The Patient

by Michael Palmer Narrated by Michael Kramer

Overview

His name is ARTIE, a miracle of bio-engineering that is about to transform the field of neurosurgery. Dr. Jessie Copeland knows him better than anyone else at Eastern Mass Medical Center- and knows it's too soon to be using the tiny robot on a living patient's brain. But, Jessie's department chief is too busy to worry about such ethics. And neither of them has any idea that ARTIE will attract a patient from their worst nightmares.
Claude Malloche is a master assassin, more rumor than man, for whom murder is an art. No one can identity his face. Now Malloche has a deadly brain tumor, and he intends to have the best neurosurgeon in the world operate on it.
To ensure Jessie's cooperation, Malloche has devised a plan of intimidation that puts at risk her life and the lives of hundreds of innocent people. Neurosurgery requires nerves of steel, but in coming up with a scheme to fulfill her oath as a doctor while thwarting a diabolical killer, Jessie will be performing the most complex surgery of her career- on a knife-edge of terror.

Editorial Reviews

bn.com

New York Times bestselling author Michael Palmer scores again with his ninth outing, The Patient, a slick and intriguing mix of medical thrills and international espionage. True to form, Palmer ratchets up the suspense with every turn of the page, incorporating a fast-paced plot with a cast of unforgettable characters. And this time out, one of the most intriguing characters is ARTIE, a mechanical marvel of medical science and bioengineering that holds the capability of advancing neurosurgery light-years ahead. Ironically, this advance may also lead to the deaths of thousands.

Neurosurgeon Jessie Copeland is a brilliant and talented woman doctor in a field dominated by testosterone. One of the worst offenders is Carl Gilbride, the chief of neurosurgery and Jessie's immediate superior. Jessie is hired by Gilbride to help him develop a biomechanical device that will revolutionize brain surgery, a device that Jessie is far more experienced in using. But when the device is ready to be tested on humans, the egocentric Gilbride snatches a chance for fame and glory by using it on an Olympic gymnast who is diagnosed with a simple brain tumor.

The surgery is a resounding success, and the new device, named ARTIE for Assisted Robotic Tissue Incision and Extraction, is in all the headlines. It attracts the attention of Claude Malloche, a chameleonlike terrorist responsible for more than 500 deaths worldwide. Malloche has a deadly brain tumor that can't be operated on by normal means; ARTIE, therefore, is his only hope, and Malloche will kill anyone who gets in his way. Jessie finds out about Malloche when a rogue CIA agent named Alex Bishop solicits her help. Bishop's brother was one of Malloche's victims, and Bishop has spent five years tracking the man. Bishop knows about Malloche's brain tumor and is certain the killer will show up at Jessie's hospital in hopes of being operated on with ARTIE. The problem is that Bishop doesn't know what Malloche looks like.

Gilbride, starstruck by all the attention he gets from the first ARTIE procedure, decides to perform a second one. But this time the case is far more complex, and he bungles the operation. In the end, he is forced to call for Jessie to bail him out. Shortly thereafter, Malloche's identity is revealed, and his wife, along with a small band of henchmen, takes the entire neurosurgery unit hostage and coerces Jessie into performing surgery on Malloche's tumor. Not only are the lives of all the patients and staff on the neurosurgery unit at risk, but Jessie learns Malloche has planted a number of deadly nerve gas bombs around town, each one set to be triggered if Jessie refuses or in any way bungles the procedure. Now Jessie must perform a procedure that risks not just one life but thousands. She and Alex have a few tricks of their own, but the stakes are frighteningly high and the price of failure devastating.

Physician Palmer, who spent 20 years working in emergency care and internal medicine, brings the medical aspects to such vivid life you can almost smell the alcohol. The life-and-death race of the neurosurgical problems Jessie faces would provide plenty of thrills all alone. But Palmer adds to the intrigue with an ever-escalating plot of psychological suspense that pits the wits of a gifted and caring neurosurgeon against a cold-blooded killer who has nothing to lose. If you suffer from high blood pressure or a racing pulse, you might want to get a doctor's note before reading this one.

—Beth Amos

Barnes & Noble Guide to New Fiction

From best-selling author Palmer comes this "great," "fast-paced" medical thriller, which thrusts a gifted neurosurgeon into a world of escalating danger when a terrorist suffering from a brain disorder catches wind of the doctor's new technology and insists the surgeon operate - and guarantee the outcome with his life. "A winner - I'd recommend it." "A tantalizing story of intrigue and survival." "True movie material - made for Jodie Foster!"

