Tammy Euliano Interview - Fatal Intent ~ JeanBookNerd

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Tammy Euliano, MD, is a practicing anesthesiologist and tenured professor of anesthesiology at the University of Florida. In addition to a prolific list of academic publications, YouTube teaching videos, and numerous teaching awards, she has also written award-winning short fiction. Fatal Intent is her debut novel. Tammy lives in Gainesville, FL, with her husband.

Where were you born and where do you call home?
I was born in Minneapolis, Minnesota, but raised in central Florida. I moved to Gainesville for college in 1983 and have lived there ever since. It’s where I met my husband, did all my medical training and where we’ve raised our three children. We’re huge Gator fans and have three orange and blue rooms in our house.

Tell us your most rewarding experience since being published.
As I write this I haven’t actually been published, but the most excited I’ve been was when I received each blurb from authors I respect. They came one at a time, often when I was at work, and I was bursting with excitement each time. It was also extremely rewarding when my kids read the book and enjoyed it, 2/3 of them aren’t big readers, so that they took the time and effort really made my day.

What inspired you to write FATAL INTENT? How did this book came about?
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.

As my career progressed and I achieved the goals I’d set for myself, it came time for reinvention, and that’s when this “encore career” became a possibility. The characters of Fatal Intent took up residency in my head, invading my sleep, and even my waking hours. It was time to give them voice. I resigned my time-consuming administrative positions, wrapped up my ongoing research projects, handed off most of my teaching responsibilities to up-and-coming faculty who needed it for their resumes, and dropped to part-time at the hospital so I could make a real investment in my writing.

From there it took several years to learn how to write. It’s so very different from the technical writing I did for decades. Once I found my tribe of writing supporters and teachers and editors, at last it came together and I couldn’t be happier to finally share Kate’s and her crew with the world.

What do you hope for readers to be thinking when they read FATAL INTENT?
I hope they’re rooting for Kate, maybe learning a little about her environment and medicine from the inside. More importantly, I hope her story will stimulate discussion about meaningful life and compassionate death. Fatal Intent provides no answers, nor do I have a strong opinion, only that end-of-life is a discussion we need to have, both in our homes with our loved ones, and on a national stage.

What was the most surprising thing you learned in creating Kate’s character?
As with many beginning authors, my protagonist started out as basically as a white-washed me. The me I thought I wanted to be. Then terrible things started happening to her, and she showed a resilience far beyond what I think I could handle. I learned several important things: one, she is way cooler than me; two, when authors say their characters go their own way, it’s not as crazy as it sounds; and three, my hero characters will always have a dog, and not a little yappy one, but a golden, or lab, or mid-large size rescue. Oh, and four, any good friends or love interests will also love the dog!

If you could introduce one of your characters to any character from another book, who would it be and why?
I would introduce Aunt Irm to Rein-Marie Gamache of the Louise Penny series. She is a thoughtful, intelligent woman and I think Aunt Irm would have great fun chatting with her about the world and the practicalities of life.

TEN FACTS ABOUT FATAL INTENT

1. Like Kate, I am an anesthesiologist, trained at the University of Florida, including a fellowship in obstetric anesthesia. Unlike Kate, my parents are very much alive, and, in addition to Kate’s former Air Force brother, I also have a sister. Oh, and my husband is quite far from comatose. And no, I am not considering ways to put him into a coma so I can run off with my boyfriend, though Christian is kinda…nope, nevermind.
2. The simulator mentioned in the story is a real thing that was invented at University of Florida and I was fortunate to work on the project as a medical student and am even on one of the patents. In fact, getting involved in the project is what convinced me to stay in medical school and I am forever grateful to Drs. Dave Paulus and Mike Good for inviting me to participate. As one of the only schools with a simulator, we were the first to figure out how to teach with it and it was central to my early career.
3. The story where Kate is faced with a patient whose ventilator is to be disconnected the following day, and her family’s question about why Kate gets to play God is a true story that happened to me during my internship.
4. Kate’s friend, Randi Sinclair, is modeled after my best friend growing up. We’ve been only Christmas card friends for decades now, but it was fun to bring her back. When I sent her a Christmas note this year, she was quite surprised to learn she was pregnant.
5. Great Aunt Irm was the aunt of my mentor, Dr. J.S. Gravenstein, who was raised in Germany during World War II. She was special to him and he began describing her when he and I started to write a book together prior to his death. The “krimis,” German-language mysteries, were also provided by him.
6. Carmel is my own Great Aunt. She lived nearby during my childhood and was a great friend to my mother. She always had a smile on her face, laughter in her voice, and was forever cooking something yummy from scratch. I wish I’d spent more time learning from her!
7. Fatal Intent’s working title was “Do No Harm” for the first five years of its existence, but my publisher rightly suggested the change due to the numerous Do No Harm titles already published, including a movie. But the concept of do no harm remains in the novel.
8. I credit Thrillerfest with the opportunity to obtain the incredible blurbs for Fatal Intent. Through the annual meeting of International Thriller Writers in New York City I met and learned from the amazing writers who agreed to read and blurb the book. Thrillerfest is phenomenal, as are thriller writers in general—so generous of their time, experience and talent.
9. Dr. Joe Layton is a real person, almost. He is modeled after a mentor and one of the smartest docs I’ve ever known. He ran our Surgical Intensive Care Units for many years, taught me an incredible amount, and had the ‘no nonsense’ personality as described.
10. Dr. Ricken is not modeled after anyone I’ve ever worked with, because surgeons are uniformly kind, friendly conversationalists—That’s my version of an unreliable narrator, did it work? Truthfully, I know some wonderful surgeons, but of all the difficult people in medicine with whom I’ve worked, I can think of only one who wasn’t a surgeon. When I was the director of our anesthesiology residency program, one of my most challenging tasks was defending my residents against the hateful behavior of some of our surgeons. It was only a few, but wow. And they weren’t particularly interested in my feedback. Fortunately, efforts over the last decade have reduced this “bad personality parade,” vastly improving the OR environment, to the betterment of patient safety.

What is something you think everyone should do at least once in their lives?
Wow, it’s so dependent on who they are and what they enjoy. Falling in love is an obvious one, listening to the stories of an old person, especially about what turned out to be important in their life. But as far as experiences…a sunrise and sunset over an ocean (probably not the same ocean), canyoning if they’re physically able, napping while spooning a cuddly dog, reading a story that makes you cry, doing something kind for someone just because.

If you could go back in time to one point in your life, where would you go?
Wow, that’s a tough one. I’d love to have the joints of a 30-something, and I do miss my kids like crazy, but I can honestly say I’ve never been happier and wouldn’t trade my current life for anything…even well-oiled knees.

What is your most memorable travel experience?
You ask very difficult questions. We’ve been so blessed with incredible travel opportunities to all the major national parks in the US, Costa Rica, the Galapagos, even New Zealand. But you asked the most memorable, which would have to be my medical mission trip to Haiti. Far from my favorite, but extremely memorable. It was just a surgeon, me as the anesthesiologist, a nurse and a few other volunteers. We operated on dozens of locals who had no other access to medical care. Their pathology was far beyond anything we see in the US and it was wonderful to have a significant impact on their lives. Meanwhile, working as a team was such a pleasure the austere conditions didn’t matter.

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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