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  About the Book

From The Sisterhood, Michael Palmer’s first New York Times bestseller, to The Patient, his ninth, reviewers have proclaimed him a master of medical suspense. Recognized around the world for original, topical, nail-biting suspense, emergency physician Palmer’swork has been translated into more than thirty-five languages. Now he reaches controversial and startling new heights in a terrifying tale of cutting-edge microbiology, unbridled greed, and murder, where either knowing too little or trusting too much can be FATAL.

In Chicago, a pregnant cafeteria worker suffering nothing more malevolent than flulike symptoms begins hemorrhaging from every part of her body. In Boston, a brilliant musician, her face disfigured by an unknown disease, rapidly descends into a lethal paranoia. In Belinda, West Virginia, a miner suddenly goes berserk, causing a cave-in that kills two of his co-workers. Finding the link between these events could prove FATAL.

Five years ago, internist and emergency specialist Matt Rutledge returned to his West Virginia home to marry his high-school sweetheart and open a practice. He also had a score to settle. His father died while working for the Belinda Coal and Coke Company, and Matt swore to expose the mine’s health and safety violations. 

When his beloved Ginny succumbed to an unusual cancer, his campaign became even more bitterly personal. Now Matt has identified two bizarre cases of what he has dubbed the Belinda Syndrome–caused, he is certain, by the mine’s careless disposal of toxic chemicals. All he needs is proof.

Meanwhile, two women, unknown to one another, are drawn inexorably to Belinda, into Matt’s life–and into mortal danger. Massachusetts coroner Nikki Solari comes to attend the funeral of her roommate, killed violently on a Boston street. Ellen Kroft, a retired schoolteacher from Maryland, seeks the remorseless killer who has threatened to destroy her and her family.Three strangers–Rutledge, Solari, and Kroft–each hold one piece of a puzzle they must solve, and solve quickly. If they don’t, it will be far more than just their own lives that are at risk.

Michael Palmer has crafted a novel of breathtaking speed and medical intricacy where nothing is as it seems and one false step could be FATAL.

Author Notes

Fatal will, I hope, become the most controversial of my books. Five years ago, I began to think that I might want to write a thriller dealing with vaccinations. My interest in the field was the result of our efforts to diagnose and treat the developmental delay of our son, Luke.

As a physician and parent, my interest in vaccinations did not go beyond the perfunctory. If the pharmaceutical industry or the FDA or my family pediatrician said “vaccinate” I vaccinated, whether it was my patients or my children. No questions asked. In 1990 my son Luke was born. He received the standard vaccinations despite the fact that he was felt to have “allergies” including one to milk. At 8-months of age he began having ear infections–almost continuously until 19-months of age, when I insisted he have tubes put in. The procedure stopped the need for antibiotics, but I believe the damage to his nervous system was already done.

By the time Luke was 3 years old, he was diagnosed as having a form of autism. Years later, the diagnosis was honed down to “Asperger’s Syndrome,” also known as “right brain autism”, a condition on the spectrum between severe low-functioning autism and mild ADD. In making the rounds of various treatment centers, I became acquainted with many, many parents and their developmentally delayed children. The similarities from case to case were often striking, with chronic ear infections frequently preceding the onset of symptoms. More and more, the issue of vaccinations came up. Could our children’s immunizations have somehow compromised their immune systems, making them prone to ear infections and the subsequent dangers of excess antibiotics? Other parents believed that vaccinations directly caused their children’s autism.

I began reading and researching and found that while there are few answers in the area of vaccine-caused disease, there are many unanswered questions. Over the years, I became determined to write a thriller that raised these issues, just as others of my books have dealt with euthanasia (The Sisterhood), corporate medicine (Flashback), infertility (Side Effects), managed care (Silent Treatment), alternative medicine (Natural Causes) and academic research cheating (Miracle Cure). Over countless hours of research for Fatal, I examined the literature and spoke to parents, vaccine advocates, proponents of vaccine caution, and my academic friends. It was my hope as always in my writing, to craft a riveting story that raised questions rather than answered them. In the case of Fatal, the plea is made for a renewed look at vaccinations, extended clinical research, tighter controls on the studies necessary before a vaccine is released, and a review of those vaccinations which should be made mandatory. I am grateful to many for their teachings, but especially Barbara Loe Fisher and Kathi Williams of the National Vaccine Information Center, Gratefully, through hard work and concerned professionals, Luke is overcoming the obstacles of his condition and is thriving. I hope someday soon, we learn what is behind his diagnosis, and that of so many others. As with The Patient, there is an author’s note at the end ofFatal which will help direct those interested in learning more about environmental medicine or vaccines.