Palmer's 10th medical thriller rides on his usual wave of unrelenting adrenaline, and will make readers think twice the next time they're due for a routine vaccination. The physician-hero this time is Matt Ruttledge, a doctor in bucolic Belinda, W.Va. When several of his patients turn up in the emergency room, babbling incoherently and sporting unsightly lumps on their faces, Ruttledge blames the town's main employer, a large mining operation with a history of safety abuses and environmental neglect. As more patients turn up with the same fatal symptoms, Ruttledge discovers that a larger culprit may be responsible...