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New York Times and USA Today best-selling author Pull a trigger and everything changes. Medical student Laura Nelson had just finished examining her first patient when she is forced to make a split-second decision that will alter the course of her life―forever. One life will end, and one life will never be the same. But keeping her dreadful secret will be one of the toughest challenges Laura will ever face. With a persistent and perceptive detective hot on her trail and a host of eerie incidents suggesting that maybe her secret isn't really a secret, Laura is drawn into an unseemly web of peril, deceit, and treachery and is forced to risk both her freedom and her sanity. Will her deadly secret come to light, or must she live forever in the shadow of death? Set amidst the upheaval and smoldering chaos of the Detroit riots of 1967, Shadow of Death is a haunting tale of unrest, fear, and consequences. Hailed as a stunning debut novel, Shadow of Death provides a spine-chilling glimpse of what lurks in the shadows.

360 pages, Hardcover

First published March 1, 2006

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1029 people want to read

About the author

Patricia Gussin

15 books94 followers
New York Times and USA Today best-selling author Patricia Gussin is a physician who grew up in Grand Rapids, Michigan, practiced in Philadelphia, and now lives in Longboat Key, Florida and Amagansett, NY. She is the author of seven novels including Shadow of Death, nominated Best First Novel by the International Thriller Writers Association, and After the Fall, Gold Medal winner of the Florida Book Award for Popular Fiction in 2015, and second-time Gold Medal Winner for Popular Fiction in 2017 for Come Home. Patricia’s novels are classified as mystery/thrillers and fall within the sub-genre of domestic suspense. Her novels are inspired by her medical expertise and her experience as a mother of six, trying to balance family and career.
She and her husband Robert Gussin are also vineyards owners in New Zealand, growing grapes for Villa Maria Estates Winery.

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5 stars
182 (26%)
4 stars
212 (31%)
3 stars
187 (27%)
2 stars
78 (11%)
1 star
22 (3%)
Displaying 1 - 30 of 54 reviews
Profile Image for Amber.
10 reviews1 follower
December 23, 2011
I'll admit I was interested in what was going to happen next but I also found myself growing increasingly incredulous at all the many coincidences, etc. I found the entire premise of the book a little difficult to believe and even aggravating at times. Further, I couldn't help but roll my eyes at certain aspects of the story that were introduced and then barely touched on and/or shrugged aside as if it no longer mattered. All in all, a decent read but not one that I would read again.
55 reviews1 follower
April 1, 2013
This was interesting for the first half of the book then there were too many coincidences to make it even remotely believeable. The second half seemed to drag on with the question of what is going to happen next and how can such an intelligent woman make such incredibly dumb decisions. If the book ended around midway, it would have been more enjoyable and more believeable. The writing style was very good as the story flowed but it kept making unnecessary turns.
Profile Image for Cindy Stavropoulos.
170 reviews3 followers
June 28, 2020
Interchangeable Lives & Coincidences