Toby Bromberg

Taut suspense and roller coaster action highlight The Patient. Dr. Palmer knows his material and once again treats readers to an unforgettable reading experience.
— Romantic Times

Publishers Weekly - Publisher's Weekly

Palmer's ninth medical thriller (after Miracle Cure) probably isn't the book to be reading when you've got a slight headache. Early on, a star Olympic gymnast feels a small pain in her skull, and soon she's having a brain tumor zapped by a flashy new surgical robot. The author, who was a full-time practitioner of internal and emergency medicine for 20 years, tells readers so much about the actual work of brain surgery that some might decide to skip over a few of the more agonizing moments, such as the frenzied operation on a young boy with a bullet wound. Yet these bloody and painful details put readers firmly inside the skin of Dr. Jessie Copeland, a neurosurgeon in her 40s with a combined undergraduate degree in biology and mechanical engineering. Now working under egomaniacal chief surgeon Carl Gilbride at a top Boston hospital, Jessie gets to try out ARTIE (Assisted Robotic Tissue Incision and Extraction) on cadavers, while Gilbride coaxes foundations to cough up millions for the revolutionary new procedure. Attracted by the media attention generated by ARTIE's use (too early, Jessie thinks) on the gymnast, shadowy terrorist Claude Malloche, known as "the Mist," who also has a brain tumor, comes to the hospital for treatment--and winds up holding patients and staff hostage in case the operation fails. It's finally up to Jessie and a rogue CIA agent to keep everyone healthy. This graft between medical and terrorist thriller has some rough edges, but the operation is a success. Agent, Jane Rotrosen Agency. (Apr.) Copyright 2000 Cahners Business Information.|

Library Journal

Jessie Copeland is a brilliant neurosurgeon and engineer. Her work has led to the creation of "ARTIE," Assisted Robotic Tissue Incision and Extraction, a robot that will help to revolutionize neurosurgery by reaching tumors that could not be reached using standard surgical techniques. Jessie thinks that with a little more work and testing, ARTIE will be ready for use on live humans. However, her supervisor, a man with a taste for fame and grant money, uses ARTIE on a world-famous gymnast without Jessie's knowledge. Suddenly Jessie finds herself in the middle of an onslaught of publicity. She also finds herself the target of Claude Malloche, a dangerous assassin with a brain tumor. With Lisa Harrow's narration, this tape starts out extremely slowly, and listeners will be able to predict many of the plot twists in the first three sides. However, the final three sides will leave readers breathless as the CIA and FBI race to save the city from destruction. Those who enjoy spy thrillers with a medical bent will enjoy this particular novel. For large public libraries.--Danna Bell-Russel, Library of Congress Copyright 2000 Cahners Business Information.

Beth Amos

April 2000

New York Times bestselling author Michael Palmer scores again with his ninth outing, The Patient, a slick and intriguing mix of medical thrills and international espionage. True to form, Palmer ratchets up the suspense with every turn of the page, incorporating a fast-paced plot with a cast of unforgettable characters. And this time out, one of the most intriguing characters is Artie, a mechanical marvel of medical science and bioengineering that holds the capability of advancing neurosurgery light years ahead. Ironically, this advance may also lead to the deaths of thousands.

Neurosurgeon Jessie Copeland is a brilliant and talented woman doctor in a field dominated by testosterone. One of the worst offenders is Carl Gilbride, the chief of neurosurgery and Jessie's immediate superior. Jessie is hired by Gilbride to help him develop a biomechanical device that will revolutionize brain surgery, a device that Jessie is far more experienced in using. But when the device is ready to be tested on humans, the egocentric Gilbride snatches a chance for fame and glory by using it on an Olympic gymnast who is diagnosed with a simple brain tumor.

The surgery is a resounding success, and the new device, named Artie for Assisted Robotic Tissue Incision and Extraction, is in all the headlines. It attracts the attention of Claude Malloche, a chameleonlike terrorist responsible for more than 500 deaths worldwide. Malloche has a deadly brain tumor that can't be operated on by normal means; Artie, therefore, is his only hope, and Malloche will kill anyone who gets in his way. Jessie finds out about Malloche when a rogue CIA agent named Alex Bishop solicits her help. Bishop's brother was one of Malloche's victims, and Bishop has spent five years tracking the man. Bishop knows about Malloche's brain tumor and is certain the killer will show up at Jessie's hospital in hopes of being operated on with Artie. The problem is that Bishop doesn't know what Malloche looks like.

