When Irv Tinsley, an epidemiologist investigator with the Seattle-King County Public Health Offices arrives at a remote country cabin to examine a body, he finds its condition “a bit off.” There’s a strange smell emanating from the corpse, and an unusual pattern of decay.

Toxicology tests indicate the man may have died from a suspected new strain of animal flu that mutated and jumped to humans, like China’s recent outbreaks of a disease that spread from pigs to humans. Tests also find traces of an outlawed agricultural chemical on the body. As the CDC steps in, Irv’s boss tells him to leave the investigation to the federal agency, and concentrate on keeping tabs on lab efforts to identify the strain.

The Theory of Irv by Greg Vigdor is more than a medical mystery.  Subtitled “An American Health Policy Detective Story,” it’s also a novel about the weaknesses of our health care industry.

Recently demoted for speaking to the press about E. coli dangers associated with Seattle’s ethnic restaurants, Irv decides to secretly continue his basic public health sleuthing: Who was the victim, and how did he get to the cabin? And why did his boss seem to want him off the case?

His investigation leads him to a possible source for the agricultural chemical, and hints that the mysterious death of the still unidentified man, possibly a migrant Mexican worker, has wider, more sinister implications. As the body count increases, so does Irv’s danger.

The novel’s craftsman-like construction weaves together the backstories of Irv and other characters, including a political consultant whose grandfather died as the result of hospital error; public health officials with little or no public health experience; a U.S. congressmen impatient with government dysfunction, and a health care executive more interested in making money than quality care.


Vigdor has more than 40 years of experience in health care, and recently retired as president and CEO of the Arizona Hospital and Health Care Association. He’s now volunteer president of the Washington Health Foundation, a non-profit, award-winning organization dedicated to improving the state’s health system, both for individuals and institutions. He helped revive the organization in the 1990s, and wrote The Theory of Irv to lay out health care’s issues, and to educate people about them. Proceeds from sales of the book will go to the WHF.

The novel mixes fact and fiction to describe the history of efforts to improve American health care, starting a century ago with the Committee on the Cost of Medical Care. In 1932, the committee recommended national health care insurance and government regulation of medicine, but critics advised against this, citing fears of communism and socialism. The controversy continues to this day.

Vigdor’s efforts to understand health care began when he tried to read his own health insurance contract. “I didn‘t have the foggiest idea about what the contract said or meant.“ In a recent interview, he stated, “There are so many pieces of the health care system, but they are all disconnected. Some work incredibly well, but it’s the best and worst of everything all wrapped together.”

Among its many strengths is how The Theory of Irv puts these disparate, big picture pieces into a compelling, entertaining and human framework. You’ll root for Irv as he goes undercover to discover the truth, and you’ll come away with a deeper understanding of the importance, and the complexities of health care reform.

Buy this book!

Greg Vigdor has spent four decades working within the healthcare system, trying to forge big and meaningful change. Now, he is writing about these issues as an author of this novel and a monthly blog as President of the Washington Health Foundation, sharing his unique and practical ideas for improving health and health care for all Americans.