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Natural Causes

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Dr. Sarah Baldwin races to a Boston hospital with a young woman whose normal labor has suddenly become a matter of life and death. As she struggles to save both mother and baby, she doesn't know that two other women have already died under horrifying identical circumstances.

And so begins Sarah's own nightmare, as she learns that the prenatal herbal vitamins she prescribed are the only thing these women have in common. Soon Sarah is fighting to save her career, her reputation--her life. For she's certain there must be some unknown factor linking these women, and as she gets closer to the truth, it becomes clear that someone will do anything--even murder--to keep a devastating secret.

465 pages, Mass Market Paperback

First published March 1, 1994

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About the author

Michael Palmer

61 books122 followers
Michael Palmer, M.D., 1942-2013, was the author of Political Suicide, Oath of Office, A Heartbeat Away, The Last Surgeon, The Second Opinion, The First Patient, The Fifth Vial, The Society, Fatal, The Patient, Miracle Cure, Critical Judgment, Silent Treatment, Natural Causes, Extreme Measures, Flashback, Side Effects, and The Sisterhood. His books have been translated into thirty-five languages. He trained in internal medicine at Boston City and Massachusetts General Hospitals, spent twenty years as a full-time practitioner of internal and emergency medicine, and served as an associate director of the Massachusetts Medical Society’s physician health program. Michael died unexpectedly on Wednesday, October 30, 2013 in New York. He was 71. His 19th novel RESISTANT will be released on May 20, 2014.

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5 stars
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Displaying 1 - 30 of 155 reviews
Profile Image for Jim.
550 reviews82 followers
February 27, 2021
Dr. Sarah Baldwin is a 3rd year OB/GYN resident at Medical Center of Boston (a.k.a. MCB). Sarah is talented and bright. She probably could have had her choice of more prestigious hospitals but MCB allows her to practice alternative medicine. Such as prescribing herbal supplements to her maternity patients.

When one of her patients goes into labor Sarah goes to her home expecting to perform a home delivery. Instead the patient is rushed to the hospital and Sarah, and the hospital, fight to save the life of the mother and her unborn child. The mother is saved, thanks to Sarah's use of acupuncture, but the baby cannot be saved.

Sarah may be a proponent of alternative medicine but this is still Boston and in no time Sarah is being sued. An investigator from the CDC is brought in and it is learned that two other patients of Sarah have also died. The only thing they have in common is that they all took her herbal supplements. Sarah's once bright future and possibility of being chief resident is derailed. Sarah finds herself having to fight to save her career, her reputation, and her life.

Sarah's career and reputation is not the only thing that gets derailed. The book starts to derail here too. What started out with some promise of examining the place of alternative medicine in Western society gets lost in a story, while entertaining, becomes more and more ridiculous and improbable. When Sarah was sued her insurance carrier provided a lawyer. The two of them start investigating the deaths of Sarah's patients themselves and having several close calls with being killed. Oh ... they also find themselves falling in love.

There are plenty of bad guys and only a couple of likeable characters that you can get behind. Several of the situations in the book are ridiculous. But, the story is entertaining and in the end good triumphs over evil. All of the bad guys will be exposed.
Profile Image for NATUI.
117 reviews1 follower
May 18, 2010
I finished this book last night, and I am kind of pissed at what a let down it was. This book hooked me from the first few pages. It was so interesting that I couldn't put it down. About three quarters of the way through the author must have had visions of a Hollywood thriller. The characters are thrown in to evermore implausible and stupid situations. The plot went from amazingly believable to eye-rollingly awful. Think Bourne Identity on top of James Bond layered with Mission Impossible. If half that crap had been taken out, this book would have easily been five stars for me. As it stands, I'm just disappointed and irritated that such a great story was sandbagged.
Profile Image for Carol.
2,324 reviews71 followers
November 18, 2016
Natural Causes by Michael Palmer

From The Book:
Dr. Sarah Baldwin races to a Boston hospital with a young woman whose normal labor has suddenly become a matter of life and death. As she struggles to save both mother and baby, she doesn't know that two other women have already died under horrifying identical circumstances. And so begins Sarah's own nightmare, as she learns that the prenatal herbal vitamins she prescribed are the only thing these women have in common. Soon Sarah is fighting to save her career, her reputation--her life. For she's certain there must be some unknown factor linking these women, and as she gets closer to the truth, it becomes clear that someone will do anything--even murder--to keep a devastating secret.

