A Letter from Robin Cook to His Fans

Here it is twenty-five years after the publication of Coma, and I find it a shocking milestone for me as an individual (Where have twenty-five years gone?) and, in a particular sense, a rather sorry milestone for society and medicine. My motivation for writing Coma was to dramatize the looming shortage of organs for transplantation. The medical community had been racing ahead, improving the efficacy of transplantation and providing hope for certain desperately ill people, but at the same time giving little thought to the supply side of the equation. Since I had done some transplant surgery myself, I was particularly concerned about this situation, and it became my dream that an entertaining novel and a subsequent movie could influence public policy to nip the developing problem in the bud.

Unfortunately things didn't turn out the way I'd hoped. Although I succeeded in scaring people away from operating room 8, which certainly wasn't my goal, the larger issue was not solved. In fact, Coma could be published today since its story line and message are even more currently cogent, with more people waiting for lifesaving organs than in 1977 and more people dying for a lack thereof. It is indeed a sorry situation because appropriate organs are regularly given over to the microbes and worms for a lack of appropriate public policy.

On a lighter note, Coma essentially created a popular new genre: the medical/biotech mystery thriller. I am pleased that the book's reception vindicated my belief that stories of social significance involving medicine and medical research could be as entertaining and engaging as those dealing with detectives, spies, political intrigue, and traditional whodunits. As I reread the book after all these years, I squirmed a little at my ingenuousness. It was, after all, only my second book, compounded by the fact that I'd taken all the wrong courses in college for such an endeavor! At the same time I marvel that I was able to do it at all, considering the handicap of such scant writing experience and having to do it in the wee hours of the night while functioning as a busy doctor-in-training by day. But I certainly enjoyed rereading some of the scenes, like the one in which Susan Wheeler is chased into the anatomy storage locker. It gave me goose pimples all over again. In real life seeing the cadavers hanging up in a similar refrigerator had been the most visually disturbing experience of my first year in medical school.

One other point of interest: The name I selected for the hit man whom I made a really bad character is the name of one of my former roommates from college. I used the name because I'd been disappointed he'd dropped out of sight and had not contacted me for a long time. Needless to say, after Coma came out, I did hear from him!