From Coma to Spasm: Robin Cook’s Wild Ride Through Medical Thrillers

Hello and welcome to the Thriller Zone.

I'm your host, David Temple.

And on today's show, which will be what episode?

We're coming up on 250.

Yeah, 248 episodes.

Today I have the pleasure of sitting down with a genuine legend.

You know, every once in a while you will meet or you will follow a thriller author that you think, what are the chances of my ever being able to sit down and speak with that person?

Today is one of those times.

And we're coming up, what, four and a half years now on this podcast, and there have been a few moments that I went, wow, this is one of those landmark situations.

This guy I followed.

And you'll hear it in this inside the show.

I remember the day the book came out.

It was around the sp.

I want to say, the spring of 77.

I'm in high school.

Yeah.

I'm coming up on graduating high school.

And this book came out.

And about a year later, one of my childhood heroes, Michael Crichton, directed as a film, the author, Robin Cook, the book coma.

And now, 42 books later, Spasm, another number one New York Times bestselling book.

Yeah, you're gonna hear David gets a little geeked out.

But you know what?

That's who I am.

That's what happens.

Great interview.

We had such a blast, and I think you're gonna really enjoy it.

It's about an hour and so it's a little bit longer than usual, but it's worth every single solitary minute.

So please, without any further ado, kick back, relax and enjoy as we about wrap up the year.

One of my all time favorites, Robin Cook, right here on the Thriller Zone.

Top of the morning to you.

Good morning.

Good morning.

I'm sorry, I just realized I didn't have my phone so I could silence it.

Nice.

Let me do the same thing or I'll get fubarred.

You look fantastic, by the way.

Well, thank you.

Holy moly.

The reason I, I.

Sorry, the reason that sounds a little bit odd is I'm like, I'm.

I'm flashing back, Rob.

And by the way, welcome to the Thriller Zone.

I'm David Temple.

Thank you, David.

I'm gonna geek out, so just bear with me for about 10 minutes and it'll all settle down and we'll be good.

But I've been reading your stuff since, if not day one, practically day one.

So when I got a chance to talk to you, and I've been working on this for maybe a year, I went, robin Cook.

Are you kidding me?

Is he still around.

Okay, now I see why you say that after what I just said.

You're still alive.

God dang it.

That's amazing.

Well, you know, it's interesting, because the other night, I was out to dinner with.

With a very good friend of mine that I used to play tennis with.

You know, we.

We drove each other into the ground, et cetera, and he and I are.

Are the same age.

And I had to say to him, I said, you know, Joe, it's.

It's.

I really feel like I'm enjoying being with you.

I said, because, you know, I had five roommates in college the last year of college, and I'm the only one left.

Wow.

And he said, I had eight members of my study group in law school, and I'm the only one left.

Whoa.

So it's.

It's a rather strange sort of set of circumstances.

Well, what are you, like, 60 now?

50?

58.

60.

You're teasing me.

Well, that's all right.

I don't mind.

I look at it this way.

My mom used to say, who is now past, rest her soul.

But she used to say, mom, how you doing today?

She goes, well, I'm on this side of the grass, son.

Good for her.

Well, you know, I have to say.

Yeah.

That I've actually always practiced what I preached.

And I realized early in medical school that lifestyle was probably as important as what we were learning.

You know, the idea of being a doctor, taking care of people.

But there wasn't this emphasis on lifestyle in the sense that.

The fact that health is much more strange than ill health.

In fact, the fact that our bodies work as well as they do, when you think about it, it's incredible.

Yeah.

I mean, you.

When was the last time you worried about your calcium level in your blood.

Yet?

Never.

Your body has to do that constantly.

Yeah.

Light variation, you know, that would be.

That could be curtains.

Sure.

Well.

And not to make it about me, but I just am on the other side of prostate cancer, so.

Oh, yeah, that went.

Matter of fact, I've got a book coming out right now, and it.

Basically, the title of it is Life in Two Columns, the Shit that Matters and Everything Else.

Because the moment I got that prognosis, I'm like.

Well, as a buddy of mine said, he goes, you know, how you feeling?

I'm like, dude, I'm feeling pretty good.

But I'll tell you, when you hear that C word, you.

You put life into two columns, and that's when we both went, oh.

But you.

My point, Robin, is you realize how important that health is and how hard you got to work to keep it there.

And if you don't, you're, you're messed up.

Yeah, well, I agree.

And most people, because, you know, when I, when I was in the last year of college, I was, I was pretty heavy.

I was just shy of 200 pounds.

In fact, I was probably the heaviest halfback in our football league.

And, and I realized, you know, it's probably be a good idea for me to lose some of this muscle mass.

And.

And that's I think has stood me in very good stead that I did that well.

And to your point about muscle mass, what I'm learning about, and I don't want to make this a whole all about health, but you are a doctor, for crying out loud.

And I did play one in a miniseries back in the.

But.

The muscle mass, the working out into keeping the muscle strong and alive is really everything I've read about it.

For longevity is the magic pill because you let that atrophy and, and you're, you're in a world of hurt.

Yeah.

And it, and unfortunately it does get to a point however, where you start losing muscle mass no matter what you do.

Oh.

