Fatal Complications by John Benedict

By Wendy Tyson

FATAL COMPLICATIONS is John Benedict’s third crime novel. Kirkus Reviews called Benedict’s debut novel Adrenaline, “a mystery story rife with suspense,” and its popular sequel, The Edge of Death, was published to strong reviews. In anticipation of the release of FATAL COMPLICATIONS, The Big Thrill sat down with Benedict to talk about medical thrillers, sources of inspiration, and his (dead on) advice for aspiring authors.

Congratulations on the release of your newest novel. Your protagonist, Luke Daulton, is an anesthesiologist—a job that demands quick thinking and involves high human stakes. What inspired you to write medical thrillers?

This is a very good question—one that has a short answer and a long answer. I’ll give you both. The short answer goes something like this and deals more with the practicality of the question: The cool part about being a medical thriller author is that there are so many clever ways to kill people in a hospital setting. Plus there is always lots of drama, big egos, and life-and-death scenarios that play out on a daily basis in the operating room. This makes for great characters and exciting backdrops for my stories. Finally, most readers don’t exactly know what takes place in a modern OR, especially when it comes to the anesthesia end of things (where I specialize), so this can add realism and interest to a story.

The long answer delves into the heart of my inspiration and involves a little true-life story: One day it struck me—at two in the morning in the midst of another grueling twenty-four-hour shift. I had just finished interviewing a nice lady with an appendix about to burst—we’ll call her Linda. I had done my best not to yawn as I went through the routine questions that an anesthesiologist is obliged to ask. She appeared nervous, which soon gave way to tears. I did my best to comfort her, took her hand, told her I would take good care of her. That I would watch over her carefully in the operating room and see her through surgery. And I would be there when she woke up in the recovery room. She appeared to calm down a bit. I wrapped up my pre-op assessment and asked her to sign the anesthesia consent form, while assuring her the risks would be minimal. She raised her eyebrows at this and the fearful look returned. I wondered: What the hell does ‘minimal’ mean when you’re talking about life and death? More tears. She told me of her two young daughters at home that desperately needed a mommy. I felt my own throat tighten. I quickly buried my emotions, tried not to think about my own wife and three sons, and focused on the task at hand as we wheeled her litter back down the hall to the OR.

After Linda was safely tucked in the recovery room, the operation a success and the anesthetic uncomplicated, I lay down in the call room to try to catch a couple of z’s. My mind wandered as I lay there. Rarely, I thought, does a person willingly surrender control of his or her mind and body to a virtual stranger. Yet, this is exactly what happens when the person is a patient being wheeled in for surgery and the stranger is their anesthesiologist, whom they have just met minutes beforehand. Talk about an extraordinary amount of trust. This degree of trust made a distinct impression on me that night, some twenty years ago.

Other thoughts followed soon thereafter. What if the trust Linda had exhibited earlier was ill-conceived and her doctor was actually bad? Not just incompetent or sleepy, but downright evil. Being an avid reader of thrillers, I thought this chilling concept would make for a good story. Too bad I wasn’t a writer. But I still couldn’t shake the evil concept; it kept gnawing at me until eventually I had to put it down on paper—lack of writing experience be damned. So Adrenaline was birthed, my first medical thriller novel that explores this issue of absolute trust implicit in the anesthesiologist-patient relationship—specifically, what happens when that trust is abused and replaced by fear.  Adrenaline was finally published twelve years after my encounter with Linda.

Can you tell us a little more about Luke Daulton and some of the elements of his past that have made him the man he is today?

Luke is a thirty-year-old newly graduated anesthesiologist who has just taken his first job at Swatara Regional Hospital in Hershey, PA. He is also recently married to Kim, the love of his life, who is pregnant and soon to deliver their first child. Luke is a complicated character. He is on the one hand, a very caring physician and a man capable of real love. However, he has his own inner demons to deal with. Growing up, he had a love/hate relationship with his father, an overbearing self-made man. Luke’s father instilled in him the belief that to make your way in the world you must rely only on yourself—there is no touchy/feely spiritual realm—and any reliance on such is a waste of time and a clear demonstration of weakness of character. Luke’s dad also had heart problems and died suddenly while Luke was only eighteen. Luke has always felt some degree of responsibility for his father’s death (you’ll have to read the story to find out more) and this haunts him and ultimately drives him to pursue a career in medicine to have more of a sense of control.

What can you share with us about your book that is not on the back cover?

