Tattoo by Anthony Britto, MD, St Martin’s Press, New York, 1997, 376 Pages.  $25

Review by Del Meyer, MD

Plastic surgeon Anthony Britto shows promise as a writer in his first mystery, Tattoo.  Britto’s protagonist, also a plastic surgeon, is drawn into a pleasantly unpredictable “who-done-it” where he first features as a murder suspect and later as a potential murder victim.  While the pace is initially slow and the use of the first person seems a bit cumbersome, Britto warms to his task as the book progresses.  By the end, chapters are shorter and the suspense brisk.

The title refers to the literal tattoos inscribed on various characters, but also hints at the villain’s larger racist agenda.  The plastic surgeon, Dr. Lloyd, becomes a target because he erases distinguishing features of race, allowing “scum” to mix with “the chosen race.”  For this “contamination,” Dr Lloyd must die.  But the reader wonders whether the villain is a Klan member or has opted for the White Aryan Resistance, and whether the brave plastic surgeon will prevail, action dominates with only occasional elucidation on the current state of medicine.  Britto gets on a platform once or twice:

            …small community hospitals were sacred cash cows…[Staffed by] a benign crop of Marcus Welbys—who would spare no effort, and no expense in testing and x-raying, ultrasounding and scanning, scoping and graphing, and generally probing and jabbing until they, and their patients, were completely satisfied that a headache was, in fact, only a headache. . . . All this was just fine as long as somebody was willing to pay for it.  Then, when the winds and whimsies of the insurance companies began to blow the other way, and patients began to shift their allegiance to the HMOs, it was as if Moses had come down from the mountain and broken his tablets.  The orgy was over.  Nurses, once pleasant, turned dour with the burden of paperwork, while bedpans were ignored and left to cut red rings in sore buttocks.  Call bells pealed unanswered …


             In California, specialists in private practice were becoming anachronisms.  Managed care had taken over, and their admitted goal was to slash the cost of insurance of limiting the number of consultants a patient could see. . . . In the new order of medicine the general practitioner ruled, and the specialists were fighting for insured patients, stabbing one another in the back for a place in the breadline.

             But for Dr. Lloyd “there was something else that made it all worthwhile—the force of the scalpel and the suture.  The power to cut.  This was the most exhilarating, the most absorbing and the most rewarding thrill of all.”