Oxygen
Carol Cassella, 2008
Simon & Schuster
320 pp.
ISBN-13: 9781416556114
Summary
With the compassion of Jodi Picoult and the medical realism of Atul Gawande, Oxygen is a riveting new novel by a real-life anesthesiologist, an intimate story of relationships and family that collides with a high-stakes medical drama.
Dr. Marie Heaton is an anesthesiologist at the height of her profession. She has worked, lived and breathed her career since medical school, and she now practices at a top Seattle hospital. Marie has carefully constructed and constricted her life according to empirical truths, to the science and art of medicine.
But when her tried-and-true formula suddenly deserts her during a routine surgery, she must explain the nightmarish operating room disaster and face the resulting malpractice suit. Marie's best friend, colleague and former lover, Dr. Joe Hillary, becomes her closest confidante as she twists through depositions, accusations and a remorseful preoccupation with the mother of the patient in question. As she struggles to salvage her career and reputation, Marie must face hard truths about the path she's chosen, the bridges she's burned and the colleagues and superiors she's mistaken for friends.
A quieter crisis is simultaneously unfolding within Marie's family. Her aging father is losing his sight and approaching an awkward dependency on Marie and her sister, Lori. But Lori has taken a more traditional path than Marie and is busy raising a family.
Although Marie has been estranged from her Texas roots for decades, the ultimate responsibility for their father's care is falling on her. As her carefully structured life begins to collapse, Marie confronts questions of love and betrayal, family bonds and the price of her own choices.
Set against the natural splendor of Seattle, and inside the closed vaults of hospital operating rooms, Oxygen climaxes in a final twist that is as heartrending as it is redeeming. From the publisher.)
Author Bio
• Birth—ca. 1956-57
• Raised—Dallas, Texas, USA
• Education—B.A., Duke University; M.D.,Baylor College of Medicine
• Currently—lives on Bainbridge Island, Washington
Carol Cassella is a practicing anesthesiologist and novelist. She was a closet writer for years before blending medicine and fiction in her first novel, Oxygen, the story of an anesthesiologist tangled in the aftermath of an operating room catastrophe. Oxygen was an Indie Best Pick for July 2008, and selected as one of the best first novels of 2008 by The Library Journal. The novel has become a national bestseller and was released as a trade paperback in June, 2009.
Carol grew up in Dallas, Texas and graduated from Duke University with a degree in English Literature. After working in publishing for several years, Carol decided to pursue her fascination with all the weird and wonderful ways humans behave and misbehave by studying medicine. She initially intended to become a psychiatrist, but when she couldn’t separate the body and the soul she veered into internal medicine and then, six years later, into anesthesiology. She is board certified in both internal medicine and anesthesiology. Prior to writing fiction, Carol wrote about global public health issues in the developing world for the Bill & Melinda Gates Foundation.
Carol now lives on Bainbridge Island, WA with her husband Steve and their two sets of twins. She enjoys hiking and cross country skiing in the North Cascades. (From the author's website.)
Book Reviews
A subtle, compelling plot that twists and twists again. This quickly becomes a book you cannot put down.
Dallas Morning News
A finely crafted mystery, as well as a sparkling literary work.
Denver Post
A startling plot twist, combined with Cassella's first-hand understanding of our ailing healthcare system, makes this involving debut just what the doctor ordered.
People
Powered by Cassella's 25 years in the medical field, this nicely wrought debut follows the travails of an experienced Seattle anesthesiologist after an eight-year-old patient dies while under the knife. In the aftermath, Dr. Marie Heaton is entangled in both her grief and a malpractice lawsuit. As the many meetings with attorneys blur together and autopsy results are awaited, Marie, who regrets having missed out on the "intended stream of marriage and motherhood," mediates the domestic squabbles in her sister's family; leans on and gets leaned on by colleague and ex-lover-turned-best friend, Joe Hillary; and tries to come to a détente with her widowed father, who is losing his vision and with it his autonomy. As Marie is increasingly scrutinized, a few unexpected twists slyly work themselves into the investigation of the death, and the ice between Marie and her father slowly thaws. The prose is competent and the plot moves at a brisk pace, but the real hook is Cassella's knowing portrayal of the health industrial complex's inner workings; she knows the turf and doesn't spare readers the nasty bits.
Publishers Weekly
Discussion Questions
1. After Jolene's death, Marie thinks almost as much about Bobbie as she does about her own experience. Why is it so important for her to see Bobbie? What does she hope to accomplish?
2. Marie says that no death she has witnessed affects her as Jolene's does, yet one experience was different: the death of her mother. How do you think learning of her mother's condition and attempting to help her parents understand it while she was in medical school affects Marie as a doctor? How was the time of her mother's death a turning point between the life she was raised for and the life she chose?
3. When Marie learns that the Turner Syndrome revealed in Jolene's autopsy could make losing the case and therefore her career more likely, she wonders "if all the money and possessions were stripped away, what, exactly, would be left?" What choices does the case force Marie to reconsider? What doubts does she have about her life and career?
4. Discuss the relationship between Marie and her sister, Lori. Why doesn't Marie tell Lori about what happened to Jolene immediately? What conflicting emotions does Marie have about Lori's life and marriage?
5. When Marie and Joe are in the hotel in Texas, he describes his theory of the "Big O," a theory that could apply to several characters in the book, perhaps Joe most of all. Why is it significant that Joe be the one to hold this hopeful belief? In what ways are each of the characters "cloaked"?
6. Marie's father is literally going blind, and yet each of them is blind in a way, unable to see through their estrangement and past wrongs. What does Marie learn about how her father "sees" her during her visit? What does she "see" in him? What is the significance of the gift of her mother's ring?
7. The balance between vulnerability and control functions on several levels in the novel: Between doctors and patients in the operating room, during the legal battle in the aftermath of Jolene's death, and in Marie's relationships with her father and Joe. What happens when the balance shifts in each situation? What does Marie learn about control within each context, or from each person?
8. Joe is one of the most surprising characters in the book. He buoys Marie up, he gives her strength, but in the end he is revealed as the weak one. Were Joe's feelings for Marie genuine? Does his letter change your opinion of him? Ultimately, how does Marie feel about him?
9. Betrayal is an important theme in the book. Marie is betrayed by Joe and the hospital. Bobbie and Jolene are betrayed by them too. Marie's father believes she betrayed him and his faith when she was a teenager. What other betrayals can you think of? What motivation is at the root of each betrayal?
10. Consider the depictions of hospitals and doctors on television versus in Oxygen. How does the novel's authentic portrayal of medical culture, its routines and its dilemmas, differ from what you see elsewhere?
11. The ending of the novel is particularly bittersweet. Marie's innocence is intact, but Joe's innocence, and her relationship with him, are undone. Were you surprised? Were you satisfied with this resolution?
(Questions issued by publisher.)