Cover image for To the bone : a novel
To the bone : a novel
McMahon, Neil.
Personal Author:
First edition.
Publication Information:
New York : HarperCollins, [2003]

Physical Description:
244 pages ; 24 cm
Format :


Call Number
Material Type
Home Location
Item Holds
X Adult Fiction Central Closed Stacks
X Adult Fiction Central Library

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The death of a young model in a San Francisco emergency room provides the first piece of a complex puzzle of cruelty and murder implicating a famous plastic surgeon.

Author Notes

Neil McMahon is the author of five novels, including the recently published Lone Creek. McMahon is also a carpenter in Missoula, where his wife coordinates the Montana Festival of the Book. Praised by fellow writers like Michael Connelly, James Crumley, Annick Smith, and William Kittredge, McMahon is working on the sequel to Lone Creek. He also held a Stegner Fellowship at Stanford

(Bowker Author Biography)

Reviews 2

Booklist Review

Emergency-room physician Carroll Monks returns in his third adventure, and once again the San Francisco doctor has to moonlight as an amateur sleuth to solve a mystery. This one is particularly important to Monks, since it involves one of his own patients, a beautiful young woman who died under his care. Facing charges of malpractice from the girl's parents, Monks follows the trail of clues he gleans from the body. Mysteries featuring physicians as sleuths are plentiful, but the Monks mysteries manage to follow the basic formula while being different from most of their competitors. McMahon is a more stylish writer than many medical-thriller authors--far superior, for example, to Robin Cook. His plotting is different, too: while there's plenty of medical detail, as the formula requires, he approaches the story as though it were a police procedural. Just like the good ol' gang at McBain's 87th Precinct, McMahon forces Monks to follow the clues one lead at a time. An excellent series propelled by solid plotting and an intelligent protagonist. --David Pitt Copyright 2003 Booklist

Publisher's Weekly Review

This exhilarating new medical thriller by the author of Twice Dying and Blood Double brings back sleuthing physician Carroll Monks, plunging him into personal jeopardy. Monks is on duty at San Francisco's Mercy Hospital when a beautiful young woman is brought to the emergency room in a coma. He makes a radical attempt to save her life by administering a blood thinner; the attempt is unsuccessful, and the patient dies. The girl's enraged parents intend to bring a medical malpractice lawsuit against Monks that could ruin his career. Wracked with guilt, Monks sets out to investigate the patient's history. As he soon learns, the dead woman, Eden Hale, was a model and aspiring actress reduced to doing porn films. Delving further, Monks becomes convinced that there's more to the girl's death than simple malpractice. Specifically, his suspicions center on Dr. Welles D'Anton, San Francisco's premier plastic surgeon, who caters to the rich and beautiful, and who operated on Eden shortly before her death. D'Anton is arrogant but expert-hardly the type to make a mess of a relatively simple procedure. Thus, Monks has his work cut out for him. This exciting and tautly written thriller crackles with suspense and narrative tension throughout. The hospital scenes are believable and the plastic surgery angle is convincingly detailed. Monks, a most engaging medical detective, is at his best with his back to the wall, and McMahon comes into his own with this scalpel-sharp effort. (Sept. 5) Forecast: McMahon's first two thrillers were well received; his third (a Doubleday, Mystery Guild and Literary Guild selection) may vault him onto bestseller lists. (c) Copyright PWxyz, LLC. All rights reserved



