The Last Surgeon

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"Michael Palmer's latest novel pits a flawed doctor against a ruthless psychopath who has made murder his art form. Surgeon Dr. Nick Garrity, a vet suffering from PTSD - post-traumatic stress disorder - spends his days and nights dispensing medical treatment from a mobile clinic to the homeless in D.C. and Baltimore. In addition, he is constantly on the lookout for his best friend, Umberto Vasquez, who was plucked from the streets four years ago for a secret military mission and has not been seen since." "Psychiatric nurse Jillian Coates wants to ...

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The Last Surgeon

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Overview

"Michael Palmer's latest novel pits a flawed doctor against a ruthless psychopath who has made murder his art form. Surgeon Dr. Nick Garrity, a vet suffering from PTSD - post-traumatic stress disorder - spends his days and nights dispensing medical treatment from a mobile clinic to the homeless in D.C. and Baltimore. In addition, he is constantly on the lookout for his best friend, Umberto Vasquez, who was plucked from the streets four years ago for a secret military mission and has not been seen since." "Psychiatric nurse Jillian Coates wants to find her sister's killer. The police ruled her death a suicide, but Jillian does not believe that Belle Coates, an ICU nurse, took her own life, even though every bit of evidence indicates that she did. Belle has left a subtle clue that connects her with Nick Garrity - a clue that only Jillian can decipher." Together, Nick and Jillian determine that each of those involved in a fatally botched case in an operating room three years ago is dying, one by one. Their discoveries pit them against genius Franz Koller, the highly paid master of the "non-kill" - the art of murder that does not look like murder. As doctor and nurse move closer to finding the terrifying secret behind these killings, Koller has been given a new directive: His mission will not be complete until Jillian Coates and Nick Garrity, the last surgeon, are dead.

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  • The Last Surgeon
    The Last Surgeon  

Editorial Reviews

Publishers Weekly
In this anemic medical thriller from bestseller Palmer (The Second Opinion), former trauma surgeon Dr. Nick Garrity, who suffers from PTSD as the result of a suicide attack on his field hospital in Afghanistan, is now in charge of the Helping Hands RV, a mobile clinic that plies the streets of Baltimore offering medical aid to the homeless. Meanwhile, a high-priced hit man starts to commit a series of murders, his first victim being Belle Coates, a nurse in Charlotte, N.C. When Belle's sister, Jillian, who lives in Virginia, searches for her sister's killer, she finds a connection to Nick. Several missing homeless men lead everyone to a massive plot involving high-level politicians and a secret CIA program. The action is all fairly predictable, the characters off-the-shelf, and the writing, if not exactly purple, at least mauve: “A guttural, primal scream exploded from Nick's throat as he crouched by the body.” 250,000 first printing. (Feb.)
Library Journal
The death of nurse Jillian Coates's sister and the disappearance of a fellow soldier from the Gulf War front drive Palmer's latest medical-themed novel. Jillian doesn't accept the police's conclusion that her sister was a suicide and quickly becomes obsessed with proving otherwise. Her efforts bring her in contact with Dr. Nick Garrity, a veteran and former surgeon now helping the homeless from a mobile health van. Nick is dealing with posttraumatic stress disorder and his guilt over Umberto Vasquez, who saved his life in Iraq and then disappeared into a civilian life of alcoholism and homelessness. As their investigations converge, Jillian and Nick are led to the Singh Center, a mysterious and very profitable plastic surgery facility. To solve what becomes a series of murders, Nick and Jillian must deal with ruthless government officials and a very talented paid assassin. VERDICT Palmer's latest has an appealing couple at its center, plus good pacing and gritty action to keep the pages turning. Some scenes include descriptions of graphic violence but are appropriate for the story. This latest should please Palmer's fans and all those who enjoy their suspense mixed with medical characters and settings. [See Prepub Alert, LJ 10/15/09.]—A.J. Wright, Univ. of Alabama at Birmingham
Kirkus Reviews
Another medical thriller from prolific Palmer (The First Patient, 2008, etc.). In this author's world, heroes and villains are easy to tell apart. Dr. Nick Garrity, whom his many admirers call "Dr. Nick Fury" after a dauntless cartoon character, is our good guy. He suffers from PTSD as a result of injuries sustained in Afghanistan during a suicide bombing that killed his fiancee. Along with wisecracking nurse Junie, Nick now dishes out care on the streets of Baltimore and D.C., making rounds in a medically renovated RV. His nemesis, though he doesn't know it yet, is psychopath Franz Koller, who murders for both money and pleasure, disguising the seemingly unrelated deaths paid for by a mysterious organization called Jericho as "non-kills" (i.e., suicides or accidents). Creepily, Koller is quite popular with students at the local high school where he substitute-teaches as a cover. He makes winsome Belle Coates' death look like a suicide, but her sister Jillian, a psychiatric nurse, suspects murder. Looking through Belle's condo, Jillian finds a collection of Nick Fury comics with "Dr." written into the title; they put her on the trail of Dr. Nick Garrity. He's been trying to track down a couple of war buddies who mysteriously disappeared four years before, but he finds only one, hideously disfigured and working in the washroom of a "gentleman's club" in D.C.'s Chinatown. Nick and Jillian join forces to uncover the nefarious secrets of a snazzy plastic-surgery clinic in suburban Virginia. Four years earlier, a terrorist supposedly died before he could be operated on for a heart condition, but the plastic surgeon colluded with the CIA to pull a bait-and-switch. Will ultra-professionalassassin Koller survive? Will Nick and Jillian get together? Let's just say that Palmer knows which side his bread is buttered on. As predictable as an IV drip. First printing of 250,000
From the Publisher
Praise for

