Trauma: Michael Palmer and Daniel Palmer
Within the pages of this emotionally charged novel many people will experience traumas in different ways. Some in response to an event that has left them devastated, maimed or even in denial of the events that led up to experiencing this trauma. People can go into shock; their emotions can become unpredictable, flashbacks to events that trigger behaviors that are violent and physical systems that hamper their daily lives. Many of the characters you will meet in this novel will experience traumas that most of us might not be able to handle. The authors did extensive research on combat Post-traumatic stress disorder which many men and women that having served in the military suffer from when reentering society. Some find it hard to cope with reality. Others become despondent, violent and often imagine they are still at war. Many veterans suffer despite the help they might receive whether talking to a psychiatrist or taking medication. Support is often needed in many other ways. But, this novel will bring to light a special treatment that has been developed to hopefully help eliminate PSTD.
Carrie Bryant is a young neurosurgeon in the fourth year of her residency at White Memorial Hospital. But, one mistake would take it all away from her. Saving one patient and not really focused on the second due from being tired, fatigued and stressed out from the first case, she walks into the second operation not fully aware of a serious mistake that she had made. When Leon Dixon is readied for surgery and the instruments are in place and the MRI is up no one including the surgeon performing the operation realizes the problem that will cause irreparable damage Leon.
As the problem becomes acute and the situation tense what happens will bring Carrie in front of the board and she decides to resign. Going back home she enters her parent’s home, welcomed by her brother Adam who suffers from PTSD. Sometimes things happen for a reason as she has a chance or accidental meeting with an investigative reporter named David Hoffman who comes to interview her brother. But, the situation turns tense and Adam reacts violently.
Carrie becomes aware of a new program at the VA hospital, which targets patients with PSTD. Many veterans suffer with this despite treatment with therapy or medication. A new program, which I researched while reading this novel, focuses on Deep Brain Stimulation. This program has shown promise in a from of stereotactic neurosurgery. “Inserting electrodes guided by a stereotactic frame, as well as CT and MRI imagine, deep into brain nuclear complexes that are involved in complex movement patterns.” Helping patients with Parkinson’s disease and hopefully ridding someone of PSTD for good. “The basolateral amygdala (BLn) is an optimal target for high-frequency DBS in PTSD based on neurocircuitry findings from a variety of perspectives. DBS of the BLn was validated in a rat model of PTSD by our group, and limited data from humans support the potential safety and effectiveness of BLn DBS.The time to consider Deep Brain Stimulation (DBS) surgery is when quality of life is no longer acceptable on optimal medical therapy as administered by a movement disorders neurologist.” The question is would we have problems with veterans using this program? That question and many others come to light as we learn more about the programs with Carrie. A Dr. Alistair Finley is in charge of the DBS program at the VA but a Dr. Sandra Goodwin heads neurology and her team and the protocols set in place will definitely surprise readers and cause Carrie to wonder just what the program is really about, who is helped and what happens next will alert readers that Carrie might have gotten in a little over her head. As Finley explains the program in graphic detail and readers will enter the OR and experience what the staff does and the patient undergoes, you learn about DARPA, Defense Advanced Research Projects Agency and their involvement, the funding for the program and why Carrie was asked to become the DBS surgeon.
Dr. Sandra Goodwin is the head of neurosurgery and she is anything but happy having Carrie on staff of the VA. Reminding her every step of the way of the job description, when she oversteps her welcome and that her job is to only install the DBS wires within the brain of the patient, Carrie becomes alarmed when told that she cannot follow up with a patient after surgery, has to turn everything over the Goodman and Navarro her assistant and their staff and go on to the next case. When trying to see one of the patients she is told she cannot. When she learns that the patient and the second one she operated on has left the hospital and signed out she wants to know why. Answers are not forthcoming. Cover-ups are definitely quite evident but why did they ask to sign out? Where are the two patients and what happens when things go sour?
When Carrie gets too close to what is really going on she is asked to take some time off. But, someone wants to silence her and she is not only stalked while jogging, her car is run off the road, seriously injured and warned that she better back off. With David at her side they devise a plan to uncover what is really going on at the VA hospital. Why some patients go missing? Why some are doing better and what really happened to the Sam Rockwell the man whose position she took. Steve Abington’s condition turns bad as he seems to be hallucinating but is it something else? Does he have what Carrie deems as palinacousis, hearing voices or sounds that are real but seem to go on and on in the patient’s head and never stop? Abington and another patient named Fasciani go missing and exhibit the same symptoms. Telling her that she cannot follow up with her patients gives her much pause for thought but not thinking anything when Finley tells her to comply. Using virtual reality sessions triggering their memories and fears they hope to eliminate the emotions associated with a traumatic event. As you read pages 259- 263 you will learn more about the program and what Carrie and David decide to do in order to find out what is really going on and who is behind the missing patients. Curtis Gantry and Braxton Price are just pretending to do their jobs at the VA but what and who they are will make people think twice before entering any operating room or hospital. Just what they are doing and how this links to the missing patients will give you chills.
When Goodwin starts coming down on Carrie, she is injured, forced to back off and then told she can not access medical records to learn what might have caused the two patients to want to leave the program, someone has decided to set her up, hopefully eliminate her and making sure that their real agenda gets carried out. What would happen is there was an experimental drug that could cure these patients? What would happen if the side effects outweighed the positive? When Carrie shows up for a meeting with Finley she does not expect the rest of the welcoming committee as authors Michael Palmer and Daniel Palmer create a situation that alerts readers that not everyone can be trusted, faith in a program to help might not be the only reason it has been implemented. Betrayals, lies, deceits, denials and mistrust all play a part as Carrie and David race the clock and time to hopefully stop what others have put in place. As David uncovers the truths about certain people involved and learns who just might be behind the new drug and why, he and Carrie create an elaborate plot that will not only endanger them both but catches Carrie in a web so frightening she might not survive. When her brother asks to be a part of the program and she says it is too soon to tell if it works, what he does will surprise readers and alert them that Adam is violent, that his PTSD is hampering his thinking.
When Carrie asks the wrong questions and someone overhears her thoughts you won’t believe who is behind this conspiracy and cover up. Why did they hire her? What did they hope would be the outcome of having her on staff? What happens when a doctor cares about her patients and finds out that there are some that would rather you not? The research into DBS is extensive. The outcomes are recorded as you hear the voices of those that are trapped within their own minds hoping that someone will set them free. But, what happens when Carrie is caught, placed with those that these people hope to eliminate what happens will give you much pause for thought as the authors take you deep inside the halls and operating rooms of a hospital whose goal appears to want to help patients but in reality you won’t believe the truth.
PSTD is real and if a program like DBS can work that would be amazing. Some have Traumatic Brain Injuries and others Traumatic brain injury occurs when an external mechanical force causes brain dysfunction. “Traumatic brain injury usually results from a violent blow or jolt to the head or body. An object penetrating the skull, such as a bullet or shattered piece of skull, also can cause traumatic brain injury. Mild traumatic brain injury may cause temporary dysfunction of brain cells. More serious traumatic brain injury can result in bruising, torn tissues, bleeding and other physical damage to the brain that can result in long-term complications or death.” (Mayo clinic.org). The final pages will give you more than electric jolts and the patients come alive, their realities are frightening as some have TBI’s and others PSDT. Once again both authors deliver a plot that will keep you riveted to the printed page and wondering if Carrie and David can stop what has been started or will it be too late for them both? Dr. Carrie Bryant: Caring can be dangerous!
Fran Lewis: Reviewer
Let’s dedicate this to The memory of an amazing Doctor and outstanding author: Michael Palmer