To the Bone Chapter One "Mercy ER, this is Medic Twelve with Code Three traffic." The voice, choppy with static and backed by a wailing siren, came over Mercy Hospital's paramedic radio, from an ambulance out on the San Francisco streets. Code Three meant that it was racing toward the hospital as fast as the night allowed. The Mobile Intensive Care nurse monitoring the radio leaned closer and pressed the talk button on the handset. "Medic Twelve, this is Mercy ER," she said. "Go ahead." Carroll Monks walked across the Emergency Room and stood beside her, listening. "Mercy ER, we're bringing you a young white female, age approximately twenty-five. She's unconscious, with almost no blood pressure. She does have a very weak femoral pulse, but no radial pulses. Ah, hold on a second, Mercy." Monks heard the driver yell something to his partner in the ambulance's rear. His words and the reply were lost in noise. The driver's voice came back on. "We haven't been able to start an IV. We can't find any veins. Repeat, she does not have an IV running. She has respiratory depression and we are oxygenating her." The nurse said, "Medic Twelve, do you have any history on her?" "Negative, Mercy, not much. She was in an apartment, alone. Looks like she's had a recent surgery, probably her breasts. We found some Valium, but we don't think it's an overdose." "Who called her in?" "She managed to call 911. We got sent by City Triage." Monks took the microphone from the nurse, and said, "Any signs of massive bleeding?" "There's some vomit with blood in it," the driver rasped through the static. "But not massive." "Nothing from the surgery? Other external wounds? Blood around the apartment, or in the bathroom?" "Negative, Mercy," the driver said again. Monks's mind started tracking a flow chart of probabilities, for a young woman who was bleeding badly, with the blood staying inside her. None of them were good. The nurse watched him questioningly, a look asking if he wanted any more information. He shook his head, giving her instructions as he handed her the microphone. "Take her directly to the trauma room, Medic Twelve," she said. "Roger, Mercy. ETA is six minutes." Monks turned back to the ER and the next pressing task -- organizing who was going to need to be where, during the next half hour. Screws had been tightening in his head all night, and this had the feel of being the most severe one yet. It was 3:51, an early Friday morning in July. San Francisco was going through a heat wave, with temperatures that had hovered in the nineties for the past several days. The usual cooling sea breezes and evening fog were gone, driven off the coast by hot winds that swept through the Central Valley like blasts from a furnace. Inland, the thermometer had been topping 110. But inland, they were used to it. Here, the leaden air and damp armpits and gummy asphalt underfoot were like a sudden sneaky enemy, one that worked just below the level of consciousness. Monks could sense it in faces -- tension, friction, as if a layer of social lubrication had been eroded by the heat. People were rubbing too close together, and the ER had been simmering hotter as the hours passed. It was amazing how many human beings were up, about, and in need of medical help, all through the night. He had just left the bedside of a seventeen-year-old girl who was giving birth to her third baby, a process she had started some twenty minutes earlier in her boyfriend's car. Staff were trying to get her sent to OB, but OB was busy, and the on-call obstetrician was not yet available. It looked like the youngster was going to appear in the ER any minute now. In the next bed, a fat middle-aged man was doing his best to die of a heart attack. They had shot him full of clot-busting drugs and shocked him back to life three times, but the monitor kept quavering in the danger zone. This was tying up two nurses and the other ER physician on duty. A cardiologist was supposed to be on the way to take him to the Cath Lab, but cardiology was busy, too. The knife wound in Bed Five was coming around without complications, but during the past minutes, his voice had risen from querulous to strident and he was becoming combative. The SFPD cops who had brought him were gone, back on the streets to deal with their own hot night. Hospital Security would probably have to be called to put him in restraints, but Security had their hands full right now in the lobby. One uniformed officer was moving uneasily among the crowd of at least twenty, while another flanked the desk where the triage nurse worked to separate out the most gravely ill and injured. Many were in pain, most had been waiting a long time, and there was a volatile racial mix of young black and Hispanic males, with girlfriends or wives who looked at least as tough as the men. Monks had been peripherally aware of a lot of restless movement on the other side of the lobby's glass doors -- bobbing heads and strutting bodies, a dizzying collage that made him think of a huge, many-limbed beast about to fall into a frenzy and tear itself apart. And now an ambulance was on its way, bringing a woman in critical condition. At least, Monks thought, this would bring more uniforms. It might help stabilize the tense crowd. He stepped to the main desk. "Call City Dispatch Center," he said. "Tell them we're going on diversion." Leah Horvitz, the charge nurse, nodded and reached for the phone. Leah was a fiercely competent veteran, uncowed by any situation Monks had ever seen. But even she looked relieved ... To the Bone . Copyright © by Neil McMahon. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold. Excerpted from To the Bone by Neil McMahon All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.