THE LAST SURGEON

“Prepare to burn some serious midnight oil.”—Boston Herald

“Highly suspenseful and compelling.”—Booklist

“Palmer has always been a good writer but he has never crafted a story as suspenseful as this one…This is the kind of book you read with a bright light on and all the doors locked…Franz Koller is one of the most deadly villains to grace the pages of a novel since the introduction of Hannibal Lecter.”—Huffington Post

“Should please…all those who enjoy their suspense mixed with medical characters and settings.”—Library Journal 

“The thrill of the non-kill…[is] chilling.”—North Shore Sunday

“More twists and turns than a sociopath’s psyche…inventive and effective, an entertaining and engaging read.”—California Literary Review

THE SECOND OPINION

“A heart-pounding medical thriller…satisfying, expertly paced [with] enough suspense to keep readers happily turning the pages.”—Boston Globe

“The novel is not merely a thriller but also an exploration of its central character’s unique gifts and her determination to communicate with her comatose father despite overwhelming odds. Another winner from a consistently fine writer.”—Booklist

“A splendid novel.”—Globe and Mail (Canada)

THE FIRST PATIENT

“An exciting thriller that is full of surprises and captures the intense atmosphere of the White House, how the medical system works, and how the 25th Amendment could be brought into play. I thoroughly enjoyed it.” —President Bill Clinton

“An incredibly realistic, frightening thriller that is every White House doctor’s nightmare. “ —Dr. E. Connie Mariano, White House Physician 1992 - 2001

“Endlessly entertaining…the roller-coaster ride of a plot builds to an undeniably shocking conclusion.” —Publishers Weekly

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Product Details

  • ISBN-13: 9780312587499
  • Publisher: St. Martin's Press
  • Publication date: 2/16/2010
  • Edition description: First Edition
  • Pages: 373
  • Product dimensions: 6.10 (w) x 9.30 (h) x 1.40 (d)

Meet the Author

Michael Palmer

Michael Palmer (1942-2013) wrote internationally bestselling novels of medical suspense, including The First Patient, The Second Opinion, The Last Surgeon, A Heartbeat Away, Oath of Office and Political Suicide. His book Extreme Measures was adapted into a movie starring Hugh Grant and Gene Hackman. His books have been translated into thirty-five languages. Palmer earned his bachelor's degree at Wesleyan University, and he attended medical school at Case Western Reserve University. He trained in internal medicine at Boston City and Massachusetts General Hospitals. He spent twenty years as a full-time practitioner of internal and emergency medicine. In addition to his writing, Palmer was an associate director of the Massachusetts Medical Society Physician Health Services, devoted to helping physicians troubled by mental illness, physical illness, behavioral issues, and chemical dependency. He lived in eastern Massachusetts.

