"Lie Still "
(Reviewed by Chuck Barksdale NOV 12, 2003)
David Farris' first novel, Lie Still, is an exciting medical thriller with complex and realistic characters. Farris, a pediatric anesthesiologist, uses his medical expertise to provide a convincing and enjoyable suspense novel narrated in the first person.
This book is told in three different time periods; the present and two periods of about seven and eight years before the present. Resident Doctor Malcolm Ishmail begins the story telling of an unexplained medical emergency that had occurred seven years prior to the present. At that time, Dr. Ishmail is a surgical resident in an Emergency Room in a small town in Arizona. Henry Rojelio, a frequent visitor to the ER, although only 13, has returned with one of his frequent breathing problems. While apparently stable, Henry has a cardiac arrest and although Dr. Ishmail's efforts do save his life, Henry is in a coma and unlikely to return to normal.
The efforts to save Henry's life provide the first suspenseful parts of the book, as in the following excerpt that shows both the human and professional part of Malcolm Ishmail.
I said, "There's no reason for this kid to be dying."
I knew they were all thinking, Even if heart starts, brain still dead.
The books say even the best chest compressions achieve only 20 percent of normal blood flow. However, I had seen a patient open his eyes and look at me during CPR. He nodded to a question. Ten minutes later he died. You don't forget that.
"Anybody got any ideas?" I said. "Am I missing anything?" Before you let go it's always best to be sure no one on your team is silently thinking you've forgotten something. "Anyone object to stopping?" There was verbal silence.
Robin spoke. "Maybe one more round of drugs."
"Sure," I said. "Epi. And give him some bicarb." I nodded at Vickie and Patty.
One of the gallery spoke: "American Heart Association doesn't recommend bicarb.
I nodded, "Yeah, I know. And I know why. And I want it anyway."
"Want to try high-dose epi?" Patty asked.
"High dose?" I said, obviously seeking guidance.
"It's kind of new. One of the other docs told me about it. I guess it's still controversial, but apparently sometimes it works when nothing else does."
"Okay," I said. "How much?"
"Well, like six or eight milligrams at a time in an adult."
"Okay. Give him four," I said. "And two amps of the bicarb. Sometimes it helps the epi work."
The nurses injected the drugs. The chest was bellowed up with the breathing bag and compressed down by Robin's weight in alternating synchrony. We all stared silently at the EKG monitor. At first nothing happened. In fact, it probably took a full minute, but the needle made a sudden jump up in the middle of its regular CPR-induced bounces. We all saw it, but all knew it could as likely have been from sunspots as Henry's heart. Then it did it again. And again. "Hold compressions," I said.
Dr. Ishmail then explains his present day situation, implying that his problems with Henry led to his current situation as a fill-in emergency room doctor in his hometown of Hooker, Nebraska and other similar towns in Nebraska. Farris also provides a little more detail of Malcolm Ishmail's early life and medical training.
Farris takes the reader about 8 years prior to the present, Dr. Ishmail's second year of surgical residency at the University of Arizona Maricopa Medical Branch in Phoenix, Arizona. Events at Maricopa ultimately led to Dr. Ishmail being in a small town ER in Arizona trying to save Henry Rojelio instead of still at Maricopa. Malcolm's residency is under the supervision of brain surgeon Miriam "Mimi" Lyle. His description of her in this excerpt shows his physical attraction that foretells what would become an affair with Dr. Lyle. This excerpt also introduces the first of several semi-erotic sections by Farris, most of which are more descriptive than this one.
She eschewed the low-maintenance short-cropped hair considered mandatory for any woman in a surgical specialty. Hers was long and a deep auburn. It didn't flounce and bounce like a TV model; she generally had it braided and wound up on top of her head, but with her perfectly sculpted neck it looked elegant. She had a long thin nose, thinly arched eyebrows, and pale blue eyes. She usually wore fitted clothes, so there was ample evidence to believe that her body was everything a woman's body, in the tightly closed eyes of a twenty-seven-year-old, often lonely male, should be. Despite her being at least a dozen years older, my Y chromosome went on alert whenever she was near. Call it a schoolboy crush.
A significant portion of the novel is spent on the developing relationship of Malcolm and Mimi and the eventual concern that Malcolm has on Mimi's ability as a brain surgeon. Malcolm struggles with the best way to handle Mimi and her disregard for her inferior abilities while preventing unnecessary harm to her patients. Malcolm's handling of this situation has a significant impact on his medical career.
This novel appears to be a standalone with no mention of a sequel, and really no reason for one. Hopefully, Dr. Farris will continue to write suspenseful medical novels, as this is a great start. I'm certainly looking forward to more.
- Amazon readers rating: from 13 reviews
Read a chapter excerpt from Lie Still at MostlyFiction.com
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Bibliography: (with links to Amazon.com)
- Lie Still (October 2003)
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- MyShelf.com review of Lie Still
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About the Author:
David Farris, now a pediatric anesthesiologist, has spent more than twenty years practicing obstetrics, emergency medicine, pediatric critical care, and anesthesia for high-acuity surgery. He received his medical degree from the University of California, San Diego. He lives in Portland, Oregon, with his physician-wife and their two sons, and devotes his practice primarily to infants' and children's heart surgery.