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The Fourth Procedure
An accomplished attorney prepares to argue a life-and-death case before a Supreme Court nominee hostile to her cause....One of the country's leading surgeons, a pioneer in organ transplants, answers an emergency call to assist an operation in progress...And in a morgue in Washington, D.C., a medical examiner and a police detective hover over a body found in a parking lot, a body that has been tampered with.... Congressman Jack MacLeod is haunted by an episode that changed his life forever. Now Jack's life is about to explode again when the police arrive at his door. Evidence links him to the strange death of a man who last lived in a halfway house in his New York City district.... Suddenly events spin out of control. Backroom deals made by the most powerful men in the country threaten to destroy Jack's political future. The secret from Jack's past falls into the hands of a media-savvy opponent who can't wait to use it. And, in the shadows, a plan so outrageous and unthinkable it will smash every assumption about the limits of the human body, is hearing its shocking conclusion....
532 pages, Mass Market Paperback
First published January 1, 1995
7 people are currently reading
413 people want to read
About the author
Stanley Pottinger
12 books12 followersJohn Stanley Pottinger was an American novelist and lawyer. In the 1970s, he held federal offices involved with civil rights enforcement. He also worked as a banker in the 1980s.
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Displaying 1 - 30 of 45 reviews
May 18, 2022
I read this book probably 25 years ago. I remember exactly one thing about it. Otherwise, I only have a vague feeling it was meh and too long.
But that one thing was so true—so perfectly, pathetically true—that I still remember The Fourth Procedure and think about it every time the abortion debate rises above the general noise. And that one thing is this: . It’s absurd but the truth behind the “what if” is undeniable, because time and again we’ve all watched people in power lack empathy for anyone different from them or for any concept they haven’t personally experienced.
So is The Fourth Procedure a great book worth reading? Not at all. Its genius could be captured in a short story, or probably even a tweet. But it is on the very short list of “books that I read in the 1990s that I can still name,” and I give Mr. Pottinger points for that.
But that one thing was so true—so perfectly, pathetically true—that I still remember The Fourth Procedure and think about it every time the abortion debate rises above the general noise. And that one thing is this: . It’s absurd but the truth behind the “what if” is undeniable, because time and again we’ve all watched people in power lack empathy for anyone different from them or for any concept they haven’t personally experienced.
So is The Fourth Procedure a great book worth reading? Not at all. Its genius could be captured in a short story, or probably even a tweet. But it is on the very short list of “books that I read in the 1990s that I can still name,” and I give Mr. Pottinger points for that.
November 7, 2008
You will never think about abortion the same way as before reading this book.
June 21, 2013
This book revolved around a subject that I'm pretty passionate about, so, in a lot of ways, it was hard for me to read. There is also a *LOT* going on plot wise, especially in the beginning, and it can be a little hard to keep up with everything. The story is part medical mystery, part murder thriller, with a little bit of romance and political intrigue thrown in just to mix things up a bit; frankly, I think the author may have done better by simplifying the plot a bit and leaving a few things out.
Having said that, Fourth Procedure left me always wanting to read more to find out what was going on. Though occasionally extremely graphic, the author has a way of drawing the reader in and forcing them to actively think about what's going on. At times, the novel can be a very emotional read. I was also particularly impressed by the way Pottinger writes female characters; the strong women in this book are its main driving force. I think I actually found myself checking the sex of the author once or twice because I was so surprised that a male could so thoroughly depict a woman's mindset in the manner that Pottinger achieved.
Having said that, Fourth Procedure left me always wanting to read more to find out what was going on. Though occasionally extremely graphic, the author has a way of drawing the reader in and forcing them to actively think about what's going on. At times, the novel can be a very emotional read. I was also particularly impressed by the way Pottinger writes female characters; the strong women in this book are its main driving force. I think I actually found myself checking the sex of the author once or twice because I was so surprised that a male could so thoroughly depict a woman's mindset in the manner that Pottinger achieved.
July 25, 2022
I read one medical procedure mystery/thriller and really liked it so I tried another. The first one (by a different author), I loved. This one, not so much.