My Thoughts:
Interesting to see the world of medicine through the eyes of Dr. Sarah Baldwin. She's the type of doctor that almost anyone would want to have. One that is not afraid to employee methods such as Western science medicine as well as using holistic practices such as acupuncture. But she gets into trouble after two women die and one woman is maimed in their pregnancies after taking her herbal supplement which she recommended instead of the usual vitamins. An investigation follows which delves into the politics and money of the medical profession.

The book started out as a whirlwind page turner that had so much promise....exciting passages that detailed medical emergencies as this bizarre blood clotting illness that consumes its victims with horrific speed... and realistic insights into internal hospital politics...and believe me there are many. Eventually it dissolved in the average hospital melodrama of big money...corporate greed...and institutionalized medicine versus the persecuted doctor. It seemed that Michael Palmer just couldn't figure a way to end it all on a different note than all the previous medical thrillers.
Profile Image for Sarah.
1,848 reviews
June 26, 2012
Sarah's patients are dying in labor and it may be connected to the herbal supplements she's been prescribing. I hated every character in this book. Their science was bad and their ethics were bad. A lot of their other dimensions were also bad, but I think they're generally covered by those, because life is generally covered by those.
Profile Image for Margaret.
189 reviews3 followers
April 22, 2018
Dr. Sarah Baldwin has been prescribing herbal supplements for her expectant mothers, when one of her patients starts hemorrhaging when she is in labor. Sarah find that there has been another similar case that resulted in death for both the mother and child. The hospital where Sara is on staff is struggling both by reputation and financially and is danger of takeover by a larger organization. While Sara's herbal supplements are suspect as being the cause of the hemorrhaging, Sara's standing
with the hospital is crumbling and gets worse as a one of her patients files a lawsuit against her. Sara's malpractice insurance hires a attorney to represent Sara and things get more complicated by the minute. As always, there is greed and millions of dollars at stake and people die while trying to find the truth.
Profile Image for Mae.
169 reviews2 followers
August 7, 2020
This story just aggravated me. I know that he is trying to write a book that centres on doctors but would it hurt him to include some actual police people to work with the doctors? He also has a habit of introducing a character on page 10 and then we hear nothing about this character or what he has to offer to the story for another 100 pages and he pops up again. He also starts a new chapter with the characters updating each other on a situation that they were involved in 3 chapters previous as opposed to writing about that part of the story and including us in the story. It is hard to feel anxious about characters because he does not describe the actual situation that is supposed to heighten the nerve wracking level of the story. He also makes his characters seem like idiots. We are dealing in this story with doctors and lawyers and fairly high profile CDC investigators but at no point do they take their concerns about women dying in child birth to the police. Instead they go off and investigate a member of a Chinese gang and practically get killed. They next go off and spy at a warehouse instead of alerting the police and wind up in serious trouble and get rescued by a stupid doctor who gets herself locked up on a psych ward and has to use her womanly wiles to escape from the ward. Mind you the description of her womanly wiles leaves a lot to be desired and he must have been one desperate man to fall for them.
He also made me laugh because he used one big word in the whole book that I had to look up. What is the point of that. No where else in the book does he use words like this. It is almost as if he had a calendar that gave him the word for the month and he had to use it in his book. "Soon though, she felt her spirit begin to regroup within a nidus of anger."
Profile Image for L.M. Pampuro.
Author 11 books72 followers
April 6, 2020
Oh my gosh! For a person who gets squeamish at the sight of blood, a medical suspense story seems like an odd reading choice yet I couldn't put this book down! It has a great plot yet it was the multiple subplots that kept me going.
I wonder, based on the wacky world we live in, how much might be closer to truth than fiction. Read this book!
5,200 reviews53 followers
May 28, 2016
Medical thriller - Dr. Sarah Baldwin is a fast-track OB/GYN resident at the Medical Center of Boston, a hospital which seems ideally suited to her holistic healing background. When one of her patients is stricken with sudden, almost unstoppable bleeding, Sarah saves her life with a combination of acupuncture and meditation techniques, briefly becoming a heroine. Then, it turns out that this patient and two others who died under similar circumstances were all taking a natural herbal vitamin supplement Sarah had prescribed. The young resident soon finds herself pitted against several powerful interests, including an HMO poised to take over the struggling hospital. With the help of an attractive if inexperienced lawyer, a dedicated investigator for the Centers for Disease Control and the head of MCB's department of internal medicine, Sarah tries to avert the threats to her career and, as later becomes clear, to her life.
Profile Image for Darren.
1,675 reviews29 followers
August 18, 2015
It was a good book. I liked it a lot. It was a well written book. I look forward to reading more books by this author.
Profile Image for Carey.
86 reviews
August 21, 2019
I thoroughly enjoyed reading this book. On the back cover there is a quote from the Library Journal stating that the book "reinvents the medical thriller" Most of the time I really don't care about these published quotes that critics gave. Sometimes they can be misleading. I've read some pretty bad books who had Reese Witherspoon or Oprah quoting that they love the book.This was not the case here, this was a very exciting "medical thriller" to read.
In addition to it being a medical thriller, I would also subcategorized it as a "legal thriller".
Palmer shows in depth knowledge of the Medical Industry, the inner-politics of public hospitals. Everything from yellow journalism to false lawsuits is covered here and in such a neat, organized, and professionally manner. Money talks and to quote Charles Montgomery Burns: "what good is money if not to bring terror in your fellow man?"
Medical jargon such as homeostasis, coagulation, endotracheal tube, acute pulmonary edema, and disseminated intravascular coagulation (DIC.... especially DIC) are scattered throughout the book. But don't let these terms scare you because Palmer does a pretty good job not to overwhelm the reader with them. Palmer knows what he's talking about and has actual experience to back it up.
Roughly 70% of the book takes place in a hospital setting. Basically a massive hospital complex with multiple buildings... and new buildings being constructed. You actually feel that you are in the hospital campus.
My major complaint is that:


