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Here is Robin Cook's most controversial medical thriller-the shocking story of experimental fertilization, the passion to create life, and the power to destroy it.

336 pages, Paperback

First published January 1, 1991

106 people are currently reading
2689 people want to read

About the author

Robin Cook

189 books5,031 followers
Librarian Note: Not to be confused with British novelist Robin Cook a pseudonym of Robert William Arthur Cook.

Dr. Robin Cook (born May 4, 1940 in New York City, New York) is an American doctor / novelist who writes about medicine, biotechnology, and topics affecting public health.

He is best known for being the author who created the medical-thriller genre by combining medical writing with the thriller genre of writing. His books have been bestsellers on the "New York Times" Bestseller List with several at #1. A number of his books have also been featured in Reader's Digest. Many were also featured in the Literary Guild. Many have been made into motion pictures.

Cook is a graduate of Wesleyan University and Columbia University School of Medicine. He finished his postgraduate medical training at Harvard that included general surgery and ophthalmology. He divides his time between homes in Florida, New Hampshire, and Massachusetts where he lives with his wife Jean. He is currently on leave from the Massachusetts Eye and Ear Infirmary. He has successfully combined medical fact with fiction to produce a succession of bestselling books. Cook's medical thrillers are designed, in part, to make the public aware of both the technological possibilities of modern medicine and the ensuing ethical conundrums.


Cook got a taste of the larger world when the Cousteau Society recruited him to run its blood - gas lab in the South of France while he was in medical school. Intrigued by diving, he later called on a connection he made through Jacques Cousteau to become an aquanaut with the US Navy Sealab when he was drafted in the 60's. During his navy career he served on a nuclear submarine for a seventy-five day stay underwater where he wrote his first book! [1]


Cook was a private member of the Woodrow Wilson Center's Board of Trustees, appointed to a six-year term by the President George W. Bush.[2]


[edit] Doctor / Novelist
Dr. Cook's profession as a doctor has provided him with ideas and background for many of his novels. In each of his novels, he strives to write about the issues at the forefront of current medical practice.
To date, he has explored issues such as organ donation, genetic engineering,fertility treatment, medical research funding, managed care, medical malpractice, drug research, drug pricing, specialty hospitals, stem cells, and organ transplantation.[3]


Dr. Cook has been remarked to have an uncanny ability to anticipate national controversy. In an interview with Dr.Cook, Stephen McDonald talked to him about his novel Shock; Cook admits the timing of Shock was fortuitous. "I suppose that you could say that it's the most like Coma in that it deals with an issue that everybody seems to be concerned about," he says, "I wrote this book to address the stem cell issue, which the public really doesn't know much about. Besides entertaining readers, my main goal is to get people interested in some of these issues, because it's the public that ultimately really should decide which way we ought to go in something as that has enormous potential for treating disease and disability but touches up against the ethically problematic abortion issue."[4]


Keeping his lab coat handy helps him turn our fear of doctors into bestsellers. "I joke that if my books stop selling, I can always fall back on brain surgery," he says. "But I am still very interested in being a doctor. If I had to do it over again, I would still study medicine. I think of myself more as a doctor who writes, rather than a writer who happens to be a doctor." After 35 books,he has come up with a diagnosis to explain why his medical thrillers remain so popular. "The main reason is, we all realize we are at risk. We're all going to be patients sometime," he says. "You can write about great white sharks or haunted houses, and you can say I'm not going into the ocean or I'm not going in haunted houses, but you can't say you're n

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Displaying 1 - 30 of 177 reviews
Profile Image for Exina.
1,269 reviews414 followers
February 26, 2019
Vital Signs left a deep impression on me, one of the best and most memorable novels by Cook I’ve read.
Profile Image for hotsake (André Troesch).
1,509 reviews19 followers
October 21, 2024
This was a ridiculously fun book. The first half of the book was the typical and mildly interesting medical mystery featuring an extremely obnoxious main character being as annoying as humanly possible. The film then transitions into a James Bond/'60s Batman/Crocodile Dundee hybrid. Robin Cook was obviously out of his league during the second half and I had to laugh out loud at his attempts to write action scenes.
Profile Image for Kim.
314 reviews188 followers
June 4, 2023
3 stars

I flew through the first half of the book, totally sucked in at the first page. The second half however, twisted and turned for too long before getting to the conclusion
Profile Image for MikeR.
327 reviews11 followers
June 17, 2025
⭐️⭐️⭐️ – Vital Signs by Robin Cook
“I came for the fertility thriller, stayed for the medical paranoia… left slightly annoyed by everyone involved.”

