Customer Reviews

terrO.R.

5 star:		(19)
4 star:		(20)
3 star:		(14)
2 star:		(1)
1 star:		(2)

 

 

I thoroughly enjoyed this short, well-written novel from an anesthesiologist who did not put me to sleep with his first attempt at novel writing. When he commented on one of my reviews about my perceived evils of tort reform, I thought his book would be centered on medical malpractice. Alas, it had an interesting plot and an even more interesting twist that must have intelligence agencies asking themselves why they hadn't thought of it.

In addition to a first-rate plot, the reader can gain an understanding of what our doctors go through everyday wondering when they get out of bed, if one of their patients is going to die in one, on the gurney, or if they will end up in a "lawsuit" instead of scrubs. This must be unnerving for even the most confident and competent physician.

The doctor/author provides as much technical information about the operating room as Tom Clancy can provide about the Bradley Fighting Vehicle. But after a while, to this layman it sounded a lot like the doctor was attempting to"intubate the bandersnatch through the snarknoggin to prevent the patient aspirating his bifurcatedhomeopotatos."

Since this was self-published, I take it the author made the fatal mistake of relying on Microsoft grammar/spelling check too, which can have code blue-level consequences. Microsoft cannot diagnose spacing, double periods.., the wrong preposition, or know when to hyphen-ate if its life depended on it, and it happened enough to be as frightening as watching a surgeon lick a scalpel clean before your surgery. It can scar the reader and writer forever. (Maybe he could sue them for malpractice!) I also wished the Oath had been placed at the beginning, and the non-Hippocratic oath removed. It appeared satirical in an otherwise serious topic.

The book was a pleasant surprise, and the doc has a talented writing style considering English is a "second" language for him. This book will not knock you out.

Reading Terro.r. is not an Erro.r.


P.S. Doc, this Heine's for you!

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 "The 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.

Paul Weiss

terrO.R. tells the story of Dr. Phillip Newman, an anesthesiologist who has a patient die while under anesthesia in the beginning of the story. The patient was 19 years old, his name was James Walker, and he was having tattoos removed surgically. Inexplicably, things went wrong in the O.R. and James didn't make it. Dr. Newman is puzzled by the phlegmatic reaction of the father to his son's death and further surprised when he is hit with a medical malpractice suit within twenty-four hours of James's death. The suit spirals out of control, and grows from a simple malpractice suit to a suit filed against the hospital for $100 million dollars. It should also be noted that Mr. Walker refused an autopsy for religious reasons.

Having the story told from the point of view of an anesthesiologist is certainly interesting. It may be the only major branch of medicine without a POV represented in literature. We learn *a lot* about what an anesthesiologist does, what their responsibilities are, their successes and frustrations. Although to be honest, I'm not sure I wanted to know much more about that side of the table, so to speak. When I'm out on the operating table, all I want to know is that I'm out.

While this book has a fascinating premise, I have a few minor quibbles. First, the dialogue is largely unbelievable. Even if the ubiquitous (<--itself an overly used word in the book) exclamation points were removed, people just don't talk like this in real life. For example, see the exchange between two doctors that begins on page 100 and ends on page 101. Second, we're party to too many surgeries that don't have anything to do with the plot. What this means is that this short book, already a novella in its own right, could have been shorter. Third, for a medical thriller, I didn't find myself glued to the page with heart-beating intensity. Not every thriller is going to provide a perfect example of such intensity, but it should be there somewhere. This felt too clinical, almost like a write-up of post-operative notes.

For as technical as the author was in his descriptions, one description puzzled me. His wife ordered a bottle of "Chardonnay Grand Cru" for dinner. There really is no such thing, and I suspect that the author knows this. What his wife really ordered was a bottle of white wine from the Burgundy region in France from a Grand Cru vineyard, mostly likely from the Cote de Beaune district. Grand Cru is the highest mark of quality given to Burgundian wines. (Other French wines, some Bordeaux's even, have "Grand Cru" on their label, but it doesn't really mean anything.) If you're drinking white wine, and you're told it's from Burgundy, 99.9% of the time - and especially if you're in a restaurant - you're drinking Chardonnay. If you were drinking red Burgundy, you're drinking Pinot Noir. I could get more technical. For example, Aligote is often considered the "second white grape" of Burgundy, so it's possible that you could be served a white wine from Burgundy from the Aligote grape instead of Chardonnay, but if that were the case the bottle would say something like "Bourgone Aligote". Pinot Blanc is also grown in Burgundy, but again - Chardonnay is the main grape.