And I've noticed that.

And I've realized in a way that medicine.

Has not had as much attention paying to aging as it really should have.

When I started talking to fellow physicians in the mass general.

About perhaps muscle mass or considering the loss of muscle mass, maybe this is something we should, we should really think about more because.

But they had a knee jerk reaction to the idea of either taking particularly growth hormone or, or, or testosterone, which are the things that really keep your muscle mass.

And yet both of those drop as you get to a certain age.

Yeah.

Let me.

This is funny because a few years back I went to a doctor and said, you know, I need some more testosterone.

My numbers in the gym are dropping.

Can you help a brother out?

And she goes, yeah, yeah, we can do that.

Let's run a few, you know, just a blood test.

Now listen to this, because this was, this was, this was five years ago.

So she ran a quick test.

My PSNA PSA numbers were through the roof.

She goes, david, your numbers.

This should have been this kind of a climb in about 20 years.

You did it in two.

If we had given you testosterone, it would have killed you probably.

Yeah.

So here we are.

No, that's true, that's true.

Yeah.

Well, well, I see your guns are loaded.

You showed up with the loaded guns.

So I mean, you're ready to Play.

Well, actually, I'm about to hit the bike out on my bike.

Is it a trek by any chance or is that just the jersey?

No, it is a track.

I forgot that I was an advertisement here.

It is a trek.

Yeah.

Yeah.

Well, I want to start here and I'll be very respective of your time because thank you for showing up on early.

I mean, Jesus, that is amazing.

But I'm recalling, Robin, it's high school graduation, 1977.

I'm probably two years into really going, you know, I, I love reading and I, I think I might be able to write.

I don't know, I mean.

And then I picked up your book.

This is 77.

I want to say, I want to say Spring.

And I'm like, holy.

This is, this is the kind of book I like reading at.

That was enough almost.

And this is, this was, I mean this was medical thriller.

What is that?

Right.

So I'm reading this and I'm just completely in love with it because your style was so amazing and within.

There's two things folks I want to.

My listeners are big, prominent, prominently writers and so forth.

Thriller writers.

So I want you to hear this.

Robin is writing this book during nights while you're what, an ophthalmology resident?

Yeah.

Scribbling away.

Yeah.

I hope I can make something out of this.

Geez, can I?

Can I?

You get picked up within a year.

That doesn't even happen anymore hardly does it, Robin?

I mean, you've been in it for a few decades.

Well, you know, there was quite a, an interval between my first book, which was a commercial failure.

And my second book, which you're talking about.

And, and in fact, I almost didn't really write another book.

I thought, well, I don't know.

And you know, I thought people would really be interested in this issue about sort of the dark side of medicine, but they weren't.

And, and if I wasn't, hadn't been teased as much as I had been by the Harvard ophthalm faculty because my book came out as I started my residency and.

But you know, I had already done a surgical residency, so I, I was kind of not the same as my fellow EYE residents.

I had already done a whole residency and then had been in the military, so I was.

Well, you're, you were a big deal is what you're trying to say.

Well, not really.

You know, when, when you start out as a, as a first year resident, no matter what the program.

Yeah.

You're kind of.

This is.

You're in Hayesville.

Yeah.

And so.

And I got a bit teased about the fact that I wrote this book and crying a little bit about surgical residency and how they.

You're.

You're being intimidated.

And.

Which I don't think is really healthy.

And so.

But that stimulated me to write another book.

And I said, you know, I'm going to write another book, and this one I'm going to call the Retina Rip off.

Because, you know, my.

What started me writing was the idea that medicine and business were in.

Were.

Were married and becoming closer and closer together and.

Which I thought was a big mistake.

And.

And it's continued to this day.

Yeah.

And so that's really been my recurrent theme.

But I thought, there's no reason to write a book if nobody's going to read it.

And.

And so then what I did was.

Well, I actually talked.

Are you interested in this or.

Robin, this is why I'm here.

Are you kidding me?

I'm, like, just trying to stay.

Yes, go, please.

You know, I. I played basketball.

I played basketball for a long time, and I would play very much, like three, four times a week.

And when I was an eye resident.

The medical side of Harvard, we played the business school and the law school.

And in the business school, I kind of cornered a couple of these young professors, et cetera, that.

Who were playing.

And I said, you know, do you guys have any suggestions for me?

You know, I. I wrote this book.

Nobody bought it.

And they said, yes, we teach by the case method.

So they said, you know, take a couple of cases that you think were successful and study them and see if there's anything that you can get out of that to take advantage of or try to emulate.

And that's exactly what I did.

And so that period of time between my first book and coma, I spent kind of researching bestsellerdom.

Now, let me interrupt.

Is this when you were doing the index card maneuver, where you're studying bestsellers and you're kind of reverse engineering thrillers?

Is this that same.

Yes.

And in particular.

I chose two books to really study.

And I chose Love Story by Eric Siegel.

Yeah.

And Jaws by Peter Benchley.

Geez.

Well, you picked two monster hits there.

Exactly.

And when I compared it to my book, Year of the Intern.

And I tried to say, you know, what makes these.

Why did these books succeed and mine didn't?

And I realized that there was.

