Mystery and suspense writer Lawrence Block once said there was a huge readership in this country who didn't care about anything but plot. Literary style? Depth of characterization? Narrative tension? Not for these readers. They crave story. Nothing else.

I believe most of these people are reading Michael Palmer. In The First Patient he gives us, with little grace of style, paper-thin characters propelling a formula plot. Gabe Singleton, a country doctor from Wyoming, was once the current president's roommate at the Naval Academy. He was, however, expelled and given a prison sentence for killing a woman in an auto accident while in a drunken blackout, an act that gives us two formula elements at once: the character suffering from guilt and the tragic mysterious incident that took place but cannot be remembered. Note to readers who are new to the game: when something happens to characters so they don't remember it, be very suspicious.

Since leaving prison, Singleton has rebuilt his life to a point where he now suffers from the Hawkeye Pierce Syndrome, which is characterized by other people in the book constantly telling him how wonderful he is and how many good, life-transforming deeds he has done. Singleton, however, like the true hero he is, remains self-effacing.

All of this is backstory. The action proper begins when his old friend, the president, asks him to come to Washington to serve as his personal physician. He agrees, and only when he has moved to spacious quarters in the Watergate hotel does he discover that the president is suffering from seizures. It seems that the leader of the free world is losing his mind.

There is a ruthless hitman on the loose, military physicians who are jealously protecting their turf, nurses who are actually members of the Secret Service -- all the elements you would expect. The action builds to a secret-revealing confrontation.

On a narrative level, The First Patient chugs along, keeps the action moving and works, provided you suspend a tendency to disbelieve. It can provide fans a few days of pleasure. On a literary level, though, it's like a slice of pie you've been anticipating that didn't live up to your expectations.