February 25, 2012
Although this NYT best-selling book was written in 1999, it is still relevant today, and I've been reminded of it several times just reading recent headlines about women's issues in politics, particularly abortion rights. I don't think it's available in print anymore, but you can find it used for cheap and also on Kindle.
Bear in mind that this is a "sci-med" book (combining the science fiction and medical genres, a la Michael Chricton and Robin Cook) so there are elements that are futuristic, not to mention mind-blowing. But it has terrific arguments, pro and con, about the issue of abortion. Caveat: I personally could not read all of the book's opening pages, but had to skim them because the scene was just to graphic for me. Fortunately, the rest of the book wasn't that way or I wouldn't have been able to get through it! I recommend this book for anyone who wants a terrific read about women's rights. The author wrote a book about another social issue, racism, in "A Slow Burning." Both are gripping and relevant.
Bear in mind that this is a "sci-med" book (combining the science fiction and medical genres, a la Michael Chricton and Robin Cook) so there are elements that are futuristic, not to mention mind-blowing. But it has terrific arguments, pro and con, about the issue of abortion. Caveat: I personally could not read all of the book's opening pages, but had to skim them because the scene was just to graphic for me. Fortunately, the rest of the book wasn't that way or I wouldn't have been able to get through it! I recommend this book for anyone who wants a terrific read about women's rights. The author wrote a book about another social issue, racism, in "A Slow Burning." Both are gripping and relevant.
September 15, 2007
I read it for the mpreg. I had to sit through 500+ pages of dull plotting; bad characterization (where everyone’s motivations are based on lame psychoanalysis 101 crap); loads of hilariously bad sex (two orgasming people are like paratroopers! I did not know this); utterly unrealistic portrayals of how politics, news organizations, the police, and the justice system work; painfully regurgitated pro- and anti-abortion arguments; a nasty botched back-alley abortion scene; and two horrible, disturbing rapes. And after all that, the mpreg wasn’t even sexy mpreg.
So not worth it.
So not worth it.
June 15, 2011
A FIERCE DEBATE ABOUT ABORTION
A good work developing the principle of empathy. (the ability to share another person feelings and emotions). Outstanding, breakneck pace, mindboggling, suspense never ever ends until the last page. The unveiling of the fourth procedure is utterly chilling. The author have got what it takes to be an excellent writer When is his next one ?
A good work developing the principle of empathy. (the ability to share another person feelings and emotions). Outstanding, breakneck pace, mindboggling, suspense never ever ends until the last page. The unveiling of the fourth procedure is utterly chilling. The author have got what it takes to be an excellent writer When is his next one ?
September 6, 2022
What do we need to do to get this book back in print?!!!!! Every Supreme Court nominee should be required to read this. Frankly should be required reading for all senators, representatives and presidents.
First read this in the late 90’s, scary to reread it in 2022.
First read this in the late 90’s, scary to reread it in 2022.
Read
January 4, 2013Great book!!!!!
August 14, 2019
How to sum up The Fourth Procedure? Firstly, I read an uncorrected proof, so be aware that this version may be different from the one eventually published.
There are many facets to this tale that could appeal to a wide range of readers, which is a plus. The power wielded by the Supreme Court. The lengths some people end up going to to defend their side of a political issue, in this case abortion and/or a woman's right to choose. Medical research that goes outside the bounds of what is considered ethical. Politicians using dirt on others to promote their agendas. There is more, but you see what I mean - something for a variety of folks.
The early scenes kind of got to me and to be truthful, I almost put it down and didn't return to it. It was more graphic than I was comfortable with but, now that I saw the thing through, I believe that is the point: you will step outside of your comfort zone and hopefully examine your own convictions. Not with the intention of changing your beliefs; I feel Pottinger stayed mostly neutral in that way and it's not an attempt to bring you to a certain side of the social issues that is thinly disguised in a novel. More, it's an uncomfortable look at several issues we might not otherwise let ourselves dwell on overmuch.
I will say that the last 10 to 15 pages should give you pause. Without spoiling anything, I can say that if you're not very aware of the massive injustice women the world over continue to endure (in places highly developed as well as those considered "3rd world), these pages will illuminate things for you. Starkly. I like to think I'm aware of these issues and I have to say it got me right in the gut.