Despite the not so good reviews, I really, really enjoyed this book. It is fiction but the 1968 riots and humans lives mirrors the aspect of today’s world. It’s interesting how this book illustrates the past but in today’s world the situation remains the same. I loved how the characters were interchanged and connected. Because, I believe we do all interchange and connect in some way or form for reasons we may not understand. The book is centered on Laura, a med student. She is married with children and endured a horrific experience after leaving the hospital one night and manages to live her life all the while feeling fear and desperation. She becomes mentally detached from her husband, Steve, and falls for another man. (No spoilers) The other characters in this book play vital roles in the consequence and shattering experience that she encounters. The characters’ lives are also effected and some overcome their own obstacles. All was very coincidental and I’m not so sure those commonalities could really happen in real life orrrrr......could they? I enjoyed the book and didn’t realize it was a series so I may grab the next one.
Profile Image for Amelia Christensen.
29 reviews1 follower
February 28, 2025
Me encantó el libro. La historia de desarrolla en 1967-1971 en Detroit, en tiempos de mucha violencia en la ciudad por temas raciales y desigualdad socioeconómica. Es fuerte, toca temas difíciles como sexual assault y asesinato, pero la manera en q se desarrolla la historia me hizo leerla en un día sin poder parar. Me gustaría saber más de las Detroit riots de 1967 luego de leer el libro, y eso es lo que más me gusta: que los libros que leo sean una puerta para conocer más del mundo.
Profile Image for Gina.
1,171 reviews101 followers
April 10, 2016
This book wasn't really a murder/ mystery but really a family drama revolving around around a murder. I did like learning about a time in history, the Detroit riots in the 60's, but I did find the story a little unbelievable. Laura Nelson is a Med Student and the book follows her studies through her four years of medical school in City Hospital in downtown Detroit starting just months after the end of the riots when racial tensions are still high. I had a difficult time believing that such a smart character such as Laura would keep making such dumb decisions that would threaten her career. She kept major secrets from her husband, Steve, but was critical of him when he held back on her. There were just so many things that happened to Laura that it was just incredible that no one caught on to what had really happened, especially when her best friend from school, Susan, was the detective's only daughter. I can't believe no one put together all of the coincidences surrounding Laura's experience. It was all just too much! I couldn't maintain my level of believability even though I knew it was fiction. There were too many twists and turns that the author threw in that it all became too much. I don't think I will be continuing with the series because there are better books out there IMHO. 3 stars.
Profile Image for Karla.
604 reviews10 followers
September 13, 2009
Melodramatic and predictable - this would make a good Lifetime movie.
Profile Image for Betty.
337 reviews20 followers
July 22, 2018
Categorizing this as a mystery or suspense is ridiculous. There was no mystery element at all. This was a psychological drama about the impact of crime. There was a minor level of suspense, minimized by the reality that it was obvious things would not turn out well. And the absurd number of coincidences made the entire story pretty preposterous, to the point that one of the big reasons I found myself continuing to read the book was to discover the next unlikely connection between characters from vastly divergent lives.

I would ordinarily give this only a single star, but it earned the second star because I did like Laura and her circle of friends. And it was a good reminder of the challenges that women face when trying to enter a male-dominated field, and especially how exponentially greater those challenges were not terribly long ago, with pressure and little to no support from friends, families, and colleagues and constant criticism of a decision to be something other than a stay-at-home mom.
Profile Image for Jamie Pancake.
Author 1 book1 follower
September 4, 2018
Laura is a medical student, who, despite the fact that her husband would rather that she stay home and raise their children, works hard each day in the classroom as well as in the hospital when she is seeing patients. After she is raped and forced to defend herself with deadly force, she fights to keep the events of that evening a secret, even as she learns how close her family is to that of her assailant.
Profile Image for Donna Mallery.
958 reviews86 followers
September 8, 2024
I really enjoyed this book. I’m not sure why there were many subpar reviews! Poor Laura has her hands full as a mom and medical student! Talking about pressure! There’s a lot happening in this story, and that might have been too much for many. There’s a ton of characters and lots of violence! Leading to police interference. And Laura is in the thick of the detective’s suspicions. There was one minor part that kept this from being 5 stars for me.
48 reviews1 follower
December 8, 2024
Reminded me of Crash

I really enjoyed this book. It reminded me of the 2004 movie Crash. The character's lives interact and weave together in dramatic life-changing events.

The book follows Laura, a medical student, during the 1967 Detroit riots throughout her 4 year education. Many racial interactions between her family and the Diggs/Jones family.

I will be reading more in this series
161 reviews
May 4, 2018
I really enjoyed this book - a romance mystery. It explored much of the rage of the Chicago riots in the 60s and certainly gave me some new insights to life for those caught in poverty there.

The author explored family relationships and how unexpected and complex they can be. People do inexplicable things out of love, terror and fear.

I will definitely read the next one in the series
Profile Image for Cynthia Scott.
20 reviews2 followers
February 1, 2021
Not even remotely believable. The story drug on and on with coincidence after coincidence to the point of absurdity. The main character made choices that left me with little sympathy for her. I think this could have been a much better book without all the melodrama and I don't feel i could recommend it to anyone. Will not continue the series.
Profile Image for Holly.
114 reviews
February 25, 2023
slow at first

It starts very slow and a very immature depiction of the characters. As Laura becomes close to Dr Monroe, the story picks up, and it seems the the author has found his rhythm. The coincidences start coming together and the situation gets more dire for her. I read the last third in one sitting, the climax was worth it.
Profile Image for Christina.
241 reviews
January 3, 2017
Pass on it.

