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Oxygen

by Carol Cassella (Goodreads Author)

3.53 · rating details · 1,917 ratings · 490 reviews

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 medi

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Hardcover, Large Print, 519 pages

Published November 3rd 2008 by Thorndike Press (first published July 1st 2008)

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Dec 27, 2009

Thomas rated it

· review of another edition

Oxygen is about Dr. Marie Heaton, an established anesthesiologist at the tip of her career. Her life is consumed with putting people out of their pain and supplying them with oxygen; her entire existence revolves around her work. However her carefully constructed lifestyle falls apart when one of her patients dies on her operating table. Soon enough a malpractice suit is filed against her by a single mom who has lost her only child - also, she has to deal with her father's vision loss and their...moreOxygen is about Dr. Marie Heaton, an established anesthesiologist at the tip of her career. Her life is consumed with putting people out of their pain and supplying them with oxygen; her entire existence revolves around her work. However her carefully constructed lifestyle falls apart when one of her patients dies on her operating table. Soon enough a malpractice suit is filed against her by a single mom who has lost her only child - also, she has to deal with her father's vision loss and their awkward, obstructed conversation after no communication for three years. This book takes place in Seattle, and also inside the stressful, unnerving hospital rooms where thousands of near-death experiences are avoided every day.

I was close to giving this book a 3/5 stars, but realized that it was probably closer to 4/5. The one thing that made me pick it up was the hook, "With the compassion of Jodi Picoult..." because I am a huge Picoult fan. Anyway, after reading the fluffy first pages I was hooked. While the first chapter may intimidate some readers it really got me interested, even though I have no clue about anything of the world of medicine.

Cassella is obviously a talented human being - English lit. at Duke, and later on graduating from medical school to practice anestheiology. Her writing exhibits her talent tremendously. While the first part of the book was a little heavy on the medical jargon overall the writing was flawless and combined both emotion and medical skill. There is no questioning the research and expertise the author has when reading this novel. The only thing I didn't particularly like about the writing on rare occasions was that it became a bit too stiff - sometimes not "compassionate" enough, like the book jacket advertises.

For the plot I would like to split it up into two parts. The first part, the trial and lawsuit, was absolutely fabulous. Engrossing and addictive the story just grabbed me and didn't let me go - the twist in the end was one of the best I've ever read and really took me for surprise without jumping the shark. However, the second part, which was her falling apart family and relationship with her dad, was a bit weak for me and I didn't enjoy the majority of it. There is one chapter dedicated to the main character's relationship with her father when she was an adolescent and during that chapter I just had to put the book down because it seemed so unrealistic.

Other than the few things listed above, Oxygen really reads not as a debut novel but as a medical thriller filled with mystery and suspense. When I first picked up the book I never thought I would say this, but I'm really looking forward to reading Cassella's sophomore effort.(less)

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Aug 31, 2008

Karen rated it

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My Review of Oxygen: A Novel by Carol Cassella

Carol Cassella’s mixture of mystery and medical thriller, supported by the authenticity of her many years as an anesthesiologist, results in her page turning debut book, Oxygen: A Novel. Casella’s Dr. Marie Heaton is also an anesthesiologist who is passionate and professional about her life’s work. She works at Seattle’s First Lutheran Hospital where she prides herself in the care and expertise with which she conducts her everyday life a...moreMy Review of Oxygen: A Novel by Carol Cassella

Carol Cassella’s mixture of mystery and medical thriller, supported by the authenticity of her many years as an anesthesiologist, results in her page turning debut book, Oxygen: A Novel. Casella’s Dr. Marie Heaton is also an anesthesiologist who is passionate and professional about her life’s work. She works at Seattle’s First Lutheran Hospital where she prides herself in the care and expertise with which she conducts her everyday life as a physician.

