Unexplainable death under anesthesia occurs almost daily in American Operating Rooms. TERRO.R. is a contemporary maze of intrigue and frightful medical investigative discoveries in such cases of cardiac arrests on the O.R. table. Hopefully, this timely novel is fiction...
In his first outing, Neuschatz has done himself proud and written a novel that bodes well for more work to come! But TerrO.R. is a debut novel that is not without its flaws.
The good news is that the plot premise is imaginative (dare I say unique), compelling and frightening.
As an anesthesiologist, Dr Philip Newman is all too aware that tragic, sudden, unexplained deaths sometimes occur on the operating table. So when James Walker, a young man in perfect health, succumbs to cardiac arrest during a routine cosmetic surgical tattoo removal, Newman is devastated but not unduly surprised. But when an autopsy is forbidden by the family on religious grounds and a massive malpractice suit is served with such blinding speed that Walker's body has barely had a chance to cool, Newman begins to question events more closely. Eerie similarities between Walker's operating room death and other similar unexplained fatalities have Newman balking at what would otherwise be an automatic out of court settlement of the malpractice suit. With the cooperation of hospitals, surgeons and anesthesiologists from across the country, Newman conducts an Internet based epidemiological investigation that uncovers a plot so frighteningly plausible you'll find the hairs on the back of your neck tingling with horror.
The even better news is that Neuschatz writes well! The daily life and work of an anesthesiologist are included with a wealth of arcane minutiae and technical detail that could easily blow right over the heads of lay readers or simply bore them to death as the plot bogs down and fails to move forward. But Neuschatz seems to have deftly avoided these problems. His writing educates, informs, entertains and manages to keep a compelling plot firmly on track.
Now here's the bad news.
It is clear that Neuschatz has serious criticism to level at the US legal system, the liability insurance system, the overwhelming litigiousness of US society and the fact that many malpractice suits are settled automatically out of court (regardless of actual fault) with the resulting costs being passed on to medical practitioners in the form of increased liability premiums. In fact, it is these very problems that form the quite plausible basis for Neuschatz' ingenious plot premise.
However, Neuschatz let his emotions get in the way of his writing and the resulting ending was a serious letdown for this reader. He forgot that the criminals in his thriller were the perpetrators of an enormous fraud that got discovered. The hospitals, the doctors AND the insurance industry were the victims - I repeat - the victims. But once the plot had been uncovered and revealed for the fraud it was, Neuschatz simply dropped the thriller plotline like a day old hot potato now gone cold and swiveled his gun sights to the insurance industry.
Instead of offering constructive criticism as to how the insurance and legal industry might make changes to prevent the real occurrence of a fictional story like this one, he ended his novel with an epilogue that was pure vitriol and sarcasm directed at judges, medical malpractice lawyers, juries and HMOs. As a result, I was left with the final sour thought that perhaps Neuschatz considered the cons as simple users of a flawed system and the system itself to be the criminal. Neuschatz is entitled to his opinion, of course, but ... purely from the point of view of reviewing TerrO.R., the ending flattened the entire reading experience and dragged what might easily have been a 4 or 5 star exciting debut down to a 3-star overall impression at best.
I would advise some movie or TV producer to take an option on this frankly amateurish, but nonetheless, terrific first novel. He or she will get not only a first rate plot idea, nicely delineated, but an expert script advisor since author Dr. Joseph J. Neuschatz is, like his hero, "Dr. Philip Newman," a practicing anesthesiologist.
This "Philip Newman, M.D." may or may not bear a striking resemblance to Joseph Neuschatz, M.D., and this may or may not be a memoir slightly embellished for novelistic purposes, and indeed, this may or may not, as the blurb on the cover suggests, be fiction. (Actually, Neuschatz's tagline is "I hope this timely novel is fiction." Nice. Even better would be simply, "I hope this novel is fiction." The "timely" is a little too cloying, like something from a TV commercial.)
Ironically I cannot tell you what makes this novel so interesting and so worthwhile since to do so would reveal the ending. Some works of literature begin with the ending and nothing is lost. Some works depend heavily on the ending being unknown to the reader, otherwise the story is spoiled. In the case of this "terror in the Operating Room" tale, it is better if you read the book without knowing how it ends; but trust me, Neuschatz's idea is ingenious, and for all I know might have actually happened.
