Oxygen: A NovelOxygen: A Novel by Carol Cassella

My rating: 5 of 5 stars

This is a fantastically satisfying read. Within the intersecting circles of thriller, medical drama and popular fiction, Carol Cassella’s confident debut emerges in vivid, three-dimensional relief. With her first-hand knowledge of the field of anesthesiology, Cassella creates an original and compelling plot: a child dies in the middle of surgery and all fingers point to the one most responsible for keeping her alive — the anesthesiologist.

For this reader, the mystery is not in the who- that is obvious as the stage for the disaster is set. The mystery is how the truth will be revealed. The book rolls out from the child’s death during a routine operation through the months it takes to mount a malpractice suit against the doctor, Marie Heaton, and the hospital, which promises to stand behind her. Cassella deftly constructs an agonizing drama as Marie lives her weeks of personal torment, waiting helplessly for attorneys and administrators to decide her fate.

Cassella writes Marie’s voice so clearly- you believe how this woman moves, behaves and reacts. Her emotions and motivations ring true- you walk in her shoes, body weary from a 24 hr shift, your heart pounds with every phone call, your hands shake as Marie tears open the autopsy report that may exonerate her from the little girl’s death. Secondary characters are fully-realized as well; even walk-on roles are detailed enough to pivot the mood of the narrative.

I’m always on guard with books set in my backyard, looking for the slightest detail out of whack. Cassella nails Seattle, right down to the orientation of light on a rooftop, the playground that’s across the street from Queen Anne High School Condominiums, the dim, smoky interior of Larry’s Bar in Pioneer Square (the book is set prior to 2006, before Seattle’s ban on smoking in eating establishments and before Larry’s was closed after a New Year’s Eve murder). First Lutheran Hospital is so clearly Swedish Hospital. I can see its hallways and even an operating theater, where I have gained a great appreciation for the skills of anesthesiologists in recent years.

Cassella includes a family drama, involving Marie’s elderly father. He lives alone in Fort Worth and his declining health has forced a critical decision point for Marie and her sister, a Houston stay-at-home mom of three. Marie’s leave from the hospital allows her time to confront her father’s needs and their confused relationship. It also gives her time to consider her own lonely state and the promise of love with a trusted friend.

I’m pleased to be so pleased with a novel that, if you strip it down, is a formulaic fiction. An inciting incident leads the protagonist into crisis, sub-plots introduce characters to provide protagonist with depth and backstory, a false resolution notches up the crisis, a plot twist changes the game minutes before the end. But it works. It works because Casella’s characters are real and earn your empathy, it works because the subject matter is both original and to-the-moment relevant, it works because of the author’s terrific sense of pacing and attention to detail. Three cheers for the home team! This is a Northwest writer I’ll be keeping an eye on.

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