Treachery by Design: An Authentic Medical Mystery

Madison Shaw and Jack Wyatt Medical Mysteries #3

by Gary Birken

An untreatable illness. A dangerous misdiagnosis. A deadly plot that hits too close to home.Drs. Jack Wyatt and Madison Shaw have finally settled in to a comfortable life together. But during a friendly college tour with Jack's daughter Anise, they learn that her mother, Jack's ex-wife, is suffering with a perplexing combination of symptoms. Within days, she and ten of her work colleagues are in the ICU with an identical untreatable illness.

Wyatt and Shaw soon find themselves embroiled in another medical mystery. All the brightest doctors in D.C. are scratching their heads, while Anise's mother and her co-workers steadily worsen. As Jack races against increasingly dangerous symptoms to nail down a diagnosis, Madison and Anise investigate the stunning events that led to their illness.

And now that the truth is out, no one is safe.

Treachery by Design is the pulse-pounding third book in the Madison Shaw and Jack Wyatt medical mystery series by Gary Birken, M.D. perfect for fans of intricate plots, thrilling races against time, and chillingly authentic medical content.

Read Treachery by Design today and unravel a breathtaking medical mystery.

Genres: Medical, Thriller

364 pages, Kindle Edition

Published December 19, 2024

About the author

Gary Birken is a full-time pediatric surgeon, medical thriller author, husband, father, grandfather, and more.

Born and raised in New York, Birken completed his undergraduate studies in Ohio, spent two years studying in Paris, before returning to complete his general and pediatric surgery training at the Ohio State University Hospital and Columbus Children’s. Upon completion of his fellowship in pediatric surgery, Birken moved to Hollywood, Florida where he has spent his entire professional career. Presently, Birken serves as the Surgeon-In-Chief of the Joe DiMaggio Children’s Hospital.

As an Author, Gary Birken approaches novel writing as a means not only to entertain, but to educate the reader in a particular area of medicine. Birken’s approach to each book is first selecting a timely or controversial topic in medicine and then, using it as a springboard, Birken weaves a story of suspense and conspiracy around it.

When Birken is not in the operating room or writing his next medical thriller, he plays tennis, basketball and holds a black belt in martial arts.

Reviews

[Cathrine "Capi" · Rating 4 out of 5]

I have really enjoyed this series, and this one was no exception ... except the editing for this Kindle edition was ATROCIOUS! I bypassed many typo, grammatical, extra word/missing word phrases errors, etc. until about halfway through, then I started editing..there were pages where I found 2 or 3 major errors (and a couple minor errors too!) and I found myself being distracted by the errors and not following the story. Several places where the wrong name was given...ugg....having been a medical transcriptionist/editor for 50ish years, this kind of stuff drives me NUTS!!! Hopefully the publisher will get my submissions and decide to go through the text a little more closely. I will be reading the next book in the series, because I like medical mysteries, so hopefully it will be edited better!

[Jayne · Rating 5 out of 5]

captivating medical thriller

I have read all 3 of Gary Birken’s novels. I hope there are a lot more to keep us readers captivated. One complaint - there are way too many typos in his books. I am a stickler for correct spelling and wish that the editors would do a better job at their craft,

[R.E. E. Derouin · Rating 4 out of 5]

Treachery by Design by Gary Birkin 9/3/2025 Kindle

This book is the second in which doctors Jack Wyatt and Madison Shaw join forces to chase down an elusive malady. This case hits closer to home as Jack’s ex-wife is the afflicted patient. Her mixtures of multiple symptoms make a diagnosis and the possibilities of cure, near impossible. She is not alone in her suffering, as nearly a dozen coworkers have fallen to the same ailment. Their employer and the government, to whom they have contracted, have a strong interest in moving attention away from them.

I found this an interesting read, though logic was stretched when little was done to establish a connection among the ill. There was an abundance of medical information that made for dry reading at times, but overall I enjoyed the story and characters. Yes, I’d recommend this book, especially to those who enjoy medical mysteries.

[Kerry Moquett · Rating 3 out of 5]

The book starts out well asa medical mystery puzzler and builds up suspense. (SPOILER ALERT). But the last quarter of the books gets mired down in espionage theme that at best muddied. It seems the authrioe tried to do too much in the book and missed the mark. There are confusing elements at the end that are not wrapped up well. The ending of the book is not satisfying and leaves the reader with the question of why did I read this. Books 1 and 2 in the series are cohesive and well done overall. This Book 3 was a disappointment at the end. I am not sure I want to read any more by this author.

[Jacob Peled · Rating 5 out of 5]

This is the fifth book by Gary Birken that I’ve read, and once again he delivers a flawless five-star medical thriller. Birken knows exactly how to combine nonstop suspense with authentic medical detail, creating a story that is both gripping and believable. The novel weaves together conspiracy, murder, complex illnesses, and the looming threat of a pandemic, keeping the tension high from start to finish. The pacing is tight, the stakes are constantly rising, and the medical elements enhance the plot rather than slow it down. This is medical suspense at its best and a must-read for fans of the genre.

[Nancy · Rating 3 out of 5]

While I liked this third installment in the Jack Wyatt and Madison Shaw medical mystery series, I liked the first two books much more. Perhaps that’s because this one involved the federal government, a government contractor, corrupt government and corporate officials and espionage all the while preying on everyday workers. Although the first two books had a number of typos, this book had many instances where you had to re-read the sentence to be sure what the author was trying to say. Get a new editor!

