The Interview: Author Robin Cook

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Author of best-selling medical thrillers such as Pandemic, Outbreak, and Contagion (along with 34 other titles), Robin Cook’s works have often addressed the question of what would happen if a dangerous, contagious virus hit the world. He is also a true polymath: a surgeon of ophthalmology, a former Navy submarine officer, an amateur Egyptologist, internet entrepreneur, film producer, and avid skier, biker, and tennis player. His life reads like an Ian Fleming novel—top-secret naval assignments, time working for Jacques Cousteau, while his novels are page-turners—only now, they feel oddly prescient. At the age of 80, Cook still keeps his medical credentials up to date and returned from his place in Florida to his Boston home at the outbreak of the Covid-19 pandemic in case he could lend a hand on the front line. Now, on the brink of starting his next novel, Cook took time out to talk COVID-19, American healthcare, and a life lived outside the lines.

Does this pandemic make you feel vindicated about the things you’ve written regarding the threat of a contagious virus gripping the world?

I’ve been worried about this for 40 years, so I’m not surprised in the slightest that this happened. In fact, I thought it would happen sooner. Each year, I’ve thought, “This is going to be it,” and several times, I was sure it was, like when the bird flu appeared in 1997. That really scared me, because it had a fatality rate that was somewhere between 40 and 60 percent.

The fatality rate was the most alarming aspect?

It’s not that simple. Even with a high fatality rate like with Ebola, in some respects, it makes it easier to contain. I was more worried about the transmissibility. Coupled with that kind of fatality rate, I was scared that it might mutate into a much faster transmissibility. I thought we were close to that.

But we weren’t.

Thankfully, no, and it was contained. But I always think about Sir Isaac Newton, and the bubonic plague in the 17th Century. He isolated himself at his country home, which I’m glad about, because we might not have gotten a few great books if he hadn’t. I have a small ski house that’s all by itself on a mountain in New Hampshire. It’s very isolated, and I actually stocked that house with N-95 masks in 1997, and a number of other things, as well. Cash and small bills. That’s how scared I was back then.

You were ahead of the curve.

Well, it wasn’t me. The people who know a lot more about this stuff than I do were worried. You know, I made this decision a long time ago, actually in medical school. I thought entertainment and fiction could play a bigger role in getting out medical information. And that’s how and why I started writing in the first place.

How many times have you tackled the subject of pandemics?

Oh, a number. I wrote Outbreak. I wrote Contagion. I wrote Pandemic. And you know what else? I just remembered this now, I wrote an article for Foreign Policy in 2009. The point of it, at the end, was that I felt very, very strongly that the international community, through the World Health Organization, should really up vaccine development and the infrastructure that’s necessary for that.

Do you think we’d be in a different position now if we had?

Yes, and also if we’d learn from others. In Asia, people are much more used to these kinds of outbreaks and much more attuned to these things. The second they get a cold, they wear a mask so they don’t spread it.

What was your first thought when you first heard about COVID-19?

Well, I knew that coronavirus causes the common cold, to some degree, so I was hoping that it was going to be more like that. Then I started hearing the reports that it was a kind of pneumonia, and I knew it was serious. That’s when I started saying, “This is probably going to be a real problem.” I started getting some requests for interviews and stuff like that, and I just decided not to do it on a national scale. I didn’t want people thinking I was somehow taking advantage of a bad situation or capitalizing on it, because I’ve gotten a little bit of that in the past.

Where do you think this virus came from?

Just what the experts are saying: zoonosis, meaning it came from an animal. Whether it was bats, or pangolins, or some combination of things, no one knows. But I think it is further evidence that we human beings are taking over the world, more and more, and invading animal reservoirs of viruses etc. I mean, that’s where HIV came from. It’s where Ebola came from. The Ebola virus didn’t just suddenly appear. It’s probably been around for years, and I think the same with this. This particular virus probably thrived in a very narrow animal kind of circumstance and for whatever reason, jumped to humans.

If you were going to grade this country’s response, what would you give the federal or state governments?

I’m astounded by the fact that we’re in a circumstance where almost every day, you have the “medical experts” say one thing and then the politicians saying another. There’s this conflict, and I think it’s a disastrous situation.

How about the conspiracy theories?

I don’t give them any credence at all, but we live in an environment of conspiracy theories. There’s a conspiracy theory about everything. It’s one of the downsides of the internet. There are wonderful, great upsides, but the fact that any idea, no matter how far-fetched or illogical, gets disseminated so rapidly, and then immediately politicized, is terrifying. And the fact that Trump initially thought this was a hoax by the Democrats and they were just trying to use it against him somehow is, in a way, the most interesting and disturbing aspect of all this to me.

Why did you decide to ride it out in Boston, instead of your place in Florida or New Hampshire?

