Image of a biotech lab where genetic engineering is conducted

One of the deepest veins mined by science fiction authors and futurists alike is the field of biological science. After all, the white-coated folks in biological labs and the physicians and surgeons who tend to our health have no doubt had the greatest impact on our lives. Together with the growing fraternity of public health officials, they have more than doubled our life expectancy during the past century. And future developments promise to continue the trend. Yet at the same time, we humans have faced a growing threat from the microscopic foes called pathogens. We hardly need the experience of the past two years of the COVID-19 pandemic to remind us. But the medical and biological thrillers listed here do a good job of that.

Estimated reading time: 16 minutes

This post was updated on September 26, 2023.

The great, the good, and the just okay

The 27 books listed here cover a lot of ground in both space and time. But what they have in common is that biology is central in their stories. With a single exception, they all neatly fit any definition of science fiction. They’re arranged in three tiers. First are the 10 best, all rated ★★★★★. Those are the ones I consider “great.” They’re followed by 12 titles I’ve rated ★★★★☆, which are good but not great. In the third tier you’ll find five titles rated ★★★☆☆. All I can say is that the writing is of professional quality and is readable.

Fair warning: this is NOT a list of the “10 greatest medical and biological thrillers.” Included here are the 27 books in this sub-genre that I’ve managed to read and review over the past decade since I began reviewing books online. No doubt you could name other titles that deserve to be on the list. Maybe I read them years ago but haven’t reviewed them. Or maybe I’ll come across them someday and add them to the list. But what you see is what you get now. 

Within each of the three lists the books appear in alphabetical order by the authors’ last names.

The top 10: great medical and biological thrillers

Cover image of "Oryx and Crake," one of the biological thrillers featured in this article

Oryx and Crake (MaddAddam Trilogy #1) by Margaret Atwood (2003) 402 pages ★★★★★ – Margaret Atwood’s brilliant dystopian fiction

Oryx and Crake is the opening salvo in the Maddaddam Trilogy, and a powerful one it is. The tale is set in what appears to be the late 21st Century following catastrophic climate change and . . . something else. Whatever it was that happened was so severe that Atwood’s protagonist, a young man named Jimmy who now styles himself as Snowman, believes he is the only human being left alive on Planet Earth. His only companions are vicious, genetically engineered hybrid animals gone feral—wolvogs, pigoons, rakunks, and such—and a small community of gentle near-humans who live by grazing on grass and trees while Snowman survives by scavenging through the moldering remains of his lost civilization.

With consummate skill, Atwood gradually reveals the backstory through flashbacks, as Snowman recalls, episode by episode, how things came to be the way they are. We learn of his complex relationships with Oryx and Crake, and of their pivotal roles in the catastrophe—the one a petite and beautiful former child prostitute, now the love of Snowman’s life; the other a brilliant young man who has been his best friend since childhood.

Oryx and Crake is brilliant speculative fiction—a cautionary tale about the prospects for the human race that veers dangerously close to today’s reality. Read more.

Cover image of the novel "Semiosis"

Semiosis (Semiosis Duology #1) by Sue Burke (2018) 326 pages ★★★★★ – In a unique first contact story, human colonists learn that plants can think

Why is it, do you think, that animals are capable of thought, and plants aren’t? Or are they? Certainly, many aspects of plant behavior suggest conscious action. And at least one scientist, Daniel Chamovitz, director of the Manna Center for Plant Biosciences at Tel Aviv University, “argues [that a plant] can see, smell and feel. It can mount a defense when under siege, and warn its neighbors of trouble on the way. A plant can even be said to have a memory.” And whether any of this means that plants can think is the subject of Chamovitz’s book, What a Plant Knows. The book was reviewed in 2012 in Scientific American. Now, author and translator Sue Burke takes the argument several steps further in her unique first contact story, Semiosis.

The basis of Burke’s portrayal of highly intelligent plants is the setting on a world that human colonists have dubbed Pax. Revolving around a nearby star that requires a 23-year journey, Pax is older than Earth by a billion years, and the life it supports has been evolving much longer. There is intelligent animal life but none that comes remotely close to that of homo sapiens. It’s the plants that compete for resources with the human settlers. Read more.

