“A fantastic medical and supernatural thriller with a memorable hero.” “The supernatural elements are well developed and believable, creating scenes of insanity that feel truly consequential. Readers will be drawn in by the novel’s great characters, steady pace, and satisfying ending.”


“This is a compelling book with a realistic plot woven into a fantasy story. Death’s Pale Flag by Gary Simonds is an excellent book, combining elements of a thriller, medical drama, comedy, and paranormal themes.”

Full Review


The Verdict

Memorable, thrilling, and entertaining, author Gary Simonds’s “Death’s Pale Flag” is a must-read medical thriller meets paranormal novel of 2023! The grounded realism of the characters and backstory with the engaging paranormal twists and fascinating connection between the mind and the paranormal the author touches upon made this a truly amazing novel to get lost in. If you haven’t yet, be sure to grab your copy today!

Rating: 10/10


Author and neurosurgeon Gary Simonds, masterfully draws his readers into both the professional and chaotic neurosurgery universe. I was struck with the sheer humanity and even venerability of the neuro surgical team. We tend to put our medical professionals on hero pedestals. This intensifies the already perfectionistic, workaholic, overcommitted struggle for achievement, among these medical personalities in danger of succumbing to human fallacy.


“Highly recommended for fans of the autobiography ‘When breath becomes air’ and TV shows ‘The Good Doctor’ and ‘Gray’s Anatomy’- Death’s Pale Flag is a cozy fiction with light horror and the enlightenment of attending a mental health seminar, all in one book.”

FROM WAYNE SOTILE – Sotile Center for Resilience

This book is magnificent. While weaving a fascinating paranormal mystery tale, Gary Simonds has artfully depicted the pain and poignancy (and nobility) of life in neurosurgery, both for the surgeon and his/her spouse/family. Like all good art, he engages the reader, then takes them on not just a narratively-described but an emotionally-cathected journey; the relentlessness of brain surgeon, Ryan’s work/life and existential/humanistic conflicts are grueling to experience, as is the endless compassion and questioning that his wife, Kelly, must live with. In fact, despite the increasingly unsettling paranormal events and the heart-racing peeks into the neurosurgery universe, the heart of this novel lies in the Brenan’s struggle to save their marriage.  

Lovers of medical trillers will enjoy the accurate portrayal of the minute to minute critical decision making involved in caring for the tidal waves of sick and injured patients crashing upon our hospitals every day. Lovers of ghost stories will savor this story of a man who is relentlessly and inexplicably haunted, rather than a dilapidated house or mist-laden hollow. And, this is a novel that should be assigned reading for anyone who wants to explore the fallout of workaholic overcommitment to even the most noble of causes, and those who wish to TRULY understand life in medicine and life in a “medical family.”

Further thoughts: 

The writing is sensational. The characters are compelling – the reader thirsts for evermore info about Kelley and Ryan; the wordsmithing of contexts and settings is eloquently intelligent; and the drama of the story is well-paced.

Descriptions of in-the-trenches experiences of a neurosurgeon and the interplay with other members of the team and the variety of patients dealt with (their brief stories describing the circumstances that lead to the tragedies that resulted in their injuries) are nothing short of fascinating and galvanizing.

The theme of “that which you focus on and immerse oneself in magnifies; what you ignore in life shrinks” is powerful… We readily come to understand that much can be lost in that cauldron of duty to endlessly needy constituents, ego gratification, going where the affirmation is, the reflexive avoiding of the tensions of a failing home life, etc.. 

The vignettes that offer a glimpse into life in the E.R., ICU’s, and operating rooms are “grab the reader by the shirt and shake them into paying attention” effective. They are fast-paced, fascinating, educational, and awe-inspiring. They leave the reader’s head spinning. And each vignette begs for the reader’s consideration of its meta theme:

-Caring for a seriously ill or injured patient, also necessarily involves caring for a host of devastated family members. 

-Dealing with less competent, compulsive, and/or caring colleagues

-Dealing with arrogant and difficult colleagues

-Recognizing the heroism and altruism of the many unsung heroes on a medical team

-The glee of educating naïve medical students

-The joy of seeing a resident turn into a trusted professional

-The relentlessness of the mission …constantly called 

-The sustaining value of intelligent banter among a “band of brothers”

-The existential anxieties that come from a constant barrage of witnessing the frailty of life 

-The almost inexpressible admiration that stems from experiencing the grace and love shown by people, during the worst of times

-The existential quandaries that eventually come – “am I truly making a difference? Am I worth the amount of money I get paid?”