🧬 Plot (Spoilers, Tuberculosis, and Test Tubes Ahead)
Dr. Marissa Blumenthal, once the razor-sharp CDC heroine of Outbreak, returns—but this time, she’s more erratic, paranoid, and slightly exhausting. When she and her husband, Robert Buchanan, struggle with infertility, she begins the usual tests, IVF cycles, and clinical appointments. Robert? Emotionally checked out. The man has the supportive range of a dead stethoscope.

After yet another failed treatment, Marissa’s suspicions are piqued. Other women she meets—like Wendy Wilson—are also inexplicably infertile. Their stories echo hers too closely. The common thread? Scarring of the fallopian tubes—from a type of tuberculosis.

And it turns out: this isn’t coincidence—it’s conspiracy.

Marissa uncovers the research of Dr. Tristan Williams, an Australian doctor who vanished after publishing a paper linking TB to infertility through fallopian tube scarring. His disappearance isn’t the only thing that starts to smell like a cover-up. When Marissa starts tracing patients across international borders, she learns the unthinkable:

It’s horrifying. It’s vast. It’s Cook at his medical-paranoia best—if only the characters didn’t feel like they were written with expired medical ink.

👩‍⚕️ Characters (…and Their Bedside Manner)
Dr. Marissa Blumenthal – Formerly cool-headed, now in full conspiracy panic mode. Less CDC sleuth, more emotionally reactive amateur detective. Probably also explains why Cook gave up on her character as a "series."

Robert Buchanan – Marissa’s emotionally disengaged husband. Gold Star for emotional support, Robert?



Dr. Tristan Williams – Aussie whistleblower who tried to expose the TB-induced infertility connection—and promptly went missing. He’s a ghost in the plot but essential to the mystery.

Wendy Wilson – Intelligent, composed, and a refreshing dose of grounded logic. Quickly becomes a key ally to Marissa as they uncover the chilling truth.

Gustave Anderson – Wendy’s husband, a calm, rational scientist.

A Dozen Other Fertility Industry People – All strangely evasive, suspiciously cheerful, or morally compromised.

🧪 The Medical Issue Examined: Tuberculosis as a Weapon
The medical core of the novel is classic Cook: plausible, terrifying, and stomach-churningly real. The idea that a weaponized strain of TB could be causing fallopian tube scarring, silently sterilizing thousands of women, is chilling.

Cook explores:

Medical ethics and abuse in fertility treatment

Involuntary sterilization

Profiteering in reproductive medicine

Women's bodily autonomy and vulnerability in medicine

Medical gaslighting of female patients

This is the Robin Cook I signed up for: the man who makes you afraid of your next doctor’s appointment.

✍️ Writing Style (And the Curious Case of Brisbane)
Here’s where things fall flat. The medical tension is strong, but Cook's descriptive prose is not. This hit home when Marissa visits Brisbane—a city I know well—and it's barely recognizable. Just scattered tourist name-drops and lifeless scenery.



It made me realize: Cook doesn’t do atmosphere—he does action and plot. Expect detailed medical jargon, not rich settings or emotional nuance.

🏁 Final Word
Vital Signs has a strong premise, a solid ethical dilemma, and the potential for high-stakes medical intrigue. But it’s hampered by flat characters, dialogue-heavy scenes, and settings that feel more like green-screen backdrops than real places.

Marissa’s regression from driven investigator to reactive protagonist is disappointing—especially given the strong female character she was in Outbreak. Wendy and Gustave provide some redemption, but they arrive too late to fully turn the ship around.

Still, the core issue—abuse of power in reproductive medicine—is both compelling and deeply unsettling. If you can tolerate the eye-rolling moments and the cardboard cities, there’s a worthwhile story underneath.

