This fascinating medical thriller is a terrifying look behind the scenes of Portola, a failing hospital in San Francisco, and the corrupt Parnassus Physicians’ Group (PPG) that runs it. When Tim Markham, director of PPG, becomes a victim of a hit-and-run accident, he winds up fighting for his life in the ICU at the hospital he works for. One would think he’d be well cared for in his own hospital, surrounded by the many doctors and nurses he employs. However, one would be wrong! People are dying in this ICU, and not from their various injuries and illnesses. When Tim winds up dead, Detective Abe Glitsky heads up the investigation and quickly singles out his chief suspect, Dr. Erik Kensing, a doctor who holds a grudge against Tim and PPG. Things get complicated when Dismas Hardy, a renowned Defense Attorney and Detective Glitsky’s best friend, takes the case. Together, they discover a serial killer is stalking the halls of Portola, CEOs are taking kickbacks to promote unstable drugs, and patients’ lives are taking a back seat over profits. Well-written and full of colorful characters, the author gives the reader a horrifying glimpse into the medical insurance world where money means more than The Oath. ( )

I was tempted to only give this one star because of the tricky ending, but I decided to chalk it up to Lescroart's sense of humor. Aside from that, I enjoyed this book very much, but that's not surprising as I have enjoyed all of his books so far.

It seems like there is more humor in this series as I continue to read it. The two main characters, Glitsky and Hardy go well together. Glitsky is a good straight man for Hardy's frequent jokes and wisecracks - that is, when they're speaking to each other. Occasionally, one or the other gets a bit carried away with his job and causes friction with the friendship, but they usually kiss and make up. Well, not literally of course, even though it is San Francisco.

The humor is somewhat welcome in this one, as the subject is pretty serious, and affects most everyone - medical care, or lack of it as is often the case. Here, it's about an HMO that is business first and care last. There are some sad facts that I'm afraid are true. Drugs on the formularies are there because they're cheap, generic drugs are not the same as the name-brand ones - they simply have the same main ingredient, but side effects may make a difference. And you can't sue for medical malpractice, because it's an insurance company, not a hospital. And the biggest problem in this story is that the HMO gets paid a set amount for most patients, so if these happen to get in the way of the higher-paying ones, well, something's got to give and sometimes it's the patient's life. Oh well, usually nobody notices.

So, read it and weep. It's a good story, and it doesn't hurt to have a bit of reality mixed in. ( )

Dismas Hardy, San Francisco attorney, takes on a client who becomes a suspect in a murder case. Eric Kensing was the attending physician when the head of an HMO died in his hospital. The victim had been hit by a car but an autopsy showed that excessive levels of potassium had been administered to him just before he died, bringing on a heart attack.

Hardy believes his client is innocent but Kensing has difficulty comprehending that he is the prime suspect. He manages to lie to his attorney about critical times and persons, thinking it doesn't matter; he's innocent. His obfuscations cause Hardy a great deal of pain, but he continues to work for his client. And part of that work involves looking for the real killer.

Hardy's relationship with Abe Glitsky, homicide detective, is threatened along the way. The two have been friends for years but they are working different sides of the fence this time, and acting in the best interest of different interests.

Much of the book is, in fact, about these two men. The plot is a vehicle for exploring their feelings and actions. Which appealed to me, given that I prefer plots that are character-driven.

It turns out that there are several possible murderers, but only one other stands out. Again and again Kensing emerges as a real possible. Are we to find out that Hardy has it wrong? It's happened before. I won't tell.

It's a good legal thriller, more on the outskirts of the law than on the courtroom. ( )

Defense attorney, Dismis Hardy is back in this story which includes many of the regulars from the series. This time the CEO of a major health provider company is the victim of a hit and run accident. He's in the ICU and in dire straights. But, when he dies, it comes to light that he was actually murdered in the hospital. I really like this series and this is a good installment. ( )

I hesitate to mark this as a legal mystery as, unlike many of Lescroart's other books, there is very little that takes place in a courtroom except for a couple of grand jury scenes.

No need to summarize the plot as the book's description does that just fine without any spoilers and this book would be ripe for spoilers. Not a great book, just a lot of fun. I especially enjoyed the repartee between Glitsky and Hardy, two best friends, who manage to focus on their own conflicting jobs and irritate each other no end, yet manage to forgive and forget.

You'll learn some interesting economics of running a hospital and HMO and trying to keep the HMO going provides the motivation for several of the "mercy" killings that lead to the penultimate murder. I did find the murderer's motivations to be rather unconvincing, but then again, I don't value money and power the way her/she/it (no spoilers there) did. ( )