You could really look into this, and you could read these books with this kind of idea in mind to try to think of or.

Or to see where my book fell off and.

And These books succeeded.

And, and, and to try to see how these books, how these projects were put together.

You know, when you read about, like Peter Benchley's book.

Was, you know, the way it was written, et cetera, the, how he was encouraged and how he put it aside and, and you think, how did it come out to be such a success?

Well, it took advantage of a universal fear.

Boom.

That we all have.

Yeah, we all have.

And so when you read the book, you were already drawn in because it was something you were afraid of.

I mean, the idea, how can you go in the ocean and not think about a shark?

And, and, and just to put a finer point on that, to this day.

And how long has this been?

To this day?

I, I am semi terrified of the water because of that.

Ever since then.

It's ridiculous.

I know it's ridiculous.

And I live in San Diego.

I am 1.2 miles from the beach where surfers are in there every single cotton picking day.

And they'll.

You'll see a tail or dorsal vent every once in a while and they're like, yeah, just a shark.

It's not going to bother me.

What, don't you remember?

Yeah, yeah, exactly.

Well, and, and then if you look at the other one.

Love story.

Yeah.

We also share certain emotions, and that one really grabbed some emotions that we all sense or all feel.

So here was this combination of a universal fear and universal emotions that these writers, whether they're psychologists or not, they weren't.

But anyway, they had this idea and to put these together.

So actually coma had both universal fear.

There's no one that doesn't go in a hospital, particularly having anesthesia, who thinks, am I going to be walking out of here?

That's the same thing of going in swimming.

Sure, sure.

Yes, you are.

But at the same time, when you go in swimming, you're going to also be able to walk out because you're not going to get eaten by a shark.

And most likely in medicine, yeah.

I mean, anesthesia departments, particularly in good hospitals, are really, really well run.

And.

You'Re not going to have any problem, but you always worry about it.

So here I was, taking advantage of the fact that everybody has the same fear.

But here, here's what I want to know, Robin.

Where was that?

Do you remember the moment?

And I know it's been a few years.

Do you remember that moment when you're studying Love Story, you're studying Jaws, you're coming off of this, what felt like a failure, and you go, do you remember that moment where you went, oh, oh, wait, I've got it.

You know, I wasn't that optimistic, but I. I thought it was enough to make the effort.

And luckily, I was no longer a surgical resident.

I was a ophthalmology resident.

Right.

And to me, being an ophthalmology resident in comparison to being a surgical resident was being on vacation.

Yeah.

So every night I was back in my little teeny tiny apartment.

And that's when I, I was, I. I wrote coma at night.

So I want to.

I want to make sure I punch up this one idea.

So first of all, you write the story.

Number two, you write it, you get it picked up within.

Within a year.

And then within another year, 78, I'm now graduating, and the movie comes out.

Michael Crichton, childhood hero comes along, goes, oh, I think I'll direct that thing, and it becomes a monster stratospheric smash.

Talk to me about that.

I mean, first of all, I know you're still like going, oh, geez, I made it with the.

Selling the book.

But then you have Michael Crichton, and I realize Michael Crichton in 78 wasn't what he was in 88, etc, but he was.

You guys both shared that medical expertise mindset.

And, and he was a killer director.

I mean, what was that like?

Well, you know, there was a little.

There's a different.

We actually, we were friends.

Yes.

And.

And in fact, I was.

Do you know I was in the Navy and I was in San Diego.

No, talk to me.

Yeah, I was.

I.

You probably don't remember it, but the Navy used to have this program called Sea Lab, and it was with aquanauts.

Yes.

You know, living under the sea and all that sort of stuff.

And I, I was one of the aquanauts.

I got drafted after my surgical residency and I was actually a relatively high ranking officer because I got credit for all my education.

One day I was normal, and the next day I was a Lieutenant commander.

And so anyway, I was there and I, I had known a little bit about Michael Crichton.

And because I knew he had gone to medical school like I had, I knew he had not done an.

An internship or residency.

So anyway, I called him up and I said, you know.

I'm down here and we're doing diving research.

And he was fascinated.

And so he came down, I had him come down and I showed him all our dive systems that we were doing because we were doing thousand foot dives.

And then he wrote the book Sphere.

Yeah.

And that was because of coming down to visit Me and learning about, you know, he was.

He was kind of a sponge like guy.

Yeah.

Very intelligent.

Yeah.

And absorbed things immediately.

And could see some of the.

Immediately saw that aspect of it and whatnot.

And so when I wrote.

After I wrote Comma, I actually held out for him to be the director.

Oh, what can you do?

They actually wanted Brian De Palma to be the director.

And I said, no, I want Michael Crichton.

And because I was just afraid a director would turn Coma into some sort of horror picture rather than try to be exact about the medical.

That's hard enough.

Yeah.

I was gonna say.

And Brian De Palma would have probably inched it over into that lane.

That's what I was afraid of.

Yeah.

And so with Michael Crichton, I at least knew that he would be true to the medical aspects of it.

Wow.

Although we ended up having some arguments about it because.

Yeah.

He felt that it would be better to.

Reveal the secret, what was going on and then.

And then have it be mostly the second half kind of be a chase.