Just… maybe don’t come here for character depth or real Brisbane flavor. You’ll find more in a Pizza Hut’s parking lot.

Profile Image for Terri Lynn.
997 reviews
June 29, 2012
This was a wild and crazy book and I went along for the ride. I like Robin Cook and have been a fan since the first book Coma.

Dr. Marissa Blumenthal is a pediatrician who is desperately seeking pregnancy and childbirth. The problem is that her Fallopian tubes are sealed shut with what appears to have been a bout of tuberculosis though Marissa never had the disease. Marissa had been told that she had an abnormal pap smear (note to self- do NOT trust maniacal doctors who tell you that you have an abnormal pap smear and want to render you unconscious to do a biopsy)6 months after she married Robert Buchanan whose first love is money and who is about as warm and compassionate as a block of ice.

Two years later, she is on her 4th round of in-vitro after being told that her Fallopian tubes are sealed shut. She is pumped full of hormones and has a husband who is fed up with paying $10,000 (in 1990) a shot at the in-vitro that has not worked. Their marriage becomes a source of stress and I can't imagine why Marissa wants a baby or became a pediatrician because she seems so easily annoyed with the children and their parents in the practice she works for.

Nasty things begin to happen that makes Marissa dangerously curious. On the day of her 4th in-vitro, she and Robert witness a very upset woman who demands her medical records at the Women's clinic. She is taken upstairs to see them then gets murdered and shoved out the window. At first it is thought to be a suicide but Marissa's friend at the medical examiner's office says the woman was dead before going out the window. Not only that, when Marissa has him check, it is found that this woman had the same tuberculosis-sealed-the-Fallopian-tubes problem.

At a support group meeting, Marissa is shocked to run into her doctor friend Wendy Wilson who- you got it- has the same problem. In fact, several other women at the meeting have this rare situation and ALL of them go to the same clinic.

Soon Marissa and Wendy are on the trail of answers to their suspicions and things get ugly. They are attacked and nearly killed when slipping into the records computers at the clinic to see how many others have the same problem. They get arrested. Finally, they go off to Australia to find a doctor who is associated with another clinic that is tied to the one in Boston where they go and find that it is a worldwide problem and someone is willing to kill about it. When Wendy is murdered, Marissa hooks up with the very bizarre and funny doctor who lost his job trying to prove that the problem existed.

The things that go on after they meet is wild!It goes from Australia to Hong Kong to the People's Republic of China, Thailand and the USA and with a blend of terror, humor, and murder. I enjoyed this a lot.
Profile Image for Giridharan.
31 reviews25 followers
December 13, 2013
I had really high hopes for Robin Cook after reading 'Mindbend'. But this book never met my expectations. Robin Cook should have sticked to his cup of tea - the medical field. Instead he takes us on a wild goose chase, starting from America to Australia, then to Hong Kong and then to China. And somewhere in the middle, the plot was completely lost. The initial scenes were really wonderful and I felt I had stumbled upon a fantastic book after a long search. But then that joy did not last long.

The author needed only 2 pages to give answers to all the mysteries that surrounded the hospitals. All the other pages were just covered by chases, murders and travels. What on earth was the protagonist doing travelling all round the globe on a wild goose chase? And even after all those adventures, I never really got my answers. I guessed the plot right from the start and it took the author 400 pages to tell me that my guess was right.

The characters were loosely developed except for Marissa and Wendy. Three - fourth of the book was like reading some fantasy book. I wonder how such a big treachery were left unnoticed except for a pediatrician. The author surely has written better books.

Overall, a pretty ordinary book with a promising start that loses its way in the middle.

For more reviews, view my blog!
www.giribookworld.blogspot.in
Profile Image for Kym Moore.
Author 4 books38 followers
August 28, 2024
FYI-There are spoilers!

This is the second time I read this book. I first read it in 1991 when it was released. Vital Signs is truly a medical thriller laden with an unimaginable conspiracy surrounding women patients being treated for infertility with IVF. As the story unfolds there is something deeper and more sinister about what's behind women's reproductive rights and the clinics covering up horrific secrets than you could imagine.

