The numerically titled Women's Murder Club novels by James Patterson and Maxine Paetro are becoming an institution. The solid storytelling, engaging characters and, perhaps most importantly, the anything-can-happen plot lines have made each of the books in this series a notation on the must-read lists of hordes of readers. THE 5th HORSEMAN is no exception.

Patterson and Paetro are at their best here, weaving a number of plots together to create a novel that dips and flows across genre lines. Something is horribly wrong at San Francisco Municipal Hospital, where patients admitted through the emergency room and seemingly on the road to recovery take a turn for the worse and die. Maureen O'Mara, a high-powered plaintiff's attorney, brings a medical malpractice suit against the hospital. Attention is focused specifically upon Dr. Dennis Garza, who seems to have a poor track record with patients who are given over to his care. The Women's Murder Club --- San Francisco Homicide Detective Lindsay Boxer, attorney Yuki Castellano, reporter Cindy Thomas, and medical examiner Claire Washburn --- is compelled to take a closer look at the hospital, and Dr. Garza, when a tragedy strikes particularly close to home for one of them. The quartet slowly comes to the conclusion that there is something far more insidious occurring at Municipal Hospital --- and that the suspicious deaths, rather than being accidental, have been by intent and design.

Meanwhile, Boxer has to deal with a serial killer who is murdering young women and leaving them posed in public, dressed in designer clothes and sitting in high-profile automobiles. Patterson and Paetro are particularly clever here, keeping the novel spinning along on twin plot lines, while all the while a third crime is being committed under the noses of the Women's Murder Club --- and the reader. Accordingly the book is part courtroom thriller, part medical suspense, part murder mystery, and…something else. The whole, however, is even greater than the sum of its parts.

THE 5th HORSEMAN continues the winning ways of a series that shows no signs of fatigue or flagging. The willingness of Patterson and Paetro to try, and do, anything keeps the Women's Murder Club on top, and undoubtedly will do so for some time to come.