This one was just a bit tedious for me. There are far too me many oddities. I found the diction to be annoying at times. It was just not the kind of book that I could enjoy.
Profile Image for Karren.
248 reviews2 followers
November 6, 2019
I had to finish it, but I began to lose interest in how incredibly unbelievable the main character is. Come on - she must be Wonder Woman. For me even fiction has to have a degree of believability, so that’s what spoilt it
Profile Image for Jennifer.
34 reviews3 followers
February 25, 2025
Couldn't put this one down

So much wound into this story. Racism, hatred, guilt, and fear, but also love. This author will definitely be one that I follow and I can't wait to read the next book in the series.
796 reviews1 follower
July 27, 2025
This was a really good book(1st one from Patricia Gussin)that I have read. But it won't be the last I really liked her writing and the way the story grabbed me right from the start and never let go. The characters were excellent and the story itself was awesome.
155 reviews1 follower
December 31, 2019
Good story line but the main character Laura becomes annoying and hyprocritical pretty quickly.
191 reviews
Read
October 5, 2022
I read some but did not like the general tone of the novel.
This entire review has been hidden because of spoilers.
Profile Image for Mary Ann Miller.
83 reviews24 followers
March 15, 2023
Just finished and started right into the next Dr. Laura Nelson book. Always love a good mystery mixed with medical science.
Profile Image for Brandy.
49 reviews4 followers
October 15, 2016
I abandoned the book in the first half. I wasn't interested in the setting, the characters angered me, and the scattered plot lines advanced too slowly to hold my interest.
Profile Image for Tracey Gavin.
6 reviews1 follower
March 10, 2022
This is the second book I have read by this author. I wish I had started here with my journey of this author's books. It is the introduction to Doc Nelson. This one moved much quicker than my previous book. I enjoyed how the characters were intertwined in their story lines. I did not like that the hero had to resort to some illegal means to come out on top. I do still plan to read further writings by this author.
14 reviews
March 6, 2017
Should have five more stars!

I just spent five years with a cast of remarkable people! The whole story is so engrossing...so believable. As you read, you feel like you're living along side them. I can't wait to start the next book in the series!
Profile Image for Stephanie.
691 reviews27 followers
January 30, 2015
First let me just say the only reason I read this book is because I was a First Reads winner of this author's After the Fall book. When I received the book I found out it was the 5th in the series. I do not read books out of order (I know I should lighten up right?). That being said, this obviously is the 1st book in the Laura Nelson series and it was a tedious read for me. It was OK and at times it was interesting but it was way too much coincidence/happenstance and ridiculousness.

The story focuses on Laura Nelson a 1st year med student at a hospital in Detroit, Michigan during the 1967 riots (There is a lot of racial politics and fear going on. There was also some women's lib stuff addressed). She is mistaken for a blond haired doctor who irrevocably injures a patient after he was shot, causing him to die not from the gunshot wound (even though he had been shot in the head) but by the botched medical procedure. The patient's brother, Johnny, sees this occurrence but only sees the doctor's blond hair and assumes it's Dr. Nelson. Johnny is hell bent on making her pay. He later attacks and rapes her. During the assault, Dr. Nelson shoots and kills him and then worries the rest of the book if she will get caught(it made no sense how she rationalized not telling the police but whatever).

There are interwoven storylines and characters. The author was basically saying it's small world and we all have interconnected lives even if we don't know it. The problem with that in a story like this, is that there are so many characters and overlapping storylines and sometimes the transition from one person to another was not cohesive.

******SPOLIERS AHEAD*******

There is also the story of the family of Johnny, Johnny's friend, Snake who is OBSESSED with Johnny's sister, Stacy and getting Revenge against the doctor that killed Johnny's brother and all the white people. Even though he is a talented artist. There is the story of Dr. Monroe the head of surgery who is in love with Dr. Nelson even though he is married to a ridiculous socialite who is having an affair with a woman named Ruth who works at the Law Firm of one of the other medical student's husband. Dr. Nelson is also 24 years old and has 4 children under the age of 5 and by the end of the story has 5 children. Yet she maintains a ridiculous work scheduled and basically straight A's in med school. (I'm not saying It's impossible but COME ON).

