Embarking on the writing of a novel is a truly novel (ha!) experience. As a physician, researcher and teacher, who wrote extensively throughout my career in academic medicine, including an introductory anesthesiology textbook with my mentor, I assumed the words would flow and a book would appear. I couldn’t have been more wrong. Though a life-long reader, I soon realized I’d never analyzed the craft of the books I love, which of course is the author’s intent. Very quickly I learned terms like point-of-view and head-hopping and passive voice and wow, the world of writing is no less dense than medicine. I went to trusty Amazon to find a book to teach me to write a book, which seemed kind of meta, and discovered there were pages and pages of great-sounding titles, and whole books on setting and character and theme…oh my, what had I gotten myself into?

I started with K.M. Weiland’s “Outlining Your Novel” and learned a ton. With that guidance I came up with an outline for the book that had been in the back (and often front) of my mind for several years, a book about a mercy-killer for hire and the surrounding implications. The idea of managing the end-of-life has fascinated me since way before any kid should think about such things, with a debate in my 5th grade class about the fate of Karen Ann Quinlan, a young woman in a persistent vegetative state whose parents wanted her ventilator disconnected, while the State of New Jersey disagreed. I don’t recall what side my 10-year-old-self argued, but the question never left me. Medical technology and the ability to keep the body alive has far out-paced our ethical ability to deal with the implications.

In medical school and residency, the question resurfaced repeatedly, while watching families’ extended mourning in the ICU, and anesthetizing patients for innumerable procedures despite little to no hope of a meaningful recovery. Meanwhile, the absurd cost of medical care in the US frequently made the news, especially expenditures in the last few months of life and final hospitalization.

As my career advanced and I achieved the goals I’d set for myself, it came time for reinvention, and that’s when this “encore career” became a possibility. The characters of Fatal Intent took up residency in my head, invading my sleep, and even my waking hours. It was time to give them voice. I resigned my time-consuming administrative positions, wrapped up my ongoing research projects, handed off most of my teaching responsibilities to up-and-coming faculty who needed it for their resumes, and dropped to part-time at the hospital so I could make a real investment in my writing.

And so, Dr. Kate Downey, the protagonist in my debut novel, came to life. She is quite a lot like me. Shocking for a debut author, I know. Though a few years my junior, ahem, we share careers as anesthesiologists who specialize in obstetric anesthesia and teach medical students and residents, sometimes using a simulated operating room environment. Our personalities overlap a bit, or did when I was her age, but there the similarities end. Instead of my tragedy-free life to date (knock wood), she suffered the loss of her parents and now the traumatic brain injury of her husband. Boy, are we authors cruel, or what? I have to keep reminding my husband that Kate is not me, and he is not her comatose husband, Greg. As for her dog, I’m afraid mine is just as energetic, spoiled, and completely untrained…times two.

One of Kate’s many blessings, though, is her Great Aunt Irm, who moved in after Greg’s accident. I based this character on a favorite relative of my early-career mentor. Dr. Gravenstein was a model physician and teacher whose Aunt Irm was important in his orphaned childhood in Germany during World War II. He planted the seed that set me on this encore career as an author, so I borrowed Aunt Irm as a bit-part character, except she stole the show. My readers and I have fallen in love with her -- her maternal instincts despite being childless, her loyalty and compassion, her mixed up English idioms.

Without the unwavering support of my husband and kids (and dogs), and the invaluable cheer-leading of my writing buddies, Fatal Intent would not have come to be. It would be several years and innumerable versions before Oceanview would bring it to a bookstore near you (or your computer), but I am hopeful Kate’s story will stimulate discussion about meaningful life and compassionate death. It provides no answers, nor do I have a strong opinion, only that end-of-life is a discussion we need to have, both in our homes with our loved ones, and on a national stage.

ABOUT THE AUTHOR:

Tammy Euliano, MD, is a practicing anesthesiologist and tenured professor of anesthesiology at the University of Florida. In addition to a prolific list of academic publications, YouTube teaching videos, and numerous teaching awards, she has also written award-winning short fiction. Fatal Intent is her debut novel. Tammy lives in Gainesville, FL, with her husband. For more information, please visit https://teuliano.com and follow the author on Facebook.