Synopsis:
Respected neurologist and researcher Stella Murray was confident the FDA would approve the experimental medication based on its demonstrated superior efficacy. Knowing a serious side effect would not derail the approval process, she reports that a patient had a significant reaction to the investigational drug.
Shortly thereafter, Grand Rapids Detective Troy Evans is called to investigate the suspicious death of a Site Monitor who, he learns, worked with Murray. Evans asks Murray to educate him on the unfamiliar world of medical research. She discloses that conducting investigational drug studies has become a multibillion-dollar industry, with power brokers providing more oversight than the government.
When Murray informs Evans that a second Site Monitor has been killed, they team up to take down the corruption that is mercilessly burying unwelcome researchers and results of a promising drug trial.
Favorite Lines:
“Sometimes having the loudest voice in the decision-making process didn’t matter.”
“Filling out the death report was his way of delaying that which he dreaded the most. Notification of the parents.”
“‘You can be a real dick sometimes. How does your better half, no, your extremely superior half put up with you?’ ‘She tells me that I was lucky to marry up.’”
My Opinion:
I received a copy of this book from the author in exchange for my honest opinion.
SETTUP opens in a way that immediately tells you what kind of story you’re stepping into—fast, clinical, and a little unsettling. The ER scene with the teenage patient in status epilepticus isn’t just dramatic for the sake of it—it feels real. The details are sharp, almost uncomfortably so, and you can tell right away that this book is going to lean heavily on medical realism. It doesn’t ease you in. It drops you straight into it.
From there, the story expands quickly into something bigger than just a single patient case. What starts as a medical situation turns into something that feels more like a layered thriller—part hospital drama, part research conspiracy, part crime story. Stella Murray is probably the emotional anchor of the book. She’s competent, driven, and grounded in a way that makes the more chaotic elements around her feel believable. Her concern about the study drug doesn’t feel dramatic—it feels like someone who knows something is off but doesn’t yet have proof.
And then the book takes a turn.
The introduction of the corporate side—and especially the darker thread involving the trial, the pressure to suppress adverse events, and the decision to eliminate a problem rather than solve it—is where things shift from grounded to unsettling. The email exchange with KFAP is honestly one of the most jarring parts of the book, but in a way that works. It’s bizarre, a little darkly comedic, and also deeply uncomfortable. The contrast between the tone of those emails and the seriousness of what’s actually happening creates this strange tension that sticks with you.
KFAP as a character is… a lot. He’s unpredictable, unsettling, and written in a way that almost makes him feel detached from reality. But that’s also kind of the point. He’s not meant to feel normal. He’s meant to feel like someone operating outside the rules everyone else is trying to follow. And when his storyline intersects with the medical plot, the stakes suddenly feel very real in a different way.
The detective side of the story adds another layer that I actually liked more than I expected. Evans is methodical, grounded, and a nice counterbalance to the chaos happening behind the scenes. His sections slow things down in a good way—they give you space to process what just happened while also pushing the mystery forward.
If there’s one thing this book does well, it’s juggling multiple threads without losing the core tension. The medical mystery, the ethical gray area of clinical trials, the corporate pressure, and the crime element all feed into each other. You can feel the pieces moving toward something bigger, even when the story jumps perspectives.
This story reads like a hybrid between a medical drama and a conspiracy thriller with a darker edge. It’s not subtle, but it is engaging. And once things start connecting, it becomes hard to put down.
Summary:
Overall, SETTUP is a fast, detail-heavy medical thriller that starts in the ER and expands into a layered story involving clinical trials, corporate pressure, and a criminal subplot. The medical realism is strong, and the tension builds as the threads begin to connect. The tone can shift a bit—especially with the assassin storyline—but it adds a darker, more unsettling edge. Best for readers who like medical dramas with conspiracy elements and multiple POVs rather than a single, straightforward narrative. Happy reading!
Check out SETTUP here!
Book Trailer