Though Oath of Office is only peripherally a “medical thriller,” Michael Palmer has managed to write a gripping and topical political/science thriller revolving around the controversial subject of genetically engineered food crops. Dr. John Meacham has just allowed himself to lose his temper, and verbally abuse a patient for the first time in years. The first time since he nearly lost his medical license for doing the exact same thing. All those years ago, years of good behavior and a professional approach are lost. Then, he blew up at a patient for continuing to smoke despite a massive heart attack. The medical board gave him a six month suspension and sent him for treatment. The first time his anger was fueled by an honest motive of caring for his patients' continued health, booze, and working too many hours. And he snapped and let lose a tirade of words that struck to the core and the patient reported him. But now, he has been through anger management, he has been through AA and he has managed to control that temper… until now.
But now, working at a small rural practice, Roberta Jennings has managed to make him snap. She is obese, morbidly so, yet she continues to overeat, continues to not even take serious any of a number of diets he has prescribed. And even without the booze, even without the long hours, he has snapped again and let lose with another profanity-laced tirade. Right after Jennings left, threatening to call the board again, he realizes that his entire staff heard him. He realizes that every patient in the waiting room could not have helped bearing witness to his verbal abuse. He sees no way out — the board will surely take away his license to practice medicine and no excuse will spare him. The thought enters his mind that if he eliminates the witnesses, his staff and the waiting patients, if he leaves ‘no witnesses,’ so it’ll only be Jennings’ word against his. He takes the pistol from the locked drawer in his office. The pistol he placed there after a fellow doctor's practice was robbed. And he empties it. Seven people are left dead, and then Meacham realizes he has done a very bad thing. The board will never let him keep his license now. So he turns the gun on himself.