the book is grisly and upsetting in parts (sex and the mentally handicapped play a big part in the unraveling plot). But for an AIDS-era reader, I felt this book strived to get beyond the conventions of the genre and tap into my real fears. You can feel Spanogle juicing these pages to make them jump. That's not much to ask for, but so many authors forget about it. I've known this author for years, as a friend and fellow reader, and I realize personal recommendations might not mean as much as the "professional reader" folks above me. But this book impressed me.

Joshua Spanogle is currently a student at Stanford Medical School, but he has already acquired quite a bit of backstory. A Yale graduate, Spanogle has also served as a researcher at the University of Pennsylvania's Center for Bioethics. As if medical school wasn't time-consuming enough, Spanogle has written a medical thriller, ISOLATION WARD, that infuses elements of medical acumen and detective work to result in one of the more memorable books of recent note in any genre. Spanogle's creation is Dr. Nathaniel McCormick, an officer of the Epidemic Intelligence Service, which in turn is a branch of the Centers for Disease Control and Prevention. The title "officer" connotes hierarchy and bureaucracy, and McCormick does not play well with others. Additionally, his personality is closer to that of Gregory House than Marcus Welby. These traits do not mesh well with his supervisors in the CDC, the hospitals he visits, law enforcement...well, you get the idea. This guy has an authority problem. And what makes it additionally tough for his superiors is that McCormick, more often than not, is right. When a number of people begin showing up at a Baltimore Hospital emergency room with extremely nasty symptoms, McCormick --- loose cannon that he is --- goes rolling across the deck and over a number of toes. It doesn't take long to figure out that the patients are all residents of group homes. McCormick himself notes that he doesn't like being stuck in examining rooms --- an interesting attitude for a physician --- and is soon out in the streets and neighborhoods of Baltimore, investigating the patients, their employers and their friends, and kicking over rocks in the best manner of Robert B. Parker's Spenser and Raymond Chandler's Marlowe. When an individual with a link to all the patients is found brutally murdered, McCormick's unauthorized investigation takes him to Northern California, where he not only uncovers the bizarre and frightening etiology of the mystery disease, but is also forced to confront and resolve issues from his own past that have a bearing on his present. Spanogle has created a unique character here; McCormick is slightly irritating yet ultimately likable, and there is no question that he is an irresistible force attracted toward the truth. Considering that medical research and detective work are quite similar, it is somewhat surprising that characters such as McCormick are not more common in fiction. Spanogle, with McCormick and ISOLATION WARD, has raised the bar for future creators his first time out. Recommended. --- Reviewed by Joe Hartlaub