“The 5th Horseman” by James Patterson and Maxine Paetro – Three-Headed Hydra

James Patterson and Maxine Paetro have, over the course of many novels, become the faces of the Women's Murder Club series, a partnership which began over a decade ago. 

The 5th Horseman is the second book co-authored by the two writers, and in it we follow Lieutenant Lindsay Boxer's investigation into a mysterious string of patient deaths at a hospital with more than a few things to hide, as well as two other killers leaving their mark in the area.

James Patterson and Maxine Paetro Summon the Horsemen

Solving complicated crimes is something most people have fantasized about in one form or another, but for obvious reasons, have never followed through with it. Thankfully, in the realm of fiction different rules apply, ones which allowed for the existence of the Women's Murder Club, and in The 5th Horseman by James Patterson and Maxine Paetro, they see themselves pushed to the limit.

Before proceeding, this is the type of series which doesn't require being read in order, though you do risk missing out on some background information in relation to certain main characters. If you'd like to, you can have a look at our 4th of July review to see what the previous chapter in the series was all about.

In The 5th Horseman, the Women's Murder Club is facing three separate lines of investigation. To begin with, Lieutenant Lindsay Boxer is leading an investigation into a hospital where over thirty patients passed away rather inexplicably. She believes a serial killer is roaming the hospital grounds, likely working there, and covering up his work under the guise of medical mistakes and mystery.

Second, the newest member of the club, attorney Yuki Castellano, has a very good reason for joining this inner circle of investigators. Her mother fell victim to a serial killer whose calling card involves placing buttons on his victim's eyes. With the club being her sole potential recourse for justice, Yuki never loses sight of her reason for joining.

As if the city wasn't in enough peril already, there appear to be multiple serial killers working together, targeting night workers and posing them in expensive outfits and cars. Though the ladies already have their hands full with a city seemingly bent on degeneration as well as their personal woes, this is the type of case they can't afford to set aside.

Maximum Momentum in The 5th Horseman

I hope this won't sound like I'm making a knock against Patterson, whose success speaks for itself, when I say his thrillers generally aren't the types of books to send the reader into deep thought. On the contrary, they're meant to be consumed and enjoyed as a good bit of entertainment, and I think this applies quite well to the Women's Murder Club series.

Let me be clear here, I think there is absolutely nothing wrong with that, and there is definitely a place for these types of novels; everyone needs a break for the heavy topics of the real world every once in a while. As far as offering a bit of engrossing escapism for a few hours, I'd say The 5th Horseman succeeds with flying colours.

The three investigations we are following aren't exactly related to each other. As a matter of fact, one of them seems to be a completely standalone affair, while the other two are only connected in vague and roundabout ways. While at first this felt like a bit of a weakness or a missed opportunity, I got around to this structure for the speed at which the individual stories advanced.

Having numerous narratives leaves less room for meandering about and shuffling one's feet, meaning Patterson and Paetro are pretty much always focused on advancing the plot in one way or another. Of course, this comes at the detriment of potential character development, although it is still present through the actions and decisions of the protagonists, some more than others.

In addition to the investigations, we're also treated to some legal thriller material as we take breaks from the pursuits after serial killers to witness a court battle: the hospital where the patients died versus their grieving families. The battle is quite tense in its own right, and though I personally can't gauge its accuracy, it felt believable to me.

The Many Forms of the Criminally-Insane

Objectively-speaking, it felt to me like the three principal lines of investigation were all written almost equally-well, but I think it's unavoidable for readers to have a preference for one story over another. For me, the case which most drew my attention was the one revolving around the hospital, partly because it felt closer to the real world in certain ways.

In my opinion, this felt like the main case around which the book revolved, and it was even written a little better than the other ones. When I say better written, I mean it in the sense of how the investigative thread gets unravelled. There are some genuinely good twists and misdirections by the authors, even for the people like myself who have gotten used to their works.

Though the case feels like it deals with a subject relating to the real world (medical professionals using the authority of their position to commit dastardly deeds), it never really leaves the realm of fiction, both for better and worse. While keeping the links to real life makes it easier to digest, it also removes a bit of potential heft and importance which I think would have been welcome here.

As for the other cases, their resolutions seem a bit more straightforward than the hospital one. Mostly we are led from one clue to the next, following the line of inquiry without paying much attention to anything else. This isn't to say they aren't well put-together; the chain of logic is strong, the discoveries made feel impactful in the moment, and the ultimate encounters are nothing if not thrilling.

One aspect of the book I'd like to give real credit to Patterson and Paetro for is the amount of suspense they're capable of building, even when we essentially know our protagonists are adorned with plot armour and the series would die without them. When the danger is there, it feels real and urgent, no matter who it targets.

The Final Verdict

The 5th Horseman by James Patterson and Maxine Paetro is an excellent addition to the Women's Murder Club series for a few reasons. It offers well-crafted suspense, interesting investigations into serial killers, and a captivating court battle to top it all off.

If you're looking for a good medical thriller to take your mind off the real world, or have enjoyed the previous novels in the series, then I do recommend you give this book a shot.

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James B. Patterson Personal site James Patterson is an American writer who has dedicated a large part of his literary career to writing murder-related thrillers, inventing in the process two memorable character-based series in Alex Cross and Michael Bennett. His most prominent works include Kiss the Girls and Along Came a Spider.

Maxine Paetro Maxine Paetro is an American author who began her published career all the way back in 1979 with How to Put Your Book Together and Get a Job in Advertising, which was revised for the fourth time in 2010. She has remained an active author, writing numerous novels since then, including Manshare, Windfall and Woman of God. Additionally, she is known for collaborating with James Patterson on numerous entries in the Women's Murder Club series.