Thursday, January 21, 2010


One reason that crime fiction is so appealing to its fans is that very often, the stories center on contexts and situations that we all encounter. We can identify with the characters in a murder mystery if they’re in situations we’ve faced, and that can add to the suspense. One of those common experiences is getting involved with the medical profession. Almost all of us have been to a doctor or a dentist, and many of us have experiences at hospitals, too. These contexts can be especially suspenseful for a murder mystery, because most of us feel vulnerable when we’re at a hospital, dentist’s office or doctor’s office. We can understand the feelings of anxiety and suspense that victims in this setting must feel. There’s also very often a sense of urgency associated with the medical profession. Many people don’t go to a doctor, dentist or hospital unless there’s something wrong, and even those who visit the doctor or dentist regularly may have a sense of stress that’s almost as high as it would be if they were ill. So it’s no surprise that medical contexts play an important role in crime fiction.

Sometimes, the hospital is the setting for a mystery; with all of the emergencies that go on in hospitals, and with all of the opportunities for things to go horribly wrong, the hospital makes for a very suspenseful place for a mystery. Many people, for instance, are familiar with Robin Cook’s medical thrillers, which often take place in hospitals. In Terminal, for instance, medical student Sean Murphy takes an externship at the exclusive Forbes Cancer Center, and is asked to do some research on a synthesized antibody to a particular form of cancer. Murphy, however, is more interested in Forbes’ astoundingly high rate of cancer remission in patients with medullablastoma. Before long, he realizes that the hospital administrators are hiding some very dark and dangerous secrets about cancer and cancer treatment. Matters are only made worse when some of the patients at Forbes begin to die inexplicably. Now, Sean and his girlfriend, Janet Reardon, are in a race to find out what’s going on at Forbes before they become victims themselves.

Cook’s not the only author who uses the hospital context. We also see the hospital milieu in Michael Palmer’s thrillers. For example, The Second Opinion takes place mostly in Boston’s renowned Beaumont Clinic. Dr. Petros Sperelakis, an internationally renowned internal medicine specialist, and founder of the Sperelakis Center for Diagnostic Medicine at the Beaumont, is severely injured in a hit-and-run accident. His daughter, Dr. Thea Sperelakis, who’s been working with Doctors Without Borders (Médecins Sans Frontières), returns to Boston to help care for her father. As she and her brother, Dmitri, piece together what happened to their father, they become more and more convinced that he was deliberately struck. Petros Sperelakis is badly injured and in a coma, but he’s still able to communicate after a fashion, so he tries to let Thea know what happened and why he was victimized. Through her father, Thea learns of a terrifying secret: there’s deliberate medical fraud going on at the Beaumont, and those behind it will do anything to protect themselves. Thea gets a job at the clinic and goes undercover to find out the truth her father tried to reveal. She’s hampered by her other two siblings, who are eager to have their father’s life support removed. She’s also challenged by Asperger’s Syndrome. Nevertheless, she uses her phenomenal memory for and attention to detail to uncover the Beaumont’s secrets.

Even when a murder mystery doesn’t take place in a hospital, a medical context can add a layer of suspense. For example, in Agatha Christie’s One, Two, Buckle My Shoe (AKA The Patriotic Murders and An Overdose of Death) Henry Morley, who’s Hercule Poirot’s dentist, is shot in his dental office. Inspector James “Jimmy” Japp is called in because it’s thought that the real target for the murder might have been Alistair Blunt, a wealthy and powerful banker who’s also a patient of Morley’s. Japp asks for Poirot’s help when he finds out that Poirot visited the dentist that morning, and together, they find out who shot Morley and why. What’s interesting about this novel is that in several places, Christie refers to people’s fear of going to the dentist. In fact, the beginning of the novel features several “snapshots” of Morley’s various patients – including Poirot – making up their minds to brave the dentist’s chair.

