“There’s nothing between us but secrets and threats.”

I really liked Payne’s book The Lucky One so I was excited to read another one by her. I didn’t like this one as much as that one, however it had a lot less swearing in it which is a plus.

What took this one down a few notches for me was a lack of mystery, a pretty one-dimensional plot, too much coffee, and the whole oft-used scenario where someone discovers something alarming and gets mad and hurt and even though the other person is like ‘Let me explain…’ the mad/hurt/scared person says ‘No. I will not listen to potential answers. I shall flee the scene and live in confusion and misunderstandings because I just can’t even. And don’t ever touch the same ground as me.’ And if they would have just listened for five whole seconds, everything could have been avoided.


As to the lack of mystery: there is a disclaimer at the beginning which warns readers of physician-assisted suicide in the book. I suppose that’s important in case that’s a trigger for some but for a thriller it felt like the author was giving away information that lessens the suspense.

Thus, I went into it thinking the book was going to be about deaths happening in a hospital and then them realizing it was a doctor assisting patients to die. This is partially right, except we find out pretty soon that the main character, Chloe’s ex-husband (Jameson), is a doctor who does physician-assisted suicides so the ‘mystery’ becomes more about whether or not the higher death rate at the hospital is actually because of him or someone else.

And that part I figured out at like 20%. To be fair, there were a few times where I thought maybe I was wrong after all, but overall, the book didn’t feel like the twisty psychological thriller it promised to be.



Another Annoyance #1:

It’s repeated and hinted at multiple times that Chloe and Jameson have some sort of shared secret that they’re guilty of.

“I never thought I’d get a second chance at happily ever after. Not after what I did, and to someone I loved, no less.”

“After what we did, he isn’t allowed to be the love of my life.”

I got annoyed with all the cloak and dagger stuff surrounding her past because when we find out what they did, we really aren’t surprised at all.


Another Annoyance #2:

The coffee and the wine. I get that it’s the Pacific Northwest and they are coffee fanatics out there and that doctors and nurses require much coffee, but I feel like every time the author needed to move the plot forward she used coffee or wine to do that- Hey let’s get drinks! Hey, can I grab you a coffee? Can you grab me a coffee? Should we go drink coffee? Can you reinsert my coffee IV line?

If you don’t believe me, here are the facts: the word coffee is used 85 times and wine is used 87 times. Folks, that’s much times. I cross-referenced these numbers with a few other digital books I have just to see and those books used these words less than 20.

Perhaps a reader who actually likes coffee will love this, but for me it felt like coffee was it’s own character. And a bitter one at that.


Another Annoyance #3:

I feel like there were a lot of plot holes required for this story to be a thing. I just think it would be pretty hard to hide all of this at a hospital. Especially when they have had a task force created to research the high death rate and determine a cause and then results go missing and people on the task force start dying.

And the hospital has cameras. Sure the camera was off during some of the deaths, but wouldn’t that also be a red flag?

At the end when a character goes missing from their room, even though Chloe had been looking at the cameras previous times, she doesn’t check them at that point. Probably would have helped.

I’m not familiar with how hospitals work and typically I can suspend reality for the case of a book in a lot of scenarios, but considering the whole high death-rate in a hospital where people might be killing patients is the entire premise and setting for the book, I wish it would have been a more plausible situation.


Another Annoyance #4:

They have a soap dish in their bathroom at home. What kind of psychos prefer bar soap to wash their hands??


Another Annoyance #5:

Chloe finds herself in a bit of a love triangle with her ex-husband and her current fiance. She suspects her ex-husband of murdering patients, but to her fiance it just looks like she’s obsessed with her ex-husband and he’s not super thrilled they’re working so closely together.

It creates some tension between her and her fiance. But no matter how bad it gets, she is just not ‘ready’ to tell him the truth. I get how this is important to the story as Payne wrote it, but I don’t like when a story requires a character to withhold information from a person they wouldn’t. Maybe at first, but there comes a point when withholding the information makes no sense anymore.



Physician-Assisted Suicide

Because this is a major part of the book, let’s talk about this controversial subject. (Also sometimes called ‘death with dignity’ or ‘right to die’ or ‘aid in dying’- AID.)

Whether or not physician-assisted suicide is ethical or moral is not really discussed in the book, it’s kinda just a given:

“he was doing it because he believed people had the right to choose when they died when they were terminally ill. When they were actively in pain and suffering and there was no light at the end of the tunnel.”