Here's my point (and I have one) - anyone reading this review was probably put off or bored with the above details. Unless you're an oenophile like me, you probably skimmed that paragraph. I found myself skimming some of the more technical paragraphs in this book, and if I'm skimming in a 160 page book, then those parts, more likely than not, aren't necessary.

As I said, the premise is fascinating and the solution both frightening and - currently - unbearably possible. But it needs more work. The solution as to why this boy died (and others like him around the country) was arrived at too quickly, after pages and pages of material (surgeries, etc.) that didn't contribute much to the story. We should have been slowly led to that conclusion, instead of having it plop down on front of us.

I noticed that another reviewer commented specifically on some issues with editing. I hope the author takes that, and what I've written, as constructive criticism, for I'm sure that is the intent of both reviews.

The problem is not the classification of the book (novella? novel?), but the fact that it remains far behind its potential. Doc Joe has an interesting idea for a plot, but he has not found the right language for it. His dialogues strike me as not entirely right. People don't talk like that, not even in TV shows.
Most of the prose is very specialized description of medical procedures, which goes too far for me, as I am a little squeamish. It would be a challenge to write about medical procedures for laymen in an interesting fashion without becoming trivial. Maybe it can not be done. For sure, insiders may have appreciated JN's compact style.
Finally, I think Doc Joe really wanted to write an essay with a message, which is that malpractice practices are killing the medical profession in the US. He may be completely right with this, but he would not have needed a fictional wrapping for his thesis. Fiction should not be used for messages, at least not for rubbing it in the readers' faces.
Maybe he could restart and write two things: one essay on how malpractice suits kill the medical profession, and one terror thriller on how medical doctors can get entangled in unexpected complications?

Dr. Neuschatz has written a very intriguing novel about the the life of an anethesiologist Dr. Phillip Newman and his wife Kyra who is a pediatric nurse. Due to a serious unexpected death in the Operating Room, the story takes some unusual twists and turns which no reader can anticipate. There is a major surprise ending that will satisfy any reader of medical mystery thrillers. Dr. Robin Cook may be the more experienced novelist and best selling author but Dr. Neuschatz provides an equally thrilling reading experience. His book contains a highly contemporary theme which will leave a huge impact on the reader at the end. Furthermore, while the book explores a serious subject, there is much humor in the book, making it quite fun to read.

Unfortunately and unexpectedly, one of Dr. Phillip Newman's patients codes during surgery while he is being administered anesthesia and subsequently dies. It is a young man who is 19 years old who elects to have surgery to remove some tattoos. He had no allergies, no significant medical history and of note, no previous surgeries (therefore never had general anesthesia either). Suddenly, Dr. Newman is faced with a huge lawsuit for malpractice ... The hospital wants him to settle out of court. Although, Dr. Newman is reassured by his colleagues that this is how it is in modern medicine, it bothers him and he begins to research possibly causes for this most unfortunate death. Despite being reassured, that any physician can expect this in a highly litigious society (such as ours), he does not accept this explanation. Dr. Newman starts asking probing questions, what could have gone wrong? What special factors were over-looked? He arrives at some startling conclusions after he takes on the role of scientist and epidemiolgist. He realizes, some of the dyes used in the tattoo *could* have caused a reaction with the anesthesia. He does an internet search and asks some questions on an anesthesiolgist specialty site, looking for similar cases.