In fact, in more than one Christie murder mystery, it turns out that the killer is a medical professional. I won’t mention titles, so as not to spoil anyone’s fun. It’s interesting, though, to see how that anxiety about medical professionals – especially considering how much trust we must put in them – is reflected in her writing.

The medical professional isn’t always the “bad guy,” though, in crime fiction. In many novels it’s the medical professional who’s the sleuth. That’s true in Ruth Rendell’s To Fear a Painted Devil. In that novel, Patrick Selby is severely stung by wasps during a birthday party for his wife, Tasmin. At first, he seems to be recovering nicely, but a few days later, Selby dies. Initially, his death is put down to a severe allergic reaction to the wasps. Dr. Max Greenleaf, who attended the party and who tended Selby, isn’t so sure. He begins to investigate the death and finds out that the death was murder by poison.

Rebecca Tope’s Dark Undertakings also features a medical professional as the sleuth. Trainee undertaker Drew Slocombe is conflicted by the death of printer Jim Lapsford. Lapsford has apparently died of a massive heart attack, and Lapsford’s doctor, Dr. Lloyd, and Lapsford’s family are only too happy to accept that verdict. In fact, the coroner has issued a death certificate, and Lapsford’s cremation is only days away. Slocombe’s not convinced of the cause of death, though, because there are several signs that the death was not natural. For example, Lapsford’s dog, Cassie, suddenly dies the day after Lapsford does, after she licks her master’s face. Slocombe pushes for an inquest and uncovers evidence that Lapsford ‘s death was murder. There are plenty of suspects, too, as Lapsford was far from a faithful husband.

We also see medical professionals as sleuths in Robin Cook’s and Michael Palmer’s medical thrillers. In those novels, the sleuth is nearly always a medical examiner or a practicing doctor. Colin Cotterill’s Dr. Siri Paiboun is also a medical sleuth. He’s Laos’ chief medical examiner and as such, he often encounters unusual death. When that happens, Dr. Siri’s job is to investigate the death(s) and find out what really happened. Sometimes, that investigation goes against what Dr. Siri’s superiors would like, but he is committed to finding out the truth.

Perhaps the most famous medical-professional-turned-sleuth (and one of the first) is Sherlock Holmes’ friend and partner, Dr. Watson. When the two first meet in A Study in Scarlet, Watson’s just returned from Afghanistan in poor health, and is eager for a rest. He’s intrigued by Holmes, though, and before he knows it, he’s caught up in the mysteries that Holmes solves. Although it’s Holmes who puts together the clues in their sleuthing, Watson is neither helpless nor stupid. He frequently contributes medical clues, and Holmes respects him for it.

Crime fiction really has an interesting duality of perspectives when it comes to medical practitioners. In many novels, they’re sleuths. Even in novels where they’re not sleuths, medical practitioners often provide the sleuth with useful clues. At the same time, there’s an entire subgenre – the medical thriller – in which doctors are often responsible for murder. Perhaps that duality comes because of doctors’ specialized knowledge, or because many of us feel particularly vulnerable when we’re in a medical office. Whatever the reason, the role of the medical professional can add interest and suspense to a well-written plot.

Do you enjoy novels that feature the medical field? Or do you see them as either too technical or too implausible?


  1. I honestly think that it is an acquired taste. I personally love it but I am a huge fan of most things medical because on how much time I have spent in a hospital. Then again, for others it can be like tomato. Interestingly enough most individuals dislike tomatoes as a child then grow to enjoy them more. Some of the time it can be like that where a person may dislike it at one point then try it again later and start to enjoy it. Great post!


  2. Emma,
    Thanks for your kind words : ). You could very well be right about medical mysteries being an acquired taste, although I'd never thought of it that way before. I'm not surprised at your interest in them if you have a strong medical background yourself. I'm sure there's much in that kind of novel that you can identify with and understand on a deep level.