My sense is that I thought it would be better to keep the secret going a little bit longer because it was kind of fabulous the way.

Investigating it and stuff.

But that was a minor disagreement.

And.

And.

So it was a.

It was a very positive experience for me.

And.

And so, yeah, it.

It.

You know, it.

It's amazing that the power of.

I mean, playing basketball with the business school guys ended up having this kind of result.

And so that's why my.

One of my characters, Jack, plays basketball.

Oh, of course.

Well, you know, you.

You.

I want to say you feel.

It feels like you have lived a truly charmed life.

I mean, to have that kind of success, that kind of education, those kind of connections, it.

You know.

You're a lucky guy, dude.

Oh, there's no doubt, David.

There's no doubt.

Luck has played an enormous role.

But also, I have.

I have to say that I've been an extremely hard worker.

Yeah.

And I did not.

And I don't want to take anything away from that.

I mean, I. I'm not.

Well, yeah.

Yeah.

I mean, you know, for instance, when I got to college, I realized I was on my own.

I had never had any discussions with my father or anything because I don't know what.

You know, I still to this day don't understand why we didn't really have any relationship.

And so I. I had to put myself through both college and medical school.

Wow.

And.

But, you know, that actually turned out to be a big plus.

Because everything that's happened wouldn't have happened had I not had to do that.

For instance, in medical school, I had to work at night.

And I ended up with a job working for the hospital at night, running blood gas.

Determinations for the open heart surgery department.

Wow.

And I did that every night, every weekend for four years.

But it got me through medical school with no debt.

But more importantly, the person who ran the lab in the daytime, the professor, was a French emigre and he knew Jacques Cousteau.

And it turned out that when Jacques Cousteau, at that time, when I was a medical student, was preparing to do his conshelf experiments, where he was putting divers down to live under the sea at one atmosphere, and he had no way of knowing what the blood gases were.

If you want to be scientific about it, sure.

So I was asked if I would set up a lab for Jacques Cousteau, the same lab that I ran at night.

So I. I was the one that got all the equipment.

And then here I was, a destitute medical student, and I spent two months every summer with the Cousteau group.

Now, that was repayment enough, obviously.

However, during one of the summers, a United States Naval, very high ranking naval officer came to investigate this, what Cousteau was doing.

And I helped translate for him with the divers that he wanted to talk to.

And then when he left, he said, young man, if you ever find yourself in the Navy, give me a call.

Well, I thought, I'm not going to the Navy.

Well, what happened is when I finished my surgical residency, I was immediately drafted by the Navy, assigned to the Marines.

And I was immediately assigned to go to Da Nang in the mid-60s to run a surgical ward.

And I called up this naval officer.

Wow.

And he made it possible for me to become part of his organization, even though it was supposed to be reserved for career Navy.

I wasn't career Navy.

I was drafted.

Yeah.

But to do that, I had to go to submarine school.

Now, a lot of people would say, oh, my goodness, he went to submarine school, you know, and to take six months out to study, you know, how these nuclear submarines work.

Yeah.

And I had to learn everything.

And then I thought, all right.

Then he said, fine, you're done.

Now go to diving school.

Which I did hard hat diving.

I was in the last class.

And then I said, you know, I got so interested in submarines, I really want to go out on a real operational patrol.

And he thought I was crazy, but arranged it.

And so I was out on a nuclear submarine.

And why I'm telling you this is because it was being on the nuclear submarine.

We went underwater.

We never even came to the surface for 75 days.

That's, that's where I wrote my first book.

Whoa.

On a submarine, underwater.

Wow.

In the Philippine Sea.

And had I not been on that submarine, I probably never would have written a book.

I mean, I had thought about it.

Yeah.

Look at.

When do you have the time?

No.

And, and I wanted to ask.

One of the questions I wanted to ask is, did.

Were you one of those kids that grew up, oh, I want to be a writer.

Did you know?

Yeah.

So this is what's amazing to me.

Almost every single.

I bet you 95 to 97% of the authors who get on this show, and it.

We're coming up on five years now, you're going to be number 250 episode, I think.

And they all went, oh, I've, I've always dreamed of being a writer since I was a kid.

My first story was at 4 years old.

And I'm like, really?

That's amazing.

So that's cool to know that you're like, oh, no, I got, I got 10 other careers ahead of you there, Dave.

Well, you know what?

When I was in college.

I, I, I wanted to go to medical school to get into medical, and I wanted to be able to choose the medical school.

I didn't, you know, I really.

So I realized I had to get very good grades, which I had done in high school, et cetera.

So I knew I could do it.

And.

But my first, I had to take humanities course the first year, and my first paper in college that I wrote, which I thought it was pretty good, I handed it in, I got a C minus.

And I could see my aspirations for medical school flying out the window.

Oops.

From then on, I said I have to stay away from these difficult courses like humanities, English, history, writing, anything that's graded subjectively.

I had to stay away from, oh, intuitive.

I became.

I was a chemistry, math, physics major, black and white.

And you either knew the material or you didn't.

Yeah.

Oh, that is brilliant insight.

I never thought about it that way.

So.

The last thing I thought, you know, to be a writer, I should have taken or courses and learned stuff about writing or whatever.

