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F. Paul Wilson. Forge, $23.95 (348pp) ISBN 978-0-312-89034-6

In this taut, battle-of-wits medical thriller that turns on vengeance, members of a joint congressional committee investigating medical ethics are dying as quickly as Bill Clinton's health-care reforms, through apparent suicide, disease or accident--and each of the deceased has been operated on by top plastic surgeon Duncan Lathram. Beautiful resident Gina Panzella, who works for Lathram, has complete faith in her boss until, with the help of an old schoolmate turned FBI agent, she investigates the surgeon's past and discovers a motive for vengeance, as well as a diabolically clever method for murder. Wilson, a practicing physician whose fiction has recently shifted from traditional horror (The Keep) to medical terror (The Select), paces the revelations masterfully and uses character and dialogue to boost what could have been a routine mad-doctor yarn into a gripping cat-and-mouse game between his heroine and his villain. One off-note mars the narrative: Lathram's habit of using obscure words, which sometimes makes him sound like W.C. Fields (``Gina, my dear cygnet... how could you?''). Otherwise, this is a smart, exciting tale that's given added dimension by Wilson's investing the villain with a righteous cause for his maniacal behavior. The author leaves little doubt that the congressmen marked for death are the real blackhearts here, and so at times readers may find themselves rooting for the homicidal Lathram as much as for his opponents. Wilson doesn't make too much of this, though; he's apparently too professional to dam the river while he muddies the waters a little, and too conscientious to shortchange his story by simplifying the complicated issues it raises. (Oct.)