Starting out as a routine day, with a busy schedule that includes a pediatric case of an 8 year old, mentally challenged girl later in the afternoon, Dr. Heaton’s day suddenly turns into every doctor’s worse nightmare. What should have been a simple operation to remove a cyst on little Jolene Jansen’s back, results in tragedy and finds Marie shockingly facing a malpractice suit as she questions herself as to what went wrong.

What follows is Marie’s life falling apart as she is enveloped in legal paperwork, autopsy results, self recrimination, and the realization that people who were her supporters are quick to abandon her. Her one time lover, Dr. Joe Hillary, becomes the person she thinks she can count on to help her make it though this horror and try and save her career.

Add to this, a problem in Marie’s personal life as her aging father is becoming more dependent on others as his eyesight fails. Marie finds that the responsibility for his care suddenly comes to her even though her connection with her family in Texas has not been a close one for years. Her sister Lori, however, is busy raising a family and so Marie is left with not much of a choice as to the care of her father.

Everything in Dr. Heaton’s once precisely ordered life begins to crumble as everyone and every part of her life suddenly seems to be crashing in on her. How Carol Cassella brings the story to its climax and Marie Heaton’s life turns out, is told with the expertise of a seasoned writer. The truth of the profession and the workings of medical field are never glossed over by Casella as she gives the reader a REAL look at what goes on in this medical industry while still engaging us in a thriller that only leaves us wanting more from this wonderful new author.
Submitted by Karen Haney, August, 2008

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Jan 07, 2009

LJ rated it

· review of another edition

Shelves: contemporary_post_1945, female_author, medical_thriller, novel

OXYGEN (Novel/Med. Mys- Dr. Marie Heaton-Seattle-Cont) – Good
Cassella, Carol – 1st book
Simon & Schuster, 2008, US Hardcover – ISBN: 1416556109

First Sentence: People feel so strong, so durable.

Dr. Marie Heaton is a skilled anesthesiologist. Her life is off track and her career at risk when a child dies during surgery and Marie is being sued for malpractice. Although she tries to keep working, she must work to find out exactly what happened during the operat...more

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Oct 22, 2011

Amy rated it

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This review has been hidden because it contains spoilers. To view it, click here.

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Aug 06, 2011

Nikole rated it

· review of another edition

I adore medical shows on television. When E.R. was on, I watched it religiously. When there is nothing else good on tv, I love turning on discovery health and nine times out of 10 I will find myself completely enthralled with whatever drama is on folding on screen.

Medical novels, on the other hand, is not a genre I have spend much time reading. In fact, if my memory is correct, I have only attempted to read one Robin Cook novel and was so-underwhelmed that I have never delved into fict...more

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May 22, 2011

Amy (SpedBug) rated it

· review of another edition

Shelves: library-book, didnt-want-it-to-end

Dr. Marie Heaton’s life is her work as an anesthesiologist. She has friends, but they’re comprised of colleagues who live the same hectic, work-centric life as she. Forced to take a leave of absence from her demanding job, she finds herself returning to her most important relationships – those with her family – for support and for reparation.

Oxygen is a novel about a single medical mistake with an unconscionable result. It is about a doctor who, while struggling with guilt, refuses...more

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Jan 28, 2011

Paul Pessolano rated it

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Dr. Marie Heaton is an anesthesiologist. She works at First Lutheran Hospital in Seattle. She has had a great career and takes pride in her profession.

Marie's life starts to unravel when a young special needs girl dies on the operation table. Marie and First Lutheran are being sued by the young girl's mother for malpractice. An autopsy finds that the girl had a previous heart condition but went undetected by everyone.

The hospital is working with Marie until they find ...more

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Oct 10, 2010

Lark Fillmore rated it

· review of another edition

Dr. Marie Heaton is an experienced anesthesiologist practicing in Seattle. During surgery, her patient dies. While the entire surgical team is sued, it was ultimately Marie's fault and therefore she takes it the hardest.

