Photo: John Earle
Robin Cook is a man of many talents. His first novel, The Year of the Intern, was written while he was serving in the Navy on board a nuclear submarine. Coma was written at night while he was an ophthalmology resident, and was published in 1977 while Dr. Cook was a student at the Kennedy School of Government. Coma is credited with creating the literary genre of the medical thriller.
Robin Cook has written thirty-four novels which have sold over one hundred million copies worldwide. There have been a dozen films, television movies and mini-series made from his work. In each of his novels, he elucidates various medical/biotech ethical issues, while entertaining his readers with thriller-style stories.
His latest novel, Host, focuses on fourth-year medical student Lynn Peirce and her fellow medical student, Michael Pender. Lynn's boyfriend, Carl, enters the hospital for routine knee surgery, and fails to regain consciousness postoperatively. He is considered brain dead and transferred to a facility where he will be maintained and monitored.
Lynn believes there is much more behind the tragedy, and begins searching for evidence of medical error or malpractice. What she uncovers, with Michael's help, is far more disturbing, and leads to a series of events way beyond anything she or Michael could have imagined.
Your novels have been instrumental in changing the public's perception and the media's portrayal of medicine. Will you talk about that?
That's the reason I started writing novels. In medical school, I realized the fraternity I was joining was very different from the one I thought I'd be joining. My impression of medicine had been formed by watching television and reading novels. But once I began medical school, I realized the patient was not the center of things; the doctor and the medical profession were. I thought, 'Someday, I'm going to write about the way it really is.' I also realized very quickly that hospitals were extraordinarily dangerous places. I wanted to write things about medicine that were closer to the truth.
Host, as do your other novels, covers a major ethical issue in the news today. Will you discuss the pharmaceutical industry, corporate takeovers, and the issues involved in research and development, and escalating drug costs?
I've been progressively horrified by the medical-industrial complex. They've become increasingly powerful, and are charging unbelievable amounts of money for their product. Even though some people want market forces to rule prices, there are no market forces in the health care industry. No one knows how much anything costs, or the cost of developing a drug. Big pharma, hospitals, and health insurers have free reign. I think the worst offenders have been the pharmaceutical companies. Drug prices have been skyrocketing. I thought I had to write a book that targeted the pharmaceutical industry, and did so with Host.
In the past, I've been right on the mark. What I write about comes to pass within a short time. It's ironic that just as Host is coming out, Valeant raised the price of an old-line medication, astronomically. This has nothing to do with costs of manufacturing or developing the medication. Despite what the pharmaceutical companies say, they are interested in their own bottom line and in benefitting their shareholders.
They make a fortune out of our misfortune.
You once said, "I think of myself more as a doctor who writes, rather than a writer who happens to be a doctor." Will you tell us more about that?
The transition to becoming a doctor is a long and mystical one. You spend years in the process, beginning with taking pre-med courses in college, continuing with tentatively examining patients as a medical student, and finally having enough knowledge and experience to feel comfortable with the identity.
You've paid a high price to become a doctor, and it's something you never want to surrender.
Being a writer is somewhat different. When you write, you think, 'If I can get this book published, I'll think of myself as a writer.' But that's not the way it happened with me. I ended up thinking, 'I was lucky this time, but can I do it again?'
Host is my thirty-fourth book, but every time I start a new one, I have the same crisis of confidence. I wonder, 'Am I going to be able to do this? I know the medical issue I want to write about, but will I be able to present it in an entertaining way?'
So, I never really feel I'm a writer. I'm more comfortable with the identity of a doctor.
What I really like is getting a letter from a reader saying, 'I read your book and decided to go into medicine.'
When that happens, it makes me feel, 'Maybe I am a writer.'
Why do you think your novels have achieved such worldwide popularity?
First, healthcare issues are worldwide. The cost of healthcare is a universal problem. Even the industrialized countries with far better healthcare systems than ours are having problems with healthcare costs. Ultimately, at some time or another, we're all patients. My stories depict situations that could happen to any of us. If you read a book about a great white shark with an appetite for human beings, you can say to yourself, 'I'm not going in the water.' But none of us can say we won't ever go into the hospital. In fact, there are non-fiction books published, exploring how dangerous hospitals can be.
Perhaps another reason is when I write these novels, I view myself as a potential reader. I ask what would propel me through a novel about an issue I may not want to know about, or simply can't know about. Many of my novels deal with medical technology, and some people think that's beyond their ability to understand. The technology isn't difficult to grasp, if it's described in a certain way, which is what I try to do. So, I force my poor wife to read the manuscript. If she doesn't understand something, it needs more work. If she does, then it's good-to-go.
What's the most important lesson you've learned about writing?
The most important lesson I've learned was to relearn what I had to do in college. There, to get a good grade, I had to impress the professor.
In order to do well with writing, I had to learn how to entertain the reader. I'm going to have a positive response from readers, not by impressing them, but by entertaining them. And of course, there's a great deal of competition out there: whether someone's going to read a novel, watch a movie, or television, or go online. I have to make an effort to keep someone interested. Luckily, we're all more similar than we are different. So, if I write something that entertains, it's most likely going to satisfying for the reader.
What, if anything, keeps you awake at night?
What keeps me awake at night is fear of illness.
As a medical student, I was like every other one: I was coming down with just about everything I was studying.
As I get a bit older and know the statistics, I realize the possibility of succumbing to some problem becomes progressively greater. We all fear illness, and being caught up in the machinations of hospitalization, and all it entails.
But, there's a positive aspect to this. Sometimes, I wake up at night with an idea. The idea for my last book, Cell, occurred to me at 3:00 in the morning.
You're hosting a dinner party and can invite any five people, living or dead, form any walk of life. Who would they be?
I'd invite David McCullough, a wonderful historian, writer and conversationalist. I would like to invite Simon the Magician--the bad boy in the bible. He tried to buy from St. Peter, the ability to cure. Why not have someone who really wanted to cure people? I would have to invite Jesus of Nazareth. If one wants to believe the stories in the New Testament, he was the most amazing healer of all. I'd invite Upton Sinclair whose book, The Jungle, changed something really bad--certain public policy--in a way I'm trying to do on a lesser scale. And, I'd invite FDR. He probably had the best chance of all presidents to get us a rational national health policy. I wish he had been able to accomplish that, in addition to all he did do.
Congratulations on writing Host, your thirty-fourth novel. It's a terrifying excursion into the world of medicine, money, manipulation and one of the most pressing ethical and public policy issues of our time.
Mark Rubinstein's latest novel is The Lovers' Tango.