Dr. Marissa Blumental wishes to have children with her husband Robert, but finds out both of her fallopian tubes are stopped up. At a support group meeting, Marissa finds a college friend of hers ((Wendy) who she'd lost touch with since graduation is also at this meeting for the very same problem. After discussing the similarities with their cases, they believe something is amiss and agree to investigate. , After Marissa finds out about a patient (Rebecca Ziegler) who is being treated at the same clinic she goes to and has allegedly committed suicide by jumping from a window at the women's clinic, she becomes suspicious. At first, it seems like Rebecca is depressed but Marissa suspects there's something more to Rebecca's story.

Marissa and Wendy decide to do their own investigation because something seems awry. But, their lives are threatened and someone is trying to murder them, but who? Marissa doesn't get the type of support she feels she needs from her husband Robert throughout her IVF treatments, but something strange keeps gnawing at her to look into some medical questions that don't make sense. When Marissa and Wendy embark on a trip to Australia to find Dr. Tristan Williams, who wrote a medical paper that created a lot of controversy at the Female Care Australia Clinic and is mysteriously under the radar and no longer working for the FCAC, things become more deadly.

When Marissa catches up with Tristan Williams, their investigation regarding his paper also takes a wild life and death, hairraising journey when they discover the dark secret behind the Female Care Australia Clinic, the U.S. fertility clinics, and female patients worldwide.

This is a thriller you can't put down. It's a nailbiter! Yes, I highly recommend it! Yes, more people die!

SPOILER
These clinics are sitting on a potential gold mine with their IVF technology. The IVF program was so successful that the players in the game needed to do something to maintain and grow revenue. They had to make sure that IVF wasn't successful too quickly. So, at $10,000 per cycle, they wanted to run their patients through as many cycles as possible. Yet, ultimately they wanted all of their patients to conceive. That meant a better reputation for them. More business!

Marissa and Tristan discovered that the whole infertility industry is unregulated and unsupervised. The government just looks the other way. In places like the PRC (People's Republic of China), sterilizing women, especially after they had one child was common. The trick was to sterilize without leaving evidence of it, or leaving evidence that could be misinterpreted.

The story will end well for Marissa and Tristan.
Profile Image for Roberta.
1,997 reviews333 followers
August 13, 2016
This novel has been brought to you by the Australian Tourist Office. The exotic settings and the travelling are a put-off for me: "hey, I'm doctor Blumenthal, and even if I practically have no jobs I enjoy spending all the family savings in crazy investigations, luxury hotels and real chinese food, instead of talking to the police. Oh, and I resent my husband when he tries to talk finances."
OMG, there's also kung-fu! After all they're in Hong Kong now... these stereotypes will kill me, but they are so bad they almost turn out good (almost being the key word).

And here's come the CDC, our deus ex machina. Our heroes are rescued (and no one questions they actions), and they'll live happily ever after.

Sorry but I didn't like it. Too unbelievable, like a bad hollywood stunt with some asian actors doing martial arts. I was looking for a medical thriller, not a bad action movie. The discovery and explanation of the intent and schemes of the bad guys took what? 2 pages? It was rushed. Let's move on to the next one.
Profile Image for Allyt_hobart.
240 reviews2 followers
July 17, 2018
This has not aged well. I remember reading other Robin Cook thrillers years ago and enjoying the ride. This one however has a completely unbelievable plot, one dimensional characters and the ride is farcical.
Profile Image for Shannon M..
520 reviews69 followers
December 20, 2021
This would be my second favourite book by Robin Cook. It's wonderful.
Profile Image for Glenda.
954 reviews85 followers
June 20, 2023
In the eyes of her envious peers, Marissa Blumenthal has it all: a superb professional reputation, a flourishing pediatrics practice, even a fairy-tale marriage with the man of her dreams—Robert Buchanan, an entrepreneur involved in health-care administration and research.
But there is one thing Marissa does not have: the child she desperately desires. And when tests confirm that her sealed fallopian tubes have rendered her infertile, her perfect world begins to crumble. Obsessed with becoming pregnant, Marissa barely even notices the disastrous effect this is having on her marriage and career.
When a little medical sleuthing points to suspicious origins of her infertility, Marissa boldly challenges the law. Along with Wendy, a new friend with a similar infertility problem, she breaks into a fertility clinic, travels to Australia, a center of in-vitro fertilization, then on to Hong Kong.

