With a name like "Viral," you'd expect this book to be about COVID-19. But in Robin Cook's 2021 release (Penguin Random House, $27.00, ISBN: 978-0-5933-2829-3) the title refers to an encroaching wave of an even deadlier disease without a vaccine to protect those exposed to it.

It appears after Brian and Emma Murphy’s beach barbecue on Cape Cod that Emma has been bitten by an Asian tiger mosquito--because they are swarming northward due to climate change. The result is that Emma comes down with a case of Eastern Equine Encephalitis, or EEE as it is known. The symptoms of this plague come on slowly, beginning with a high fever, lost appetite, followed by eventual convulsions that are almost certainly fatal. Emma dies, leaving Brian with a four-year-old daughter and an impossible medical bill for Emma's treatment in Manhattan Memorial Hospital (MMH Inwood). And then being sued almost instantly for a bill that his Peerless Insurance refuses to pay. By the time Emma dies, her medical bill is $221,448.49. Add to that the fact that his and Emma's own security business is dead due to COVID-19. Brian is then besieged by an unbridled entrepreneurial capitalistic collection company's unconscionable acts to collect the bill, up to taking his house.

His daughter, Juliette, is inconsolable over her mother's death and wake, during which she is supported by good friends and grandmothers. Still, she is contrary about everything, claiming psychosomatic symptoms. Brian is beside himself, often slipping into pure rage, and falling into his own grief.

Upon a recommendation from a lawyer, he seeks out a Billing Advocate who takes his case beside the numerous other people in dire straits like Brian. It is amazing how many people in his neighborhood are in the same unbelievable crisis with the same company, Premier Collections, because of employment-based healthcare drying up. Next he discovers that the collection agency is owned by MMH Inwood. It is only after his huge bill that he narrows down the bad guy and woman behind these tactics.

He narrows his interest to Heather Williams, CEO of MMH Inwood, and the grand master behind the  new billing and collections scheme, Charles Kelley. Their predatory plan is to strip all the underinsured of their rights and options while drawing huge salaries from the company. He pleads and threatens them to no avail.

And then Juliette begins to exhibit the symptoms of EEE. Brian takes her to the MMH Inwood emergency department where he waits three hours for her to be seen. He accuses the hospital of making him wait three hours because of the bill he already has. They send her home as a normal child. Again, the next day he needs to take Juliette back because of her symptoms flaring up. Again he is made to wait for three hours even though patients come and go while he sits. The doctor sends her home because he can't find a fever. Brian begs him to run some blood tests to determine her illness. The doctor declines.

The next day she begins to convulse and is rushed back to the hospital from where she is not seen again. Brian is enraged. He plans a retribution for Heather and Charles which is creative and deadly.

That is the end of the story. Who won the conflict? What did they win? Was it the virus, EEE?, Or the hospital? Or the insurance company? Certainly not Brian. The virus left him destitute and alone, with silence as his only companion.

I liked this book because it woke within me an understanding of the medical/insurance connection. Where would I be if I was sick and unemployed?