“I also knew how much he cared about people. How much he hated to see them in pain, and I knew this came from a place of caring.”

“Jameson was offering a great kindness. A great, horrible kindness.”

“he was so honest that he told me he was doing something that while ethical, was illegal.”

PAS or AID is different than euthanasia because the patient is administering the drugs, not the physician. The physician merely prepares the drugs and is present.

PAS should also not be confused with palliative care which is care given to patients by trying to alleviate symptoms and pain as best as they can as they are dying, which with modern medicine is usually pretty effective.


This is a controversial issue that has a lot of gray areas. Like the character in the book who had ALS, an incurable disease and a painful way to die, it’s hard to think about ‘forcing’ someone to endure that in the last days of their life.

I don’t know if I land on a concrete black-and-white stance in regards to this issue as I think there are so many factors to consider in each case and medical things that I don’t know about.

But here are some thoughts and information about it. It’s worth pondering and thinking through the implications of PAS.

The main argument for PAS is patient autonomy. People want to be in control of when and how they die. It is often driven by severe pain and discomfort that they want to be free of. They believe they should have the right to choose when they die.

However, a Canadian physician interviewed in this article reveals that research studies show that the driving force for patient autonomy is less about their pain and more about their desire to control their death.

He also says, “When death itself can be considered as a medical benefit, the sky seems to be the unfortunate limit for patient autonomy, and it introduces a level of subjectivity into medicine that we wouldn’t otherwise tolerate.”

Oregon, where this book takes place, is one of the eleven states that currently allows PAS. There’s some information coming out of there that gives pause.

After a high profile PAS death in 2014 in Oregon, numbers showed that others who ended their lives this way more than doubled. PAS can actually lead to more PAS just like how the show 13 Reasons Why led to an increase in suicides in teenagers.

Research also shows that doctors weren’t present for one-fourth of the cases. It’s unknown how frequent there are complications with this method of death.

Additionally, another factor often not considered when patients are electing to die is that their judgment may be clouded by clinical depression which can be treated, but this is rarely taken into consideration.

This article listing the arguments for both sides of the issue states, “Opponents of AID are concerned that in Oregon, greater than 70 percent of patients who elect AID are elderly and have cancer, but fewer than five percent are referred to a psychiatrist or psychologist to rule out clinical depression.”

While patient autonomy is important, I am a firm believer in the sanctity of human life. And that life should not be taken. While there are some gray areas as it stands, I think the ‘slippery slope’ opposing argument of PAS is a really important one to think about.

If we start legalizing PAS when patients want to alleviate their pain- where are the lines drawn for that? At what point is it too much pain? Which diseases qualify a patient? It would easily start applying to a broader and broader patient base than it should.

As Wayne Grudem fleshes out in his book Christian Ethics, the ‘right to die’ can also easily become ‘obligated to die.’

“If euthanasia is allowed for some patients, who are suffering, then how can we prevent it from being applied to more and more patients who are suffering?… a society can quickly move from merely allowing the ‘right to die’ to the belief that there is ‘an obligation to die’ on the part of the elderly and the very ill people who are ‘draining resources’ from the society.”

He then goes on to reveal alarming statistics coming out of the Netherlands where euthanasia is legal. It is estimated that “in 1990 nearly 6000 of approximately 130,000 people who died in the Netherlands that year were involuntarily euthanized.”

While there are some examples of people who used PAS that seem right, it’s hard to deny that the legalization of PAS and euthanasia can lead to more and more death. Death of patients that could still recover, death of patients involuntarily, death of infants of children who can’t make those choices for themselves, and an overall subjective scale on what quantifies a life worth living.

Just some thoughts to ponder!


Recommendation

I won’t write Jessica Payne off because I liked her other book and this one shows me she can write without using a lot of swearing. However, there were a few things, as listed above, that made this book a hard one to recommend.

I think if you’re easy to please when it comes to thrillers, you’ll probably enjoy this.

If you’ve read a lot of thrillers and have become a bit picky, my annoyances with this one may be yours as well.

I also would not recommend if physician-assisted suicide is a trigger for you.


[Content Advisory: 17 f-words, 14 s-words, a couple sex scenes are implied but only a few sentences of content]

**Received an ARC via NetGalley**