By day, Tammy Euliano, MD, is a Professor of Anesthesiology and Obstetrics & Gynecology at the University of Florida where she cares for patients, teaches medical students and residents, performs research, and invents cool stuff. She’s been honored with numerous teaching awards, more than 100,000 views of her YouTube teaching videos, and was featured in a calendar of women inventors (copies available wherever you buy your out-of-date planners).
By night, she plays games with her family (now remotely), plays tennis (badly), cuddles her dogs, reads, and writes medical thrillers. In her writing, she is intrigued by ethically blurry topics and enjoys positioning characters on all sides of a debate, each with a well-reasoned position…or humor…or dogs.
Vacations are for exploring our amazing world. She has dragged her family of five to all the major US national parks, Alaska, Hawaii, Canada, Costa Rica, the Caribbean, the Galapagos, the Mediterranean, Europe, and New Zealand. Trips are spent soaking up the history and culture while also experiencing nature, often in extreme fashion.
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Betty: What inspired you to write the story you’re sharing with us today?
Tammy: The idea of managing the end-of-life has fascinated me since way before any kid should think about such things. We had a debate in my 5th grade class about the fate of Karen Ann Quinlan, a young woman in a persistent vegetative state whose parents wanted her ventilator disconnected, while the State of New Jersey disagreed. I don’t recall what side my 10-year-old-self argued, but the question never left me. Medical technology and the ability to keep the body alive has far out-paced our ethical ability to deal with the implications.
In medical school and residency, the question resurfaced repeatedly, while watching families’ extended mourning in the ICU, and anesthetizing patients for innumerable procedures despite little to no hope of a meaningful recovery. Meanwhile, the absurd cost of medical care in the US frequently made the news, especially expenditures in the last few months of life and final hospitalization.
Actually getting words on the page took a bit longer. After writing an introductory anesthesia textbook with my mentor, we decided to continue our teamwork with a novel. Sadly he fell ill and passed away, but I had the bug and found the time to start Fatal Intent.
Betty: Which character arrived fully or mostly developed?
Tammy: Definitely Dr. Kate Downey, the protagonist. She’s quite a lot like me. Shocking for a debut author, I know. Though a few years my junior, ahem, we share careers as anesthesiologists who specialize in obstetric anesthesia and teach medical students and residents, sometimes using a simulated operating room environment.
Our personalities overlap a bit, or did when I was her age, but there the similarities end. Instead of my tragedy-free life to date, she suffered the loss of her parents and now the traumatic brain injury of her husband. Boy, are we authors cruel, or what? I have to keep reminding my husband that Kate is not me, and he is not her comatose husband, Greg. As for her dog, I’m afraid mine is just as energetic, spoiled, and completely untrained…times two.
Betty: Which story element sparked the idea for this story: setting, situation, character, or something else?
Tammy: The situation. Long intrigued by end-of-life issues, the seeds of a plot began germinating in my head (kind of a gross image, really). Over time, the story world and its characters began invading my real life, popping to mind at all hours, sometimes quite inconveniently.
Betty: Which character(s) were the hardest to get to know? Why do you think?
Tammy: The villain, of course. Initially I imagined him wholly evil, then realized he was sort of doing a good thing, just in a bad way, then decided he needed to be evil-er both to raise the stakes and to make it clear what should happen. It was fun trying to get into his head and understand his motivations.
Betty: What kind of research did you need to do to write this story?
Tammy: Since it’s set in my real-life world, not as much as I’ve had to for other books. I did read up on some medical details, how home deaths are managed, and end-of-life laws around the world. Google is my go-to, but I’m fortunate to have connections throughout the medical world to get answers to my questions. Also, there are Facebook groups of lawyers, doctors, and police who will answer questions with their expertise.
Betty: How long did it take for you to write the story you’re sharing with us? Is that a typical length of time for you? Why or why not?
Tammy: This story took at least three years to write, though that included realizing I didn’t know how to write and starting over multiple times as I learned what not to do. It’s sequel took less than a year, and I’m hoping the next will be shorter still. I’ve developed some skills, though have much more to learn!
Betty: What rituals or habits do you have while writing?
Tammy: I’m fortunate to have two great writing locations, one at my house, and one at a lake house we visit on weekends. At both I have a laptop stand and can write standing up outside where my dogs conveniently bring me balls to throw…well, not exactly BRING, but hide somewhere under a bush nearby to keep me awake. Another habit is using a large white board to make a mind map of my plot and finally, having characters write me a hand-written letter about their lives and motivations. It makes them more three-dimensional in my mind. As a friend reminded me, “Each character is the hero of his/her own story, even the villain.”
Betty: Every author has a tendency to overuse certain words or phrases in drafts, such as just, once, smile, nod, etc. What are yours?
Tammy: I pay attention to “just,” but use “but” way too much. And smile and nod are always a problem, as are look and gaze. I try to picture the movie version and those words just (oops) seem right. I need to continue to read great writers critically to learn how they get around such seemingly insurmountable stage direction.
Betty: Many authors have a day job. Do you? If so, what is it and do you enjoy it?
Tammy: I’m a physician, an academic anesthesiologist specializing in obstetrics, to be specific. Besides caring for women in this most special moment, I also teach medical students and residents, and have worked with my husband’s engineering team to develop new medical devices. Since I began writing, I resigned my administrative positions and therefore enjoy my job infinitely more. Managing people is not my forte.
Betty: As an author, what do you feel is your greatest achievement?
Tammy: Fatal Intent is surely it. Related are the amazing blurbs I was able to get from the likes of Lee Child, Kathy Reichs, and Tess Gerritsen, all heroes of my author journey.
Betty: Success looks different to different people. It could be wealth, or fame, or an inner joy at reaching a certain level. How do you define success in terms of your writing career?
Tammy: Learning that I reached readers in an impactful way would define success for me. That I held their attention, took them away for a while, made them think, maybe taught them something, but most importantly that they enjoyed their time in the world of my imagination and it brightened their day (or night, or hopefully both). Ideally, that it also stuck with them afterward in some meaningful way.
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.
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I agree wholeheartedly with your friend’s advice that the villain is the hero of his/her story, too. Thanks so much for taking time out of your busy schedule to share your intriguing story with us, Tammy!
Happy New Year and happy reading!
Betty
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