Gilbride, starstruck by all the attention he gets from the first Artie procedure, decides to perform a second one. But this time the case is far more complex, and he bungles the operation. In the end, he is forced to call for Jessie to bail him out. Shortly thereafter, Malloche's identity is revealed and his wife, along with a small band of henchmen, takes the entire neurosurgery unit hostage and coerces Jessie into performing surgery on Malloche's tumor. Not only are the lives of all the patients and staff on the neurosurgery unit at risk, but Jessie learns Malloche has planted a number of deadly nerve gas bombs around town, each one set to be triggered if Jessie refuses or in any way bungles the procedure. Now Jessie must perform a procedure that risks not just one life but thousands. She and Alex have a few tricks of their own, but the stakes are frighteningly high and the price of failure devastating.

Physician Palmer, who spent 20 years working in emergency care and internal medicine, brings the medical aspects to such vivid life, you can almost smell the alcohol. The life-and-death race of the neurosurgical problems Jessie faces would provide plenty of thrills all alone. But Palmer adds to the intrigue with an ever-escalating plot of psychological suspense that pits the wits of a gifted and caring neurosurgeon against a cold-blooded killer who has nothing to lose. If you suffer from high blood pressure or a racing pulse, you might want to get a doctor's note before reading this one.

--Beth Amos

Beth Amos is the author of several mainstream suspense thrillers, including Second Sight, Eyes of Night, and Cold White Fury.

Publishers Weekly

Palmer's ninth medical thriller (after Miracle Cure) probably isn't the book to be reading when you've got a slight headache. Early on, a star Olympic gymnast feels a small pain in her skull, and soon she's having a brain tumor zapped by a flashy new surgical robot. The author, who was a full-time practitioner of internal and emergency medicine for 20 years, tells readers so much about the actual work of brain surgery that some might decide to skip over a few of the more agonizing moments, such as the frenzied operation on a young boy with a bullet wound. Yet these bloody and painful details put readers firmly inside the skin of Dr. Jessie Copeland, a neurosurgeon in her 40s with a combined undergraduate degree in biology and mechanical engineering. Now working under egomaniacal chief surgeon Carl Gilbride at a top Boston hospital, Jessie gets to try out ARTIE (Assisted Robotic Tissue Incision and Extraction) on cadavers, while Gilbride coaxes foundations to cough up millions for the revolutionary new procedure. Attracted by the media attention generated by ARTIE's use (too early, Jessie thinks) on the gymnast, shadowy terrorist Claude Malloche, known as "the Mist," who also has a brain tumor, comes to the hospital for treatment-and winds up holding patients and staff hostage in case the operation fails. It's finally up to Jessie and a rogue CIA agent to keep everyone healthy. This graft between medical and terrorist thriller has some rough edges, but the operation is a success.

From the Publisher

[A] rip-roaring page-turner.”—New York Post

“The Patient might be [Palmer’s] most riveting book yet, leaving hardly enough time to take a breath.”—Denver Post

“The Patient is what Die Hard movies are made of: brilliantly nasty terrorists hectoring innocent folks, with only a wisecracking lone wolf to forestall.”—Milwaukee Journal Sentinel

AUG/SEP 00 - AudioFile

Dr. Jessie Copeland, respected neuro-surgeon, teams up with Artie, a robot, to revolutionize brain surgery. A heartless mercenary is diagnosed with an inoperable brain tumor, exactly the type Artie was invented to treat. The mercenary and his co-horts hold hostage Dr. Copeland, the hospital and the city as she works to save him. Reader Harrow, who has a young voice with no trace of an accent, portrays Dr. Copeland's nightmare with precise mood swings and subtle tones of terror. Sloppy editing allows a ringing phone to mar one cassette. This is a good story for those who like action-adventure and technical details of medical procedures. G.D.W. © AudioFile 2000, Portland, Maine

Product Details

BN ID:	2940169320718
Publisher:	Penguin Random House
Publication date:	02/22/2005
Edition description:	Unabridged

Read an Excerpt

They were nearly three hours into the operation and not one cell of the cancer had yet been removed. But by neurosurgical standards, three hours was still well within the feeling-out period—especially for a procedure involving experimental equipment. And despite huge progress recently, ARTIE most certainly remained experimental.

"Let's try another set of images with enhancement of the tumor, please."

To a physician, all growths, benign and malignant, were tumors, although the term "cancer" was generally reserved for malignancies—those tumors capable of spreading to distant organs. This particular cancer, a glioblastoma, was among the most virulent of all brain tumors.

Staring straight ahead at the eight-inch monitor screen that was suspended from the ceiling to her eye level, Jessie Copeland set her gloved hands down on the patient's draped scalp, which was fixed by heavy screws to an immobile titanium frame. The physical contact wasn't technically necessary. From here on, ARTIE would be doing the actual surgery. But there was still something reassuring about it.

"You playing gypsy fortune-teller?" Emily DelGreco asked from across the table.

