CAUSES UNKNOWN by Leslie Horvitz

Michael Friedlander is a prodigal son-type—he dropped out of medical school in the 1960s, and has been on the move since. He has lived on both coasts, and a few places in the middle. His younger brother Alan is a successful businessman in New York City. Alan earns enough to live comfortably, and it isn’t rare for Michael to find an envelope with a few hundred dollars in his mailbox.

Causes Unknown opens with Michael traveling from his current home in New Hampshire back to the City. His brother Alan is dead from an apparent self-inflicted gunshot wound. Michael hasn’t been back to New York—his childhood home—in fifteen years, and he is feeling more than a little guilt as he recollects his brother, and contemplates meeting his parents for the first time in as many years.

His brother’s suicide is unexpected and difficult for Michael to comprehend. Alan’s life was seemingly perfect—he was successful, engaged to a beautiful woman, and had a deep pool of friends. And when Michael cleans out his brother’s apartment he notices a few things missing: specifically a computer and a VCR. This is where the mystery of Alan’s death takes on a slightly more sinister turn, and Michael isn’t satisfied until he uncovers what happened to his brother.

Causes Unknown was originally published in 1989—it was re-released by Leisure Books in November 2006—and it has the feel of an early Patricia Cornwell; including several grueling autopsy scenes. It is a unique blend of medical thriller, private eye novel, police procedural, and strangely enough serial killer drama. It opens with a flash—the story is interesting, entertaining, and runs along quickly. Unfortunately it hits a slow patch around two-thirds of the way through—the action fizzles a bit, and the author gets more interested in high-level cover-ups and shadowy figures than showing us a great story.

That doesn’t mean I didn’t enjoy Causes Unknown. It lost some of its early promise, and damn how I wish it hadn’t, but the pace was sharp enough and the mystery was deep enough to keep me interested until the end. If you enjoy Patricia Cornwell, or any of the late-Eighties and early-Nineties medical thrillers, you will probably like Causes Unknown.