at the start of the book the maintenance crew were on strike arguing for better pay and benefits. They felt underappreciate and underpaid since the hospital was constructing a new multi-million dollar building. Given various small clues throughout the book I was fully expecting the maintenance staff was going to play a bigger role during the intense action pack Grand finale.
I remember when I had 50 more convincing myself that they were going to come in any moment and play a role.... With 30 pages remaining I even held onto this hope, when there was even quindecim pages remaining I had hope. But alas, they didn't have such an influence. I would like to think in the original unabridged version they had a greater role at the end.


Despite this little disappointment, I still enjoyed Palmer's writing.
I genuinely cared for each main character and it was a pleasure reading about them. Even though some chapters ended in the cliffhanger where one character gets kidnapped and then the very next page started a new chapter with a different character who's in Atlanta I never lost interest in their stories. At the end the other stories wrapped merged into each other.
Great writing!!!!!
Profile Image for Paul Weiss.
1,204 reviews143 followers
February 18, 2019
One of Michael Palmer's weaker efforts!

We all know what it means to die from natural causes but, in this era of modern medicine, it is an exceptionally infrequent occurrence for someone to be cured by "natural causes". Indeed, the conflict between natural medicine in all its forms - homeopathy, chiropractic, herbal remedies, acupuncture, naturopathy, midwifery, and so on - is the theme of Michael Palmer's latest medical thriller entitled, of course, Natural Causes!

The story starts off with dizzying speed graphically describing the catastrophic deaths of a number of women in labour who essentially bleed to death because of an obscure viral illness that prevents blood clotting. The career of Sarah Baldwin, a young up and coming obstetrician, is in jeopardy as the initial epidemiological research on the deaths seems to indicate that the culprit is herbal supplements she had recommended to her patients in the early stages of their pregnancy.

It seems such a shame! Natural Causes started out as a whirlwind page turner that had so much promise - exciting passages that detailed medical emergencies as this bizarre blood clotting illness consumed its victims with horrific speed; realistic insights into internal hospital politics, the necessity to generate funds through community foundations and the grueling routine of medical training; and, most interesting of all, the conflict between advocates of alternative medicine and standardized medical care as we understand it in the western world of modern medicine.

