25 Women to Read Before You Die

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Oxygen Cover



Reading Group Guide

Discussion Questions:

1. After Jolene's death, Marie thinks almost as much about Bobbie as she does about her own experience. Why is it so important for her to see Bobbie? What does she hope to accomplish?

2. Marie says that no death she has witnessed affects her as Jolene's does, yet one experience was different: the death of her mother. How do you think learning of her mother's condition and attempting to help her parents understand it while she was in medical school affects Marie as a doctor? How was the time of her mother's death a turning point between the life she was raised for and the life she chose?

3. When Marie learns that the Turner Syndrome revealed in Jolene's autopsy could make losing the case and therefore her career more likely, she wonders "if all the money and possessions were stripped away, what, exactly, would be left?" What choices does the case force Marie to reconsider? What doubts does she have about her life and career?

4. Discuss the relationship between Marie and her sister, Lori. Why doesn't Marie tell Lori about what happened to Jolene immediately? What conflicting emotions does Marie have about Lori's life and marriage?

5. When Marie and Joe are in the hotel in Texas, he describes his theory of the "Big O," a theory that could apply to several characters in the book, perhaps Joe most of all. Why is it significant that Joe be the one to hold this hopeful belief? In what ways are each of the characters "cloaked"?

6. Marie's father is literally going blind, and yet each of them is blind in a way, unable to see through their estrangement and past wrongs. What does Marie learn about how her father "sees" her during her visit? What does she "see" in him? What is the significance of the gift of her mother's ring?

7. The balance between vulnerability and control functions on several levels in the novel: Between doctors and patients in the operating room, during the legal battle in the aftermath of Jolene's death, and in Marie's relationships with her father and Joe. What happens when the balance shifts in each situation? What does Marie learn about control within each context, or from each person?

8. Joe is one of the most surprising characters in the book. He buoys Marie up, he gives her strength, but in the end he is revealed as the weak one. Were Joe's feelings for Marie genuine? Does his letter change your opinion of him? Ultimately, how does Marie feel about him?

9. Betrayal is an important theme in the book. Marie is betrayed by Joe and the hospital. Bobbie and Jolene are betrayed by them too. Marie's father believes she betrayed him and his faith when she was a teenager. What other betrayals can you think of? What motivation is at the root of each betrayal?

10. Consider the depictions of hospitals and doctors on television versus in Oxygen. How does the novel's authentic portrayal of medical culture, its routines and its dilemmas, differ from what you see elsewhere?

11. The ending of the novel is particularly bittersweet. Marie's innocence is intact, but Joe's innocence, and her relationship with him, are undone. Were you surprised? Were you satisfied with this resolution?

Enhance Your Book Club:

Consider the ethical dilemma presented in the book and discuss the responsibilities of physicians and hospitals. For more on medical ethics, visit the American Medical Association's principles of medical ethics page http://www.ama-assn.org/ama/pub/category/2512.html.

Rather than buy the wine or food that your group would usually have, consider donating to a charity such as the one for which Marie works in the novel's epilogue. Learn more by visiting the websites for Changing Faces (http://www.changingfaces.org.uk/) or Facing the World (http://www.facingtheworld.net/).

What Our Readers Are Saying

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Average customer rating based on 2 comments:

Lindsay Weber, September 16, 2009 (view all comments by Lindsay Weber)
Although this is fiction, everything this real life anesthesiologist describes is true, from the malpractice lawsuits in healthcare right down to the descriptions of the OR and its penchant for gossip and heavy eye makeup showing above a surgical mask. You will be frightened by the discovery in the end but come to understand that it is sadly common. As a nurse already fascinated by anesthesia, I loved this story and highly recommend to those in healthcare and those who are not.
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Laurie Blum, August 18, 2009 (view all comments by Laurie Blum)
"As the daughter of a family practioner who began treating patients in the late 1930s (pre-penicillin) when ether was the preferred method of anesthesia, I could truly relate to the dedication of the medical profession that is so effectively presented in Carol Cassella's "Oxygen."
The author's precise narrative style perfectly mirrors the workings of a gifted physician’s mind. With blade-sharp insight, she lays bare the failings of a well-run but flawed hospital & the larger health-care system. When a routine procedure goes horribly wrong & leads to the death of an innocent child which includes the horror of a single mother, Dr. Marie Heaton, anesthesiologist, finds herself in the midst of a storm that threatens her career, her self-confidence & the choices she’s made inside & out of the Operating Room. The ending is deeply emotional, resonating with powerful sentiment yet never sentimental. This fiction will provide several quality hours of discussion in book review clubs. Do not miss this new book!"
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Product Details

