Realistically portrayed medical procedures and more than you'd care to know about toxic poisoning--both pump up a relentlessly predictable emergency-room melodrama. In his seventh medical thriller, Massachusetts-based Palmer (Silent Treatment, 1995, etc.), a former ER physician, goes west to the excessively scenic, ironically named northern California mountain town of Patience, where Dr. Abby Dolan, lately of San Francisco, has just joined the Patience Regional Hospital emergency room team. Everyone seems to know everyone else too well in this small, former gold-rush mining town, now the headquarters of Colstar International, a giant manufacturing concern specializing in exotic batteries, many containing the metal cadmium. It doesn't take many pages before our spunky, dedicated, fearlessly competent heroine suspects that the inexplicable ailments dragging a parade of fuzzy-warm small-town types through her emergency room might have something to do with environmental contamination at Colstar, even if blood tests and other procedures reveal nothing unusual. Palmer tries to complicate his basic Enemy of the People plot by having Dr. Dolan's boyfriend, Josh Wyler, a Colstar company man, mutate into a gun-toting crazy, so that Dr. Dolan can seek solace in the strong arms of Dr. Lew Alvarez, an impeccably handsome emergency-room physician and leader of the Alliance, a paltry group of eco-activists who want to shut down Colstar. Between passionate kisses, Dr. Alvarez suggests to Dr. Dolan that cadmium, an element used in batteries, could be causing some of Patience's residents, including Dr. Dolan's erstwhile boyfriend, to go suddenly berserk. Dr. Dolan finds herself dodging rifle fire, pickup trucks, and, even worse, bureaucratic snafus. Warmed-over Robin Cook-esque hospital paranoia, though saved by an earnest appreciation of emergency room heroics.