"The 5th Horseman." By James Patterson and Maxine Paetro. Little, Brown. 410 Pages. $27.95.
"The 5th Horseman" isn't the first thriller that has a mysterious killer hastening hospital patients to their untimely deaths, but it's one of the smoothest.
The latest in James Patterson's "Women's Murder Club" series, written with Maxine Paetro, has police Lt. Lindsay Boxer investigating dozens of suspicious deaths at San Francisco Municipal Hospital. The twist: All the victims were on the verge of being discharged and sent home.
Lindsay and her friends meet regularly to drink, dine and discuss various murder cases. The group also includes Claire Washburn, San Francisco's chief medical examiner; Cindy Thomas, a crime reporter at the San Francisco Chronicle; and lawyer Yuki Castellano, the club's newest member.
Cindy is covering a high-profile trial involving a massive class-action lawsuit brought against San Francisco Municipal, where Yuki's mother, Keiko, was taken after suffering a ministroke.
Within days, Keiko is dead, the latest victim of the Night Walker, whose calling card is two buttons placed on the eyelids of the deceased. The buttons are embossed with a caduceus, two serpents entwined around a winged staff, the symbol of the medical profession.
A grieving Yuki spends her days at the trial as Lindsay, chafing under the constraints of new supervisory duties, works to bring the Night Walker to justice.
At the center of Lindsay's investigation is the arrogant and powerful Dr. Dennis Garza, director of San Francisco Municipal's emergency services, who testifies at the trial.
"Doctors and nurses are human," Garza tells the court. "Mistakes happen. People die. Sometimes a bad wind blows."
The novel is written in short, snappy chapters, and the authors don't rush to any obvious conclusions, raising "The 5th Horseman" well above the level of other "angel of death" thrillers.