Book Review: The Regression Strain by Kevin Hwang

About the book: The Regression Strain

Genre: Medical Thriller
Publisher: Normal Range Press
Publication Date: May 26, 2025
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Dr. Peter Palma joins the medical team of the Paradise to treat passengers for minor ailments as the cruise ship sails across the Atlantic. But he soon discovers that something foul is festering under the veneer of leisure. Deep in the bowels of the ship, a vile affliction pits loved ones against each other and shatters the bonds of civil society. The brig fills with felons, the morgue with bodies, and the vacation becomes a nightmare.

One by one, the chaos claims Peter’s allies. His mentor spirals into madness and the security chief fights a losing battle against anarchy. No help comes from the captain, who has an ego bigger than the ocean.

With the ship racing toward an unprepared New York, the fate of humanity hinges on Peter’s deteriorating judgment. But he’s hallucinating and delirious…and sometimes primal urges are impossible to resist.

The Regression Strain is a fast-paced medical thriller laced with psychological suspense, perfect for fans of Michael Crichton and Blake Crouch.

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About the author: Kevin Hwang

Kevin O. Hwang, MD, is a professor of internal medicine in Houston where he sees patients and teaches residents. His academic work has appeared in leading medical journals. Nothing excites him more than chicken enchiladas, index cards, and appropriately sized packaging. The Regression Strain is his debut novel.

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My Thoughts

I’m a sucker for a good science-based thriller, and I also love medical drama, so as someone who came of age reading Michael Crichton, when I had the opportunity to review this book, I jumped at it, and Kevin Hwang’s writing caught me and held me fast from beginning to end.

What unfolds on the Paradise is more than a contained outbreak story. It is a pressure cooker at sea, blending investigative tension with deeply personal stakes. The illness may be the catalyst, but the heart of the novel lies in the people trapped with it: physicians, security officers, crew members, and passengers from wildly different backgrounds. The cast feels varied and fully human, and the story makes it brutally clear that no one is insulated by rank, expertise, or good intentions. I was especially drawn to Dr. Peter Palma, whose history shadows every choice he makes. His compassion is genuine, but so is his fragility, and that combination gives the narrative real emotional weight.

The ethical questions here are not abstract. They land hard and fast as alliances fracture and fear overrides reason. The atmosphere grows tighter with every chapter, and the cruise ship setting amplifies that claustrophobia in a way that feels almost uncomfortably plausible. The pacing never lets up, yet the author still finds room to explore what happens when advanced medicine collides with the most primitive parts of human nature. More than once, I felt echoes of 2020 in the way misinformation spreads, authority falters, and ordinary people are forced to confront who they really are under pressure.

Ultimately, The Regression Strain delivers exactly what I want from a medical thriller: credible science, escalating stakes, and characters whose choices matter. It is unsettling without being gratuitous, thoughtful without slowing the momentum, and it lingers after the final page in the way the best speculative fiction does. If you like your suspense grounded in biology and human frailty rather than gimmicks, this one absolutely belongs on your list.

Goes well with: strong black coffee in a thick mug, eaten-at-midnight leftovers from the fridge, and the uneasy feeling of being far from shore with nowhere to run.