Cook's novels reflect issues currently under public debate. Mortal Fear (1988) anticipates the government's approval of increased research into gene therapy and the use of recombinant DNA, but focuses more on a horrifying solution to the problem of high-cost medicine in an age of dwindling finances. The growth of HMOs, the allocation of health care dollars in an era of expensive technology, and the high demand for care are major concerns of the novel. Costly technology can keep some patients alive for long periods, but should these expensive resources be allocated for persons who deliberately ruin their health by overeating and smoking, for example, or are they better spent on those who are sick through no fault of their own and can get better?

The HMOs and pre-paid health plans that have sprung up only make money if people stay healthy; those who persist in high-risk, self-destructive...