First do no harm. That’s what every new doctor swears. It’s an oath, of course, but isn’t it also … an alibi?

A doctor is the only person who a victim would willingly let inject with something when they don’t know what it is, swallow whatever pills they offer, drink whatever they say, allow an intravenous infusion of whatever is in one of those plastic bags, and generally obey without any question. And isn’t that a perfect antagonist for a thriller?

Of course, most doctors are good guys, as one of the main characters assures her friend in my new book, The First to Lie (Forge Books, August 2020). The brilliantly valiant doctors and technicians and nurses and administrators and every single healthcare person now on the Covid-19 battlefield prove how — especially right now — sinister physicians only exist in fiction.

But since this is about fiction, and because my upcoming book includes a potential “personal good” versus “greater profits” motivation, it got me thinking about the power doctors have. The life and death power. Not only because of their skills and access, but because patients believe what their doctors tell them.

For instance, what if the vulnerable patient is not told the truth about what she’s ingesting? Or what pills he’s taking? Or exactly how many of whatever it is will do what it is supposed to do—but not that one more will lead to your all-too-explainable demise? 

The power to heal is also the power to harm, and when a twisted physician decides that power can be used as a weapon, then watch out, victims in crime fiction novels. You may end up served with fava beans and a nice Chianti. Psychiatrist Dr. Hannibal Lecter, remember, had also apparently sworn to do no harm. 

So yes, healthcare workers are heroes more than ever in our real lives. But in fiction? The very same skills that can save your life — can also end it. And cover up the truth.

Coma by Robin Cook. Remember when you first read this — maybe in 1977? One of the creepiest, most unsettling medical thrillers ever, and helped pave the way for the “greedy doctor” character. And if you saw the movie, remember the “bodies waiting to be harvested” scene? To certain doctors at Boston Memorial Hospital, “first do no harm” has a loophole — “unless doing harm helps someone more important.” (AZN | B&N | IndieBound | Bookshop)

The Verdict. Barry Reed’s 1980 medical-legal thriller stars a frayed-at-the-edges down-and-out lawyer — but the doctors he’s suing for malpractice are some of the most sinister medical villains ever portrayed. Who can forget the tiny but pivotal role a certain nurse plays, a defeated mouse on the witness stand, with the classic line, “I wanted to be a nurse. Who are these men?” (AZN

In House on Fire by Joseph Finder, it’s greedy doctors plus greedy pharmaceutical companies. The company produces a brilliantly effective painkiller — one they secretly know is relentlessly addictive. But as long as the doctors keep prescribing it to patients, everyone wins. Until someone decides to tell. And then, in this fast-paced David and Goliath thriller, certain medical forces have to save their own lives. (Read a Q&A with the author here || AZN | B&N | IndieBound | Bookshop)

How about a character’s therapist? In Kelly Simmons’ chilling One More Day, a vulnerable mom trusts hers to guide her through an emotional minefield. Is she losing her mind — or has she discovered something life-changing? No one believes her when she starts to “see” her missing child. What’s the responsibility of a therapist not only to guide, but to believe? What about — convince? And what happens if they are wrong? (Read Sandra Block’s review here || AZN | B&N | IndieBound | Bookshop)

Speaking of therapists, The Silent Patient by Alex Michaelides stars an especially interesting one — and his colleagues (and the instantly questionable setting) are equally intriguing. I can say no more, except that it absolutely deserves its seemingly unending run on the New York Times bestseller list. I could not put it down. (Read Neil Nyren’s review here || AZN | B&N | IndieBound | Bookshop)

Harvest. Tess Gerritsen, MD (and her friend and colleague Dr. Michael Palmer)  were pioneers in the doctors-as-bad-guys world, and Harvest was Gerritsen’s first (and groundbreaking) medical thriller. This organ-harvesting — well, stealing — plot was one of the first to tread that gruesome ground. And though it came out in 1996, it still has a top-notch nail-biting plot — and a hauntingly chilling scary-doctor-hospital setting. (AZN | B&N | IndieBound | Bookshop)

Rosemary’s Baby. If you’re having a baby, you need an obstetrician. And if your maternal instinct tells you something is untoward with the first one, then definitely you should choose another one. Ira Levin’s true classic is as brilliantly and surprisingly disturbing as it was when I first read it in l967 — can that be? — and even though the obstetrician is not the star, he seems to have taken an oath of another kind. (AZN | B&N | IndieBound)

Let me just say this. And I apologize to my dentist, who’s a good guy in every way. But every time I go to his office, I get a  flash of William Goldman’s iconic Marathon Man. (The sound of the dentist’s drill makes it even worse.) When a book description begins with “When a former Nazi SS dentist at Auschwitz …” what else do you need to know? (AZN | B&N | IndieBound | Bookshop)

As for all you real-life doctors — and every other health professional — we cheer and applaud you. Thank you.