-The deep and abiding joy and pride and, eventually, actualizations that comes from doing this heroic work

-The shame “what am I doing!” that comes when one finally “loses it”, and goes off on a colleague or patient

-Even earlier, what it’s like to have been an maximum-achiever and  leader throughout one’s life, then encounter the hazing of residency

-And more, and more

Wayne M. Sotile, Ph.D.
Sotile Center for Resilience

Center for Physician Resilience

P.O. Box 2290

Davidson, NC 28036

Web Site:

From Cynda Johnson MD, Founding Dean and President (Retired), Dean Emerita, Virginia Tech Carilion School of Medicine

From its riveting beginning to the last sentence, “Death’s Pale Flag” is a fast-paced and engaging read by author Gary Simonds.  Himself a neurosurgeon, Dr. Simonds writes the “fictional” story of Dr. Ryan Brenan, a high-powered (aren’t they all?) neurosurgeon, who just can’t stop and “smell the roses.”  He is totally absorbed in his high risk profession, and yes, totally absorbed in himself.  Only he can accurately assess the patient’s condition, choose the best surgical approach, and provide the ideal post-operative care.  The novel is a work of fiction—not autobiographical per se, but filled with the realities of the life of a neurosurgeon whose every decision has a profound effect on life itself.  Myself, I am a family doctor, knowledgeable about the scope of work of the neurosurgeon, but I could still not believe the pace and volume of high-risk work described.  So I asked Gary—is there hyperbole here?  His answer—not really; he had actually toned it down as real life in the day of a neurosurgeon would seem totally unbelievable to the reader.  Yikes!

So that’s the backdrop for a story which then explores the effect of Dr. Brenan’s personality and life-experience on his family, friends, colleagues, and—most profoundly—on himself.  A parallel reality builds inside his head—one that is not experienced by those around him.  And there are ghosts—ghosts of the past and present.  The reader wonders—is this a ghost story now or has Dr. Brenan’s mental health deteriorated to the point where he can no longer distinguish between his two realities.  And what if his parallel world eventually encroaches into the operating room setting?  Is “Death’s Pale Flag” actually a cautionary tale about the mental health effects on people whose professions involve life and death decisions on nearly a daily basis?   The novel certainly is that…and much more.


Reviewed by K.C. Finn for Readers’ Favorite

Death’s Pale Flag is a work of fiction in the psychological thriller and suspense subgenres. It is best suited to mature teen and adult readers owing to some dark themes but no graphic descriptions. Penned by author Gary Simonds, in this chilling work, we find ourselves immersed in the dark world of medical trauma and neuroscience when our protagonist Ryan Brenan starts to believe he is encountering ghosts. Frayed to his last nerve, Ryan has to wonder if the ghosts are real or if something in his brain has given way to chaos. Exploring strain, burnout, and psychological exhaustion with a thrilling paranormal twist, we follow with bated breath the turns of Ryan’s life to see where his adventures take him.

Author Gary Simonds offers a unique novel unlike anything I’ve ever read before, and the themes and combination of different genres are something I’d love to see more of in the medical thriller field. It is clear that Simonds knows the field well and speaks from personal experience in the world of neurosurgery, as the novel has a clinical overtone that provides a great level of professional detail. The narrative balances this out perfectly with the presence of our workaholic protagonist Ryan Brenan, who becomes more and more relatable as his life and struggles are revealed to us. The paranormal elements are believably incorporated and really highlight the mystery and psychological aspects of the plot well. Overall, Death’s Pale Flag is a fascinating, detailed, and engrossing novel that I would certainly recommend for medical, psychological, and paranormal thriller fans alike, as it has much to satisfy all these groups and so much more.


Death’s Pale Flag checked all the boxes -haunting, compelling, and engaging. It gets under the skin of its sympathetic hero Ryan Brennan. The author offers the psychology of being a surgeon; a human being.”