One last thing to consider: if you're easily nauseated, you might want to pass on this one. If you want to go on a wild ride, press on!
There are many facets to this tale that could appeal to a wide range of readers, which is a plus. The power wielded by the Supreme Court. The lengths some people end up going to to defend their side of a political issue, in this case abortion and/or a woman's right to choose. Medical research that goes outside the bounds of what is considered ethical. Politicians using dirt on others to promote their agendas. There is more, but you see what I mean - something for a variety of folks.
The early scenes kind of got to me and to be truthful, I almost put it down and didn't return to it. It was more graphic than I was comfortable with but, now that I saw the thing through, I believe that is the point: you will step outside of your comfort zone and hopefully examine your own convictions. Not with the intention of changing your beliefs; I feel Pottinger stayed mostly neutral in that way and it's not an attempt to bring you to a certain side of the social issues that is thinly disguised in a novel. More, it's an uncomfortable look at several issues we might not otherwise let ourselves dwell on overmuch.
I will say that the last 10 to 15 pages should give you pause. Without spoiling anything, I can say that if you're not very aware of the massive injustice women the world over continue to endure (in places highly developed as well as those considered "3rd world), these pages will illuminate things for you. Starkly. I like to think I'm aware of these issues and I have to say it got me right in the gut.
One last thing to consider: if you're easily nauseated, you might want to pass on this one. If you want to go on a wild ride, press on!
June 11, 2023
Keeping all the characters straight was making the reading a little slow initially, but once over that little hurdle, it really picked up. This was published in 1995, and the topic of the book was abortion and pro-life/pro-choice, which is still an important topic, especially since the overturn of Roe v Wade. Maybe someone should have impregnated a man, such as was done in this story. The ending really got me at her trial, listing all the things that have been and some that are still done to women in regards to their sex..ie...being sold into a harem, having the clitoris cut off, having the feet bound until the arches broke, or being murdered for failing to show virgin blood after intercourse on the wedding night.
This entire review has been hidden because of spoilers.
September 23, 2023
This book is centered around the subject of abortion. Classic left v. right politics and the fringe supporters on both sides. Without giving too much away, this has murders, bombings, medical experiments, congressmen, judges, lawyers, etc. Pretty much the worst stuff in Washington, D.C. Well done by the author in his 1st novel. Decent twists. Check it out.
October 10, 2022
More relevant than when it was first released, for sure. It has a good premise, a good story and characters, but it's too long. It's a story that could have been edited down to something smaller yet be just as good. That said, the author absolutely knows his stuff, and that is often refreshing.
September 10, 2025
An interesting concept which certainly makes you think, but far too long a book. After investing so much time into the first part of the book, I had to finish it, but the point could've been made much more succinctly.
March 18, 2017
I just could not get interested in this story. It jumped around too much...
June 3, 2020
This book covers the controversial issue of abortion with a far out scenario. It draws you into the mystery about mid book and keeps you wanting more.
April 17, 2021
Read in 1995. An explosive courtroom drama.
December 31, 2025
de nuevo muy yanki
April 28, 2013
This is a novel about the abortion debate in the United States. On the pro-choice side there is Senator Jack MacLeod with a secret from his past that he doesn’t want made public but it doesn’t stop him from courting the hatred of the other side. With him is his love interest, attorney Victoria Winters, an idealistic fighter for women everywhere and anywhere. Her close friend, Dr. Rachel Redpath is a world renowned transplant surgeon who has a personal stake in the abortion fight since her mother died during an illegal procedure. On the anti-abortion side there is Eli Graves, leader of the Red Rose Society who protests abortion clinics. Graves has a deep personal hatred of Senator McLeod and is busy digging up dirt from the senator’s past. Graves gets support from Senator Sticks Dickey. The Senator is also pushing for Judge Abner Titus to be made the next chief justice of the Supreme Court because of his strict conservative view point on abortion. The plot also throws in a beautiful young reporter trying to make a name for herself, a series of bizarre deaths of men who were involved in bombing abortion clinics being found dead after having been operated on and a mysterious young man who pretends to be two different people to further his plan to destroy the man he knows to be his father and who he believes abandoned him.