Sadly, Natural Causes ultimately failed to live up to its own potential. With one or two plot twists too many, it finally just devolved into a morass of medical thriller melodrama - big money, corporate greed and institutionalized medicine versus the vilified, persecuted lone doctor's voice crying from the wilderness! What's even worse is that Palmer couldn't find any better way to ultimately reveal the plot than that hoary old device of having the villain gloat about his megalomaniacal plans to the victim as he metaphorically ties her to the railway tracks in front of the oncoming train! How sad is that?

Despite its failings, it will still appeal to Michael Palmer fans and those who enjoy a medical thriller. But it's clearly one of his weakest efforts thus far and falls a long, long way short of the chills provided by such bombshell medical thrillers as Robin Cook's Coma or Tess Gerritsen's Harvest.


Paul Weiss
Profile Image for Stephen.
474 reviews
September 11, 2020
I came across this novel in a favorite used book store. The book is from 1994 but it feels like it could have been written yesterday. The author is a popular writer and is also a physician. Therefore his discussion of medical situations rings true.
The book is big but that won't stop you from reading it quickly. Sarah Baldwin is a 3rd year resident physician at a Boston hospital , Medical Center of Boston or MCB for short. She has also learned about herbal treatments from spending years in the Far East. And sometimes she will mix some of these treatments with the modern medicine that she primarily uses. Her current patient , Lisa Summer is having difficulties with her pregnancy . She almost dies while being treated at MCB and Sarah is mystified by her symptoms . She loses her baby and part of her right arm. This , of course, is the starting place for one very exciting book.... as murder, herbal medicines and some very horrendous people vie to keep Sarah from finding out about what really is happening to Lisa. I can't go into detail because there are so many details ...but trust me you will love Michael Palmer's book.
Profile Image for John Heise.
53 reviews1 follower
February 21, 2018
If you have never read a Michael Palmer book, this would be an enjoyable read. It is a national bestseller but it is in line with each of the other six Palmer books that I have read, all written prior to this one. This involves a female doctor who is respected in her field and who also dabbles in Eastern medicine. Of course, as is the case with Palmer novels, someone in the medical community is involved in heinous activities resulting in the death of multiple women during labor prior to giving birth. There are some questionable times in this book. For example, who would ever allow someone they love to be placed voluntarily in a locked psychiatric facility without a fight or an argument? The ending is somewhat expected, as well.
Profile Image for Antonio Rosato.
889 reviews32 followers
May 17, 2021
"I medici oggi hanno notevoli capacità, ma non sono Dio in persona. Non lo sono mai stati e non lo saranno mai. Se lei non riesce ad accettare il fatti che malgrado i suoi sforzi alcune delle sue pazienti perderanno il figlio, il braccio, o magari entrambi, prima o poi questo mestiere la divorerà viva".
Romanzo abbastanza deludente. Si tratta, in parole povere, di un thriller medico che non aggiunge niente di nuovo nel panorama letterario: abbiamo i soliti dottori avidi di denaro al punto da mettere in secondo piano la salute dei loro stessi pazienti. Tutto qui!
Per il resto, l'azione è ridotta veramente all'osso (ne troviamo un po' giusto nelle battute finali) e suspense del tutto inesistente.
Profile Image for Megr.
87 reviews
January 11, 2022
At first I thought this was just going to be a "time-passer." Ended up a fun thrill ride! I actually left it at the airport when I had like 30 pages left and COULD NOT WAIT to get it back!!
This follows Dr. Sarah Baldwin through a conundrum of a case. (Medical, legal and ethical cases; everything I love!) People have died, more are in danger of dying and the main suspect, Sarah, doesn't even know if she's guilty. She has a great support team by her side, but way more enemies: from the Boston Gen Hosp, Chinatown gangs, greedy lawyers, and those unknown.
One reason I love stand-alones is you never know what's going to happen; no body HAS to survive for the next novel!
Def recommend.
Profile Image for Linda.
975 reviews38 followers
August 11, 2018
I recommend the book.
Another medical thriller! The author's writing mechanics were very good. The book was somewhat predictable, and the lawyers and doctors did not act and think like I expected they would. The author did not get bogged in the action or trip me by keeping secrets. I did not get a good mental picture of the main characters' physicality, but I expect they were nice looking people. I vowed to limit this book to three stars from page one, but the book had that 'something extra' that warranted four stars.