Another strength of the novel is the absolutely authentic detail about the life of an anesthesiologist that Neuschatz presents. We learn how he works and what he worries about, what his days (and nights!) are like, what his relationship with other professionals in the OR is like. We get a sense of what the pecking order and the shared (and singular) responsibilities are. In reading this I gained a new respect not only for doctors but for anesthesiologists, about whom hitherto I knew almost nothing.
Here are a couple of interesting bits of information gleaned: (1) "The masseter, the muscle we bite with, is by far the strongest muscle in the entire body" (129); (2) Epinephrine and adrenaline are essentially the same thing. (I always wondered about that.)
There are some problems with the novel. Neuschatz could have used a professional editor. A more diligent proofreader would have helped as well. There are many typos, curly quotes running the wrong way, and sometimes left out, and way, way too many exclamation marks(!) Here's secretary Jennifer and Dr. Phil saying good-bye on the phone from page 55:
"See you soon, Phil!" "See you soon Jen!"
And here's Dr. Phil greeting Dr. Ed (p. 63):
"Good morning Ed!" "Good morning Phil!"
(Actually this could be played for comedy, come to think of it. If some producer does make a movie of this I would recommend a kind of tongue-in-cheek mock documentary style with an overriding air of mystery amid the Internet sleuthing.)
Near the end of the novel one has the feeling that Neuschatz and his proofreader were in a big hurry, e.g.:
On page 142 a surgeon is quoted as saying: "You better don't think that I am going to say nice to meet you!" I think the "don't" should be "not."
On page 144, there is a question about whether a plastic vial for potassium cyanide existed during Hermann Goring's time. Phil Newman says, "I don't think it wasn't invented yet." I imagine he means, "I don't think it was invented yet."
And on page 145 Newman says he likes "French food, but you're not going to make me watch Jerry Lewis movies are you? French would great!" No doubt he means "French food would be great."
A dialogue doctor wouldn't hurt. Although some of the dialogue is actually first rate, and some of it is refreshing in being something close to...well, corny, some of it is just plain unnecessary and artificial. Dr. Phil Newman is a corny man, and I have known a few doctors, and they can be as corny as Kansas in August (if you will), and so that's okay. In fact, Phil Newman's penchant for corny jokes is kind of endearing. Here are a couple:
"Good morning Phil! Have you met my new assisting partner, Dr. Rahman? His real name is Saleem, but we call him Sam." "Good morning Sandy, and good morning Sam. My real name is Doctor Philip Newman but, after we work together for at least five minutes, you can call me Phil!" (p. 104)
Dr. Newman's wife says something about ham in a deli, and then being told that it is a kosher Jewish deli, puts her hand over her mouth and says, "Oops! I forgot." Newman advises her that she has just used an expression he hasn't heard in years, a word forbidden in Operating Rooms. She wonders what the word is. Newman replies, "The absolutely taboo surgical word is: 'OOPS!'"
One more: the operating room devoted to chest and lung cases, "known for its abundant sputum and blood" is nicknamed "Marlboro Country."
A more dramatic plot unraveling would also help. The reader should discover and figure out things on his or her own. There is too much interior monologue explaining and too much talking the plot. While the "victims" have beards (hint #1) their tattoos could have ominous meanings--nothing as obvious as "God is Great" of course (hint #2), but maybe--well, I can't say.
Bottom line: an intriguing story line, some excellent doctor/OR detail and atmosphere, and an agreeable protagonist overcome some inexperienced novel writing skills to make this just the sort of book that is interesting and fun to read, and a book that--I am not kidding--might very well be made into a movie or a TV drama.
--Dennis Littrell, author of the mystery novel, “Teddy and Teri”
This book goes behind the scenes of the operating room world where anesthesiologists have no more than transitory contact with patients before they go under the knife. The concept behind the novel is scary and adds to the mystery of what is happening in the plot as the protagonist doctor tries to unravel why a young man would die under curious circumstances. Meanwhile, the reader is brought more into the world of the science behind anesthesiology and why it's so important to have a good one if you ever need surgery!
