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Sinister by Design: An Authentic Medical Thriller
A mysterious illness is attacking new mothers, its root cause unknown. It's fast. It's deadly. And it may not be random.An outbreak of a new illness involving women who are all one-month postpartum leads a colleague to call on Drs. Shaw and Wyatt. When the high-profile daughter of the Governor becomes a victim of this seemingly random ailment, their unique mystery-solving skills are caught in the spotlight.
In their race to save the women, they uncover odd similarities amongst the mothers that point to disturbing conclusions about its root cause. The more they learn, the more dangerous and involved the situation becomes. And when related parties are found murdered, they must race against time to uncover the truth.
But with an increasing number of lives on the line, can they unwind the twisted knot before it's too late?
Sinister by Design, the nail-biting fourth book in the Madison Shaw and Jack Wyatt medical mystery series by Gary Birken, M.D., is perfect for fans of intricate plots, surprising twists, and chillingly authentic medical content.
In their race to save the women, they uncover odd similarities amongst the mothers that point to disturbing conclusions about its root cause. The more they learn, the more dangerous and involved the situation becomes. And when related parties are found murdered, they must race against time to uncover the truth.
But with an increasing number of lives on the line, can they unwind the twisted knot before it's too late?
Sinister by Design, the nail-biting fourth book in the Madison Shaw and Jack Wyatt medical mystery series by Gary Birken, M.D., is perfect for fans of intricate plots, surprising twists, and chillingly authentic medical content.
419 pages, Kindle Edition
Published February 10, 2026
364 people are currently reading
42 people want to read
About the author
Gary Birken
15 books140 followersGary 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.
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.
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Displaying 1 - 8 of 8 reviews
March 6, 2026
Sinister by Design by Gary Birken 2/15/2026 Kindle
Doctors Jack Wyatt and Madison Shaw are called in when the daughter of a Governor is one of several women suffering an unknown ailment shortly after giving birth. While the root cause of their sickness remains a mystery, each victim was attended by the same doctor. When other victims are located in a different hospital, it is learned that the same physician was also nearby. While the blame seems directed at him, it becomes apparent that there is a human cause behind the epidemic. The search for answers becomes imperative as the patients slip closer toward death.
Wyatt and Shaw must overcome hospital politics to convince the hierarchy of the proper direction to a cure while trying to determine the culprit behind the mayhem.
While there are too many similarities among the installments of this series, each is interesting and holds the reader’s attention. I recommend the book to anyone who likes a medical thriller.
Doctors Jack Wyatt and Madison Shaw are called in when the daughter of a Governor is one of several women suffering an unknown ailment shortly after giving birth. While the root cause of their sickness remains a mystery, each victim was attended by the same doctor. When other victims are located in a different hospital, it is learned that the same physician was also nearby. While the blame seems directed at him, it becomes apparent that there is a human cause behind the epidemic. The search for answers becomes imperative as the patients slip closer toward death.
Wyatt and Shaw must overcome hospital politics to convince the hierarchy of the proper direction to a cure while trying to determine the culprit behind the mayhem.
While there are too many similarities among the installments of this series, each is interesting and holds the reader’s attention. I recommend the book to anyone who likes a medical thriller.
February 12, 2026
A masterful medical thriller!
Sinister By Design, book 5 in the Madison and Shaw series, brings the protagonists to Florida to investigate a mysterious illness afflicting women who gave birth a month ago..... at the same hospital. Madison and Shaw are a great team, with strengths and weaknesses that balance each other perfectly! The plot of Sinister By Design is very, very good, with pacing that is a perfect match. The illness is frightening and seemingly inexplicable. The writing is absolutely fantastic, with very real feeling medical environments. Overall, 5/5 well earned stars! Highly recommended to any fan of medical thrillers and thrillers in general!
Sinister By Design, book 5 in the Madison and Shaw series, brings the protagonists to Florida to investigate a mysterious illness afflicting women who gave birth a month ago..... at the same hospital. Madison and Shaw are a great team, with strengths and weaknesses that balance each other perfectly! The plot of Sinister By Design is very, very good, with pacing that is a perfect match. The illness is frightening and seemingly inexplicable. The writing is absolutely fantastic, with very real feeling medical environments. Overall, 5/5 well earned stars! Highly recommended to any fan of medical thrillers and thrillers in general!
February 15, 2026
OUTSTANDING UNEXPECTED CHALLENGES!
I liked the feeling about the care the patients were given as the story evolved. The communication between characters felt real and honest. I was honestly surprised by the ending and that was a pleasant surprise because I read so many books I often figure out the ending! I HIGHLY RECOMMEND THIS BOOK!
I liked the feeling about the care the patients were given as the story evolved. The communication between characters felt real and honest. I was honestly surprised by the ending and that was a pleasant surprise because I read so many books I often figure out the ending! I HIGHLY RECOMMEND THIS BOOK!
February 24, 2026
Great read
I’ve read all the books in this series and they all have been spine tingling. You’ll want to get to the end quickly. Don’t do it! I truly enjoyed the characters in this book. Don’t forget to read all the books in the series. You’ll love them all.
I’ve read all the books in this series and they all have been spine tingling. You’ll want to get to the end quickly. Don’t do it! I truly enjoyed the characters in this book. Don’t forget to read all the books in the series. You’ll love them all.
March 24, 2026
Very good read
Such a complicated virus. I didn't know if it was curable. Jack and Madison were awesome in finding a cure. The part about the case against Joseph Church being the cause of the virus was a shock. A must read.
Such a complicated virus. I didn't know if it was curable. Jack and Madison were awesome in finding a cure. The part about the case against Joseph Church being the cause of the virus was a shock. A must read.
March 27, 2026
I’ve read books by this author before and really enjoyed them. I found this book to really drag along. After awhile I was asking myself when something was going to happen. Too tedious and not much fun:(
February 23, 2026
The best
You are the best So talented I have read all the books When is the next I am afraid of flying but not with you
You are the best So talented I have read all the books When is the next I am afraid of flying but not with you
March 26, 2026
Another Compelling Story
Lots of twists and turns in this page turner. Keeps you guessing right to the end. Birken is a great storyteller.
Lots of twists and turns in this page turner. Keeps you guessing right to the end. Birken is a great storyteller.
Displaying 1 - 8 of 8 reviews