Fatal Intent by Tammy Euliano

Fatal Intent

by Tammy Euliano

End-of-life care—or assisted death

When her elderly patients start dying at home days after minor surgery, anesthesiologist Dr. Kate Downey wants to know why. The surgeon, not so much. “Old people die, that’s what they do,” is his response. When Kate presses, surgeon Charles Ricken places the blame squarely on her shoulders. Kate is currently on probation, and the chief of staff sides with the surgeon, leaving Kate to prove her innocence and save her own career. With her husband in a prolonged coma, it’s all she has left.

Aided by her eccentric Great Aunt Irm, a precocious medical student, and the lawyer son of a victim, Kate launches her own unorthodox investigation of these unexpected deaths. As she comes closer to exposing the culprit’s identity, she faces professional intimidation, threats to her life, a home invasion, and, tragically, the suspicious death of someone close to her. The stakes escalate to the breaking point when Kate, under violent duress, is forced to choose which of her loved ones to save—and which must be sacrificed.

Perfect for fans of Kathy Reichs and Tess Gerritsen

While the books in the Kate Downey Medical Mystery Series stand on their own and can be read in any order, the publication sequence is:

Fatal Intent
Misfire
(coming January 2023)

Reviewed by chymerra on

4 of 5 stars

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Medical thrillers are not a genre that I typically read. It’s not that I don’t like them (I do); it’s just that they don’t show up on my radar very often, even when I am looking for a new book to read. So, I was intrigued when I was invited to review Fatal Intent. After reading the blurb, I knew I wanted to read this book. I am glad that I did because it was a great read.

There are trigger warnings in Fatal Intent. The huge, most obvious one is the angel of mercy killings. There are brief mentions of the death of a spouse and child through a drunk driver and the miscarriage. The author also talks about assisted death quite often during the book. This is a touchy subject and one that I am not going to discuss in this blog.

Fatal Intent is a fast-paced medical thriller that takes place in Florida. Kate is an anesthesiologist working at a university (or teaching) hospital. Kate lives with her great-aunt Irma, an eccentric German transplant, and her black lab, Shadow. Kate has had a rough couple of years. Her husband, Greg, severely injured by a bomb while deployed, has been in a coma for a year. She miscarried their daughter because of that. And the cherry on top, the chief of staff, Dr. Walker, dislikes Kate and makes her life miserable at work. Things start to snowball when Kate discovers several suspicious deaths on and off the hospital grounds. At the same time, Kate is accused of misconduct with a student and malpractice by an unpleasant surgeon, and Greg’s brother, Adam, is going ahead with a lawsuit to take Greg off life support. As Kate fights the lawsuit, the inquiry, and the malpratice accusation, she realizes everything is connected. Determined to get to the bottom of everything, Kate soon finds herself in a situation where she needs to make an impossible choice. What choice does Kate have to make? How is everything connected? Did the hospital have an angel of mercy?

The main characters of Fatal Intent surprised me. I was prepared to be annoyed or even not like them. But, right from the beginning, the author made them relatable. Also, she wasn’t afraid to kill off a couple of who I considered main characters. It made what happened at the end of the book so much more poignant.

  • Kate—I liked and connected with her. She had a great relationship with her great-aunt Irma and 98% of her coworkers. She treated her patients respectfully and wasn’t afraid to speak up when she thought something wasn’t right. Her relationship with the chief of staff did confuse me a little at the beginning, but once the author explained it, a lightbulb went off. The only thing that she had a conflict of interest in was Greg. She didn’t want him to die starving to death. But her brother-in-law, Adam, thought otherwise. As for her investigating the deaths, she didn’t intend to become embroiled in that scheme. She was doing what she thought was right. My heart broke for her at the climax of the book. She had to make an impossible decision. No matter what she decided, it was going to hurt her.

I say this in every review, but the secondary characters made this book. Every single one added extra depth to the plotline. I liked how these secondary characters also tied into the main storyline. They had clues about who the killer was, why Kate was being singled out at work, and why Adam was insistent on taking Greg off life support. Secondary characters rarely do that.

If you look above, you see that I put a lot of genres down that this book fits into. The top three out of that group would be medical fiction, mystery, and thriller. Fatal Intent fits perfectly into those genres.

So, a little bit of a warning, the review will get a little longer here. Several main storylines in Fatal Intent are merged about halfway through the book. I didn’t understand why the author had so many until the end. Everything became crystal clear here.

The storyline with Kate, the medical student, and the accusation of misconduct made me so angry. I knew the medical student was up to no good from the moment the author introduced him. There was a point in the book where I thought that Kate would end up losing her job, but the author pulled out her hidden ace. It was mentioned, and I didn’t even think about it until it was mentioned. Of course, the ending to that storyline was very satisfactory and did tie into the storyline with the malpractice, Dr. Walker, and the angel of mercy.

Speaking of that, I was so angry about the malpractice inquiry that Kate found herself in. The surgeon was full of himself, and I couldn’t believe that the chief of staff would side with him instead of remaining impartial. I found it suspicious. Of course, this storyline ended the way I thought it would but still. I wanted to smack that surgeon upside the head and tell him to take it down a notch.

The storyline with Dr. Walker, Kate, and the deaths left a bad taste in my mouth. As I said above, Dr. Walker was so suspicious. His treatment of Kate was borderline abuse of power, and everyone in that hospital knew it. He didn’t want to listen to her when she brought up credible evidence about a new hire. Also, he was too involved with the medical student’s accusation and the inquiry. I wasn’t surprised by what was revealed during Kate’s investigation. I did like that what she turned up had an effect…haha. I was thrilled with how everything turned out. Dr. Walker reaped what he sowed.

The storyline with Kate, Greg, and Adam was one of the saddest ones I have ever read. I got why Kate didn’t want to take Greg off life support. I agreed with her that starving to death was a painful way to go, even if you were in a coma. And like Kate, my distaste for Adam was there from the beginning.

The end of Fatal Intent was heartstopping. The author was able to meld the above storylines together in a way that took me by surprise. A colossal twist (and a heartbreaking decision made) took me by surprise. It is hard to get one past me with thrillers; the author certainly did!! I didn’t see it coming and felt that I should have.

I would recommend Fatal Intent to anyone over 21. There is violence, non-graphic sexual situations (kissing), and language.

I want to thank Tammy Euliano and Oceanview Publishing for allowing me to read and review Fatal Intent. All opinions stated in this review are mine.

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Reading updates

  • Started reading
  • 4 January, 2023: Finished reading
  • 4 January, 2023: Reviewed