And I, I didn't have that.

But, you know, I got to medical school and I realized that business was, was really taking over medicine.

And this is in the, you know, the late 50s, early.

And I thought, you know, someday I'm going to write a book about medicine as it really is, not as the way people Wish it was.

And of course, then I never had a chance to write a book because I was so busy in medical school.

And then you're a surgical resident.

You don't have any time.

And it wasn't until I got drafted in the Navy that I suddenly had time, and that's when I wrote my first book.

All right, so one thing I didn't do out of the gate, which is to flash your book Spasm, which is gorgeous, by the way.

But so to your point, I want to do this real quick.

So look inside here.

It's two columns.

It said there's an arrow that says, please turn the page because he's written.

No, I didn't really say that.

I mean, here's a guy who has not, by the way, folks, no formal writing training, but lots of bestsellers, Muy importante.

Number one numero uno, New York Times bestseller.

I mean, come on.

Good for you.

Let's do this.

And yet, at this time, I actually feel lucky.

I really do feel lucky that I have this, because.

At this point, in contrast to my fellow medical students, I still am intimately involved in medicine, but without having to deal with insurance, med health insurance companies, or malpractice insurance.

Because each year I come out with a book that's about something that's related to medicine that I've had to research.

Yeah.

To.

To.

And know enough about it.

The book you just held up, Spasm, deals with something that people don't realize they don't know anything about, nor do they really care about necessarily, but it's something that they ought to know about, and that's prions.

They're going to worry about it after they're.

When they finish the book, I'll tell you that.

Right.

And.

And where.

Where did this title come from?

Yeah, where did that come from?

It's.

It's one of the main symptoms of novichok poisoning.

Novichok poisoning?

It's a.

It's a nerve agent that developed by the Russians, and they use it to kill their adversaries, usually defectors or.

And they even used it on poor Navoni, who is.

He was.

He was poisoned with novichok, and he had spasms and pain, et cetera.

And.

And obviously that means that Novichok is involved in this story.

I wonder how that is.

How did that happen?

How did that happen?

Well, let's.

Let's do this because, I mean, we think about.

You've covered organ harvesting, pandemics, medical tourism, always ahead of the curve.

So what keeps you up at night?

That's part of the first question.

And with spasm tackling bioweapons, neurological attacks like you just referenced, what's the medical nightmare that you're researching now that is also quite scary and yet to publish?

So it's two things.

What, what's keep what keeps you up at night on your own mind and what are, what's the medical night.

What's the next medical nightmare that you're going to scare the out of us with?

Well, do you mean that in general or, or in specifics?

I'll take whatever you give me.

Well, I've already mentioned in general, it's this problem of, of business.

Yeah.

And medicine in bed together.

And it's having all the terrible results that, that I kind of envisioned.

As you've mentioned, a lot of my books, I, I have been able to anticipate things happening.

Some more astonishing than others.

Like my book Fever, I wrote in very early 80s and it, and it's, and it definitely said that the future of cancer treatment is not going to be small molecule pharmaceutical agents, but it's going to be the immune system.

I'm sorry about that.

That's something that.

With a condominium.

I think they're checking the fire department.

I mean the fire.

Chuck, Chuck.

We have a spasm on level seven.

So.

What was I saying?

Well, yeah, listen.

Well, here you go.

When you think about it, viral pandemic cell nano cure, critical crisis, seizure, shock, toxin invasion, fatal cure, terminal vital signs, mortal fear, outbreak, fever.

I mean they're all about very specific medical issues and problems that, that either everyone was aware of, but most of them are ones that people are not aware of.

And.

Like with spasm, people are aware of prions in a certain sense because they remember the mad cow disease episode.

And a lot of people, I mean that's almost as scary as sharks.

To eat a hamburger and realize it's going to kind of turn your brain into mush.

Yeah.

And, and the issue about bioweapons is also something that's very specific.

It's something I've dealt with before.

I wrote a book called Vector.

Yep.

And that book anticipated the use of anthrax powder as a bioweapon and it was going to be spread in the mail.

And that exactly happened.

Yeah.

And in fact, the day that it happened, I happened to be watching the, the news.

I don't know whether it was ABC or NBC or whatever.

And the, the, they interviewed an FBI agent who was in his office.

He had his arms crossed like that, leaning on his desk and on his desk, just to the side of him was a copy of my book Vector.

And so, and researching that book, I had an opportunity to meet and talk to the highest ranking Russian defector who ran one of the big bioweapons plants in Russia called Vector, which is why I titled that book Vector.

And he told me that even though they were signatures of the bioweapons treaty, he said his organization had produced 100 tons of, of anthrax powder.

That's enough to kill everybody in the, in the world.

Yeah.

And this was back when Vector came out.

I wrote Vector.

What?

I don't know, 20 years, 25 years ago.

Oh my God.

So back to that question about what keeps you up at night.

What.

What is happening when you turn on the TV in the morning and have your cup of coffee?

If that is indeed the case, what do you see and.

Or think about that perhaps you have not written about yet, but you're going holy bananas.

What if this were to happen?

Well, let me give you very specifics.

Thank you.

I'm working on my next book already.