He knows the response of his team to the code was textbook perfect based on the current guidelines for ACLS (advanced cardiac life support) as taught by the American Heart Association. A 19 year old male died ... when it was an *elective* surgery to remove some tattoos. It should *not* have become life-threatening. It turns out news about the Code Blue which was unsuccessful in the OR passed through the hospital grapevine ... and the news spread even to a some other physician colleagues. Through some odd circumstances, Dr. Newman learned that his 19 year old patient *had* indeed had surgery at the age of 17 for a type of testicular cancer. Oddly enough, Dr. Newman also discovered, a life insurance policy had been taken out for this 19 year old exactly 3 months prior to this surgery. Strange, it seems as if it was known something would happen. In the meantime, Dr. Phillip Newman also discovered other cases similar to his, where tattoos were removed and the patients had sudden death while under anesthesia. The reader will be left hanging at this point to wonder what could have been the similarities in all these cases and it is NOT what you think. Dr. Neuschatz provides a real cliff-hanger to this question and then with a very sharp curve - the answer arrives and is much more sinister and threatening than anyone could imagine. This is a most highly recommended book. It baffles me why this book was not accepted by a publishing company and why the author had to 'self-publish' it. It has an outstanding plot and brilliant ending. It has highly accurate medical and surgical descriptions used within proper context. What more can any reader desire? Erika Borsos [pepper flower]

I was contacted by Joseph J. Neuschatz, M.D. to see if I would be interested in reviewing his novel TerrO.R.. Medical thrillers are always of interest to me, so I accepted. After a quick read (it's not very long), I can say that the premise of the novel is interesting, but it suffers the same problem as many other self-published/print-on-demand books... the lack of a good editor to clean up the writing and shape the story.

To avoid giving away too much of the plot, I won't go into much of it here. Suffice it to say that an anesthesiologist is involved in a case where an apparently healthy young man is undergoing a tattoo removal procedure. While under anesthesia, the patient goes into cardiac arrest and dies. The family sues almost immediately, and the anesthesiologist is devastated as it's his first lawsuit. After some investigation, he discovers a number of other cases that seem to have the same scenario and outcome. He takes it upon himself to try and get to the root of the problem... assuming the deaths were not accidental.

Normally medical thrillers involve surgeons or general practitioners, not anesthesiologists. Neuschatz is himself an anesthesiologist, and you learn quite a bit about the specialty during the story. The plot twist at the end was unusual, and isn't something I've seen or considered before. The major issue with the story is the writing. The conversation between the characters was pretty stilted, and I just couldn't see dialogue between two people playing out as it was written. In addition, many of the surgery scenes, while interesting, didn't have anything to do with the story. Given the book is only 150 pages to begin with, it felt as if a short story was trying to be padded out to novella size for stand-alone publishing. If it had been published by a major publishing house under the guidance of an experienced editor, I think the outcome would have been much better.

If you have the chance to read TerrO.R. and need something to fill a couple of hours, go for it. Just make sure you're not expecting something along the lines of Palmer or Cook.

Philip Newman, a Long Island anesthesiologist, loses one of his patients to an inexplicable cardiac arrest during a routine tattoo-removal procedure. When served with the inevitable malpractice lawsuit, Newman becomes determined to investigate whether other similar deaths at hospitals across the country can be attributed to a common cause. Using the vast information sharing tools available on the Internet and a network of fellow anesthesiologists, Newman mounts an impressive investigation into a variety of causes, all the while trying to maintain a healthy marriage and keep up with the intense demands of a critical profession that's under constant attack in our litigious society.

Once they get past the uneven editing and the contrived feel of some of the dialogue, fans of the medical thriller genre will find much to like here. The author is at his best when describing medical procedures and opining about the host of modern challenges faced by the medical profession. The book is also well-paced and fairly well-plotted, save for the less-than-convincing eureka moment when Newman unravels the mystery. And its concept is certainly timely, leaving me fearful that the inadequate information sharing between hospitals in this country has created an environment in which this type of scheme could actually take place.

-Kevin Joseph, author of "The Champion Maker"

NOTE: The author informs me that his book has been re-written and re-edited, and that the version of the book currently available is thus slightly longer than and otherwise changed from the version that I review here.
===
TerrO.R. is a brief, self-published novel by Joseph Neuschatz, a doctor, whose medical expertise is apparent on every page of the book. The book's protagonist is Dr. Philip Newman, an anesthesiologist at Soundedge Hospital, whose troubles begin when a 19-year-old patient, otherwise in good health, inexplicably dies during routine surgery. The case is strange at the outset: despite his age, the patient is being forced by his dominating father to have his tattoos removed. And when the operation goes awry, the father is unusually quick to sue. Neuschatz takes us through the operation and other day-to-day experiences in the life of a busy anesthesiologist. And he turns Newman into an armchair amateur sleuth insofar as Newman figures out--from a pattern of such cases--the complicated story behind the tragic tattoo operation.

