John Benedict provides pulse-raising thrills in his debut medical thriller, Adrenaline, but its inspiration came from a moment during his anesthesiology career that made him grapple with serious, down-to-earth questions. “No one knows what it feels like for doctors to put people to sleep every day, to essentially render them helpless,” he says. “It raises complicated emotions, and the responsibility is enormous and something we take very, very seriously.”

He began writing fiction in high school, but his academic interest in medicine superseded his literary dreams for many years. After graduating cum laude from Rensselaer Polytechnic Institute and completing his medical degree at Pennsylvania State University’s College of Medicine, he began work as an anesthesiologist in 1986. He got married, had children, and settled into a thriving, busy life in Harrisburg, Pennsylvania. All was well, and if something was missing, he didn’t notice it—until, in 1993, a patient unwittingly pointed it out.

“The gravity of what I did every day—and the inspiration for my first book, actually—occurred one night on a 24-hour shift in the hospital,” Benedict recalls. “A woman with two young children came in needing her appendix out, and when she saw the consent form that she had to sign to get anesthesia, she was understandably upset. For legal reasons, there is a clause in there that mentions that patients can die. I had children. I realized that night how much trust patients place in us. And what if that trust isn’t justified?”

That night changed everything for Benedict. After 15 years, he returned to writing—a process that was actually more organic than one might expect. His first novel, Adrenaline, was followed by three more medical thrillers, each with a focus on anesthesiology.

“While I was busy raising three boys and working full-time, I found time to get away on my days off and write regularly,” Benedict says. “Now that I have shifted to working in anesthesiology part-time, I have more time to devote to writing, but all along, it has allowed me to explore freedom I could never dream of as a doctor. As a writer, I can kill people, make people do crazy things. In many ways, it’s the exact opposite of practicing medicine, where you have to be responsible and think of the safety of your patient above all else.”

The result of his exploration of the dark side of the medical profession is a riotous rendition of what can happen when trust is placed in the wrong hands. In Adrenaline, which Kirkus calls a “mystery story rife with suspense” in which “twists and turns abound,” patients begin dying mysteriously in the OR at Our Lady of Mercy Hospital, and anesthesiologist Doug Landry falls under suspicion. It appears that Landry is being set up, and he sets out to unravel the mystery.

Along the way, Benedict unspools several subplots involving a hospital merger, office politics, a serial killer, extramarital romances, and drug abuse. And thanks to the author’s medical expertise, the prose ripples with realistic medical jargon and authentic depictions of what happens in the OR—as well as what occurs behind the scenes as doctors struggle with the implications of their decisions, for themselves and their patients: 

Mr. Lehman’s voice brought him back to the present. “I’m in your hands, Doc.”

Doug hated it when they reminded him of that. He turned around to get the necessary induction drugs. About twelve syringes filled with the basic anesthetic meds of his trade lay at the ready on top of his anesthesia cart. He reflected briefly on the fact that here before him was a deadly arsenal of drugs. Each syringe was potentially lethal if given in the wrong amount, wrong combination, or wrong order.

Doug shook his head to break this destructive line of thought and hooked the Diprivan syringe to the IV set and injected the entire contents. “OK. Here we go. You’re going to drift off to sleep in about thirty seconds.”…Doug could feel his own heartbeat quicken and his senses snap into focus as he pushed the Diprivan. Whenever he induced a patient, he was keenly aware of taking several irreversible steps….

In later books—The Edge of Death (2013), Fatal Complications (2015), and Bad Robot (2018)—Benedict continues to explore the consequences of naïve ethical assumptions, drawing inspiration from his own medical work. He also explores concerns about end-of-life scenarios in a high-tech age. “I love writing medical thrillers that keep readers entertained,” Benedict says. “But it’s almost as important to me that they be authentic. Some of my biggest fans are nurses, and that’s the first thing they say to me: They appreciate how accurately my books depict work and life in the OR, unlike so much other medical fiction out there, written by people who have never practiced medicine, let alone anesthesiology.” 

First published in 2005 by a small press in Pennsylvania and then self-published in 2013, Adrenaline became Amazon’s top-selling medical thriller on three separate occasions: in March and October 2014, and in December 2015. Since then, 200,000 copies have been sold, and it’s easy to see why. The plot’s pace is analogous to a particularly good episode of Law Order: Special Victims Unit, with memorable twists and turns, shifting perspectives, and complex characters that will stick with readers long after they turn the final page—such as Landry’s best friend, the high-strung Dr. Mike Carlucci, who’s struggling to hold on to his sanity and his job as he deals with the intense pressures of hospital life and his increasing dependence on drugs. 

A fifth thriller set in the OR is on its way. “Where is this one going to take us?” Benedict asks. “We’ll see. I’m working on it now, but the process can be unpredictable, and sometimes, a plot twist will occur to me six months into the writing process, and I’ll have to go back and change everything.” Readers will have to wait to see what questions he’ll tackle next.

Kathleen Willcox writes about culture, travel, food, and wine from Saratoga Springs, New York. Follow along on Instagram (@kathleenwillcox).