Which is going to be called Bleed.

Kind of surprised that hasn't happened yet.

Good for you.

Well, actually, I wanted it to be called hemorrhage.

Okay.

But the word is too long.

Yeah.

And it, and if you, if you imagine, you know, looking at a, at a, at a book.

Huh.

Instead of it being able, it would have to wrap around.

Right.

H e. I don't even know.

Otherwise it'd be so small.

Yeah.

Yeah.

So blood does it, doesn't it?

That's why we changed it to.

I changed it to Bleed.

But it's not about actual, literally blood loss.

It's.

It's the fact that, that, that those terms are used in economics as well.

And the trouble is that some hospitals are hemorrhaging capital.

Why.

And they, and a lot of these smaller hospitals are closing.

Why is that?

Why are they suddenly going bankrupt?

Because they were taken over by private equity and private equity has drained all the equity they had, whether it be in terms of.

Usually it's in terms of real estate.

And leaving.

They buy these, these hospitals are a little bit in trouble, but by taking advantage of legal maneuvers, they actually, they buy using leverage, buyout and transfer the debt to the hospital.

Big business.

Yeah.

That's going to be the next book.

Now can you give me a little inside scoop?

I promise I won't tell anyone.

When is that expected to come out?

Well, this book is going to be released.

Spasm is going to be released December 9th.

I imagine it'll probably be about the same.

But a year from now.

Can we Talk for just 60 seconds about business and in.

Anything you don't want to drill down on, I'm good with.

But do you.

You have to have seen a seismic shift in, in the business of writing, publishing, the publishing houses, etc.

Between when you started with year of the intern coma and now.

How.

How is it.

What's like.

What's the big.

What's kind of the umbrella thing that has shifted the most, the way you see it.

That men don't read anymore?

Isn't that the truth?

Um, which I think is.

Is.

It's.

Yeah, it's.

It's sad, really.

It's sad and it's problematic.

Yeah.

And.

They'Ve convinced themselves that they don't have time to read.

Yeah.

Um, it doesn't.

I mean, they're reading on their phones, et cetera, and their computers, but they're not reading books anymore.

And, and it's.

And it's.

It's.

I believe they.

They're not.

They're putting off a great enjoyment and also the fact of participating and, and being able to participate more in.

In what's going on in our culture.

Yeah.

And so I see that as the biggest change and.

Which is part of the reason that we thriller writers are suffering to a degree, because I think earlier most of our readers were men.

Yeah.

Yeah.

Men like thrillers.

And that's why I. I started writing thrillers was because I. I felt like I had a lot to say.

But let's put it in a.

In a format that people will have fun with and get them to read about a subject matter that they might not.

If it was a nonfiction book entitled, you know, Organs for Transplantation or something, they probably wouldn't read, but.

Right.

But they read Coma.

Right.

Well, do you think.

Do you think audiobooks will.

The meteoric rise of audiobooks helps offset some of that because people are willing to at least take the time to listen, whether they're walking or working in the yard or taking a long drive.

They're absorbing it that way.

Yes.

That's filled it into some degree.

I. I wish it was more.

And you see, just by looking at the bestseller lists now, is that the.

A lot of the.

Most of the bestsellers are kind of psychological romance kind of books that appeal to women.

Well, I was just getting ready to say.

You took the words right out of my mouth.

I was going to say, Robin, if you want to get more audience, perhaps since the highest, biggest, fastest growing, most obsessive Widest I could keep going with superlatives, but I'll just stop is probably romance.

Dark romance, hot romance, sweet romance, romanticy fanta.

I mean maybe you should, maybe you could look into a little romance.

Robin Cook, the romance writer.

Chicka chicka bomb bomb, right.

Well, you know, I did a little tiny bit with some of my early books about Laurie Montgomery and Jack Stapleton because I teased people with, with their relationship for a number of books until they actually got married.

Uh huh.

And now they're married.

And so there's, now I deal with that a little bit.

But you're right, I mean I, perhaps I can kind of try, try to deal with that a little bit more.

But you know, it's, it's.

I guess I don't feel as, as capable in that regard.

Robin, come on.

First of all, this is what, number 15 since 1991.

So Jack and Lori are still sticking around.

Two, you're a sensitive, intelligent, highly intellectual man with a broad.

Thirst and hunger for life.

So I think you could turn that dial just a little bit and turn the chicka chicka boom boom up a little bit.

Wow.

I had, I've had a couple of interesting conversations with Freda McFadden.

Oh yeah, has dominated the bestseller list.

She had been interviewed and gave an interview to the New York Times and in it she said that her mother, my favorite author of her mother, who really encouraged her to read at a young age, was Robin Cook.

So we ended up, I ended up chatting with her and because she's a, she's a physician also.

A, I knew that.

B, I, I wanted to ask you that because on the back of all these accolades stands her as number one.

Robin Cook is at the top of his game.

And you know you have a lot of, you have a plethora of great reviews here, but I was like, I wonder why he, what, Frida must be a fan or something so that, well.

She, she says she still is, but that was actually her mother's quote.

I had her mother read a very early version of Spasm.

It doesn't say mother.

It doesn't say mother.

It says.

Well she's, she is on fire.

