Break Bone Fever is a satisfying thriller with a touch of romance, politics, and LGBTQ. The reader is quickly hooked, and the pacing makes this book hard to put down.

The story, set in 2018 and almost entirely in Galveston, Texas, begins in a hospital emergency department, as Dr. Louise Finnerty begins a twelve-hour shift. Just before her shift ends, she discovers that one of her best friends from medical school, Dr. Gennifer “Gen” Drake, was just admitted to the Critical Care Ward, where she soon dies. The following chapter details the events that occurred four days prior, explaining what happened to Dr. Drake. As a scientist in the Insectary Division of the Gulf National Laboratory, Dr. Drake was on the verge of releasing a report that proved the recent increase in dengue fever cases was caused by global warming.

Dr. Finnerty, with help from another medical school friend, Dr. Marnie Liccione, is determined to find out why Gen died. However, the powerful political forces who deny the existence of global warming are willing to do anything to stop the truth from being told.

There is a fair amount of medical terminology throughout the story, but the authors handle it very nicely, keeping it believable and easy to understand. For example, at one point when describing the status of an ICU patient, the authors wrote, “There were still tubes everywhere—a chest tube, a nasogastric tube, a central venous line, two more IVs, and suction drains.”

In addition to medical terminology, the authors elaborate on the environment where the staff at the Gulf National Laboratory researches transmittable illnesses, some being very deadly. On a tour of the building, the authors made it simple to understand the various levels of the individual labs. For example, the authors wrote, “Level 3 labs, which are the type of labs that housed insectariums and where Gen primarily worked, involved microbes which can cause serious, and potentially lethal, disease… Research on agents like West Nile, tuberculosis, and dengue fever was conducted there.”

Despite the quick pace of this story, there is still time for romance. When two of the main characters meet, there is instant attraction. These romance scenes do not take away from any action, but rather give the reader a chance to breathe before the action continues. Indeed, the two characters treat these trysts the same way, using the time between meetings and research to have them.

The authors make good and timely use of backstory so as not to interfere with the pacing. For example, while a novice hit man is waiting for his prey to exit a store, he reflects on the events that brought him there. As such, the reader can glean another piece of information on the forces at work in the story.

Some of the backstory has nothing to do with the plot but helps to establish the setting. For example, as a character is walking down the main drag in Galveston, he notices The Grand 1894 Opera House. While the character thinks about its history, the reader is transported by the one-paragraph summary of the high and low points of the building’s history.

The authors make effective use of description. Without going overboard, they provide just the right amount of detail. When describing a room in a historical home, they wrote, “As they continued into the dining room, it felt like traveling back in time. The original oak wainscoting had been refinished. Stained glass filled the half-moons above the Palladium windows, sending multicolored beams across the floor.”

The pacing throughout the story is spot on. Near the end of the story there are some reveals. One of the earliest reveals has to do with the LGBTQ status of a character. The authors provide only a brief moment for the reader to soak that in, and then the story continues at the previous pace. Well done.

Overall, Break Bone Fever is a thrilling ride through the arenas of environmental science and deception. It is well worth the trip and is highly recommended.