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Read an Excerpt

THE LAST SURGEON (Chapter One)

"Nick, Nick, throw it here! Come on, let it go!"

Nick Garrity cocked his right arm and lofted a perfect spiral to the gangly youth waiting across the yard. The boy, who would have been happy to keep playing until midnight, gathered in the pass effortlessly and immediately threw it back.

"Okay, that's it, Reggie. I gotta take Chance for a run and then get ready for work."

"One more pass. Just one more. After dinner I'll go over to your place and take Chance out. Promise."

Through the gloom of what was going to be a stormy evening, Nick could feel the boy's energy and see his enthusiasm. A drug-addicted mother, a long-gone father, time in juvenile detention for a crime no one seemed willing to talk about, seven years in a sequence of foster homes, and the kid was still upbeat and great to be around.

How in the hell do you do it? Nick wondered.

For most of the week, Nick's mood had been as somber as the prestorm sky. And as usual, there was no reason—at least not on the surface—to explain it. A night in the Helping Hands RV would improve his flagging morale. It usually did.

He made a final throw, handled as easily as most of the others, and then motioned for Reggie to come in.

"Come on, big guy. I've got to leave soon."

"So, where're you goin' tonight, Nick? D.C.?"

"I think so. Junie keeps track of that."

"Can I come?"

"It's a school night, and you promised to deal with Second Chance. Remember, don't let him off the leash or he'll see a squirrel and chase it to the moon. Greyhounds are bred to chase little furry animals. Use the long leash if you're going to throw him his Frisbee."

"How about I go with you tomorrow?"

"We'll see."

"I never get to do anything exciting."

"Yes, you do. Staying out of trouble is exciting."

Reggie punched Nick playfully in the side.

Nick put his arm around the youth's shoulders and walked with him to the back door. The modest one-family, with three bedrooms and a finished basement, was located in the Carroll Park section of Baltimore. Nick had lived there with June Wright and her husband, Sam, for a few months before renting the first floor of a refurbished two-family down the street, close to the park. Not long after the move, Reggie Smith, now fourteen, had taken over the basement bedroom.

A sequence of kids were constantly coming and going through the Wright household, including the six-year-old Levishefsky twins, Celeste and Bethany, who had been there for almost a year now. If one looked up "saint" in any encyclopedia, pictures of Junie, a sixty-year-old nurse, and Sam, a DPW worker, might well be there.

Since Junie would be working the RV tonight with Nick, her husband would be doing the cooking. The couple had children of their own, and grandchildren as well, but at every stage of their lives together, they had added foster children to the mix.

The Helping Hands RV was parked on the street by the Wrights' house. It was an aging thirty-four-foot mobile home converted into a general medical clinic. Nick loped past it on the way to his apartment. At six-foot-one, with broad shoulders and a solid chest, he still moved like the running back he had been in college before an illegal block had taken out most of his anterior cruciate ligament. Now the repaired knee was serviceable, but hardly ready to absorb a major hit.

Nick's father, once a football player himself, was a retired GP. The option of moving to the family home in Oregon was always available to Nick, but had never been one he had considered seriously. In general, his parents were decent, understanding people, though not about their only son. There was no reason to expect they would be. In that same encyclopedia, at least in their library, his picture might have been inserted next to the word "disappointment."

"This is our son, trauma surgeon Dr. Nick Garrity," they had introduced him on more than one occasion during the years when he was their golden child, "and this is his sister."