What I liked about this book:
1. It hit on several medical hot-topics. Since the author is herself an anesthesiologist, I felt like everything she touched on in regards to medical malpractice is a reality. It is scary. Most doctors nowadays feel like its not "...more

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Jun 09, 2010

Denise rated it

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4.0 out of 5 stars A breath of fresh air in the medical thriller genre....., September 7, 2008

This review is from: Oxygen: A Novel (Hardcover)

I'm an RN and I love medical thrillers. For the past several years, however, it's been tough to find really good ones about something new and different. This really wasn't a "thriller" per se, but it was a novel that had a hint of mystery in it -- the goal -- to find out what caused the sudden, inexplicable death of an ...more 4.0 out of 5 stars A breath of fresh air in the medical thriller genre....., September 7, 2008

This review is from: Oxygen: A Novel (Hardcover)

I'm an RN and I love medical thrillers. For the past several years, however, it's been tough to find really good ones about something new and different. This really wasn't a "thriller" per se, but it was a novel that had a hint of mystery in it -- the goal -- to find out what caused the sudden, inexplicable death of an 8 year old girl on the operating room table during an elective procedure. (I used to work in the OR, and the details about that world I loved all came back - made me want to go back and work again!! The medical details really interested me from that professional standpoint.) The anesthesiologist, Dr. Heaton, who put the child to sleep is slapped with a malpractice accusation and it even goes further than that. My blood ran cold as Marie finds out from the hospital legal team and the lawyers just what this case is going to cost her in terms of her livelihood and her career. She has focused her entire life on her job and, other than a sometime boyfriend -- colleague and friend Joe, all she has is her sister and sister's family --she has a difficult relationship with her father -- and that's about it. As her life spins out of control, she goes to see her dad and tries to piece herself back together to face the future. The resolution of the case was interesting, although a bit predictable, and I felt a lot of sympathy for Marie - she made the choice for career over wife and/or mother, and saw how quickly relationships with those you love and those who love you become the only things that really matter once the workday is done. She loved her job and she focused all she had on being the best -- but in our society and with malpractice litigation run amok, being great might not be enough to protect a doctor.
The writing was good and the pace kept me turning the pages late into the night. I hope to see more from this author!
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Nov 21, 2009

Elizabeth rated it

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I expected this book to be a fluff read. You know, a good book to read on a beach. Well, since it's winter here in Minnesota, maybe I should just say, a good book to curl up by the fireplace with. It was definitely much more than that. I request books from my library that I've read reviews of or heard about from friends. This one had so many requests. I've been waiting so long, I've forgotten where I heard about it.

Dr. Marie Heaton is a dedicated anesthesiologist. She loves th...more

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Jul 01, 2009

Michaelsean rated it

· review of another edition

Oxygen by Carol Cassella was an interesting book to me. Written by a practicing anesthesiologist it tackles a subject that obviously the author knows well, but one that the average reader does not really understand that well. She does it flawlessly without making things complicated or dumbing down the medical terminology she uses.

The book is set at the fictitious Lutheran Hospital in the Seattle area. During what at first appears to be a routine surgery, there are fatal complications...more

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Aug 15, 2011

Carolyn Gerk rated it

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Oxygen follows the story of Dr. Marie Heaton, anesthesiologist as she deals with a case in which an eight year old patient dies on the operating table.
An interesting topic, kind of felt like a slow moving Grey's Anatomy episode. The information about anesthesiology was interesting, I enjoyed heaton's reflections about the power of putting a person to sleep and holding them safely in a pain free lull during crisis. Some beautiful writing and observations are scattered throughout the novel....more

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Nov 27, 2009

Michelle rated it

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Shelves: 2009

I'm not sure how to rate this. There were parts I loved and parts that didn't do it for me. What I liked: the premise, the plot twist (also enjoyed that the twist had its OWN twist), and the tension created at the end of the book that kept me anxiously reading. What I didn't like: the B storyline (just wasn't into it and kept wanting to get back to what was happening in Seattle), too much medical jargon at the beginning that made it sterile at first, and, frankly, the protagonist. I just couldn'...more

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Jan 19, 2009

Fredsky rated it

· review of another edition

Recommends it for: Any pre-meds or even pre-ops!