There is a lot going on in The Fourth Procedure and not all of it works. The writing is generally pretty good save a few overwrought scenes. The characters were well drawn except for one of the protagonists who I found annoying instead of sympathetic. There is however too much going on. I found the book to be overlong and over-plotted. It moved along at a good pace though and kept me interested right up until the ending which was ludicrous. I laughed out loud and thought “You have to be kidding me.” I kept reading to discover how it all played out but couldn’t stop shaking my head at the absurdity of it all. When it got to the trial The Fourth Procedure took one more step over the edge, plummeting to the ground.
There is a lot going on in The Fourth Procedure and not all of it works. The writing is generally pretty good save a few overwrought scenes. The characters were well drawn except for one of the protagonists who I found annoying instead of sympathetic. There is however too much going on. I found the book to be overlong and over-plotted. It moved along at a good pace though and kept me interested right up until the ending which was ludicrous. I laughed out loud and thought “You have to be kidding me.” I kept reading to discover how it all played out but couldn’t stop shaking my head at the absurdity of it all. When it got to the trial The Fourth Procedure took one more step over the edge, plummeting to the ground.
February 17, 2012
This was your typical high-drama medical thriller, though it took me a while to figure out the relevance of the title because 'the fourth procedure' isn't explained until the last hundred or so pages, nor does Pottinger give readers many clues as to what the first 3 entailed.
The book focuses on Congressman Jack McLeod; his activist on-and-off girlfriend, Victoria; Supreme Court nominee Judge Abner Titus; plus a few other significant characters and some minor ones in what is largely a novel about pro-life Titus challenging the Roe v. Wade court ruling, while pro-choice McLeod sees first-hand the consequences of preventing legal abortions after the death of one of Victoria's clients, which strengthens his position even more. Running concurrently with this plotline is one in which abortion clinic bombers are found dead with autopsy incisions, missing livers, and toy babies in their abdomens.
On the back cover, the book synopsis first mentions surgeon Rachel Redpath, who is a colleague of Victoria's and also performed Titus' kidney transplant, and her being called to a life-saving surgery. I don't recall that particular plotline, unless it refers to Titus' transplant, which occurs before the events in the book. Redpath was the character I was most interested in following through the course of the story and she seemed largely ignored for much of the book, so I was a little disappointed, as McCloud was clearly the main focus of the novel.
Overall, I enjoyed the book, it just seemed to take a while to find its focus and move from the abortion debate to the procedures referenced in the title.
The book focuses on Congressman Jack McLeod; his activist on-and-off girlfriend, Victoria; Supreme Court nominee Judge Abner Titus; plus a few other significant characters and some minor ones in what is largely a novel about pro-life Titus challenging the Roe v. Wade court ruling, while pro-choice McLeod sees first-hand the consequences of preventing legal abortions after the death of one of Victoria's clients, which strengthens his position even more. Running concurrently with this plotline is one in which abortion clinic bombers are found dead with autopsy incisions, missing livers, and toy babies in their abdomens.
On the back cover, the book synopsis first mentions surgeon Rachel Redpath, who is a colleague of Victoria's and also performed Titus' kidney transplant, and her being called to a life-saving surgery. I don't recall that particular plotline, unless it refers to Titus' transplant, which occurs before the events in the book. Redpath was the character I was most interested in following through the course of the story and she seemed largely ignored for much of the book, so I was a little disappointed, as McCloud was clearly the main focus of the novel.
Overall, I enjoyed the book, it just seemed to take a while to find its focus and move from the abortion debate to the procedures referenced in the title.
January 26, 2011
I have never been so grossed out in my life as I was when I read the prologue to this book. Holy moley. I felt a little queasy, and normally I pride myself at being able to read anything. If you plan on reading this, but the introduction puts you off, don't worry; the rest of the book is nowhere near as gross. Those first few pages really gave me a new understanding of the word "gutwrenching". I seriously felt physically unwell while reading it, and whenever I thought about it for about a week afterward.