I mean I have never seen, outside of maybe Colleen Hoover, I've never seen anybody blow up to the degree of, of Frida.

It's, it's astonishing.

Yeah.

So again, now granted, hers is not romance, but it is, I don't want to say Chick.

Look, that's not going to sound exactly right, but I, I think you should think about that.

Robin.

I'm Just saying, I'm, you know.

Right.

All right.

You know, we have touched on so many things.

Spasm, of course.

Jackie and Laurie, we just mentioned 15th Jack Stapleton novel since 91.

You've been around.

You've been through 9, 11.

You've been through the pandemics, the digital revolution.

How.

How in the world.

And this is going to sound like.

I don't want this to sound like.

Where do you get your ideas from, Rob?

And I don't want to.

I don't want to sound like that.

Well, I can answer that.

I can answer that question.

But.

But I wasn't going to ask him.

What I want to say is, how.

Do you keep the.

The genre so fresh all these years?

So I.

Okay, go ahead and tell me how you come up with the ideas and how do you keep it fresh?

Well, I. I have said multiple times that I'm probably the only person in the United States who benefits from the fact that we have the worst health care system in the industrialized world.

Isn't that the truth?

It's.

It's sad.

It really is.

It.

We're the only major industrialized country, for instance, that allows pharmaceutical companies to advertise prescription drugs.

Yeah.

I mean, just think about that.

How is it.

Yeah.

And.

And how is it that we spend on just about all prescription drugs, about four times what everybody else in the world pays?

How has this maintained itself?

Exactly.

Yeah.

So even though I've written multiple books about the pharmaceutical companies and.

And how they're kind of robbing us blind.

It.

It hasn't.

You know, one of the things that I was hoping to do when I first started writing was thinking that I could use.

Entertainment fiction as a way of.

Of.

Of Shine a spotlight.

Yes.

To shine a spotlight on.

On.

On medicine, so that I could influence public policy.

How's that working for you?

I have to say it's been a failure.

Yeah.

Because I really haven't influenced public policy.

I.

There was even a point where I thought.

I gave serious thought about going into politics in hopes of influencing public policy.

To that end.

I actually matriculated in the Kennedy School of Government in the public policy program.

And luckily, the Kennedy School cured me.

That I probably wouldn't be able to influence public policy.

Yeah.

In that.

In that way.

Because, however, you know, the first thing that I learned there was everything when you go into politics, everything is negotiation.

But that's suddenly changed, and now.

Nothing is negotiable.

Is it.

You know.

It'S.

Everything is sort of my way or the highway, which is really kind of contrary to.

What.

What politics is supposed to be about.

Yeah, we could, we.

I, I hope that changes sometime, Robin.

We could go down that little avenue, down that little dark alley for probably about an hour.

But neither one of us the time nor the stomach for that.

Probably.

Right, right.

So we'll leave that for our next conversation.

But I'm with you 100%.

Yeah.

Well, folks, the book is Spasm.

This is the king, one of the masters of the genre, Robin Cook.

I have.

I feel so honored to spend this time with you.

I, I mean that there's no blowing smoke up your skirt.

Well, you know, I could say something specific about Spasm in the sense that, yes, it is my 42nd book.

What's different about Spasm, especially in terms of Jack Stapleton, who is the main character, is that this one is a little bit different in that I propose you believe that it's going to be another Robin Cook book about Jack Stapleton.

But in a way, it's different in that he doesn't do what you expect him to do and he makes, he decides to do things.

And you think, jack, don't do that.

So I had a little bit of fun, I must admit, when I was writing it, because I felt almost the same way.

I said, jack, Milk.

And yet that's where the story was going.

And that's.

So he makes a.

In this book, he makes some poor decisions and, and then suffers from it.

So I don't know whether for those people who, who have enjoyed some of the Jack Stapleton stories, that might be kind of a, A little bit to suggest that this was a little bit different type of story.

Well, before I close with my closing question, I wanna.

Which is always the best writing advice, I always wonder, do you feel like you have the wherewithal.

And I don't mean wherewithal like mentality.

I mean like, do you feel that burning inside of you to just keep chugga luggin, luggin, knowing that any good idea comes along, you're gonna roll with it?

Yeah.

And, and I, I, as I said earlier, I feel particularly lucky that I have this opportunity to, to really research new ideas and, and whatnot.

And.

I see some of my fellow medical school classmates who have retired from surgery or something, and they seem to go downhill.

Well, because they don't have anything to do anymore.

Right.

Is that kind of part of it?

Yeah, yeah, yeah.

It's a.

You know, you were.

So as being a physician, you're always so busy from, from start of medical school.

It never really Slows down and then suddenly if, if you quote, retire, which is probably a, especially if you're in a surgical field, it's probably best.

But.

If you don't have something else to do.

It'S.

I think it's very difficult for certain people.

Take up bicycling.

It works for you, right?

How long you've been bicycling?

Like years, right?

I'm guessing.

Well, I had this kind of stop my basketball playing about.

Oh, I, I probably will.

I, you know, it might be something like eight or nine years ago because I ended up, I had snapped both ACLs and had those repaired and, and I ended up having knee replacements.

