"They were facing each other, locked in a mortal embrace, with heads thrown back as if struggling to disengage at the moment of their departure from life."

There's more at play in this involving medical mystery than appears in opening chapters. Certainly, there is the highly questionable practice of implanting pacemakers and defibrillators into the chests of patients who may not really need them. But there are also potential career-ending possibilities for any who are brave (or perhaps foolish) enough to take on the entrenched powers that exist in device-manufacturing and hospital board rooms. In fact, the ubiquitous system of treating the practice of medicine and the operation of hospitals as simply business-oriented profit centers is taken to task in this look at morals, money, and more.

The overall theme of the novel is personalized in the story of Ray, a young physician who reaches out to his teacher and mentor, Philip, when Ray's patient's life is on the line. Philip helps save the patient but cannot dissuade Ray from taking on a personal crusade against inappropriate medical practices. This fool's errand eventually leads to Ray's life virtually falling apart before even more dire repercussions occur. Philip is soon pulled back into Ray's machinations and is quickly the recipient of his own death threats and dire warnings.

Kowey, the author of this and four other Philip Sarkis mysteries, mixes highly technical medical procedures with credible human behavior and motivation to construct a puzzle that will have readers hanging on to the very last page. Even then, many will still long to tie up a rather overt loose end that has obviously been inserted to create an unquenchable thirst for the story that is sure to follow this one. If it's similarly compelling, it will be well worth the wait.

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