Hold, the new medical thriller by Amy S Peele is a crime novel that takes place in the interesting and high-stakes world of transplant medicine, which in real-life often involves harrowing drama. The one-word titles of the two previous books in the series, Cut and Match, clearly relate to organ transplantation, but the significance of this third book’s title isn’t as clear. Peele is an RN who worked many years in transplant medicine, so it must mean something and both previous novels were well-received and nominated for several awards.

The two main characters are quite appealing. Sarah Golden works for the San Francisco Global Organ Transplant Institute while her best friend since nursing school, Jackie Larsen, is a newly minted PI. They share strong camaraderie, humour and trust in each other. Each has a significant relationship, Sarah with a Miami police detective called only by the sobriquet Handsome, and Jackie with her wife Laura.

The book opens with Sarah and Jackie on a much-needed vacation in Cuba, paid for by Laura and Handsome. The sights and sounds of Havana come through well enough in a tourist-highlights kind of way, involving impressive amounts of high-quality rum and, for Jackie, a cigar factory tour. While there, Sarah has arranged a session with the head of the local transplant program, Dr Lopez, and his team. The Cubans are more than happy to meet a representative of SF GOTI and give her a tour. Unfortunately, Dr Lopez has bad news for them. Four leading US transplant immunologists have been killed in a motor vehicle accident.

One of the dead researchers was Sarah’s colleague, and she knows the others. They were all working on the same research project at their home institutions, testing a new drug intended to help transplant patients tolerate a new organ. If successful, it would reduce or eliminate the need for patients to take expensive and powerful anti-rejection drugs.

Dr Lopez arranges to meet with Sarah privately and reveals he has been secretly participating in the drug trial but too many of his patients taking the experimental drug are dying. Now that the other researchers are dead, he’s afraid for his life and desperate to leave Cuba with his family.

Although most chapters are written from Sarah or Jackie’s point of view, some are written from the perspective of Victor Botsworth, an executive of the drug company working on the new medication. Botsworth is almost a cardboard villain. Peele immediately signals that he is a manipulative bad actor, not above threats and intimidation, probably behind the deaths of the scientists, yet with a charming veneer that women other than Sarah readily fall for. He has a compelling conflict of interest. If the ongoing research showed the new drug was truly effective, it would put an end to the lucrative anti-rejection trade.

The tradition of Big Pharma harbouring villains is a venerable one. John le Carré wrote about it in The Constant Gardener and it featured in Thomas Kelso’s award-nominated Hyperion’s Fracture three years ago. But here I don’t buy it. It isn’t just that Botsworth has managed to somehow inveigle scientists in different institutions to fudge their research results, it’s that he also uses his connections in the criminal world to make trouble for Sarah, Jackie and Dr Lopez. There are ham-handed threats to both women’s families; they are followed; there is a rigged car accident involving Sarah’s grandmother. It’s all goes well beyond the bounds of credibility.

Back in San Francisco, while Sarah tries to bring Dr Lopez’s findings to her boss’s attention, the Cuban family disappears, adding to Sarah’s anxiety. It should be a happy time for her. She and Handsome will be married soon and one wonders how often she can go against his advice and pursue some inquiry or the other, putting herself in danger, without damaging their relationship. Jackie is already facing a relationship repair job with Laura.

What kept me reading were the relationships among the characters, apart from the awful Botsworth. The writing style is generally clear, though Peele’s dialog is not natural. Too often her characters speak in complete sentences, as if they were writing, not talking in the elliptical and truncated way people speak. Especially people who have been friends for years.

Another strength of Hold is the interest factor of the topic itself. Even though there isn’t a lot of detailed medical information in the novel, having characters working on such an important problem is interesting.

Oh, and no mystery writer should write this sentence about a shooting victim: “She took two bullets from a sawed-off shotgun.” Damages credibility.

For authentic Cuban crime fiction see Leonardo Padura’s The Transparency of Time.

She Writes Press
Print/Kindle
£6.95

CFL Rating: 3 Stars

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