    You make a really well-taken point, too, that there are some mysteries or genres that we don't enjoy at first, but then enjoy much more later. That's one reason for which it can be a good idea to go back to a book one didn't like at first sometimes. One may find one likes it better next time.

  3. Perhaps we won't tell the doctors I work amongst that I prefer books where the medical professionals are the killers or, better still, the victims :)

  4. Bernadette - No worries - it'll be our little secret ; ). A good medical mystery *is* absorbing, isn't it?

  5. I do sometimes enjoy them. But if they use too much jargon then I usually give up quickly!

    Mystery Writing is Murder
    Mystery Lovers’ Kitchen

  6. Medical professionals in crime fiction can never match the real life antics of some of my former colleagues and ex-colleagues. What a pity we have such strict libel laws in the UK and I cannot tell the stories. But I know how Bernadette feels........

  7. Elizabeth - I agree with you that some medical mysteries do use a lot of jargon. On one hand, using accurate terminlogy makes a book more realistic. On the other, it can be confusing and distracting. There's a balance, I think, that needs to be achieved.

    Norman - Sometimes life really is stranger than fiction. I'd love to hear some of those stories, myself, but we'll leave it to the imagination. I'm sure that you'd have quite a set of tales to tell!

  8. I certainly understand why the medical profession is used so often as a background for mysteries; all these lovely people walking around with all this fatal knowledge in their heads! It is often perceived that a killer who is a position of trust (like a doctor or a nurse) is more evil and their actions are even more betraying.

    I enjoy reading this type of crime fiction from time to time, but I don't want to feel I should have attended medical school to understand it. Some jargon is good; but in this, like in many situations involving specialized language, less is more.

  9. Elspeth - As a linguist, I completely agree with you about the use of jargon in medical mysteries (and any other kind, really). The reader wants to get involved in a suspenseful story with interesting characters and a corking murder. That can't happen if the reader has to stop every paragraph and consult a dictionary or the Internet to find out what something means. When terminology is needed for the story to be authentic, that's one thing but yes, too much is, well, too much.

    You have a point, too, about how we feel about people in positions of trust (and that includes the medical profession) who abuse that trust. Somehow, that does seem worse, doesn't it?

  10. On the whole, I like them, and if the author knows his stuff, I don´t mind it being technical. I enjoy learning something new when I read. I DON´T want them to be about a world-threatening ebola virus or something like that, though (no conspiracies for me).

  11. Dorte - I understand exactly what you mean. Medical mysteries can be gripping, and I, too, enjoy learning new things. When a person's not a fan of conspiracy novels, though, then it simply takes away from the pleasure of solving a mystery if it's all tied up in a worldwide (or even smaller) "evil plot."

  12. A hospital is a "closed room", I suppose. I love all these professional-based thrillers, eg medical/hospital, journalism, legal etc. I think it is the imposed structure that helps, also. G. Epron's novels are really good medical crime fiction - the author is a twosome, Hallie Ephron and I forget the name of the other but he is a psychologist of some kind. The novels have titles like Amnesia and Guilt. They are set in a psychiatric hospital in Massachussetts (I think) - the protag's wife has died before the first novel and he (Peter someone) lives with or next door to his mother, and is a rower. The first few of these books were superb hospital thrillers, though the most recent opened out into a terrorist plot in the city and was not so good, in my view.

  13. Surname of author is Ephron, not Epron - that was a typo, sorry.

  14. Maxine - You're right; most of those "professsional" mysteries, whether they're medical or some other kind, take place in a closed situation. To me, that adds to the suspense. I also have to say that I like the kind of new learning I get to do when I read a mystery like that.

    I'm glad you mentioned the Hallie Ephron and Donald A. Davidoff team. I must confess I haven't read their Peter Zak series; Amnesia is on my TBR list, but if you saw how long that is, you would understand why I haven't gotten there yet. ; ). From what you say, though, at least the first novels sound exciting. I'll have to look at that list more carefully. No wonder I always enjoy your comments on my posts : )