I have owned this book for nearly 20 years, but never read it. I am happy to check it off the list. It was interesting until some parts turned into an action thriller movie—complete with Kung fu moves, jumping off a ship and punching out bad guys. My daughter suffers with PCOS, a fertility issue so I understand completely the way obsessing over having a child happens. Even so, some of the things Marissa does are very foolish and hard to believe she went to the extremes she did. I was invested so I stayed to the end to see the resolution of the story.
Profile Image for J.E..
Author 10 books22 followers
April 29, 2008
This book is a mess! Robin Cook may know a lot about medication, but he obviously did not do his research for other aspects of this novel.

Maybe, I don't like it simply because of a few things I know that not everyone does, but there are far too many problems for me to ignore them. First, in Australia, the great white sharks are along the southern coast, not in the great barrier reef. Secondly, there has never been a shark attack in the great barrier reef due to the plentiful supply of food for the sharks that are there. Thirdly there would be no reason for a boat on the great barrier reef to need a shark cage. etc., etc., etc.

Most of Cook's books follow the same basic plot line with different characters and settings. I would suggest you read anything else by Robin Cook and simply avoid this one.
71 reviews3 followers
October 25, 2019
If I didn’t already have another four of his books on my bookshelf I would probably quit reading Robin Cook. I really used to enjoy his medical mysteries but lately I found his portrayal of the emotional irrational female offensive. This last book the ending was very anti-climaticAnd I don’t think it was worth the 400 page read. I usually read a book in three days and this one took me more than a week
14 reviews1 follower
August 6, 2017
I stopped when "the women sobbed for hours" after being cornered and attacked in the darkened basement of a fertility clinic. The sobbing women were doctors in the midst of a HIPAA violation, so you'd think they'd have the wherewithal to call the cops or the medical licensing board when they realize stuff at the clinic is hinky. But the again, poor Melissa can't even turn to her cardboard cliche of a husband who prioritizes His Work over Her Babies so if she's so dumb she keeps trying to have his baby I'm not sure how she passed medical school. Anyway, flat characters, terrible writing, who knows if the plot would have been as ridiculous as I truly imagine - had to give it up.
Profile Image for Ajitabh Pandey.
853 reviews51 followers
June 19, 2019
There wasn't much of a medical thrill in this book. And as compared to the previous book in the series, this was not a very engaging book.

For most of the initial part of the book, the author has focused on personal issues between the main character and her husband.

There are times when the book feels quite stretched, especially the Hong Kong episode.
Profile Image for Jim Swike.
1,852 reviews21 followers
April 14, 2014
A great thriller, bad things happening at a Fertility Clinic, I think one of Robin Cook's best, enjoy.
Profile Image for Maura.
3,883 reviews112 followers
June 30, 2019
Dr. Marissa Blumenthal, after her stint with the CDC, is now a pediatrician and married. The epilogue starts with her having a routine cervical biopsy and then jumps to two years later, when she and her husband are trying to conceive a child. It was discovered that Marissa's fallopian tubes were completely blocked and the only way to have a baby would be IVF. After 5 cycles and no baby though, the determination to have a child is destroying her marriage and wreaking havoc on her own confidence. Seeking support, Marissa meets with a group of women in similar circumstances and begins to learn that something about their situations isn't normal...there are simply too many coincidences and secrets. So Marissa and her friend Wendy set out to investigate how so many women could be similarly affected - what they find puts their lives in danger and takes them across continents to determine if there is a global epidemic of infertility or if something more sinister is at work.

