The Surgeon

Leslie Wolfe’s 2023 novel, The Surgeon, is a psychological thriller that achieved bestseller status on Amazon and UK Kindle charts. The novel follows Dr. Anne Wiley, a distinguished cardiothoracic surgeon whose perfect professional record is shattered when she loses a patient on the operating table. The situation spirals into a moral and ethical crisis when Anne recognizes the deceased patient as the man responsible for a deep-rooted family trauma. As a relentless prosecutor begins an investigation, Anne must navigate a high-stakes psychological battle that threatens her career, her marriage, and her freedom. The novel explores several themes, including The Unclear Boundary Between Justice and Vengeance, The Corrupting Influence of Unchecked Ambition, and The Pervasive Influence of Past Trauma and Secrets.

Wolfe is known for thriller series, including the Detective Kay Sharp and Tess Winnett series, that feature strong female protagonists. The Surgeon is a standalone novel that similarly centers on the complex psychologies of two determined women (a surgeon and a prosecutor) working in the high-pressure, male-dominated fields of medicine and law. Wolfe’s novels are noted for their fast-paced suspense and incorporation of research in science and psychology, a style evident in the novel’s detailed depiction of surgical procedures and its focus on the characters’ internal motivations.

This guide refers to the 2023 Grand Central Publishing edition.

Content Warning: The source material and guide feature depictions of death, child abuse, child sexual abuse, death by suicide, gender discrimination, cursing, substance use, and sexual content.

Plot Summary

Dr. Anne Wiley, a cardiothoracic surgeon with a perfect record, loses her first patient, Caleb Donaghy, during an aortic aneurysm repair. The surgery proceeds normally until the patient’s heart fails to restart. Standard resuscitation efforts are unsuccessful. The anesthesiologist, Dr. Robert Bolger, a known misogynist, accuses Anne of giving up too soon. Anne steps past the surgical drape and sees the patient’s face, now clean-shaven, and recognizes a distinctive red birthmark on his forehead. Stunned by the recognition, Anne calls the time of death after 21 minutes, leaving her team shocked and Dr. Bolger furious. Anne is distraught, questioning if she has killed the man.

Meanwhile, Assistant State’s Attorney (ASA) Paula Fuselier is promoted to head of the Criminal Prosecutions Bureau by her boss, Mitch Hobbs. Praising her passion for defending underprivileged victims, he promises to groom her as his successor. After a celebratory dinner, Paula meets her lover, a mayoral candidate, in a hotel room. They discuss their political alliance: She’ll provide him with intel on high-profile arrests for media opportunities in exchange for his future endorsement for state’s attorney.

Anne returns home and struggles with the aftermath of the patient’s death. She’s haunted by the memory of the birthmark. Her mother, a retired surgical nurse, tries to comfort her. Anne confesses to her husband, Derreck, a lawyer, that she knew the patient and stopped resuscitation efforts early after recognizing him. Derreck advises her to remain silent and keep the connection secret. Later that night, in a private ritual to cope with her trauma, Anne asks Derreck to strike her with his belt.

The investigation into Caleb Donaghy’s death begins. Anne visits the morgue to confirm the man’s identity. A flashback reveals that when Anne was 14, her nine-year-old adopted sister, Melanie, became terrified upon seeing a man in a park who had the same birthmark. Soon after, ASA Paula Fuselier visits Anne at the hospital and questions her about Donaghy’s death. Then, the hospital administrator, Dr. Jody Meriwether, known as M, summons Anne and informs her of a formal peer-review hearing.

The peer review committee finds no fault in Anne’s surgical performance. The autopsy report notes no errors and attributes a slightly elevated potassium level in the heart to the standard cardioplegia solution. Dr. Bolger is placed on administrative leave for inappropriate conduct. Privately, Anne drafts an email to the medical examiner to further investigate Donaghy’s heart, but later deletes it, fearing that it will draw more suspicion.

The novel reveals that Paula’s lover is Derreck Bourke, Anne’s husband, and that their affair has been ongoing for seven months. Paula leaks the story of the “suspicious” death to the press. In a separate case, Paula’s reckless methods lead to the murder of an 11-year-old witness, and she uses the killer’s arrest as leverage for a press opportunity with Derreck, enraging her investigator, Adam Costilla. When her boss, Mitch Hobbs, learns of her recklessness and abuse of power, he suspends her, freezes her promotion, and gives her a 24-hour ultimatum to prove her case against Anne or be disbarred.

Anne reviews security footage from the night before Donaghy’s surgery and discovers that a nurse injected a substance into the cardioplegia solution bag. Recognizing the nurse as her mother by her distinctive gait and a strand of blonde hair, Anne deletes the incriminating footage. M then informs Anne that her surgical nurse, Lee Chen, was the one who called the state’s attorney’s office (SAO). Lee confesses that Paula extorted him months ago, using a driving under the influence (DUI) charge and his mother’s immigration status as leverage, to report any mistakes Anne made. This information shows that Paula’s vendetta predated Donaghy’s death.

Anne confronts her mother, who confesses to her role in Donaghy’s death. She reveals that Caleb Donaghy was once Melanie’s foster father, and he abused her before she was adopted by Anne’s family. Anne’s mother discovered Donaghy’s identity after seeing his name in Anne’s case notes. The family had tried to bring him to justice years ago but failed. Anne then confirms her own complicity in his death. She also admits to her long-held guilt over Melanie’s death by suicide after a traumatic first date; she believes she failed to protect her sister. While they talk, M sends Anne a news video showing Paula and Derreck together at the press conference.

The novel climaxes in a violent confrontation in Anne’s office when Paula arrives with a gun to force a confession. Derreck also arrives, trying to stop her. Just as Anne enters, Paula kisses Derreck, revealing their affair. Paula then reveals that she’s Melanie’s biological sister, separated from Melanie when Anne’s family adopted her. Her investigation was an act of revenge for Melanie’s death, which she blames on Anne. During the confrontation, Paula sees Donaghy’s morgue photo, and her traumatic reaction reveals to Anne that she is also a survivor of his abuse. Enraged at being used, Derreck struggles with Paula for the gun. It discharges, grazing his lower left abdomen before firing again, critically wounding Paula in the chest.

After surviving surgery, Paula faces serious criminal charges, though Anne vows to help her. Anne’s mother confesses that she injected the cardioplegia solution with a high concentration of potassium, which is what prevented Donaghy’s heart from restarting. Derreck is cleared of wrongdoing in the shooting, claiming self-defense. Realizing that her marriage is over, Anne begins packing a suitcase for Derreck. He returns home and implicitly coerces Anne into staying with him by using his knowledge of her role in Donaghy’s death to protect his mayoral campaign. Anne feigns compliance, but as Derreck toasts to their future, she reflects that only one of them knows how to stop a heart without leaving a trace.