TerrO.R. is a sort of didactic novel, a lightly fictionalized vehicle for delivering information about medical care as well as Neuschatz's opinions about the health care industry. Neuschatz talks readers through procedures in passages that are authoritative but rather dull for the layman:

"The side about to be operated on received an intravenous cannula (attached to a syringe extension) and a deflated tourniquet. After most of the venous blood was ejected by the rolling of a tight elastic bandage (on the vertically elevated arm) from the finger tips down, the tourniquet was inflated and the bandage removed. The veins of the now pale and anemic looking arm were ready to be filled with a diluted Lidocaine solution."

There are a great many such descriptions in the book. In the non-medical parts of the book--the narrative holding the medical sections together--the writing is bland and the dialogue very stiff:

"'You never stop making me laugh, Arthur! I always know I can count on your good advice.'

"Any time, Dr. Newman! Give my love to Mrs. Newman.'

"'Only if you give my love to Mrs. Ross.'

"With pleasure! But I will be able to do that only if she decides to talk to me tonight. By tomorrow, I will probably forget!'

"'Tell her that I insist she be nice to you. You are my hero!'

"'I will tell her what you just said, for sure! Have a nice Sunday!'

"'You too...'"

There is also a loose end I would have liked tied up. (Or was that car accident really just a car accident?)

All that said, the mystery behind the failed operation is an interesting one, and its solution perhaps not so far-fetched. I can imagine the book's plot being translated successfully into an episode of a medical show such as House.

-- Debra Hamel

For wisecracking anesthesiologist Philip Newman, life is good. If all goes well at work, he'll be finished up in plenty of time to make the tennis courts. He can even overlook the fact that his ex-mistress, Peggy, is the operating room supervisor. His wife Kyra is a pediatric nurse and their symbiotic relationship provides a comfortable routine day after day.

His first patient of the day is a nineteen-year-old man in need of a tattoo removal, accompanied by his restrictive father. It's a relatively simple surgery with few expected complications. When the otherwise healthy patient goes into cardiac arrest on the operating table, Newman's life comes crashing down around him. The father refuses an autopsy based on religious reasons, then comes back with a lawsuit. Something about the situation doesn't sit well with Dr. Newman: he cannot find reason that any of his anesthetics would have negatively affected his patient.

Newman begins exploring possible theories for the death while his insurance company is in the process of settling out of court. He cannot bring himself to admit guilt. His research pays off when he discovers a pattern across the country of young men going into cardiac arrest while having their tattoos removed. Could it be the ingredients in the tattoo ink interacting with the anesthesia? Or is it something far more sinister?

TerrO.R., which is Dr. Joseph J. Neuschatz's first novel, is 150 pages long, and most chapters are four to five pages long at the most, which makes for quick reading. The reader settles into the mindset of "one more chapter because it's so short," and before they realize it, the book is finished. Each chapter affords a new development in the plot or a teasing cliffhanger that keeps the reader interested.

Dr. Neuschatz offers a privileged view of the stressors that medical professionals encounter on a daily basis, even when mystery is not afoot. This is a side that patients rarely see that could greatly improve doctor/patient relationships if publicized. An anesthesiologist himself, he provides the story with firsthand experience that makes the plot incredibly plausible.

There are a few small issues: the editing is loose, as it hasn't been through the rigors of a major publisher, and the reader will trip over a few typos and misspellings and a loose end in the plot remains at the close of the book. The deaths of two O.R. associates are hinted upon as foul play, but never actually explained or correlated with the story. Overall, Dr. Joseph J. Neuschatz has provided a valuable piece of literature that gives the reader a glimpse into the medical industry and leaves the possibilities of medical sabotage frighteningly wide open.

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.