Cover image of "Harvest," one of the biological thrillers featured in this article

Harvest by Tess Gerritsen (1996) 372 pages ★★★★★ – A classic medical thriller about organ transplants

Dr. Abby DiMatteo is a second-year surgical resident at a prestigious Boston hospital noted for its world-class transplant team. Abby frequently has the opportunity to scrub in on heart transplants and other high-profile surgeries. When she learns that a heart ready for transplant will go to the middle-aged wife of a billionaire rather than a dying 17-year-old boy, she is outraged. She talks the donor’s husband into designating the heart for the boy.

Then all hell breaks loose. The billionaire goes ballistic and sets in motion a plan to destroy Abby’s career. As she sets out to fight the billionaire’s efforts to have her disgraced and fired, she undertakes a high-stakes investigation of the case. In the process, she stumbles into an organ-transplant scandal perpetrated by the Russian mob. This classic medical thriller was one of the first books to expose the sale of human organs to a wide audience. It’s well-written, beautifully plotted, and heart-poundingly suspenseful. Read more

I’ve also reviewed Gravity: A Novel of Medical Suspense by Tess Gerritsen (An action-packed medical thriller set in orbital space), which is just as good.

Cover image of "Cold Storage," one of the biological thrillers featured in this post

Cold Storage by David Koepp (2019) 304 pages ★★★★★ – A biological thriller that may keep you up at night

You’ll meet a lot of people in Cold Storage, but four are key. The first two you’ll encounter are officers in the U. S. Air Force. Lt. Col. Trini Romano and Major Roberto Diaz are on assignment in the desert of Western Australia. Much later you’ll meet Travis (Teacake) Meacham and Naomi Williams, two young people who work as security guards at a storage facility in Missouri. But you’ve got to be patient. Trini and Roberto will show up again a lot further along. It won’t seem to make a lot of sense for awhile. But then it will suddenly all come together. And you probably won’t like what happens when it does.

Trini and Roberto work for the Pentagon’s Defense Threats Reduction Agency (DTRA). They’ve been rushed to the Australian desert to investigate a potentially lethal pathogen that crashed to Earth on the remnants of Skylab, America’s first space station. (History tells us that Skylab burned up in the atmosphere over the Pacific Ocean in 1979, but novelist David Koepp would have it otherwise.) Accompanying the two Air Force officers is a microbiologist who collects a sample of what they learn is a terrifyingly lethal fungus. Read more.

Cover image of "Deep Past," a novel

Deep Past by Eugene Linden (2019) 336 pages ★★★★★ – Is homo sapiens the only highly intelligent species ever to walk the Earth?

Most hard science fiction is about space travel, first contact, robotics, the multiverse, or some other topic that’s familiar to fans schooled in science. But here’s one that’s about paleontology, and what a revelation it is! Eugene Linden, who previously wrote more than a dozen nonfiction books about science, technology, and the environment, turns his attention to fiction in Deep Past. This tensely plotted and thoroughly enjoyable novel poses questions most scientists are loath to ask. For instance, why is it that humans are the only highly intelligent beings ever to walk the Earth? Or are we?

In Deep Past, Dr. Claire Knowland is a specialist in animal communication. The powers that be at the university assign her to take charge of a paleontology group working at a remote site in Kazakhstan. There, the head of security at a nearby site where a mining consortium is exploring the potential for large-scale operations approaches her with a startling find. The head geologist at the mining site had uncovered what looks like ancient elephant bones—at a place where elephants had never before been found. Impossibly, the bones were 5.5 million years old! Read more.

Cover image of "Nexus," one of the biological thrillers featured in this article

Nexus (Nexus Trilogy #1) by Ramez Naam (2013) 404 pages ★★★★★ – The post-human future explored in an outstanding SF novel

Nearly sixty years ago, a psychologist and computer scientist named J. C. R. Licklider published a landmark paper under the title “Man-Computer Symbiosis.” He is best known today as the Pentagon official who funded the predecessor to the Internet, the ARPANET. But Licklider’s writing has gained him the reputation as a pioneer in artificial intelligence as well. His 1960 paper foresaw a time when machines would surpass the human capacity to reason and usher in what we have come to call the post-human future. However, he did not envision machines replacing human beings. Instead, he was hopeful that machines would free us from drudgery and open up vast new possibilities for the human race.