So this started out pretty fascinating. I'd never really looked at or thought about infertility and the process for IVF and how it puts so much stress on a relationship. I mean, Marissa and Robert (her husband) are by no means perfect. He's pretty much unfeeling about Marissa and what she's experiencing, but while she's feeling emotions, she's not really thinking about anything but having a baby. Their marriage is nearly over before she considers that this need to have a baby may have destroyed the love she and Robert shared. I feel like this would have been a pretty great story if it had focused on that with a bit more local investigation. But this takes a giant leap in to crazytown story when Marissa and her friend break into the clinic to look at classified medical records (and they're both doctors!) and decide to fly to Australia to investigate further. It was by this point that I could no longer relate to these people. I mean, it was difficult enough that Marissa and her husband were shelling out $10,000 for each IVF treatment, but then she's making last minute trips to Australia and staying in swanky hotels and and then she and the new character Tristan are bribing people to take them to China and paying off local mafia in Hong Kong, not to mention taking all kinds of crazy stupid risks. And only once does Marissa think about her asshole husband that she supposedly loves. Marissa comes across as pretty selfish in this story by the end, having decided that her pursuit of the truth is all that mattered . So while this started out as a promising story, things got a bit too unbelievable and although it was fast paced and interesting, I was a bit put off by all of that.
This entire review has been hidden because of spoilers.
Profile Image for Rebecca.
435 reviews
June 29, 2021
Overall, this was an intriguing story. It was a difficult one to figure out. The ending was rather obvious, no special or unexpected twists there, but what I couldn't figure out until I was reading it was the *how* of the story - how did everything tie in together. No matter how I tried, I couldn't understand how all the medical stuff tied into the Chinese mafia, it just didn't make sense. The idea of drugs just seemed to cliché. That kind of "keep you guessing" storyline is exactly what pulls a reader in! And when the connection was finally revealed and it all made sense, I was somewhat surprised by the answer as I clearly wouldn't have guessed.

All that said, I did have a few things that made it harder to enjoy. The chapter breaks were frustrating. A chapter would begin on one day (and time), span multiple days within the chapter, including characters going to bed, etc., and then end in the middle of a scene, only pick right back up on whichever current date and time applied. There would be numerous places where a chapter break would make more sense, and I found myself constantly feeling the need to go back to the previous chapter, verify dates and times, and ensure the timeline added up, especially as there was international travel occurring. It was a bit disorienting as opposed to beneficial.

I also found the POV to be a touch distracting at times. I have read numerous third person without issue, but I believe this would be constituted as third person omniscient which maybe just isn't my preference. The narration outside of the characters was fine, but then sudden thoughts of specific characters would jar me, especially as you would get multiple characters thoughts within the same scene. The narration would also jump multiple narration points within the chapter and scene. For example, inside vehicle A (as if looking out) with thoughts from characters within vehicle then a jump to vehicle B following vehicle A with thoughts from those characters with no differentiation of scene, just the next paragraph. That might not be a deal breaker for most but it definitely threw me from the story multiple times.
Profile Image for Martina Inés.
77 reviews12 followers
June 26, 2021
Si no era por encontrar el libro en casa y ofrecérselo a una amiga sabiendo que el autor le gusta, no había chance de que lo leyera. Fue puro capricho, tengo muchos libros pendientes que me importan más que este.
Sin saber nada me encuentro con que es la segunda parte de otro libro que lo entiendo "hermano", lo cual ya cambió mi postura frente al libro. Lo dejé pasar por no sentirlo como una secuela.
Durante las primeras cien páginas aproximadamente me tuvo muy atrapada, me prometieron un thriller médico y hasta entonces me lo dieron. Después sentí que estuve leyendo algo entre Búsqueda implacable y un libro de Dan Brown, no digo que esas dos cosas sean malas pero si hubiese querido leer idas y vueltas entre aventuras y rescates y la aparición de personajes que oportunamente hablan inglés siendo nativos orientales hubiese leído otra cosa.
No había leído la sinopsis hasta varios capítulos entrada en la historia, cuando me enteré que la amiga era asesinada me entusiasmé, esperaba algo sorprendente y me quedé con sabor a poco.

En fin, me hubiese gustado que prevaleciera la parte médica que la parte de la acción.
Son tres estrellas porque al fin y al cabo fue dentro de todo interesante y logró que saliera de mi pozo de solo leer manga.
Profile Image for Fred Sandoval.
11 reviews
July 11, 2022
2.5 estrellas.

La verdad es que es un libro que no destaca demasiado en nada, pero voy a intentar separar los aspectos positivos de los negativos.