Recommended to Fredsky by: Eileen

The next time your anesthesiologist looks you in the eyes and shoots a syringe of something into your I.V., don't have read this book already.

Our heroine, Dr. Marie Heaton, an experienced anesthesiologist, is naive in the ways of the normal functioning world. She doesn't read men very well, she doesn't seem suspicious of lawyers until it's too late, and she appears to have no prior knowledge that hospitals are big business and that big business will cheerfully and resolutely bite...more

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Feb 02, 2012

Julie rated it

· review of another edition

Shelves: best-of-2012, contemporary-fiction, usa-contemporary

This review has been hidden because it contains spoilers. To view it, click here. 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 th...moreThis 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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Jun 23, 2011

Helynne rated it

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Author Carol Cassella is an anesthesiologist herself, and it is obvious she is intricately aware of the physiological, psychological and legal aspects involved in what must be the one of the riskiest of all specialized profession in terms of looking out for the fragility of human life.. But she is also a gifted writer who eloquently gets into the mind of her alter-ego Dr. Marie Heaton, a dedicated anesthesiologist at a Seattle hospital, and all the emotions that go through her heart and mind af...moreAuthor Carol Cassella is an anesthesiologist herself, and it is obvious she is intricately aware of the physiological, psychological and legal aspects involved in what must be the one of the riskiest of all specialized profession in terms of looking out for the fragility of human life.. But she is also a gifted writer who eloquently gets into the mind of her alter-ego Dr. Marie Heaton, a dedicated anesthesiologist at a Seattle hospital, and all the emotions that go through her heart and mind after she loses a young patient on the operating table and faces a bewildering malpractice suit. Here is an example of her style:
“My mind separates itself from my body. I enter some hyperfunctioning realm where I race forward in emergency protocols, calling for backup help, telling Stevenson we have to stop the surgery, turn her over . . . She is dying. My God, this child is dying I can feel blood rush into my face, the team watches me, waits for me to pull off a miracle, all of us teeter on the brink of realizing that Jolene has already been starved of oxygen for so long nothing of her former self will survive.” (28).
Marie is surrounded by supportive medical staff, but the legal counsel has some and shocks for her. In addition, she must cope with a fellow anesthesiologist and former lover who is coming back into her personal life as well as her aging father with failing eyesight with whom she has always had a strained relationship. “My father, this widowed scholar, who has always, always kept his mind so locked up from me; who has never, as far as I can recall, bothered to ask me why I, the daughter of a history professor, would prefer the calculations of chemistry and pharmacology, would choose a professor where mathematical models were applied to comprehend the human condition. He has never asked why I would choose to find my answers in the objective manipulation of facts and formulas instead of his own endless parsing of the garmented scraps left by doomed populations groping to find godly design in random famines and plagues” (218).
Ultimately, Marie resolves her multiple dilemmas as the story takes some unusual twists and turns. This is not only an eloquently written story, but also an eye-opener to all of us non-medical folk (who should be grateful that whatever we do, we will never be in the delicate and potentially lethal position that many physicians find themselves on a daily basis).

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Jan 29, 2010

JoAnn/QuAppelle rated it

· review of another edition

This was interesting material but I thought the book was just okay. Too many words at many points in the book, too many times when the narrator just went on and on and on....and then the ending seemed hurried.

I really got annoyed with reading, over and over, about how guilty Marie felt and also about her moping around. The dreariness of her everyday life and the too-long descriptions of her angst were just too much and did nothing to advance the story. Enough already!

I ...more

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Apr 03, 2011

Sarah rated it

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Shelves: own, mystery-suspense

This review has been hidden because it contains spoilers. To view it, click here.