Review: Reviewed by Rabia Tanveer for Readers’ Favorite
Death’s Pale Flag by Gary Simonds is a psychological thriller that
focuses on the story of Dr. Ryan Brenan, a neurosurgeon who
believes he can see ghosts. Ryan loves his work and lives for it.
Compassionate and kindhearted, Ryan wants to save everyone who
comes to him. Working on weekends is a habit, and that takes a toll
on his health. It starts small as Ryan forgets one thing and then
another. But things become scary when he starts to forget the
people he loves and starts hallucinating. Ryan believes he can see
ghosts while his life takes one bad turn after the other. What is
happening to Ryan? Is he truly seeing ghosts? Or is there something
very wrong with his brain?
Captivating and entertaining, Death’s Pale Flag is the kind of novel
you pick up and promptly forget the world. The story is intense and
emotional, so be prepared. Gary Simonds creates an attachment to
Ryan, making sure you connect with him from the get-go. What I
love the most about this story is how human Ryan is. We think of
doctors as invincible beings who remain detached from their
patients all their lives. Ryan’s complexity changes this and makes
sure we look at doctors in a more human light. Ryan’s distress and
issues are a clear sign that he is one of us. This is a characterdriven
story, meaning Ryan’s development directly impacts the
storyline and its development. I love how realistic and
understandable it is, despite featuring elements of ghostly visions
that can derail the attention of readers but never does. A
phenomenal story that I highly recommend!

From Janalyn P. of NetGalley

"...this is a great book and although it deals in paranormal it’s very apropos to the story and a solid four star read if not more. I would definitely be down to read more from this author in the future I just wish I could say more but it would give so much away."

From Bernadette Longu of Reader’s Favorite

Reviewed by Bernadette Longu for Readers’ Favorite

In Death’s Pale Flag, Gary Simmonds takes you behind the scenes

of an ER Unit and shows you how people cope with the mayhem

that they see day in and day out and the silly things people do to

each other and total strangers. The book captures your attention

from the first page. The main characters are Ryan Brenan, his wife

Kelly, and his daughters Ava, Riley, and Erin. Other important

characters in this story are Lisa LeClair, Darla Sutton, Dermott

Morgan, Matt and Juleen Wolfe, Dianne, Hugh O’Connor, and

Reverend Ron. These characters keep pace with the main

characters’ ups and downs. The author uses his narrative skills and

his minor characters to lead the reader through the story while

literally walking alongside the main characters and all their


Death’s Pale Flag by Gary Simmonds will make you stop in your

tracks to take time to access what is going on in the world around

you and consider how aware you are of the world and your place in

it. You will find that you cannot put the book down because each

chapter catches you off guard and will cause you to keep reading to

the end and the final twist in the tale, which is most unexpected. I

found that this was a very profound book to read and it made me

do a lot of thinking about my life and the world around me. It really

makes a person think. Thank you for the privilege of reading your

book, Gary, I really appreciated it.


This was fresh and unique. It was captivating. The characters were well developed and well written. The paranormal aspect was so intriguing. A great thriller.


From Physician Family Magazine

The Thriving Physician Review (Click Image)

From Neurosurgery

Review of “Building Resilience in Neurosurgical Residents”

ISBN: 978-0692449516

Building Resilience in Neurosurgical Residents, by Gary Simonds, MD, Chair of Neurosurgery, and Wayne Sotile, PhD, expert in physician wellness, is the summation of an interventional study of resiliency. This book catalogues the findings of a journey undertaking by the Carilion Clinic – Virginia Tech Carilion School of Medicine Department of Neurosurgery. For over a year, Dr Sotile was embedded within the department and residency program for a pervasive investigation into the wellness and leadership development of the neurosurgery residents.

This book focuses on building resilience as an antidote to burnout. We commonly hear about burnout as a state of physical, emotional, and mental exhaustion that is a pervasive epidemic among the medical community. The authors define burnout as a temporary depletion of normal coping reserves, manifesting as exhaustion, inefficiency, and cynicism. Rather than focusing solely on the malady, this book identifies risks associated with burnout and emphasizes the importance of fostering resilience by regularly and honestly assessing and mitigating these risks, specifically in the arena of a neurosurgical training program.