Thank you, Mr. Palmer, for a good read.
83 reviews
May 7, 2020
I liked it a lot. Some people don't seem to like the turn from medical mystery to thriller but that's what this book was from the beginning. Something fishy was going on and people were being set up out of greed. The author was a practicing doctor for 20 years as well and it shows. All the medical stuff seems to add up for me and that authenticity is nice in a book like this. The excerpt at the end by the columnists who hated the hospital and sarah kinda rubbed me the wrong way but other than that it was good. It was just too neat.
This entire review has been hidden because of spoilers.
Profile Image for Bob.
73 reviews
November 26, 2017
For the most part, this was an enjoyable read. It had all the parts necessary to make a medical thriller "tick", including an imaginative link between a privately marketed weight loss powder and a sudden epidemic of uncontrolled bleeding episodes in pregnant women. But, the cliff-hangers were sometimes a bit contrived, and predictable. Nonetheless, I would consider reading Michael Palmer's other novels.
Profile Image for Louise Pledge.
1,144 reviews21 followers
August 11, 2018
Can't get enough Michael Palmer! Don't know what I'll do when I've gone through every one of his books (which will be soon) 😧. I stayed up till 4 am because I just HAD to finish this one before I could even try to sleep. I feel that I must warn, however, that there's lot of offensive language in it (moreso than I remember in his other books). And if it were almost any other author, I would have quit reading after the first couple of chapters.
675 reviews1 follower
August 12, 2018
It was okay. It could have been great if the author had concentrated more on the substance of the story and less on make every character a suspect--although I did figure out who the real culprit was early on. There were just so many unbelievable, unacceptable things happening in the book that the story didn't seem possible. Or perhaps it seemed more like someone should have figured things out earlier.
Profile Image for Victoria.
892 reviews5 followers
June 19, 2019
Meh. It might have been a great mystery: women dying of rare syndrome during premature labor all of whom happen to have been patients of Dr. Sarah at the Boston medical center. But hiring a newbie to defend against malpractice, attacking a mob member and getting away with it, severe gunshot wounds survived, killers who seem to know everything... it was just too much. Not a page turner but not terrible, it just didn't really grab me.
Profile Image for Esther.
87 reviews4 followers
May 18, 2021
Gewoon een lekker spannend boek. Het begint met vrouwen die onverklaarbare bloedingen krijgen tijdens de bevalling. Het blijkt dat ze, door het gebruik van een dieetpoeder, een virus hebben binnen gekregen. Dit virus zorgt ervoor dat ze afvallen. Maar ook dat er ernstige bloedingen ontstaan tijdens de bevalling
Sarah wordt ervan beschuldigd dat zij de oorzaak is van deze bloedingen. Ze probeert wamhopig te bewijzen dat dit niet zo is. Het boek blijft spannend tot het eind.
Profile Image for Cynthia Edge.
1,115 reviews11 followers
July 2, 2017
I enjoy Michael Palmer's books because they have a lot of medical scenarios that are pretty accurate given he is a doctor. That, and I like thet thriller aspect and trying to put the piecea together. This book was an easy, quick read, though not very plausible (lots of near misses for our heroine and surrounding good guys, etc.). But, all in all what I expected!
1,267 reviews2 followers
August 2, 2018
Can't believe it took me so long to find Michael Palmer and his wonderful medical mysteries...Love everyone of them....this one covers Sarah B, the ob/gyn surgeon and her fight to clear her name of harming patients....virus, arrogant ex lover, crazy scientists, pregnant women....it was a great book...sorry it had to end.
August 4, 2018
A really good read !

I really enjoyed this book. It was full of twists and turns right up to the end. I also appreciated how there was some focus on Western medicine and Alternative Health care. I use both my GO and Alternative carefree probs on a regular basis but have rarely seen it brought up in novels.
181 reviews2 followers
September 7, 2018
Want rapid weight loss......with a risk?

Dr. Sarah Baldwin was at a loss as to why the young pregnant woman was bleeding from her nose, why she said her hands and arms were in horrid pain.
Her blood wasn’t clotting, trying everything they rushed her to surgery.
Great medical thriller about bogus diet pills.
Displaying 1 - 30 of 155 reviews

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