John Bodine is a game developer in his 20's who is married to Ruby Dawes, the love of his life. At the beginning of the story, we flash back to when he took their savings and went on a mountain climbing expedition with two other men-Brooks Hall, a new anesthesiologist who is married and David Clegg, a Boston police officer who is 7 years older, married, and the father of two children. During the climb, Clegg and Hall slide off the side and are dangling in the air. John thrusts the axe into the ice and tries to pull them up but can't. The axe is sliding. Soon all three men will fall to their deaths. John has choices to make- allow all 3 to die together or cut one man loose and allow two to live. He chooses the latter and selects Clegg who is a father as the one to save. He will be haunted by this for years. He will be so depressed that therapy won't help. Finally acupuncture supposedly helps some and Ruby decides to quit her job as a programmer and go to alternative medicine school so to become an acupuncturist. But then suddenly karma comes around and bites John on the ass. Bites him HARD.
One night as John is rubbing Ruby's feet and quizzing Ruby on her schoolwork, he discovers a dark rough patch on the bottom of one of her feet that she had never noticed before. He is concerned and gets her to the doctor. Bad news. It is a fast growing kind of melanoma and the cancer has already spread to her groin.
Now, if she lived in a civilized country like the UK, France, Germany, Italy, Japan, Australia, or one of the other European countries I have not yet named, she would get the treatment she needs but unfortunately, she is a citizen of the USA and while she is insured, someone's profit comes between her and fighting cancer. The insurance is a cheap policy since that is all they can afford on one income and keep in mind that John is self-employed. There is good news and bad news- Ruby has a 25% chance of survival if treated with Verbilifide immediately and if she follows up with surgery. The bad news is that the generic form would be paid for by Atrium, their insurance company, but is out of production indefinitely. John tries to explain this to Atrium but they are hard-nosed and keep saying they will not pay for the name brand version since there is a generic available- even if it is out of stock and likely permanently out of production. Catch 22.
John tries every reasonable approach. He sells some computer equipment he needs in his work. He begs from family. He goes to companies that help people get the meds they need. One company says they will pay $12,000 but the meds will cost $300,000! They will not fully cover Ruby's costs since she has insurance even if the insurance will not pay for the medicine since a generic is available that is in fact, unavailable. And yes, this is exactly how it works in America. I have a friend who is dying right now from this exact same thing and myself have personally experienced this. Incidentally, the $12,000 isn't coming anytime soon and Ruby's survival clock is ticking.
A desperate John does glean the information from the company that will offer the $12,000 in help that there is an insurance company UniSol Health that would cover the cost of the brand name even if the generic was available. He dreams up a plan to save Ruby. Since people who play his new online game play for free but use credit cards to purchase extras to enhance their experience (like the Facebook games such as Farmville do) they register certain info. He harvests that info to find people similar to him and Ruby in age, race, etc and then to call UniSol pretending to be a customer who has lost his card. He sets up a mailbox at Post Boxes, Etc and rents an apartment in the name of one couple Elliot and Tanya Uretsky who are 4 months behind on their premiums. He pays it up to date, moves Ruby to the new place, rents out their old place, and begins to get her the help she needs.
What John doesn't know that someone has murdered Elliot and Tanya 4 months earlier (that is why the bills weren't paid) and stolen Elliot's identify because this person is a vile wicked murderer who gets off on torturing people to death. And guess what? This creeper has been accessing the dead Elliot's email box and noticed the change in address (John had done this) and now he knows John and Ruby have stolen those ids.
John and Ruby are horrified to get a call from this creeper. He is playing a real life crime game and expects them to commit crimes to keep him from killing people. At first, they didn't take him seriously but when he tortures Ruby's former oncologist to death when they fail to shop life the pair of scarves he tagged in a store, they can see he is deadly serious and begin to commit the escalading crimes he demands.
This is a taut thriller with a lot of twists, turns, and terror. They get help from Clegg who feels he owes John his life for choosing to save his life on that mountain but will even a grateful cop willing to play dirty be able to help when Ruby is kidnapped the crazy computer expert makes his calls and emails untraceable?