Then there is the story of Dr. Nelson's husband Steve who has a complicated relationship with his parents and is Social Worker in Detroit. he just also (later in the story) happens to be the boss of Johnny's and Stacey's mother and the case worker on the case for Snake's mother. Then the investigating Detective is the father of the other med student who is Dr. Nelson's best friend.

Like I said tedious and way too many characters. Anyway glad I'm done. I plan on reading the series now and I will say the second book's synopsis sounds more up my alley but I just hope the writing gets better and the story a little more succinct. This was a book that should have taken me 3-5 days to read and it took me almost 3 weeks.
Profile Image for Matt Schiariti.
Author 8 books152 followers
November 16, 2012
Admittedly this is a book I probably never would have read if it didn't pop up on the kindle top 100 free list. Also, admittedly, I found myself having a lukewarm response to the first several chapters. I stuck with it and I'm glad I did because it soon picked up and ended up being a very good story.

Set in Detroit at the time of the historical riots, Laura Nelson is attending the local medical school, her dreams to become a doctor well underway as a first year medical student. The ongoing strife and violence of the city however doesn't seem to care about her dreams when she's assaulted coming out of class late one night in the dead of winter. Laura survives..the assaulter doesn't. Her dreams of being a doctor threatened, the dark cloud of possibly loosing her family also threatened, Laura makes a snap decision. She's not going to tell anybody. Not the police, not her friends, not her husband or family. What follows is a pretty intricate story about the consequences of the decision to keep this dark secret to herself no matter what.

It's not a story about the Detroit riots although the times and the violence in the area during them serve as a backdrop. It's a story about making what you think is the best possible decision at the time and watching the dominoes that are your life fall one after the other, after the other.

There were a few moments where you may be able to see what's coming and there were, quite honestly, some melodramatic 'mushy' moments, but overall this is a well told story that will have you turning the pages one after the other. I liked this so much I just downloaded Twisted Justice to my kindle because it follows the same characters. What's more is sometimes books written by MD's about fictional MDs can get bogged down in overly long passages about medical procedures and nomenclature. This book has just enough to get you involved in what the character's doing but not enough that you feel you need to skip page after page of medical jargon.
157 reviews8 followers
May 25, 2015
I won this book in a Goodreads giveaway in exchange for an honest review. Laura Nelson is a first year medical student. Married with two young sons, Laura's first patient examination is a gunshot victim from the Detroit riots.Shortly after the exam on her way home Laura is raped and the perpetrator threatens to kill her. Fearing for her life, Laura pulls our her gun and shoots him in the head.Because she is scared the police will take her from her children, Laura tells no one. Her friend Susan's father is a policemen and questions Laura several times because she was close by when the young man was shot to death. Then Laura finds out she is pregnant again. Is the baby her husband Steve's or is the rapist the father?Two months prior to the birth, Laura is working a rotation in the OR when a psychiatric patient rams her in the abdomen, causing her to go into labor.Fearing the outcome she confides in the medical director about the possible outcome. Laura starts to relax when twin girls are born and Steve appears to be the dad. But what gas happened to her is always at the back of Laura's mind and her life seems to be entangled with the shooting victim's family as it turned out the rapist was his brother.His mother is also one of her husband's clients, whom he has been able to help. The shooting victim's sister ends up being a friend of Laura's. The book had several twists and turns and surprises up until the end. I really enjoyed the story.
Profile Image for Ashley.
177 reviews
October 29, 2013
I admit, from the first page this book had me completely hooked. The premise of story, such a controversial time in history, has always fascinated me, and this was no exception. I love medical dramas, being in the medical field myself, so this was right up my alley. The story started out strong, and the tension never stopped building, not even up to the last pages. That being said, though, there were definitely some jarring errors I noticed within this novel.

First, the drama that is involved right at the beginning of the book between Laura and Johnny seemed a little...rushed, a little brushed off. I understand it was written within a rush of riotous scenes, but still. The casualness in which her husband brushed off their lack of love life bothered me a little too. I know for one my husband would at least find it suspicious.

The book, though, hit quite a few things right on the head as far as accuracy goes, especially the affair and the failed relationships between the human doctors. From what I have seen, it's all too common for that to happen in the medical world. The action was intense, and the story kept me clinging to the pages until I got to the last page.
Displaying 1 - 30 of 54 reviews

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