[Dayle · Rating 5 out of 5]

Buckle your seatbelts.........

Death defying Drs. Wyatt and Madison are faced with overwhelming patients with no understanding diagnoses available. Thrust into the lives of patients (including a former wife) ,they try to relieve the obstacles to further lives by taking the bull by the horns and trying to solve the mysterious ailments. Adding insults to injuries, there's the big company pulling strings in the background. Many thanks GB for a great story.

[Andrea · Rating 4 out of 5]

Recommended reading

While I really enjoyed the medical sleuthing parts, I wasnt too enthusiastic about the political/espionage parts. Altogether a great read. Could have gone more into how the heavy metal toxins were delivered and the victims reactions instead of just wrapping up at the end.

[Paige Turner · Rating 3 out of 5]

Not as good as the first two in this series. It was too bogged down in details that didn't add to the story. One thing I found very annoying is all of the errors in the book. Not just typos or grammatical errors, but character names were incorrect several times. Don't publishers staff competent editors anymore? I am seeing this more and more often in newer books.

[Dee Flores · Rating 5 out of 5]

Just when you thought it couldn’t get any better, it did!

This is my third book in this series and it was so very good. I am a big fan of Mr Birken. His book was full of suspense, great characters, and mystery. I also enjoyed the medical information shared within the story. Needless to say I’m starting #4 this evening.

[Cheryl Lynn · Rating 5 out of 5]

Scary premise

As always excellently written, I enjoy his books. This medical mystery was a little dense at first I think it always helps to have some medical background. The idea that poising would be a solution for any activity is really frightening, but obviously possible in this political environment.

[Lillian Folk · Rating 4 out of 5]

Hire a decent editor!

The editing of this book is abysmal (actually, practically nonexistent). There are glaring errors in almost every paragraph, which I found very distracting, and which repeatedly pulled me out of what is otherwise an interesting and engaging story. The first two books in the series did not share this weakness.

[Kathryn · Rating 5 out of 5]

Thrilling narrative!

Really got my attention and kept me up all night reading. It was an intriguing thrill ride all the way. I am now starting on my next book by this author, I like his style!

[Lori Kovacich · Rating 1 out of 5]

Not for me

Got all three books. First one I really got into. After starting the second one, I began getting bored. Saying the same thing kind of over and over. Reading the third one, I couldn't wait to finish it. Just to much of the same thing.

[Amy Spielman · Rating 5 out of 5]

another great mystery solved

Fast moving and extremely accurate this mind blowing story is a great read. Characters are believable and problem solving is mind blowing and makes you think twice about our government and the secrets they try to hide.

[Maryjo · Rating 5 out of 5]

fast paced medical thriller

This mystery has a “can’t put it down” element to it and great likable heroes! The medical mysteries are compelling and I always learn something from them.

[Cherie Williams Anderson · Rating 2 out of 5]

Lots of characters

This book had a lot of people to keep up with, several times I found myself going back and rereading certain passages to get it clear in my head. Overall an ok book but took to long to developer imo

[Laura Poppenwimer · Rating 3 out of 5]

This was the least engaging of this 3 book series. I had a hard time staying focused and put it down several times before I decided to read to the end. The writing seemed stilted and the plot didn't flow.

[Christine · Rating 5 out of 5]

Another excellent read written by Gary Birken. I don't do spoilers as that's not fair to the next reader. This is the last book written with Jack & Madisen until he writes the next one most likely in 2026. So it's back to his 6 stand-alone novels.

[Dr J.N.Taylor · Rating 5 out of 5]

Well written and accurate. (I am a retired physician)
Good storyline
Hope there is a Book 4 etc.

[Terri Stewart · Rating 4 out of 5]

Wow!

I was hooked from page one to the very last page. I'll absolutely be reading more from thus author at every opportunity.

[tina boehne · Rating 5 out of 5]

Super great

Wow awesome great super I loved it, really a page turner lots of twists n turns just had to finish

[Elizabeth · Rating 2 out of 5]

The author needs to hire a new proofreader! It's absolutely shameful the number of errors in this book!!! Good story otherwise!

[Jane C. Anderson · Rating 5 out of 5]

Treachery by Design

Some medical problems are almost never solved but with Jack Wyatt and Madison Shaw on the case it's a sure solve! Read and enjoy?

[sheryl boltz · Rating 4 out of 5]

Defense or Offense

Vaguely written. The story was OK but it never went anywhere . I cheered for the closer as she got all the action. Don't trust the government.

[Sandi Gillespie · Rating 4 out of 5]

WOW

This book was a good read. It made you think of what’s going on in our government right now. I await your next book

[Claude Lindley · Rating 3 out of 5]

similar plot

This one was more of the same type of plot. Personally I was disappointed in this one. So, I am unable to recommend this one. Sorry.

[Sue Hubbe · Rating 4 out of 5]

Good Story

Storyline is intriguing, but they don't proofread like they used to, and errors can be distracting. Dr. Birken is a good writer..

[Gloria A. Hacker · Rating 5 out of 5]

Great story!

It was exciting and kept me wanting to continue reading. I like medical stories and found this one very interesting. Ill read more by him.

[Julia Lawrence · Rating 4 out of 5]

great book

I think I have read all his books now. SAD. WRITE MOOR SOON PLEASE
I HIGHLY RECOMMEND THIS AUTHOR. THANKS