The book keeps you at the edge of your seat as you learn more about this physician and his life's work, his love for his wife and how technology helps to solve a medical conundrum.
TerrOR written by Joseph J. Neuschatz is a different kind of thriller. As I read the novel I cringed, waiting for it, the gun wielding or knife slashing bad person around every corner. It seemed like I was being built up for that moment, but it never occurred. I was glad because I liked the characters in the story. However, the title; TerrOR is fitting for this novel. It’s just not the kind that jumps out at you but nonetheless can give you nightmares. This could be a novel mimicking a documentary that could happen. This is an easy, feel good read.
This book was written by my grandfather who passed recently. Dr. Neuschatz was an incredible man, and he wrote this book in his fourth language. I’m glad to have this piece of him that I can hold onto. Thank you for reading and keeping his memory alive!
TerrO.R – a medical liability novel is written by Joseph J. Neuschatz and is available through amazon.com
Joseph Neuschatz born in Romania now lives in New York. An Israeli defence Sergeant and an Anaesthesiologist in New York after taking medical school in Paris, France. Joesph is retired and has appeared in many publications such as New York Times and Newsday. He is also an ex-regular columnist for Long Island's The North Shoreian Magazine. The "TerrOR" novel was inspired by an old, never explained operating room incident. Phil Newman M.D. is an anaesthesiologist looking forward to an afternoon of tennis but first he has a few surgeries to deal with. When a simple tattoo removal goes bad Phil Newman MD begins to wonder if it was merely a case of the unknown or if perhaps there is something more sinister going on. But when he learns legal proceedings have began and earlier than normally expected, alarms start ringing. Even more alarms begin ringing when another doctor from another hospital calls having experienced exactly the same situation several months earlier and worse yet these aren’t the only cases. Starting their own investigation Phil is about to discover that sometimes things aren’t as simple as they may at first seem and that there can often be a bigger picture globally rather than locally. Is someone looking to gain funds by medical aided suicide? And if so who? And why? Is this just a case of revenge? Or something a lot bigger? Possibly involving terrorism?
TerrO.R really is terrifying. Being a doctor with so much responsibility must make one feel like Atlas holding up the world, and with so many things that can go wrong if questions aren’t asked / answered must be very stressful if and or when things do go south. This book really does make you want to let every detail out should you have to go to hospital, but sadly no-one will ever know every little detail about their bodies tolerances and intolerances since they can change over time. Whilst the story itself is riveting, I do personally feel that the first three quarters of the story is full of so much medical information it is possible to get a little confused although in most cases Joseph has explained in detail what is going on or what the condition is, perhaps too much information however Joseph himself being a Doctor perhaps makes explaining to the average person a difficult task in itself and you do have to commend him for his efforts. There was also at least one incident within the story that I was not quite happy with, that I feel the story had not quite been rounded off to my liking ie I thought something was about to happen but sadly not. Joseph Neuschatz is a good writer, do not get me wrong, there are just times I feel that the Doctor took over when really the writer should have. However, the story is very straight lined and clean, therefore I would recommend it to anyone who enjoys novels based in the Operating Room and a tie to real life possibilities but, if you’re looking for something a little steamy then this book is not for you. I give TerrO.R – a medical liability novel 4 out of 5 stars.
I was approached by the author and given a free copy of his book to read and review.
This book is actually very up my alley. Being a medical professional myself, I love medical thrillers. This book is about an anesthesiologist Phil Newman and his realization that something sinister is going on in his OR and that he may take the fall for these events.
There are strong points to this book. It's obvious that Dr. Neuschatz has extensive medical knowledge. Verisimilitude is not an issue here; we believe that the Phil Newman is an anesthesiologist, and that he knows his stuff. The ultimate plot is very interesting, and I admired the ending, but it is buried and almost hidden (see next paragraph).