Today, more than half a century later, advances in artificial intelligence and neuroscience suggest the real possibility that Licklider’s vision may be realized. Some latter-day visionaries in the field, Ray Kurzweil most prominently, insist that humans will gradually gain powerful new abilities by incorporating machine-based intelligence and enhanced sensory perception, advancing the human race into a bionic, transhuman future. But will the transformation of humanity by artificial intelligence stop there? Is there a step far beyond into post-human abilities so far superior to those of human beings today that a new species will result? This is the premise of Ramez Naam‘s brilliant science fiction trilogy. Read more

Cover image of "Crux," a sci-fi novel

Crux (Nexus Trilogy #2) by Ramez Naam (2015) 624 pages ★★★★★ – Not a single dull page in this science-based sci-fi thriller

There are a lot of moving parts to this novel. We enter the thoughts of ten principal characters, by my count. The action unfolds in tiny chapters, switching from one character to another; few of these chapters are more than a handful of pages long. The print edition runs to more than 600 pages, and not a single one is dull. This science-based sci-fi thriller is, indeed, a thriller.

Yet what is most exciting of all about this novel is the science on which it is based. As the author, Ramez Naam, notes in a postscript (“The Science of Crux“), every seemingly unlikely or impossible superhuman ability described in the book is well within the bounds of possibility. He cites current research that strongly supports his contention. Thus, a reader unfamiliar with the devices and techniques of science fiction might find this story unbelievable or even silly. But it is nothing of the sort. Naam is painting a picture of what the future might well hold for us by the middle of this century. Unless you closely follow developments in neuroscience, nanotechnology, and artificial intelligence, you will be amazed. Read more.

Cover image of "Absence of Mind," one of the biological thrillers featured in this article

Absence of Mind by H.C.H. Ritz (2015) 321 pages ★★★★★ – In this original sci-fi technothriller, technology meets neuroscience

It’s the near future. Phoebe Bernhart is a psychiatric nurse at Atlanta’s largest hospital, struggling to keep her job. Plagued by headaches and a quick temper, she is prone to mouthing off to doctors and is one report away from being fired. One evening she meets Mila Bremer when their two cars collide and Mila gives her a ride to the hospital while her car is towed to the shop. Mila is a beautiful young woman who manifests the signs of the Asperger’s spectrum, and Phoebe is alternately intrigued and insulted by her lack of affect.

“Just because she doesn’t have her smartphone implanted in her head,” Phoebe thinks, “doesn’t mean she lives on a different planet.” (What this means will become clear.) Their chance meeting soon proves consequential—to Phoebe and to the world—when she encounters a baffling neurological pandemic that is flooding the city’s hospitals with “aggressive and paranoid people.” Together, Phoebe and Mila have a rare opportunity to investigate the source of the mysterious epidemic. Read more

Cover image of "Children of Time," one of the biological thrillers featured here

Children of Time (Children of Time #1) by Adrian Tchaikovsky (2015) 513 pages ★★★★★ – Accelerated evolution is the theme in a superior science fiction novel

Tens of thousands of years after Earth has self-destructed in a horrific civil war, humanity has once again reached for the stars. The human race has left behind the Old Empire, which spanned Earth and several of the solar system’s gas giant moons. Eventually, near-lightspeed interstellar ships began to spread through the galaxy, terraforming the most likely planets where Homo sapiens might find new homes.

Now, the technology of the Old Empire has been lost to time. Mere hints of that technology are accessible only to the classicists who labor to translate the old, dead languages of the meager records that survived the Empire’s destruction. But the toxic wastes the war left behind have gradually rendered Earth lifeless. Now humankind cannot rebuild where it has lived for millions of years. The remnants of the human race have set out to relocate elsewhere in starships, each of which houses a half-million people in stasis.

