This is the second book in Rubin’s Benjamin Oris series. Oris is a medical resident in Philadelphia, working as an orthopedic surgeon. His strange experiences in the series’ first entry The Bone Curse are behind him, and he is well on his way to a successful career in medicine, as well as having a pleasant domestic life, being good friends with Sophia, the mother of his young son, Maxwell.

Unfortunately, he again finds himself caught up in bizarre events when he and Sophia discover a severed leg in the park one frigid January day. It’s especially horrifying to Ben because he recognizes the limb–it belongs to a patient he himself recently performed knee surgery upon.

Once more, Ben is drawn into a macabre mystery. Soon, patients begin vanishing and more severed limbs are discovered. With the help of his friend Laurette and a forensic psychiatrist, Ben slowly pieces together an incredible theory–one that implicates a member of his own surgical team, possibly even his attending surgeon, who is also accused of ethically-questionable medical practices. Although, complicating things further, the accuser is also far from being a reliable source.

Speaking of unreliable sources, sprinkled throughout the book are chapters told from the perspective of the killer. Readers of Rubin’s earlier novel Eating Bull will be reminded of the glimpses into the twisted mind of the murderer in that novel. It’s done just as effectively here.

There’s a great cast of suspects here. Of course I kept trying to guess who it was, my suspicion shifting among 3-4 characters. In the end, none of my guesses were correct. The supporting characters in general are fantastic–I particularly liked Derek, the forensic psychiatrist, and Fisher, the chairman of orthopedic surgery and a former Army doctor. He has a penchant for creative swearing that I found very entertaining. “Holy bastard on a birthday card” is one of the more mild examples.

There are many memorable lines throughout–“No one’s willing to discuss the severed elephant in the room,” Ben muses at one point. And the pacing is great. After a gradual build-up, in the second half, the book turns into another of Rubin’s signature fast-paced, tension-filled thrillers, with a new twist coming every chapter. Mark Paxson once compared the pace of The Bone Curse to a hockey game in overtime, and the same could apply here.

And, by the way, while I don’t think it’s absolutely essential to have read The Bone Curse before reading The Bone Hunger, it will help a lot to familiarize yourself with Ben and his friends and family. Also, there are references to the events of the earlier book throughout.

All in all, this is another terrific medical thriller. I suppose a word of caution is in order for those squeamish about references to surgery, and of course, as the title suggests, the killer’s motives are based in some very unsettling desires.

I read this book in a little over one day from when I first got it. It is a fast-paced page turner, and by the second half, I just had to know what happened next. It’s a Carrie Rubin classic, full of clever lines and an intense climax delivered at breakneck speed.

[NOTE: This review is based on an ARC. The Bone Hunger releases today.]