There are other problems with this book that are detailed rather eloquently by other recent reviewers, and that I completely agree with. While we don't doubt the medical knowledge, the way that it is presented is clumsy and almost in a textbook manner. Important words are italicized as if the author is teaching a medical student. Instead of those details surrounding the actual story, it almost overloads the story. There are long passages about his research interests and paragraphs in second person, lecturing us on why he does certain things. The narrator wouldn't actually do that in real life, he'd just do his job because it was second nature to him. It might have been better to have a medical student present so there would be a reason to lecture and explain medical terminology to the audience.
Second, the conversations were stilted and did not flow naturally. I've heard this is a second language for the author and that in itself, is an accomplishment, to write a book in another language. However, he sorely needs a good editor to go over the flow of his writing and correct grammar and other mistakes.
That said, this is a decent first effort, and with a better editor, the next book will be much improved.
What a different concept to say the least. A routine tattoo removal turns into rapid tragedy. The patient, Mr. Walker dies on the table for no apparent reason. Our favorite anesthesiologist Dr. Newman is informed that within twenty-hours of the Mr. Walker's death a lawsuit is going to filed for malpractice. No one at the hospital, including his boss has ever seen a suit filed so fast. Now that is an attention getter in itself. The hospital administrator wants Dr. Newman to cause no waves and sign on for the settlement option and continue business as normal. The good Dr. will have none of it. Something is "fishy in Finland" and he wants to find out what really caused Mr. Walkers death, or will he?
Was Mr. Walker's death a freak event, or is there something more sinister in his passing? I don't even think Tom Clancy could fathom this basis.
Okay, that is the general premise of the story. It is a very fast easy read and ensures to keep the reader engaged with the style of writing. The chapters are short and exciting. This is the first book I have read with this style and flow. Very refreshing.
On a personal note, I have endured seven surgeries in fifty-two short years and treated the first six as routine. I have a new appreciation for what is at stake after the seventh operation and in reading this book. No surgery or especially the anesthesia is routine. There is always a risk no matter how well the operation is planed out. Like the construction industry I was a part of for twenty-five years, even the best plans can fail. I gained a healthy respect for the men and women who have been in the pre-op, OR and post-op after all of the procedures. We aren't perfect, we're just human.
For those in the medical field, I believe you will enjoy the re-write of the Hippocratic Oath. It definitely deals with today s world.
3.0 out of 5 stars Doesn't hit the mark as a "thriller"......, October 12, 2008
This review is from: terrO.R. (Paperback)
OK the book would have been better if someone had edited it properly. I got so annoyed with small errors in spelling, word use, vocabulary errors, verb tense, etc. Sometimes I couldn't get past it. The dialog is stilted and reads more like a script for a TV show rather than a piece of literature. Anyway, the story was about young males having tattoos removed who died during anesthesia - usually from PVCs deteriorating into V-fib -- and the patients are unrevivable. An investigation ensues and a group of anesthesiologists starts researching and examining these deaths by following the money and by trying to get patient histories. The answer: can't reveal the spoiler but let's say it was anticlimactic (look at the title). There were a lot of medical details in the book that I enjoyed because I'm an ex OR nurse, however, I kept waiting for some "thriller" but there wasn't any. Each time there would be a new case or Phil would meet a new person I'd think, "OK now we're going to be introduced to the bad guy." Anyway - it was OK.
WHEN PATIENTS DIE UNEXPLAINABLE IN OPERATING ROOMS, WHEN MEDICAL MALPRACTICE LAW-SUITS START, A NEW YORK ANESTHESIOLOGIST BECOMES MEDICAL DETECTIVE. AFTER ELIMINATING, PHARMACOLOGICAL, PATHOLOGICAL, CHEMICAL AND OTHER POSSIBLE CAUSES, HIS TIMELY DISCOVERY IS NOT ONLY SCARY, BUT ALSO SUPER CONCEIVABLE. ON THE FRONT COVER A GOOD QUESTION: "FICTION ?"
Despite being a medic, I have to admit to being a bit of a sucker for pulp fiction of the Robin Cook 'Coma' type. Which is pretty much where 'terrO.R.' (ridiculous title) hails from. And not a patch on it, sad to say. The plot is preposterous and the segue from death by tattoo to terrorism is bizarre in the extreme. And there's simply too much showing off of anaesthesiology.