Empecemos con lo positivo:

1- La manera en que Robin Cook relata una infección bacteriana describiendola como si fuera una batalla es bastante buena y evita que se vuelva algo tedioso. Además en las escenas donde emplea lenguaje médico lo hace de una manera bastante correcta, lo cual hace que las personas que sabemos de medicina entendamos perfectamente de qué está hablando.

2- También debo decir que Tristán es el mejor personaje de todo el libro. Grande Tris.

3 - A pesar de que desde la sinopsis nos avisan que Wendy será asesinada, la forma en que muere no te la esperas para nada y es bastante fuerte.

Pero bueno, ahora vayamos a lo negativo:

1- Parece ser que Robin Cook es fanático de las típicas películas de acción americanas en las que todo el mundo sabe Kung Fu, porque en su historia todos saben artes marciales, no importa si son guardias de seguridad, chinos, hombres americanos de 60 años o médicos australianos, todos saben Kung Fu.

2- Sus escenas de acción son aburridas y muchas veces carentes de sentido (y con mucho Kung Fu)

3- La mayoría de los personajes son odiosos!! Marissa, Robert, los villanos, son todos odiosos, prácticamente solo se puede empatizar con dos personajes, una muere y el otro aparece ya bastante avanzado el libro.

4- Deja varias cosas sin resolver, por ejemplo qué pasó con la triada Wing Sin y con los dos matones después de que los persiguió la policía.

5- En algunos momentos en particular del libro se notan ciertos rasgos racistas de Robin Cook, se siente como si el autor fuera el típico hombre americano que siente que las personas de Estados Unidos son superiores a las personas de otros países.
This entire review has been hidden because of spoilers.
Profile Image for Chelsea .
47 reviews
July 26, 2025
In Vital Signs, Robin Cook invites us into the world of infertility, in-vitro fertilization, and—because why not—murder. Who knew baby-making could be so…lethal?

We follow Marissa, a driven, smart, and occasionally overbearing protagonist who’s desperate to get pregnant. Some of her intensity is definitely hormone-induced (thanks, IVF), but a lot of it comes from the fact that she just cannot let things go. And honestly? Good. Because when another patient mysteriously yeets herself out of a hospital window after trying to get her own medical records, Marissa’s Spidey senses kick into overdrive.

Her husband Robert? About as interesting as dry toast. He’s more concerned with their finances than their fertility, at least through Marissa’s eyes. The man radiates “pragmatic spreadsheet energy” while Marissa's out here unraveling what turns into a chilling medical conspiracy.

As bodies start metaphorically (and sometimes literally) piling up, Marissa transforms into a one-woman investigative unit. Think: fertility Nancy Drew with a grudge and no chill. She charges through red tape, shady clinics, and ominous warning signs with the kind of determination that makes you go, “Maybe don’t do that,” but also “I respect the hustle.”

Cook’s medical knowledge is sharp (as always), and while the plot teeters on the edge of melodrama, it keeps the pages turning. The premise is equal parts fascinating and horrifying. IVF and covert sterilization plots? Not what I expected when I picked up a medical thriller, but here we are—and I was invested.
Profile Image for Abdul Malik.
2 reviews
June 19, 2019
The whole suspense of the plot could be summed up in two paragraphs. The story starts out as something really interesting and then progresses towards an unnecessary drag of a plot. To top it all off, the most odd and unrelatable character in the story - 'Tristan', annoys the living hell out of you by being a cliched 'aussie' with his "Right on luv", "Okay, luv" and so on.


The "Kung fu moves" that the author keeps repeating in the novel makes it apparent that the author is in no mood to describe action. We're just supposed to assume that the term "Kung fu move" translates to some diabolical out of the world Jackie chan - like - action that every thug is well versed in.

The ending was sort of predictable. Most of the story had unnecessary elements and felt like they had been dragged out. The only characters that I actually pictured to be realistic and relatable were 'Marissa' and 'Robert' and the dynamics of their relationship.

There are so many things that I want to point out. I really liked Robin Cook's 'Acceptable Risk' and this just doesnt deliver the same experience; it couldn't come close.