In Adrian Tchaikovsky’s outstanding science fiction epic, Children of Time, one of those immense lifeboats is approaching the nearest terraformed planet after a journey of nearly 2,000 years. What they will encounter there is a nightmare: the unintended consequences of a biological experiment carried out by a lone survivor of the Old Empire: Doctor Avrana Kern. Read more.

Cover image of the novel "Doomsday Book"

Doomsday Book by Connie Willis (1992) 592 pages ★★★★★ – A time-travel novel about the Black Death

What do we know about the past, and how do we know it? Historians rely largely on the contemporaneous written records they call primary sources. But other disciplines make important contributions to history as well, including archaeology, physics, and genetics. Still, what they learn comes exclusively from what remains of the past. What if historians could learn first-hand by sending scholars into previous centuries to compare the historical record to the reality? Award-winning author Connie Willis explores that idea in her monumental 1992 science fiction tale, Doomsday Book, a novel about the Black Death.

Kivrin Engle is a bright and adventurous first-year student in medieval history at Oxford’s Brasenose College. In the mid-21st century, time travel is well established as a method for historians to study conditions over the past four or five hundred years, and Kivrin is eager to explore 14th-century England. Together with the acting head of medieval studies, Mr. Gilchrist, and her history tutor at Balliol College, Mr. Dunworthy, she develops a plan for a two-week visit in 1320, farther back than others have previously gone. Her target is the village of Skendgate, near the city of Bath in the country’s far southwest. Unfortunately for all concerned, everything goes wrong when Kivrin sets out for the past. Badly wrong. Read more.

These are good but not great

Blood Music by Greg Bear (1985) 262 pages ★★★★☆ – A biological technothriller about genetic engineering

Darwin’s Radio (Darwin #1 of 2) by Greg Bear (1999) 544 pages ★★★★☆ – A brilliant novel about fast-tracked evolution

Darwin’s Children (Darwin #2 of 2) by Greg Bear (2002) 512 pages ★★★★☆ – A novel view of the posthuman future

Ethan of Athos (Vorkosigan Saga #7) by Lois McMaster Bujold (2011) 224 pages ★★★★☆ – Crisis on a planet inhabited only by men in the Vorkosigan Saga

The Andromeda Evolution by Michael Crichton and Daniel H. Wilson (2019) 383 pages ★★★★☆ – Michael Crichton’s extraterrestrial pathogen comes back to life

An Excess Male by Maggie Shen King (2017) 296 pages ★★★★☆ – A great science fiction novel set in a future totalitarian China

Spliced (Spliced #1 of 3) by Jon McGoran (2017) 370 pages ★★★★☆ – A YA novel about biological innovation run wild

Dead on Arrival by Matt Richtel (2017) 309 pages ★★★★☆ – Neurology meets high-tech in this gripping science fiction novel

Darwin’s Cipher by M. A. Rothman (2019) 374 pages ★★★★☆ – Genetic research goes awry in this chilling science fiction novel

Resistant by Rachel Sparks (2018) 216 pages ★★★★☆ – Resistant germs threaten humanity in this doomsday thriller

The Genius Plague by David Walton (2017) 386 pages ★★★★☆ – A suspenseful science fiction novel . . . about mushrooms?

The End of October by Lawrence Wright (2020) 400 pages ★★★★☆ – An all-too timely thriller about a pandemic

Other medical and biological thrillers reviewed here

Brain Wave by Poul Anderson (1954) 199 pages ★★★☆☆ – How would you behave if your IQ suddenly doubles?

Interference (Semiosis Duology #2) by Sue Burke (2019) 315 pages ★★★☆☆ — Humans, intelligent plants, brilliant insects, and that’s not all!

Make Room! Make Room! by Harry Harrison (1966) 223 pages ★★★☆☆ – Overpopulation in fiction and on film

Lock In: A Novel of the Near Future by John Scalzi (2014) 337 pages ★★★☆☆ – John Scalzi’s near future sci-fi novel set after a strange pandemic

Bannerless (Bannerless Saga #1) by Carrie Vaughn ★★★☆☆ – In an SF novel of life after the Fall, population control is the key to survival

For more good reading, check out:

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