Nearing his apartment, Nick heard the low rumble of thunder in the distance, sounding like a truck engine slowly coming to life.

He tensed at the sound.

He always would.

Nick's duplex would never be featured in Architectural Digest, but that was fine by him. Oak floors, a variety of posters from the local art store, plus curtains and a few plants gave the place an airy, comfortable feel. He was bent over beside the mail slot, scooping up circulars and bills from the floor, when he was hit from behind hard enough to drive his forehead into the door. He turned, knowing what to expect. Second Chance sat, head cocked, panting around the red Frisbee in his mouth.

"I'm running behind," Nick said, rubbing at his forehead, half expecting blood. "Reggie's going to take you out."

The dog pointed his snout toward the door and shifted his behind.

"No go, pal. Gotta shower."

They had been a team for almost two years, dating back to the first and only time Nick had ever been to a dog track. Lost in thoughts about Sarah, he had been on an aimless drive that ended at a casino in West Virginia. After an hour losing at the slots, he wandered over to the adjacent Tri-State track. He was in the midst of a particularly difficult time, when self-destructive thoughts had once again been seeping into his mind.

Damn PTSD.

Second Chance, a long shot in the fifth race and a natural bet for Nick, had been well in the lead when he suddenly slowed dramatically. Twenty yards from the finish, he was trampled by seven dogs as they passed over and around him, and was left nearly motionless in the dust.

An hour later, Nick and the greyhound had claimed one another at the adoption tent, where the dog's sleazy trainer tried to convince the Army trauma surgeon that Chance's uneven, lurching gait was due to nothing more than a minor concussion. Back home, the "concussion" responded dramatically when Nick, assisted by Reggie, Sam, and two Army buddies, cleaned densely packed dirt from each of the greyhound's ear canals.

Of all the therapies Nick had tried in his battle against post-traumatic stress disorder, Second Chance's presence in his life was the most consistently effective.

There were days when Nick was able to fit in some calisthenics and weights before going out on the road, but tonight, after playing catch with Reggie, there was just no time. He showered and was dressing in his usual work uniform, jeans and a faded work shirt, when he glanced over at a printout he had taped to the wall beside his bed listing the ten levels of SUDS—the Subjective Units of Disturbance Scale he used to estimate his mood at any given time. This evening seemed like a five: Moderately upset, uncomfortable. Unpleasant feelings are still manageable with some effort.

Progress, that's all he and Dr. Deems had decreed he should shoot for—just a little progress each day. Days like today, even after all these years, it was difficult to tell whether or not he was succeeding. He spent a minute patting and scratching Chance, and then pulled on a Windbreaker and headed out the door.

The thunder was louder now.

THE LAST SURGEON. Copyright 2010 by Michael Palmer.

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Customer Reviews

Average Rating 4
( 124 )
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See All Sort by: Showing 21 – 40 of 124 Customer Reviews
  • Posted December 11, 2009

    more from this reviewer

    Palmer Just Keeps Getting Better

    As a physician/writer I'm pretty particular about medical thrillers. From the first Michael Palmer book I picked up to THE LAST SURGEON, I've continued to be impressed with his ability to craft a book with just enough medical details to pique the reader's interest without getting lost in technicalities and medical jargon. Add to that his well-drawn characters and fast-paced plot, and he's set the bar pretty high. With THE LAST SURGEON, he continues the performance level he achieved with SECOND OPINION. This time the flaw in his lead character, a veteran trauma surgeon now devoting himself to caring for the disenfranchised, is post-traumatic stress disorder (PTSD). From the first time we encounter Dr. Nicholas Garrity, we find ourselves rooting for him. The female lead, Jillian Coates, has our sympathy before we even see her, as the book opens with the diabolical murder of her sister by one of the most terrifying villains I've ever encountered in a book.

    This is a great read by an excellent writer. It deserves five stars. (And for those who might look askance at my consistently high ratings, I'll confess--I just don't review books that deserve less. Matter of fact, I rarely even finish reading them. Life's too short.)

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