The authors do an excellent job of identifying the unique circumstances and demands of neurosurgery residency, and delineate how these can minimize the satisfaction and joy that comes with the privilege of being neurosurgeons. And they focus on discussing stressors to implement change in the system when possible, but always to understand best responses in myriad situations that neurosurgeons face on a daily basis.

Each identified problem comes along with a pragmatic list of questions for discussion with the residents. These are actually quite thought provoking for any neurosurgeon to spend a few moments to augment their resiliency. Questions such as “Who on your team is best at multitasking? What are his or her secrets?”, “Do you miss multitasking when you have only one thing to accomplish a time?”, “What was your fluid of choice during your workday?”, “If you could design the educational component to your residency, how would you do it?”, “Where is most important to you to have a sense of control?”, and “How much of a cut in salary would you accept in exchange for better support”.

These are poignant for neurosurgeons and important for us to strategically learn from each other’s successes and failures, creating a reserve of best practices for difficult situations.

There also concrete examples in each section in bold, most of which are quite relatable. The authors illuminate patterns caused by unique resident demands and consequent behaviors. For instance, we are all aware that modern medicine has reduced nursing responsibilities for patient decision making to “near comic lows.” When speaking of the onerous busywork of trivial decision making previously done by nurses, such as catheterizing a patient with bladder residuals of 900 mL or ordering a laxative, the point is made that residents often remain in problem-solving mode when they arrive home. Instead of being able to discuss daily family matters in a relaxed fashion, definitive judgments are swiftly passed for every problem presented. For example: “Billy did not want to do his homework tonight”- “OK, no video games for a week.” I suspect we have all exhibited portions of this behavior, but perhaps have never taken the time to put two and two together to recognize potential maladaptive coping strategies.

Resident resilience can be bolstered by a combination of empathy regarding the situation of residency and reminders of the meaning and purpose that is served by what they are going through. The authors found that residents seem particularly sensitive to scenarios that trivialize their role as a provider. The revered physician status of the past has now changed to where former allies such as nurses now regularly write up physicians for perceived slights, only compounded by the “hammer paging” for trivial questions during the midst of a real emergency or the ill-prepared ED resident trying to foist a patient with no real neurosurgical issues. This can create an atmosphere of despondency, and certainly predisposes residents to an “intolerance of incompetency” and disdain for others’ concepts of hard work (traits held by many neurosurgeons), which always leads to poor interactions and further guilt and frustration. The authors do an excellent job of looking at the reasons behind these occurrences and developing actionable plans for dealing with them in a fruitful manner.

This book is written in a pithy and pragmatic manner, with both humorous anecdotes and occasional over the top references one would expect of a neurosurgeon. It is an excellent resource for all residency program directors, chairs, faculty, ancillary staff who work with residents, and a must-read for all aspiring and existing neurosurgery residents. But it is also worth a read by any practicing neurosurgeon, as we all deal with these same circumstances, and all have likely developed the same crazy coping mechanisms, for better or for worse. I would make a special recommendation that nurse managers of neurosurgical floors and intensive care units be given access to the book, as it could improve understanding and therefore interactions with allied staff for the betterment of patient care. It is a short 110 pages with additional self-assessment tools that can be used for psychosocial self-checks. While not all programs will have the opportunity or need for such a pervasive program as was enacted at Carilion, there is much to learn from their experience. I would love to see them develop a “Cliff Notes” version of their curriculum!

“Neurosurgical residency is replete with stressors, from the mild to the extreme. There is no way to obviate all of them; so many are part of the business (complications, death, emergencies, loss of sleep). Others seem quite arbitrary and even spiteful (trivial calls, nursing complaints, etc). No matter the nature, they all add up.” One method to diffuse stressors is to catalogue and discuss them. When difficult topics are “given air” in a supportive environment, they tend to dissipate. Control is regained by developing constructive mechanisms of self-management, with collegial empathy and support. My take-home notes for all of us as we build resiliency:

Neurosurgery is a privilege

Find meaning in ones work

Mindfulness and gratitude

Many thanks to Dr Simonds and Dr Sotile for their reminders

on this subject.

Stacey Quintero Wolfe, MD

Department of Neurological Surgery

Wake Forest School of Medicine

Winston-Salem, North Carolina