"Fatal Intent"

“Fatal Intent,” by Tammy Euliano.

In her debut novel, “Fatal Intent” (Oceanview Publishing), author Tammy Euliano puts the “real” into the medical thriller.

Dr. Kate Downey is a skilled anesthesiologist and professor at a teaching hospital in central Florida. She knows she’s got a lot on her plate, especially with her husband, Greg, in a coma for the last year.

One thing Kate doesn’t need is a problem at work. She’d made an error after the trauma with Greg and the stillbirth of her daughter, meaning that she is already on probation; any misstep could ruin her career. But Kate has faith in her anesthesiology skills — and she’s meticulous in treating her patients.

As Kate explains, “Work was all I had. The one dependable constant into which I poured the splintered shards of my life. If I lost my job, I’d be lost.”

The fact that two of her patients have died in the last few days is unnerving. They were minor surgeries, and the patients got through recovery fine. So what happened? Kate is determined to find out.

As an anesthesiology teacher at the hospital, Kate is diligent in training and mentoring the interns and residents in her area of expertise. Students make mistakes, as do all doctors. But when a resident’s error overlaps with the recent patient death, Kate knows it wasn’t the cause of the patient’s demise. She just has to prove it.


Losing patients also affects Kate in another way — they make her dwell on Greg’s tenuous existence. He’s breathing on his own, but that’s the only sign he’s still alive. She respects patients’ “do not resuscitate” orders in her role as a doctor, but she isn’t sure she can make that decision for her husband, as his wife. Even though he can’t respond, Kate still takes comfort in telling him her problems and imagining his supportive responses.

She’s somehow got to muster up the courage to protect herself, find out why her patients are dying, and make decisions about Greg.


As Kate investigates the unexplained post-surgical deaths at the hospital and fights a vindictive malpractice allegation against her, she realizes there’s a sinister plan in play and she’s stuck in the crosshairs. When she traces the deaths to someone involved in all the surgeries, the murderer becomes more dangerous, and he’s willing to do whatever it takes to cover his tracks. Kate doesn’t know if she can stop him before he stops her and ruins her medical career in the process.

Euliano is herself a practicing anesthesiologist and includes her expertise on every page. As Kate makes her rounds at the hospital, we’re right there with her, considering the best courses of action. The detailed authenticity in the story based on real-life experiences provides realistic suspense, and the unusual vehicle of death — camouflaged as a result of surgery — is intriguing in its originality.


Euliano also invites us to consider moral dilemmas surrounding a patient’s right to life and right to death, as well as the decisions families and doctors must make to protect an individual’s dignity while minimizing their suffering. End-of-life issues have long fascinated Euliano. During her internship, someone even asked her how she could play God by turning off the ventilator of a brain-dead patient. Who should decide if life is no longer worth living, and if there’s no “flip to switch,” are there options other than starvation?

Fans of medical thrillers will love this realistic dive into the lives of hospital staff, consideration of medical ethics and a doctor’s vow to do no harm; and because Kate’s story is wrapped around the sobering issues of medical euthanasia and assisted suicide, readers will consider the dilemmas presented long after the cover is closed.

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