Robin Cook, the ophthalmologist who brought you Coma and other best-selling nightmares, dedicates his latest medical thriller to ''the countless couples who have suffered the emotional and physical trials and tribulations of infertility and its modern treatments.'' And who knows? Maybe he's sincere. But any couple with fertility problems-or, for that matter, any woman feeling even the slightest bit uneasy about her gynecologist-will want to steer clear of Vital Signs. Especially the opening chapters, which plunge heroine Marissa Blumenthal, M.D., into a paranoia-fest at the classy Women's Clinic of Cambridge, Mass.
Yes, Cook fans, it's the same Dr. Marissa Blumenthal, that plucky yet bland Nancy Drew in a lab coat who saved the world from a viral epidemic a few years back in Outbreak. But now she's happily married, quietly practicing pediatrics in Boston and eager to get pregnant. Unfortunately, soon after having a ''routine'' cervical biopsy at the Women's Clinic, Marissa learns that her fallopian tubes are ''sealed tight as a drum,'' apparently due to a rare TB infection. The only viable treatment? In vitro fertilization with its grueling procedures, psychological torments, exorbitant costs ($10,000 a try), and high failure rate.
In no time, then, Marissa's marriage is strained to the limit. (Hubby turns out to be selfish and insensitive.) Worse yet, she becomes increasingly suspicious of the Women's Clinic. Why, she wonders, does it have five cases involving that rare form of TB? Why does one of those patients afflicted leap or get pushed to her death from a clinic window? And why, when Marissa goes poking into the clinic files with pal Wendy Wilson (another victim of the TB virus), does she barely escape death at the hands of two Chinese security guards?
So far, so creepy even if the dialogue (''My word!'') is stiff, even if Cook's exploitation of our medical anxieties seems more repellent than usual. But at this point, about halfway through, things shift from faintly scary to just plain silly as Marissa and Wendy, on an improbable whim, fly off to Australia to investigate another shady fertility clinic. Then, after the villains arrange for Wendy's demise, Marissa teams up with a rugged Australian doc who's convinced the Chinese Mafia has a key role in the fertility-clinic conspiracy. Next stop? Hong Kong, of course, where the cartoonish violence escalates, the Asian stereotypes multiply, and the scenery consistently upstages what's left of the plot.
The farther Cook strays from his labs and operating rooms, the more his deficiencies as a writer cardboard people, charmless storytelling trip him up. This time the mix of engrossing and embarrassing is about 50/50 at best, but once hooked by those nasty goings-on at the clinic, a lot of readers will hang on for the rest of the bumpy ride. B-