Not for Profit

Scott James, an orchid-loving North Carolina plastic surgeon, takes on for-profit medicine and al-Qaeda in this vigorous if overwrought medical thriller. Opposing the plan of Herb Waters%E2%80%94the president of Jackson Healthcare Systems%E2%80%94to sell Jackson City Hospital to a for-profit chain, James finds his career and life endangered by mysterious murders. And to make matters worse, al-Qaeda operatives are hard at work assembling Silkworm missiles in a local barn. As James works to clear his name and save the day, he finds an ambiguous ally in former office manager Ethel Keyes. Double identities and derring-do abound, and James's commitment to health care for the needy seems unlikely to prevail over bullets, suicide bombers, and Silkworm missiles. Although Shepard provides some moments of genuine suspense, his novel suffers from implausible and often incomprehensible complications and a proliferation of characters.