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Book Review: The Last Surgeon by Michael Palmer

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It is three a.m. when Dr. Nick Garrity stands near the entrance to a field hospital in Afghanistan after grueling hours of surgery saving the lives of anyone brought to him. As Lights appear at a distance, he relaxes with his friend, Umberto, who asks, “Who do you suppose that is?” The two watch the headlights approach — very close — before both men realize the vehicle does not intend to stop.

Headlong, it crashes into the hospital unit. Dr. Garrity clings to the driver’s door, grabs the steering wheel, and tries to turn the truck clear of patients and nurses. His friend, Umberto, grabs Garrity and yanks him under a huge refrigeration unit just as the bomb-loaded vehicle explodes. Decimated bodies, body parts, and debris fly in all directions. Nick’s beloved Sarah is literally cut in half by the truck's front bumper when the truck detonates.

Deeply saddened and shell shocked, Nick is attempting psychological recuperation from PTSD back in the States where he drives the Helping Hands RV along with his best friend, nurse Junie. They travel city streets in Baltimore and D.C. giving medical help to the homeless. Nick learns that his heroic Army buddy, Umberto, was last seen despondent and destitute. Every attempt to locate the man to thank him for his-life saving feat in Afghanistan proves futile.

Years pass before Dr. Garrity learns from another homeless man that Umberto was seized from Baltimore’s streets for a secret mission. Even with his medical and military connections, Nick is unable to locate him — the man simply vanished from the earth.

At the same time, in another development, nurse Jillian Coates finds a subtle clue left on her sister’s hand-written suicide note that, in fact, she was forced to write her own death message and then to swallow lethal doses of sleeping pills. Ultimately, the hidden clue convinces Jillian that her sister, a nurse, was murdered.

Jillian’s path and that of veteran Dr. Garrity soon intersect. Both have a mission: Coates to find her sister’s killer; Garrity to find his friend Umberto whom he fears came to a no-good end. Garrity has faith in Jillian’s theory.

A variety of ill-fitting puzzle pieces morph together. It appears that a highly paid executioner is murdering persons who were present during a botched surgical procedure performed on a high-level political figure from a foreign country.

This killer prides himself on his non-kill methods — his victims die by mishaps, suicides, or natural causes. One by one, the surgeons and nurses who witnessed that bungled surgery are found dead. Jillian Coates’ deceased nurse sister was present during that surgery.

While searching through a host of records together, Garrity and Coates find another correlation. Nick’s heroic friend, Umberto, was snatched from his destitution because his physical makeup, particularly his facial structure, was similar to that of the high-level foreign politician who died during the botched hospital operation.

Incredibly, The Last Surgeon brings all of the bizarre pieces of this atypical medical thriller together in its final pages. But although Garrity and Coates solve this mammoth puzzle involving top level government officials including the CIA, it will be left to the reader to discover if or when either or both sleuths eventually fall victim to the same psychopathic killer who forced Lillian’s sister to commit suicide.

If you are interested in fast-paced thrillers, The Last Surgeon is an intricately intertwined medical suspense tale that will keep you guessing. Early on in the story, it seems that the mention of Dr. Garrity’s ongoing search for Umberto is a bit tiresome and not urgent.

But with a depraved killer cleverly eliminating people every so many pages, and then with the introduction of a possible connection between Garrity and Coates, I felt suspense and interest building dramatically. I wanted to figure out without being told, how all the strange, unnerving events at top levels of American government fit together; and whether either hero or heroine would survive at the story’s end. This story did not disappoint me.

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