Radiologist explores seamy underbelly of malpractice in first novel

Oct 1, 2007

It's a safe bet that neuroradiologist Dr. John Armstrong will never win a Minnie, AuntMinnie.com's annual award that recognizes the best in medical imaging. After all, he's part of a scam that involves manipulating patient images to "create" missed diagnoses, providing these forged cases as evidence in the ensuing malpractice case, and then splitting the settlement booty with the malpractice attorney (aka his best friend).

Fortunately, Armstrong is purely fictional, the main character in Locked In, the debut medical thriller by real-life neurorad Dr. Michael Esposito. After 15 years in radiology, Esposito -- who is currently in private practice in Tampa, FL -- was looking for a creative outlet and decided to try writing fiction.

His initial attempt at straight crime stories didn't pan out so he took to heart one of the oldest adages about putting pen to paper -- write what you know. In addition to having a radiologist protagonist, Locked In takes place in Tampa and is replete with characters who are trying to detangle themselves from a "terrifying world of medicine gone awry," according to the synopsis on Esposito's Web site. Esposito also drew inspiration from his preferred authors including Robert Ludlum (The Bourne Ultimatum) and Dan Brown (The Da Vinci Code).

"My favorite writer is Michael Crichton," Esposito told AuntMinnie.com. "I loved Jurassic Park. What I liked in that (book) is that he told a good story, but he also threw a little science in there so when you walked away, you felt like you had learned a little bit and that you were entertained."

In Locked In, the "little science" is a wealth of imaging terminology and medical jargon bandied about by Armstrong and his colleagues. Esposito said he isn't worried that his readers will get lost in his world of cerebellar hemispheres and arterial plaques, especially since medical TV shows are all the rage these days.

"I haven't watched 'CSI' but a few times," he said. "They've got a lot of gory stuff on there! I think people are very intrigued by (medicine). There's a lot of mystery there. It's like when I go to a law office, it's all very mysterious. People feel like that about doctors. I wanted people to understand what radiologists do. They may not understand everything, but they get a feel for the way things go and they also get taken through a good story."

While the medical thriller genre is well-established, Esposito did go out on a limb by offering up a protagonist who isn't entirely above board -- Armstrong's greed leads him to engage in decidedly shady activities.

"I did have ... some agents (say), 'I don't want a book where the character is not a good guy,' " Esposito explained. "But I wanted to do something different. (Armstrong) is a complex guy. What he does isn't right. He does try to make amends, but he's still not a good guy."

Before you start rifling through the RSNA membership directory to see if Armstrong resembles anyone you know, Esposito stated that the character is not based on any one individual of his acquaintance, either professionally or personally.

"I looked at (scandals) like Enron and saw how one bad apple can be greedy and because of that, they end up taking themselves, and others, down," he said.

At the 2007 RSNA meeting in Chicago, Esposito will have a booth on Publishers' Row where he'll be selling and signing copies of Locked In. He said that he's received good feedback from other medical professionals about the book, but that he's looking forward to what "my people" have to say about it at the meeting.

In the meantime, Esposito has begun his sophomore effort, the story of a neurologist trying to harness the power of ESP. This time his hero will be worthy of accolades, he promised.

"After reading Locked In, a friend of mine said, 'Mike, I really liked it but I hoped that (all the characters) had died. There was nobody to root for.' I understand that people want someone that they can get behind; someone who'll beat the bad guys," Esposito acknowledged.

By Shalmali Pal
AuntMinnie.com staff writer
October 2, 2007

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