It still feels like yesterday that I read COMA as a child in the late '70s. Robin Cook continues to produce stories that blend very real science within the framework of a medical thriller for readers to enjoy. His latest effort, SPASM, is set in the scenic upstate New York town of Essex Falls in Hamilton County, which is firmly amidst the majestic Adirondack Mountains range. 

Essex Falls was once a thriving place until their major employer, the Rubington Paper Mill, closed down. Now, it is barely a shell of its once great self, but its current inhabitants remain staunch homebodies who refuse to leave. One of them is Dr. Robert Neilson, who maintains a state-of-the-art medical center where the offices of the paper company had been.

"SPASM is replete with all of the medical jargon and factual data that we have become accustomed to seeing in a Robin Cook novel.... This is a timely and frightening tale by the reigning king of the medical thriller."

Neilson has come across a type of epidemic unlike anything he has seen before. So he reaches out to his old chum from medical school, Jack Stapleton, who works in New York City for the OCME with his wife, Laurie Montgomery, the Chief Medical Examiner. It begins with two deaths that appear to be connected to an unpredictable rise in Alzheimer's cases in Essex Falls.

Readers get the inside track as to the true cause of the mysterious illnesses, and it is beyond anything the residents of this small town are prepared for. At the center of the dilemma is Ethan. This young man works as an exterminator during the day, while his side gig finds him leading a well-armed paramilitary troop composed of his fellow townsmen, who call themselves the Diehard Patriots.

In an effort to bring on some international expertise, Ethan works with a group of four Russian ex-military types who temporarily relocate to Essex Falls under the guise of being citizens from the Netherlands. In reality, they are experts in microbiology. Their goal is to work with rare and deadly prions, which, when added to the local water system, could incapacitate the entire area and every citizen. They use the ignorance and gullibility of Ethan and his team to allow them access to the huge Bennett estate, where they claim to be using the barn for the purpose of brewing beer.

Things get so bad that Dr. Neilson is able to get Jack and Laurie to take some time off from the OCME and enjoy a summer vacation in the mountains. Once they get there, they realize that something far more sinister is going on --- especially when Ethan becomes one of the victims of the disease only to have his body taken from the morgue. Jack, being a big basketball hound, gets involved in the weekly town game that also includes a member of the Russian crew. It is only through his natural sense of heightened suspicion and wonder that Jack begins to believe that this individual and his friends may not be who they appear to be.

SPASM is replete with all of the medical jargon and factual data that we have become accustomed to seeing in a Robin Cook novel. Cook spends a good deal of time ramping up the threat of the potential epidemic that is being brewed up, as well as the physical threat represented by the Russian team that will go to any extent to keep their mission a secret. This is a timely and frightening tale by the reigning king of the medical thriller.