FATAL COMPLICATIONS is first and foremost a medical thriller and so has the requisite elements of the genre. However, it goes beyond this and gives the reader an in-depth character study that compares and contrasts the different faith journeys of the three main characters. Luke, who is raised with no faith, must come to terms with believing in something more than himself when faced with the death of his wife, new-born daughter and himself. Rob Gentry, an obstetrician who is caught in the throes of an out-of-control extramarital affair, is forced to examine his crumbling faith as he makes his fateful decisions. Finally, Dr. Jason Katz, chief of anesthesia, used to have a very strong faith until his son dies in a freak fire many years ago. After a long bout of severe depression that almost kills him, Katz emerges from its grip in perhaps the only way possible. He undergoes a radical transformation, and rather than losing his faith, he simply switches his allegiance to the other “team,” embracing the dark side wholeheartedly.

FATAL COMPLICATIONS is your third novel. The first two, Adrenaline and The Edge of Death, constituted a two-part series, but this outing is a standalone novel. Did you set out to write a series when you wrote your first thriller? If so, why? Do you see returning to the characters in FATAL COMPLICATIONS in future books?

I didn’t set out to write a series when I wrote Adrenaline. That was a debut novel, and I didn’t set out to do much of anything other than to complete a full-length novel. Only later, when I saw how much readers liked and identified with Doug Landry, did I start to think about a sequel. But I still didn’t really have a story idea. In fact, I was already halfway through writing FATAL COMPLICATIONS, with all new characters, when by chance I ran across a medical journal article that grabbed hold of me and changed everything. It dealt with the process of cellular death and resuscitation, and the fact that the researchers could demonstrate the evidence of living cardiac muscle cells (under the microscope) in a clinically declared dead patient—not just minutes after death, but hours. This floored me and I knew right then and there, that I had to write The Edge of Death. Doug Landry just kind of fit the part and jumped into it, joining forces with new characters, med-school dropout, Chip Allison and his spunky friend, Kristin.

I could easily see returning to some of the characters in FATAL COMPLICATIONS. Luke and Kim Daulton make a great team and I would love to revisit them. In fact, I have actually started a fourth book joining the characters in the Doug Landry series with the characters from FATAL COMPLICATIONS.   I’m sure this is against every rule in genre fiction, but luckily I’m coming into this field sideways and don’t really know the rules. Time will tell what emerges.

Like your other novels, FATAL COMPLICATIONS is set in Hershey, Pennsylvania. What were the challenges of choosing a real-life locale as the backdrop for your books?

There are pros and cons to using a real-life locale in a novel. On the positive side, I, as the author, am familiar with the local geography and layout and therefore know where all the scenes take place and can accurately describe them. I can use real street names and familiar buildings and the real natural landscape—rivers, creeks, bridges, mountains, etc. I believe this adds realism to one’s narrative. One thing I’m sure of—local readers absolutely love this and I get lots of emails attesting to this. The downside is that one has to be careful when choosing a real hospital where all the murders take place. None of my local hospitals were too keen on being associated with nefarious deaths. So, I either changed the names and characteristics of real hospitals in the area, or finally in FATAL COMPLICATIONS, I just made up a totally fictional hospital—Swatara Regional Hospital—and plunked it down in a real life location in Hershey, where it could plausibly have been built.

Kirkus Reviews said about Adrenaline, “Twists and turns abound as the story progresses, and they hit a crescendo in a scene of utter ferocity that’s violent and intense.” FATAL COMPLICATIONS deals with the idea of “murder for hire” in the operating room—a truly chilling concept. What themes do you find yourself drawn to again and again?

Okay, so I’m trying to write thriller fiction and I just happen to be an anesthesiologist in real life. The intersection of these two requires some doctors to be villains. Once I made the leap to the concept of doctors being evil, the rest came easy and I kept gravitating to a murder-in-the-hospital theme. Or more specifically, murder in the operating room. (Disclaimer time: It took me a long time to make this evil doctor leap because, first, in the thirty-plus years I have worked in the medical field, I have never run across a single colleague who would purposely try to cause the slightest harm to any of his/her patients, let alone murder them, and second, I don’t want to scare anyone about real life and have them dread going to the OR.)

The other reason I like this murder-in-the-hospital theme is its inherent simplicity. When I think about it, there are just so many good ways to bump someone off in the OR or ICU—and this is critical—and make it look accidental or natural. Good examples of this might include death via drug overdose, wrong drug, allergic reaction, botched surgery, and anesthesia. And while it’s no doubt easy to kill people in any workplace environment, it’s not so easy to do it in a way that minimizes suspicion or thwarts detection. Because, you see, the hospital is a bit unique in this regard; it’s a place where death is not an uncommon visitor. Patients sadly die everyday in a busy hospital and murder alarm bells are just not triggered with each unfortunate death. The bottom line here is that investigations by the authorities are rare, so it’s an ideal setting for the perfect murder.

From anesthesiologist to crime writer—that’s quite a career path. Can you tell us a little about your journey to publication?