Cassella, Carol
Dutton Adult
Cassella, Carol Wiley
Kells, Claire
Single women
General Fiction
Seattle (Wash.)
Medical novels
Edition Description:
Trade paper
Publication Date:
Grade Level:
from 12
9 x 6 in 1 lb
Age Level:
from 18

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Related Subjects

Fiction and Poetry » Literature » A to Z

Oxygen Used Hardcover
0 stars - 0 reviews
$6.95 In Stock
Product details 320 pages Simon & Schuster - English 9781416556107 Reviews:
"Publishers Weekly Review" by , "Powered by Cassella's 25 years in the medical field, this nicely wrought debut follows the travails of an experienced Seattle anesthesiologist after an eight-year-old patient dies while under the knife. In the aftermath, Dr. Marie Heaton is entangled in both her grief and a malpractice lawsuit. As the many meetings with attorneys blur together and autopsy results are awaited, Marie, who regrets having missed out on the 'intended stream of marriage and motherhood,' mediates the domestic squabbles in her sister's family; leans on and gets leaned on by colleague and ex-lover-turned-best friend, Joe Hillary; and tries to come to a dtente with her widowed father, who is losing his vision and with it his autonomy. As Marie is increasingly scrutinized, a few unexpected twists slyly work themselves into the investigation of the death, and the ice between Marie and her father slowly thaws. The prose is competent and the plot moves at a brisk pace, but the real hook is Cassella's knowing portrayal of the health industrial complex's inner workings; she knows the turf and doesn't spare readers the nasty bits. (July)" Publishers Weekly (Copyright Reed Business Information, Inc.)
"Review" by , "This novel is written with a clear, even hand, and the reader feels like a part of the heady world of high-stakes surgery....[A] great read with some juicy surprises."
"Review" by , "[A] vibrant debut....Oxygen" is the work of a writer who is in full command of her craft. In lesser hands, the story could have bogged in medical minutiae, but Cassella never loses sight of the fact that stories are most compelling when they are about people."
"Review" by , "Cassella's musings on medicine are astute and probing....The ethics of the drama, and Cassella's portrayal of the very real and contemporary flaws in our health-care system, make this novel a promising debut."
"Review" by , "In Oxygen, Carol Cassella's taut novel, Dr. Marie Heaton, an assured anesthesiologist at the top of her game, is forced to face the personal and professional fallout from an operating room disaster. Marie finds herself on the losing end of dollars-and-cents medicine in a malpractice suit, questioning herself, her skills, her colleagues, and her life choices. I couldn't wait to race to the end to see how her story played out, and I wasn't disappointed."
"Synopsis" by , A compelling, complex, and riveting debut by a real-life anesthesiologist, Oxygen is at once a lyrically written medical adventure and a heartfelt drama in the tradition of Chris Bohjalian's Midwives and Jodi Picoult's My Sister's Keeper.
"Synopsis" by , A riveting new book that expertly combines compelling women's fiction with medical drama by a real-life anesthesiologist and student of David Guterson. Think Jodi Picoult meets Atul Gawande.
"Synopsis" by ,
An adventurous debut novel that cross cuts between a competitive college swimmers harrowing days in the Rocky Mountains after a major airline disaster and her recovery supported by the two men who love her—only one of whom knows what really happened in the wilderness.

Nineteen-year-old Avery Delacorte loves the water. Growing up in Brookline, Massachusetts, she took swim lessons at her community pool and captained the local team; in high school, she raced across bays and sprawling North American lakes. Now a sophomore on her universitys nationally ranked team, she struggles under the weight of new expectations but life is otherwise pretty good. Perfect, really.

That all changes when Averys red-eye home for Thanksgiving makes a ditch landing in a mountain lake in the Colorado Rockies. She is one of only five survivors, which includes three little boys and Colin Shea, who happens to be her teammate. Colin is also the only person in Averys college life who challenged her to swim her own events, to be her own person—something she refused to do. Instead shes avoided him since the first day of freshman year. But now, faced with sub-zero temperatures, minimal supplies, and the dangers of a forbidding nowhere, Avery and Colin must rely on each other in ways they never couldve imagined.

In the wilderness, the concept of survival is clear-cut. Simple. In the real world, its anything but.

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