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"A fun, fast-paced read that blends the gruesome thrills of a zombie movie with the fascinating details of good medical writing and strands the whole thing in the middle of the Atlantic Ocean."

Cassandra Rose Clarke, author of The Mad Scientist's Daughter

 "Hwang’s prose is unrelentingly paced yet layered with psychological nuance."

Goodreads reviewer

"For fans of Blake Crouch, Robin Cook, or anyone interested in pandemic or biological horror stories, 'The Regression Strain' offers exactly the kind of page-turning, emotionally honest thriller that respects its readers’ intelligence."

Maria Ashford, Bookshelfie

"Outbreak meets Lord of the Flies on a cruise ship...It’s smart without being overly technical, suspenseful without relying on cheap scares, and deeply unsettling in the best way possible."

Eliza Gautam, Savor Your Reads

"well-plotted, presenting exceptional storytelling, and nuanced characters...a page-turner with strong hints of horror"

The Book Commentary

"I most enjoyed the scenes when Peter is trying to be a good doctor, under massive personal and professional strain."

The Fiction Addiction

"Physician-novelist Kevin Hwang gives us in The Regression Strain a medical thriller that you won't be able to put down! This is a book filled with both insight and emotion."

Nathan Carlin, Director of the McGovern Center for Humanities and Ethics and Editor-in-Chief of the Journal of Medical Humanities

 "Kevin Hwang's debut threads together medical acuity and a gripping plot to ask what it means to be a physician in the face of looming viral destruction and what it truly means to be alive. The Regression Strain takes you on board and doesn't let you go."

Pritha Bhattacharyya, Writer-in-Residence, McGovern Center for Humanities and Ethics

 "...a high seas thriller that will keep you turning the pages from the first port of call to the last. Welcome Aboard!"

martin bihl - Editor: the-agency-review

• Dr. Peter Palma: A young physician from Houston who's burned out and wrestling with guilt over his brother's fate

Here's what reviewers have to say about Peter:

"Where the book truly succeeds is in its refusal to present Dr. Palma as a traditional hero. Instead, we get a flawed protagonist struggling with his own mental health while trying to diagnose an outbreak that may or may not be real."

Maria Ashford from Bookshelfie

"In an environment clouded by uncertainty, he must make critical decisions to contain the crisis and minimize casualties. But as suspicion grows that he himself may be affected by the unknown agent, Peter finds himself racing against both time and his own unraveling sanity to protect the people of Paradise before they reach their final port, New York."

Timea Barabas from Bestsellersworld

• Dr. Elizabeth Hartley: The Scottish physician who fails as Peter's mentor as she teeters on the edge of madness

• Captain Forster: With an ego bigger than the ocean!

• Harrington: The security chief desperate to maintain order

• Mandy: A nurse from Portland whom Peter can't stop thinking about in all the wrong ways

• Luisa: A nurse who likes to run the show

• Dr Nora Wetzel: She tries to help Peter, but there's only so much she can do from Miami

• Natalia (Nali): Peter's sister who's too clever for her own good

• Calvin: A teenage boy abandoned by his mother

• Chessa: A dining server with a devastating secret

• Agus: A crew member and purveyor of otherworldly coffee

• Medical TV shows: Doctor Odyssey, ER

• Medical thriller authors: Michael Crichton, Gary Gerlacher, Gary Birken, Robin Cook, Tess Gerritsen, Blake Crouch

• Crossover genres: psychological thriller, horror, suspense

• Themes / tropes: contagion, outbreaks, plague, viral / virus infections, epidemic, pandemic, biotech, survival, devolution, genetic engineering, human nature

• Settings: 🚢cruise ship 

• Moods: tense, suspenseful, dark, chilling

• Pacing: ✅page-turner ✅fast-paced ✅propulsive

Why did you choose to write a medical thriller set on a cruise ship?

We’ve been on a few cruises and I’m a doctor. I was sure there was an entertaining story arising from that intersection. A story limited to a single trip across the Atlantic seemed narrow enough in scope for my first novel. Although I didn’t set out to write about any particular themes, they emerged as I mined my experience with treating patients. It became natural to explore themes related to human nature, grief, and perseverance.

So...have you worked as a doctor on a cruise ship?

No, but I think it would have been a really interesting gig for a younger me.

Are any of the characters based on real people you know?

I plead the Fifth, Your Honor.

How would describe the protagonist?

Peter's a relatively young physician, just a few years out from his family medicine residency. But he's already been through some very trying times from a professional and personal standpoint. He's looking for a break, so he takes the cruise gig. Of course, he soon finds out he's in for the "adventure" of a lifetime. He's thoughtful, vulnerable, and deeply aware of his own shortcomings. Peter isn't your typical cocky, know-it-all hero, although he has to dig pretty deep to overcome challenges facing himself and everyone depending on him.

Does one need to have a medical background to understand what's going on?

Not at all. Readers have said the medical jargon is just enough to support the story without bogging them down with unnecessary details.

Could the events in the The Regression Strain happen in real life?

Never say never, truth is stranger than fiction, all that.

What does the word "regression" refer to?

Read it and find out! Hint: Lord of the Flies, A Separate Peace, and the book of Romans in the bible all shed light on human nature. 

What do you like to read?

Thrillers, mystery, and sci-fi, with the occasional short story mixed in there. I mostly read fantasy as a teenager.

Are you writing another book?

Yes...stay tuned!

The story lends itself to rich discussion on complex themes. Feel free to use these questions in a book club conversation.

Why did Peter take on this cruise ship job?

How does Peter struggle to accomplish his goals in this story?

How does Peter view himself at the beginning of the story, and how does he view himself at the end?

What does "regression" mean in the context of the story?

What prevents us from doing the bad things we know we shouldn't do? (Peter calls these "regretful things")

What do the characters think about human nature?

What separates us from animals?

What is the symbolism of the whale in this story?

How did Peter react to his brother's request for help?

Have you been on a cruise before? How do you feel about cruises after reading this story?

What questions are left unanswered at the end of the story?

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Print Runs & Paychecks

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Mandy Nachampassack-Maloney

• Ebook

  • ISBN 979-8992727005

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  • Published‏ May 25, 2025

• Paperback

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  • Published May 21, 2025

• Hardcover (forthcoming)

  • ISBN 979-8992727029

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  • Published June 21, 2025

• Audiobook (forthcoming)