P S: I'm giving two stars just for his research. I have to hand it to him, he has worked, but it still doesn't come close to what he could've actually done with this plot idea.
This entire review has been hidden because of spoilers.
Profile Image for Phil.
7 reviews
October 19, 2019
I bought this as a Kindle book as I really enjoyed Outbreak and wanted to see what this character (Marissa Blumenthal) was doing next.

I must admit I was let down - not much of a medical thriller (sure there was the IVF issue) and it was all over the place. Being Australian I found it interesting that it moved to Brisbane (having visited some years ago), but it lost me after the shark attack nonsense. When I first read the name Ned Kelly as a villain I was thinking "Are you kidding?" The use of Australian slang was sloppy and made me cringe (we don't talk like that - even 30 years ago when this was written). The plot line was something out of a soap opera and totally unbelievable (I know this is fiction, but...). Tracking down an RFDS doctor to an outback farm pretty much lost me and the move to Hong Kong did it. I felt obligated to finish it off as I had already invested time into it.

Very disappointed - far cry from the first novel in the series.
Profile Image for Chris.
869 reviews182 followers
May 29, 2018
A little far-fetched at times but an enjoyable medical thriller none-the-less. Cook usually sets his thrillers in the New England area, but the MC in her quest for the truth left Boston for Australia, then on to Hong Kong and a clandestine trip to the PRC.

Something strange is going on at the Women's Clinic with their in-vitro fertilization program, & there are people willing to kill to keep it under wraps. Dr. Blumenthal doesn't realize the real sinister secrets when she begins to track a small co-hort of patients (including herself) with TB salpingitis. It pulls her in deeper & deeper as she searches for the "how", it tears her shaky marriage further apart, and leads her into dangerous waters.

Profile Image for Laura.
416 reviews5 followers
July 18, 2019
Cuando leí el libro de "Epidemia" me pareció conocer una Marissa fuerte y decidida, sin embargo aquí la vemos totalmente perdida, claro que las circunstancias no es que sean las mejores pero aún así toda esa chispa que le ponía a la historia se pierde.

Ha cumplido su función de entretener e incluso de instruir ya que cuando se centra en las cosas medicas no hay duda que acaparar tu atención. Sin embargo la siento un poco ilógica, a la hora ya de andar huyendo, o los accidentes que a su alrededor pasan.

Sigue con su lado predecible y aburrido en algunos momentos, el anterior me gusto pero este me decepciono.
Profile Image for Andrea Neves António.
248 reviews1 follower
July 13, 2022
Marissa Blumenthal, que conheci como estagiária no CDU, aparece agora como pediatra e com uma rotina perturbadora na sua tentativa de fertilização in vitro. A descrição dos tratamentos e dos desafios emocionais e á sua relação, como casal, está muito bem feita.
Inesperadamente, passamos para Austrália, Hong Kong e República Popular da China, máfias, atentados...
O final foi bom, embora abrupto. Gostaria de uma conversa mais extensa e esclarecedora com o médico rural da RPC, onde falassem mais das políticas e ações para controlo da natalidade ali praticados.
Tristan, embora aparecendo apenas no final, é um personagem fantástico e cativante.
This entire review has been hidden because of spoilers.
375 reviews9 followers
November 11, 2024
I am a fan of Robin Cook's books and movies. When I came across this novel at last month's Friends of the Library semi-annual book sale, I was excited to find a novel of his that I had not read. "Vital Signs" started off with a lot of promise. The plot was original, the characters believable, and the settings interesting. However, what kept me from giving it five stars, was some of the actions and dialogue of the characters. Some of the actions and dialogue did not go along with the personality of the characters. Also, towards the middle/ending of the novel, it dragged on a bit. I would still recommend this overall decent read.
1,067 reviews14 followers
July 9, 2018
This fast moving medical thriller imagine what corruption could look like in the area of women's health, particular infertility treatment and involves large amounts of money, Asian triads and several murders. If I stopped and thought about it there were several holes that could easily be poked in the plot and the dynamics between the married couples always felt a bit off - possibly a reflection of the age of the book. However, it was a rollicking read - but I'm glad I wasn't in the middle of fertility or other medical treatment when I read it.
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