And although I could play and I have gone out and shot basketball court, I haven't taken the risk of actually playing because I'm very competitive.

Yeah.

I can't say to myself, well, just do it halfway.

Yeah, I wouldn't be able to do that.

So I don't do it at all.

Nor do I play tennis anymore, which I used to enjoy.

So pickleball, you know, it's still last summer because the Mass General has taken over the hospital in Martha's Vineyard where I spend my summers.

It was.

The main source of trauma in the hospital for the summer was pickleball.

And it's not the things that you ordinarily think, right?

No.

Well, it was pickleball and then second was electric bikes.

Right.

But point being is, you think that might blow out an ACL when in reality sometimes it's just getting clobbered in the eye by the back can.

Well, that too.

But there is a lot of knee problems because of sudden pivoting and, and whatnot.

And again, if you're a competitive person, when I was playing tennis, I never would say, oh, you know, let a ball go and say, oh, good shot.

Yeah, I would try to get everything.

Sure.

So I just realized for my personality, it's probably best because I get a lot of exercise and, and I do enjoy the bike riding and I don't enjoy it with the same degree that I had with, with basketball or tennis, but nonetheless.

And you know, I, I still do, I exercise every day and.

I do my 40 pull ups and 40 push ups every other day religiously.

Good for you day.

Yeah, I think it's important.

And a lot of people say, oh, yes, I realize I should exercise a bit more next week.

I'll, I'll do that.

Yeah, yeah.

And it's always next week.

Yeah.

And next week never comes.

Right, exactly.

All right, let's do this as we Wrap up.

I want, I want that best piece of writing advice, because you're at number 42 now.

You've been at this for a few years.

You've had one great hit after another.

You're in that chair banging out the words religiously.

What is that best writing advice for my listeners who go, how did Robin do this?

What's the secret sauce?

You know, one of the unexpected things that I would recommend is to have a place, if you luck, you have to have a certain amount of room, but have a place where all you do is.

Right.

You don't do anything else there.

And the reason is, is that it's, I think, the reason that people get writer's block, which I've never gotten because I never got doctor's block.

Right.

There you go.

And I mean, there's some days where you feel a little bit more charged up than others, but still, I have a special place where I go.

And when I.

There, that's what I do, is I write.

I don't, I don't pay that electric bill that I should have paid last week or, or any other thing.

It's just, just, just, that's all.

And that's kind of a, an advice that you probably haven't heard from anyone else.

No, I, I, I can say I have not.

But I, I like that because it, it cuts down on the distractions and it tells everyone around you, this is my sacred space, so don't come knocking when I'm clocking words.

And, you know, I have another theory about writing that people might say, you know, it's probably true.

Is that the reason that you become fatigued because you're not doing anything except, you know, fooling, you know, with your hands on your keyboard nowadays or writing.

I used to write some of mine longhand.

Is that I think that it uses more portions of your brain at the same time than just about anything else we do.

I agree with that.

And so there's a lot of activity going on.

And that actually uses up, you know, sugar and all that kind of stuff and oxygen.

And why you get tired writing.

You'd think, why am I tired?

I haven't done anything.

I mean, Right.

So that's, that's my explanation.

That does make you tired because it uses more portions of your brain at the same time, from the memory to the muscular portions, to the analytical portions to the emotional portions.

Your, your pulling from all those places all at the same time.

Well, folks, once again, spasm.

Robin Cook, this has been a delight.

We went a little bit over but thank you so much for your time.

I appreciate it.

I'm so honored.

My pleasure.

It's.

It's been.

It's been fun.

Good.

Now get out there and ride your bike and stay healthy.

And we're looking forward to bleed next.

All right.

Thank you, David.

Thank you.

How cool is that, right?

Robin Cook, spasm, like I said, at the top of the show, man, I can remember that was what, 40 years ago, 30 years ago.

Crazy.

But I knew then that this cat was just on it.

Ah, man, what a way to wrap up 20, 23.

Oh, but not yet, because next week we have a very special special guest actor extraordinaire.

And now, shall I say soon to be New York Times bestseller book number two?

Could be.

It's Richard Armitage, and the book is the Cut.

You know, Richard Armitage, actor, extraordinary actor.

He's gonna be on the show.

He's gonna be our last official personality on the show.

Now, the very final show of the year is going to be the Dave and Tammy Year End Extravaganza.

But we're going to wrap it up with Richard Armitage.

I mean, Robin Cook.

Richard Armitage.

What a heck of a year.

What a heck of a year.

As we wrap season nine, what will season ten have in store?

There is just no telling.

There's no telling.

Anyway, well, this was recorded a few days after that, so it's late at night, I'm burning the midnight oil yet once again.

But I had to step in here and say, robin Cook.

It was a hell of an interview.

Just legend.

And then, of course, Richard Armitage next week.

So tune in Wednesday, and then we'll wrap the year on the 24th, Christmas Eve with Dave and Tammy Year and Extravaganza.

Thanks for being there.

And if you get a chance to pick up my book Life in Two columns, Shit that Matters, and everything Else, my practical memoir about my journey through prostate cancer.

I'd greatly appreciate it.

Until we speak again, take care of yourself.

We'll see you soon.