Because I was willing to go back to emergency room work if we really were overwhelmed. I did a lot of emergency room work, because I did a surgical residency and then, when I did my ophthalmology residency, I ran emergency rooms at night, moonlighting, to pay off my medical school debt.

Now that you mentioned the financial aspect of healthcare, how do you see that changing from this pandemic?

Well, I’m hoping it’s going to finally be the stimulus to try and change American medicine from being the biggest business in the country to what it’s really supposed to be, which is taking care of people, and not looking at it purely as a way of making money.

People have tried in the past. What makes this different?

Well, the reason we didn’t or don’t have enough ventilators is that they didn’t lead to an immediate profit. The reason we don’t have the infrastructure for creating vaccines is because they’re a loss leader. Unless they know they’re going make money, the business interests that have taken over medicine aren’t interested at all. Even the way hospitals are being run today, it’s by people who are running them the same way they would run a capitalist organization. That’s why our successful hospitals look as good as they do. All new buildings. CEOs being paid anywhere from $2 to $6 million. And they’re still not paying any taxes.

What are you reading right now?

I’m reading a book I’ve read several times. It’s called An American Sickness, by Elisabeth Rosenthal, who’s also written some very interesting op-eds recently.

When you sit down to write a new book, do you know how it’s going to end?

Always. I came at this from being a chemistry, math, physics major in college, and an MD. So, when I started writing, I had to sort of learn on my own, but one of the benefits of my scientific background was planning everything out. I outline a tremendous amount at the start of writing a book, and I know the whole story. Of course, things happen when you’re writing that you don’t expect, because your characters will say things you didn’t think of, or something, which is sort of the fun of writing. I’m about to start a new book now.

Are you still into archaeology?

I love reading about it, whether it’s an article in National Geographic or a book. When I was in sixth grade, somebody gave me the book Gods, Graves, and Scholars by C.W. Ceram. It’s so nicely written, and it makes it so exciting, so I decided that’s what I wanted to be. At that age, two of my friends and I would spend every Saturday in New York, the morning in the Natural History Museum, and in the afternoon, we’d walk across the park to the Metropolitan Museum. I loved the Egyptian stuff. I wanted to be an Egyptologist.

Do you still scuba dive?

I haven’t for some time, although whenever I have an opportunity, I just like to snorkel.

Did you actually know Jacques Cousteau?

Yeah. Well, I was there with him for, I guess, three summers, and I got to know everyone. I got to meet him many times. I was on the Calypso for a while. I met Cousteau’s father, a marvelous individual who’d been a diplomat. He spoke just like Maurice Chevalier, and with the same wonderful gestures. That was how I ended up doing what I did in the Navy, and I think if I hadn’t been drafted by the Navy, and hadn’t been on a nuclear submarine, I’m not sure I would have written my first book.

What drew you to ophthalmology?

I liked surgery. When I was a medical student, it seemed to me you did it because you wanted to cure people. That’s why you go into medicine in the first place. But with internal medicine, you kind of sit around and argue about what they have or don’t have, whereas with surgery, you fix the problem. Take appendicitis. A person comes in, they’re toxic, they’re in pain, etc. You do this operation, which actually is fairly easy, and they’re cured and you feel great. They feel great. And eye surgery is the most delicate of all. It’s much more delicate than neurosurgery. Actually, eye surgery is brain surgery, technically.

Have you ever had any doctor friends give you grief about any of your books?

A little bit. My first book came out when I had just started my ophthalmology residency at Harvard, at the Mass Eye and Ear Infirmary. I got a lot of grief. First of all, if you’re in medicine, and if you’re part of the Harvard system, you just don’t write fiction. Plus, you don’t write fiction where you’re criticizing medicine.

That book wasn’t successful.

It was kind of a big flop. Nobody bought it.

Is there a book that you’d do over?

It’s interesting you say that, because my third book was called Sphinx. It was about archaeology and Egyptology, and it did extremely well. I think it ended up selling 10 million copies or something, and they did a movie. They hired me to write a synopsis and then immediately fired me. Then they changed the story. They made it into a ’30s style love story. It was terrible. So, you asked would I do something different? Just recently, I’ve somewhat decided that I’m going to remake that movie the way I intended it to be.

Do you consider your books literature?

I’m not exactly sure what that means. I make a lot of effort. I try to keep my reader’s attention and make them understand the power of something like CRISPR-Cas9, this new gene editing technique. But will people in the future think of it as literature? Who knows?

Do you think wearing a mask in public is going to remain the new norm?

Well, it will certainly be much more accepted, which is interesting because it’s been accepted in Asia for a long time. I think people are understanding a bit more and realizing that most of it is protecting other people from you.

Have you always been super cautious about things like that? Are you a germaphobe?

Well, I’ve always been someone who has hand sanitizer in my pocket. I’ve been doing that for years. So, yeah, I guess I am to some to some degree.