I have been on a Tess Gerritsen glom lately, so even though this book isn’t part of a series, I decided to just continue trucking right along through her backlist. Most readers now would think of Rizzoli & Isles thrillers when they think of Gerritsen. However, she got her start in romantic suspense, often using her medical background to come up with some interesting plotlines.

In Under the Knife, her heroine Dr. Kate Chesne lives out her worst nightmare as an anesthesiologist. One of her patients dies on the table under circumstances that should not have occurred. Fingers are pointed at Kate as the accusation arises that she misread an EKG with fatal results.

Kate does not believe that she made such an obvious mistake and she is determined to clear her name. So, what does she do? She shows up at the office of medical malpractice attorney David Ransom, determined to tell him the real story.  The lawyer in me read this part of the book and kept thinking, “There’s all kinds of ‘no way’ written all over this situation,” and yet something about the writing kept me reading.

This novel was written in 1990, and there are a few elements in the story where that shows. No one has cellphones, and electronic charting seems not to be on the horizon. However, aside from a few details along this line, the book has aged well. Kate is a strong, intelligent heroine who doesn’t completely lose herself and turn into jello once the hero is on the scene. I also came to like David. In the beginning of the story, he represents a grieving family and sees the case against Kate as a very easy, open and shut affair. However, once he starts to hear her out, he allows himself to explore his own doubts and rethink his positions – a good sign of maturity.

In addition, for those who have read Gerritsen’s more recent books, the gradual unveiling of layers of plot might feel a little familiar here as Kate and David uncover something very wrong at the hospital where Kate works. The plotting is not as seamless as in the author’s later works, but one can see the promise in her writing in this book even more clearly than in some of her other early novels I’ve read.

On the romantic side, things run a tad thin in this book. While I liked both lead characters, the romance lacked the chemistry of a truly great relationship. I liked the romantic plot well enough, but the twists and turns of the mystery were really the stronger side of things here.

If you’re a fan of Gerritsen, this might be a good one to check out if you’re curious about her early work. And even if you don’t follow her books, this is still some pretty good romantic suspense.