"I just want to make certain the guy hasn't slipped out from under the sheets, gotten up, and run away while I'm trying to decide whether or not our little robot pal is in position to begin removing this tumor. For some reason ARTIE's movements forward and left feel sluggish to me—not as responsive to the controls as I think he should be."

"Easy does it, Jess," Emily said. "We always expect more from our kids than they can ever deliver—just ask mine. The sensors I'm watching, plus mymonitor screen, say you and ARTIE are doing fine. If you start feeling rushed, just say 'Berenberg.' "

Emily, a nurse practitioner, had been on the neurosurgical service at the Eastern Massachusetts Medical Center for several years before Jessie started her residency. The two of them, close in age if not in temperament, had hit it off immediately, and over the intervening eight years had become fast friends. Now that Jessie was on the junior faculty, Emily had moved into the tiny office next to hers and worked almost exclusively with her and her patients. Neither of them would ever forget Stanley Berenberg, one of the first brain tumor cases the two of them had done together. His operation had taken twenty-two hours. They did the delicate resection together without relief. But every minute they spent on the case proved worth it. Berenberg was now enjoying an active retirement, playing golf and carving birds, one of which—a beautifully rendered red-tailed hawk—held sway on the mantel in Jessie's apartment.

"Berenberg . . . Berenberg . . . Berenberg," Jessie repeated mantralike. "Thanks for the pep talk, Em. I think ARTIE's just about ready to start melting this tumor."

Jessie had decided to apply to medical school five years after her graduation from MIT with a combined degree in biology and mechanical engineering. She had spent those five years working in research and development for Globotech, one of the hottest R and D companies around.

"I didn't mind making those toys," she had told neurosurgical chief Carl Gilbride at her residency interview, "but I really wanted to play with them afterwards."

Under Gilbride's leadership, the Eastern Mass Medical Center's neurosurgical program, once the subject of scorn in academic circles, was a residency on the rise, drawing high-ranking applicants from the best medical schools in the country. Jessie, who was comfortably in the middle of the pack at Boston University's med school, had applied to EMMC strictly as a long shot. She was astonished when, following the interview, Gilbride had accepted her on the spot. There was, however, one proviso. She had to agree to spend a significant amount of time in his lab, resurrecting work on an intraoperative robot that a now-departed researcher there had abandoned.

Working in Gilbride's lab throughout her residency while carrying a full clinical load, Jessie had learned that her boss's true forte was for self-promotion, but she had been elated to spearhead the development of ARTIE—Assisted Robotic Tissue Incision and Extraction. The apparatus was an exciting fusion of biomechanics and radiology.

Now, after some preliminary animal work, she and ARTIE were finally in the OR.

Over the past few years, Jessie had viewed countless video images produced by the intraoperative MRI system. What she was studying now was the continuous, three-dimensional reconstruction of the brain beneath the intact skull of the patient—images that could be rotated in any direction using a track-ball system bolted to the floor beside her foot. The on-screen presentations of the MRI data were undergoing constant improvement by the extraordinary genius geeks in Hans Pfeffer's computer lab. And Jessie could not help but marvel at the pictures they were producing. The malignant tumor and other significant structures in the brain could be demarcated electronically and colorized to any extent the surgeon wished.

Jessie had always been a game player—a fierce competitor in sports, as well as in Nintendo, poker, billiards, and especially bridge. She was something of a legend around the hospital for the Game Boy that she carried in her lab coat pocket. She used it whenever the hours and tension of her job threatened to overwhelm her—usually to play the dynamic geometric puzzle Tetris. It was easy to understand why the MRI-OR setup excited her so. Operating in this milieu, especially at the controls of ARTIE, was like playing the ultimate video game.

MRI—magnetic resonance imaging—had progressed significantly since its introduction in the early 1980s. But the technique had taken a quantum leap when White Memorial Hospital, the most prestigious of the Boston teaching hospitals, had designed and built an operating room around the massive MRI magnet. The key to developing the unique OR was the division of the seven-foot-high superconducting magnet into two opposing heads—"tori," the manufacturer had chosen to call them, a torus being the geometric term for any structure shaped like a doughnut. The tori were joined electronically by under-floor cables, and separated by a gap of just over two feet. It was in this narrow space that the surgeon and one assistant worked. The patient was guided into position on a padded sled that ran along a track through a circular opening in one of the magnets. Jessie understood nearly every aspect of the apparatus, but that knowledge never kept her from marveling at it.

"Let's do it," she said, crouching a bit to peer under the video screen and make brief eye contact with her friend. "Everyone ready?"


From the Audio Cassette edition.

Videos