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Mar 08, 2010

Elizabeth *Swords for Fighting* rated it

· review of another edition

was a little weary when I first picked up Oxygen. A story about an anesthesiologist? Definitely not my usual read, but I was pleasantly surprised. Oxygen was a great read! It reminded me of a hospital drama television show like Grey's Anatomy. The reader can most certainly tell that a doctor wrote this book. The medical terminology, equipment, procedures, and anything else medical related seemed extremely accurate and realistic to me.

Marie is an anesthesiologist who has a young chi...more

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Jan 18, 2010

Katy Major rated it

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Shelves: 2010, highland-library, light, fiction

Every reader knows that the amount of enjoyment that one gets out of a book often depends not only on the book, but the situation in which the book is read. This is why many a paperback romance is consumed on the beach, why volumes of short stories sit on the backs of toilets.

One of my best friends died on December 30, at the age of seventeen. Getting my head around this and dealing with it were one thing. The weeks following the funeral, when everybody slowly forgot about what had h...more

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Feb 01, 2009

Laine rated it

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At first I wondered why I was even reading this book. It seemed to be about another supremely narcissistic doctor moaning about unpaid medical school loans while living in a downtown loft with beautiful skylines. Or caterwauling about the lack of spouse/child fully expecting to be able to order said spouse/child in the mid to late thirties in the way the rest of us would order a turkey for Thanksgiving. Oh god. The stress of being in one of the most elite professions ever, with concurrent hi...more

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May 12, 2011

Antof9 rated it

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Shelves: 2011-read, couldn-t-put-it-down, courtly, fathers, liberry, made-me-cry, mysterious, upsetting, yes-another-book-club, first-novel

This book had me intrigued at page 2, and I wasn't happy when I had to put it down for interruptions. The technical medical parts I found fascinating, with enough explanation for me to believe even if I didn't necessarily understand them. Not only is it a really interesting medical "mystery", so to speak, but I thought it was very well written.

I really liked this passage. Even though I'm not a doctor, my mom taught me these things, too:

I'm sure my mother never suspected sh

...moreThis book had me intrigued at page 2, and I wasn't happy when I had to put it down for interruptions. The technical medical parts I found fascinating, with enough explanation for me to believe even if I didn't necessarily understand them. Not only is it a really interesting medical "mystery", so to speak, but I thought it was very well written.

I really liked this passage. Even though I'm not a doctor, my mom taught me these things, too:

I'm sure my mother never suspected she was raising a doctor. Female doctors were rare in her world. She taught me the things she believed I would need in my life: how to sew a bias-cut tie as a gift for my father one Christmas -- a wide garishly flowered thing he wore once out of courtesy; how to separate the white from the yolk when making meringues, slithering the contents of the raw egg from half shell to half shell until the golden center swam naked in its clear membrane; how to pluck my eyebrows, put on a bra and pull sheer stockings up my legs without snagging the interlaced filaments.

I like the way the author periodically reminds us that Marie is a doctor. Not overtly, and it doesn't seem forced -- it's just the way the doctor's mind sees the world versus how the rest of the world sees itself. Things like this: "Lia crouches in the way of little girls, heels flat against the ground, knees accordioned against her chest, a flexibility granted before the pelvis wings open for childbearing." We know exactly what Lia is doing, and any one of us could have written the first two phrases. Only a medical professional would have even thought to write the rest. Another example: "As he leans forward to take a bite I watch the throb of his temporal artery snaking across his brow and wonder what his blood pressure is." I've often wondered if medical professionals see things like that ... and now I know they do!

I was going to say that part of why this book is so well written is the inter-weaving of the sister relationship, but then I was thinking that what I wanted to quote next was actually good life advice, and I just liked the way it was written. Anyway, I liked this passage Lori is asking her sister about the men in her life:

I raise my head up. "Do I have to pay for this analysis? Come on, I'm not that bad. I'm just busy. I have a great home, good income. No dirty socks or underwear to pick up."

