oxygen by Carol Cassella

This novel centers around the life of Marie Heaton, an anesthesiologist at a hospital in Seattle. It is written by a practicing anesthesiologist and is an interesting look into this profession. The story points out how much time and consideration one may take choosing a particular doctor for a surgery, but the anesthesiologist is usually whoever is assigned to that particular surgeon on that day. They rarely meet with the patient for more than five minutes. It seems like there should be more choice and input on the part of the patient, if this person is in complete control of your sedation.

Marie is portrayed as a very kind and caring doctor. She tries to make her five minutes with each patient reassuring. A surgery that she works on results in a death and the anesthesia is thought to be to blame. She takes this very hard. I found this surprising; of course, my only experience comes from watching ER where lots of patients die. On TV, at least, as long as the doctors did their best they pick up and move on. Marie cannot seem to move beyond this case and goes over and over in her mind what could have been done differently.

It is at this point, when for the first time she feels vulnerable in her career, that her father is becoming more and more ill. It is clear that either Marie or her sister will have to do something. This takes Marie away from Seattle and her problems there and down to Texas. The contrast between her sister’s life with a husband and three kids and Marie’s solitary life is readily apparent. How Marie resolves longstanding issues with her father and the potential harm to her career from the unexpected death in surgery is at the crux of this book.

There is a significant amount of detail in the book about what being an anesthesiologist is like. Here Marie reflects on her skills after reading the autopsy of the difficult case: “I have lost the ability to look at a stranger’s face without estimating the ease of difficulty of intubating their trachea. I have forgotten what it was like to be ignorant of the telltale clues that failing internal organs and multiplying infectious organisms surreptitiously display. Physical diagnosis is the study of optical illusions, the art of seeing through what is expected in order to detect which part of the pictures is changed, what hidden shape hides in the shadows and creases of familiar scenes. Since I began medical school fifteen years ago this second sight has seeped into me the way tea stains dental enamel or cigarettes color smokers’ fingers. To read Jolene’s autopsy report is to slap my forehead - my own moment of ‘Aha!’”

I’m looking forward to more from this author. I did wonder why the cover of this book has a picture of a button down white collar shirt on it – maybe it is supposed to belong to the patient who died? Anyway, it does not make for a very interesting cover.