You must realize the journey is long. Good agents and interested editors are very hard to find. I sent out literally hundreds of query letters to agents and even managed to hook up with several poor agents. This was primarily an exercise in frustration. Finally, I attended multiple writing conferences and did manage to get signed by a reputable agent. I thought my journey was near its end.

However, I learned that even finding a decent agent doesn’t guarantee selling the book to a mainstream publisher. Alas, my agent couldn’t sell the book. Finally, I decided to go the self-publishing route. This proved to be the way to go for me. I chose CreateSpace, which worked fine—there are several other good alternatives out there. Be prepared to pay a small amount to get your book published—it pays to price-shop.

Once set up, you can sell your book as an inexpensive ebook on Amazon (and elsewhere). The internet is an extremely valuable sales platform and if your book is half-decent, it can spread by word-of-mouth alone. Readers leave reviews and rate your book and this can attract new readers. I’m pleased to report that Adrenaline sold very well as a Kindle ebook. In 2014, over 80,000 copies were downloaded from Amazon pushing it to the #1 paid medical thriller. I also picked up over 400 reader reviews (mostly five-star). Armed with these sales numbers and positive reader reviews, I was finally able to attract a mainstream publisher (Oceanview Publishing) for FATAL COMPLICATIONS.

Any advice for aspiring authors?

Nothing worthwhile in life is quick or easy. Writing is no exception. Expect to spend a long time learning the craft and improving upon it. Don’t expect to become famous overnight or make a lot of money easily. The best advice I can give a would-be novelist is this: You shouldn’t write because you want to make millions or become a household name—you’ll likely be disappointed. Rather, you should write because you enjoy the process and feel the need to tell a story. Let the results take care of themselves.

I’ve learned to believe in myself even when no one else seemed to. I’ve also learned the power of perseverance and patience. The path to successful book publication is notoriously long and arduous for most. Developing a thick skin is also helpful to protect oneself against the many rejection letters and obligatory nasty reviews that will come your way. Finally, I’ve learned that writing a good book is probably only half the battle. Getting it published and successfully marketing it may be the most difficult part.

Where is your favorite place to write?

I write almost exclusively in the medical library at the Hershey Medical Center. (There’s a Starbucks at the med center now and so I’m always armed with a large cup of coffee or a latte.) I spent eight years training here through med school, internship, anesthesia residency, and fellowship. Upon entering the library, my mind automatically clicks into a studious mode that is conducive to writing.

And finally—what’s next for you?

I have several projects that I’m working on. As I mentioned, I’m writing a fourth book that would connect the Doug Landry novels with the characters in FATAL COMPLICATIONS and join the series together. I also have some good ideas for new stand-alone medical thrillers. Finally, I toy with the idea of writing a serious medical memoir to recount some of the most interesting, exciting, joyful, heartbreaking, inspiring experiences and patients that I have encountered during my thirty-year journey as a front-line, in the trenches anesthesiologist. We’ll see what eventually comes out.

Also, I’m trying hard to get the word out about my books by attending conferences, giving talks and participating in blogs, etcetera.   And now that I’m with Oceanview Publishing, I’m also trying to promote the other Oceanview authors I’ve had the pleasure to meet. I’ve read some of their novels and they are amazing! In addition, the owners, Bob and Pat Gussin, marketing director, David Ivester and all the other folks at Oceanview are truly a terrific bunch of people to work with, and I am absolutely thrilled to be a small part of the team.

*****

Dr. John Benedict, husband and father of three sons, graduated cum laude from Rensselaer Polytechnic Institute and entered post-graduate training at Penn State University College of Medicine. There, he completed medical school, internship, anesthesia residency and a cardiac anesthesia fellowship. He currently works as an anesthesiologist in a busy private practice in Harrisburg, Pennsylvania.

Dr. Benedict has been writing stories since high school, but his writing was put on hold to pursue a medical education and start a family. Finally, after a 15-year pause, he returned to the keyboard to scratch the writing itch again and thus Adrenaline, his first novel–a gritty medical thriller with a realism borne of actual experience–was born.

Besides creating scary stories, the hallmark of Dr. Benedict’s writing is genuine medical authenticity–a rare commodity in thriller fiction these days. He draws on his 25+ years of experience as a board-certified anesthesiologist to infuse his writing with a realism that renders it both vivid and frightening. As one of only a handful of anesthesiologists throughout the country writing fiction, he gives readers a taste of what really goes on in the operating room, the human drama inherent in this high-stress, high stakes environment where lives are saved and sometimes regrettably lost. Readers will find out what it’s like to hold someone’s life in their hands, as the author provides an illuminating glimpse into the fascinating, but poorly understood realm of anesthesia.

To learn more about Dr. John Benedict, please visit his website.