"Picking up dirty socks and underwear gives you humility, a fine attribute and a valuable tool for personal growth, I find. Besides men can learn to pick up socks if you're patient with them."

And then there's a mini-reconciliation between father and daughter. I think this is just beautiful. "And being able to share such an honest fact relaxes some of the strain between us. My mother's love for both of us still has power." (emphasis mine)

I don't want to say much else for fear of spoilers, but this book wasn't what I expected, and it was much more than I expected. I recommend it to anyone, regardless of interest in things medical. Certainly it revolves around that, but it's so much more, and so well written that I think most readers will be pleasantly surprised by how good it is.

Also, it was brilliant to have the advice Marie gave to her niece come full circle. Even better? The author didn't point out to us what she had done. She just wrote it. If you caught it, you caught it. If not, oh well. Either way, I loved it.(less)

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Sep 05, 2010

Diane rated it

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Shelves: general-fiction

This book had me hooked from the first several pages. The author begins with a really beautiful description of the fragility of life as a patient lies on the operating table, and the fine line an aesthesiology walks to keep the patient alive. The description was chilling, and thought provoking.

A doctor who has devoted her life to her career, and truly cares about her patients, is devastated when an 8 year old girl dies on her operating table, and her role in it comes under scrutiny...more

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Aug 01, 2010

Ashley rated it

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This book is Greys Anatomy, without all the unbelievable crap. I say that because this book is filled with medical drama, real life drama, twists and turns, as well as the realities and unfortunate layers that make up our medical system without any crazy love triangles.

Carol Cassella, an anesthesiologist herself, never loses the reader in medical jargon, and weaves both a highly stressful malpractice suit with the daily complexities of being a full time doctor into the character of ...more

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Jul 05, 2010

Katie rated it

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The first few chapters of this book gave me such an appreciation for what my husband does day in/day out. The author (an anesthesiologist) beautifully describes the moment when the patient ceases to act for themselves, and fully puts themselves into the hands of the anesthesiologist, who will breathe for them, manage their life during the surgery. But oh my, when things go wrong during a routine surgery, I honestly had to stop reading for a day. I just couldn't imagine the stress of it all, t...more

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Jan 04, 2009

Kathleen Hagen added it · review of another edition

Shelves: 2008-mysteries-suspense, 2008-audio-books

Oxygen, by Carol Cassella, narrated by Jennifer Ikeda, produced by, and borrowed from Recorded Books.

This is a debut novel by a freelance medical writer and a practicing anesthesiologist. It is worthy of standing alongside the best medical thrillers. We are introduced here to Dr. Marie Heaton, a very successful anesthesiologist who loves her work and passionately cares about each patient she helps come through an operation. She works for an undr-staffed overburdened hospital, Firs...more

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Aug 08, 2010

Jim Thomsen rated it

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Carol Cassella's debut novel is a medical thriller wrapped in the well-made and warm comforts of a literary novel. The author's carefully crafted, richly nuanced, minor-key prose calls to mind the work of fellow Bainbridge Islander David Guterson, who is cited in the book's acknowledgements as a friend and helpmate.

The story: Dr. Marie Heaton, an anesthesiologist at a Seattle hospital, is traumatized in more ways than one when a child dies on the operating table under her care. As s...moreCarol Cassella's debut novel is a medical thriller wrapped in the well-made and warm comforts of a literary novel. The author's carefully crafted, richly nuanced, minor-key prose calls to mind the work of fellow Bainbridge Islander David Guterson, who is cited in the book's acknowledgements as a friend and helpmate.

The story: Dr. Marie Heaton, an anesthesiologist at a Seattle hospital, is traumatized in more ways than one when a child dies on the operating table under her care. As she searches her mind for what she could have done wrong, even though no immediate evidence arises, the child's mother presses ahead with a lawsuit that could topple Dr. Heaton's hospital — and the hospital has no intention of letting that happen, even if they have to hang Dr. Heaton out to dry. Meanwhile, her sister's teen daughter seeks her counsel, her estranged father is going blind and a former lover — and fellow anesthesiologist — is drifting back into her heart as the threat of criminal indictment hangs over her head.