Apart from that, I enjoyed the book. It raised some really interesting viewpoints about abortion, threaded into an interesting story. There were some pretty well written opinions worked in at appropriate places. However, I feel like the book has a pro-choice slant to it, so I imagine that readers with anti-abortion views will probably not find it as engaging. I honestly can't tell to what extent the anti-abortion characters were making straw man arguments. They seemed to me to have as much substance as any other real-world arguments.
Apart from that, I enjoyed the book. It raised some really interesting viewpoints about abortion, threaded into an interesting story. There were some pretty well written opinions worked in at appropriate places. However, I feel like the book has a pro-choice slant to it, so I imagine that readers with anti-abortion views will probably not find it as engaging. I honestly can't tell to what extent the anti-abortion characters were making straw man arguments. They seemed to me to have as much substance as any other real-world arguments.
April 30, 2010
A thriller with a political message. Very interesting. As someone else wrote "you will never view abortion the same way again" True. Embedded within an otherwise run of the mill psycho thriller with a rather outlandish plot line were some pretty fascinating discussions about abortion. If not for that, I might have rated this with just two stars because the plot really was way too contrived and completely out of the realm of reality. This book also had what I call gratuitous sex scenes - they added nothing to the story or character development. I'm not sure that I will seek out this author again.
October 2, 2012
I probably never would have picked up this book in a bookstore, but I did pick it up when found on a table at a family member's house. It was one of the oddest thrillers I've read. I gave it three stars because there are sentences and paragraphs here and there of really good writing, but I found it needlessly too long, and unbelievable in too many spots.
I was also taken by surprise by the strong feminist theme, and the ongoing discussion about abortion. That's not really hinted at on the cover description.
I can't say "it's not worth a read", but I can't say I would highly recommend it either.
I was also taken by surprise by the strong feminist theme, and the ongoing discussion about abortion. That's not really hinted at on the cover description.
I can't say "it's not worth a read", but I can't say I would highly recommend it either.
December 19, 2020
The premises of having someone kill someone and then perform an autopsy that even stumps the ME on the perfection of it did intrigued my interest. However there was many sub plots and going back between multiple characters.
Well really made me put down this book was two sentences early in the novel:
“Honey had left Brooklyn in December, and no it was February, the one month of the year that was eight weeks long. There was no way he could get through it without seeing her.”
This passage is in the perspective of your street criminal. I guess the author is portraying street criminals as dumb. IDGI. Pass on it.
Well really made me put down this book was two sentences early in the novel:
“Honey had left Brooklyn in December, and no it was February, the one month of the year that was eight weeks long. There was no way he could get through it without seeing her.”
This passage is in the perspective of your street criminal. I guess the author is portraying street criminals as dumb. IDGI. Pass on it.
June 26, 2007
Awesome book. Never heard of the author before this and was very impressed. Definitely keeps you thinking and there are some crazy twists and turns. Very relavant to current events surrounding abortion.
September 15, 2007
Amazing. Incredible. It took me some time to get into this book, but once I did, it was so good. I gave up food to read this book!!! (I would read through breakfast, lunch, and dinner and then realized that I didnt eat one bite.)
September 9, 2010
overall, incredibly bad plot and characters. the opening scene was really gripping, very disturbing because of the realism and he should have stopped there and published it as a short story. from there, characters did not ring true, especially the Senator. sorry i bothered with it.
October 10, 2011
I enjoyed the writing style but the premise was hard to believe. It was hard to suspend disbelief with this book. Especially the ending. The detail in the book was good and bad, especially the murder, surgery and sex scenes.
February 27, 2013
I seem to recall that I didn't like the story that much, but I kept the book because I was really moved by a passage near the end explaining a character's actions. Very compelling. I also thought that the whole concept of the story was very unique and interesting.
October 31, 2013
His first book and a really great novel. Medico legal thriller with some futuristic twist. Better than some Robin Cook novels, comparable to the best Arthur Hailey for explanations. The final premise is just great!
Displaying 1 - 30 of 45 reviews