For most of "Oxygen," these compelling conflicts are patiently unveiled with unerring authenticity in Cassella's thoughtful, deliberate prose style. The insights into the collision of commerce and care are stunning, and the empathy with which doctors and patients alike are regarded is remarkable. There are no easy villains here, no one-dimensional saints. Even Marie Heaton, who is at early risk of coming off as a tedious martyr, displays some grace-saving character depth as the story marches on.

What works less effectively is the thriller-style twist that resolves the issue of blame in the child's death. I've read "Oxygen" twice, slowly and carefully, and just don't see how I could have seen the twist coming, how I could have reasonably strung together subtly dropped clues and kept up with Cassella's seismic narrative shift. The story, which hummed along in low gear up until that point, takes a speedy shift into Michael Crichton or even Robin Cook territory, with a villain being swiftly unmasked, mortal danger being hinted at and resolutions scattered along in the wake of a near-runaway third act. I felt as though Cassella, who had been holding my hand on a leisurely stroll up to that point, suddenly took off at a sprint and yanked me along until we both collapsed from lack of breath.

That's more of an inconsistency than a dealbreaker, however, and hardly tarnishes the shine of a standout debut novel. In the end, the reader turns the last page feeling immeasurably enlightened about what happens behind the curtain of calm in an operating room — a stage production that extends all the way into the boardrooms and executive offices. What Cassella has to tell us about the health-care system and the professionals who populate it may not be terribly reassuring, but it is information we need to have.

And that all that essential information just happens to be wrapped up in a richly absorbing story is more than gravy. (Which we shouldn't be consuming if we don't want to end up on an operating table ... and the last thing we see on that table is the anesthesiologist's mask slowly blotting out the light as it covers our faces. It's an image that will stay with you for a while after you finish "Oxygen.")

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Oct 23, 2009

Carol rated it

· review of another edition

If you believe that author’s should write what they know you should like this book. And even if you think that’s not true, as some authors do, you’ll appreciate that Carol Wiley Cassella brings her profession as an anesthesiologist to life in the pages of her debut novel, Oxygen. As oxygen (the gas) is required for breathing, Cassella’s book is equally breathtaking. Though there is an element of mystery to the story, it is really more an exploration of the medical system and its inadequacies. It...more

· see review

Dec 11, 2010

Lisa Christen rated it

· review of another edition

This was a good book. BUT I was surprised that it wasn't a book that I just had to pick up, at least until the end. It kind of meandered along for awhile and grabbed my attention, but didn't REALLY grab my attention. This is a story about an anesthesiologist living and working in Seattle at a local (but not actual) hospital. Her life is day-in, day-out, same ole thing, until a death of a child occurs under her care. This is what the book is about with a bit of family her and there. It is a...more

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Mar 06, 2011

Jo Ellen rated it

· review of another edition

This was a challenging book for me to read. The scenario of the anesthesiologist losing the patient and subsequently being sued was so unpleasant, and so close to home, that I had to make myself keep reading. I was so sympathetic to Marie that at times I felt like I was experiencing her hurt and pain. I guess that is a sign of a good writer! By the time she visits her sister and father I was so ready for something other than the lawsuit, that it felt almost a relief to be learning of her fam...more

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About Carol Cassella

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. Prior to writing fiction, Carol wrote about global public health issues in the developing world.

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“Some things don't ever get settled. You just make a place for them. Learn to let them sit there with you, side by side with the good. (244)” — 4 people liked it

“Tears of grief are unique. They contain chemicals that aren't found in the more mundane droplets of moisture that bathe the eyes, as if our tears wash us free of some noxious cause of sorrow. (150)” — 2 people liked it

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