This guide is designed to be a starting point for your book club's discussion. Feel free to explore the questions that resonate most with your group and to let the conversation flow organically. Enjoy your discussion of TANGLED DARKNESS!

Questions for Critical Thinking

1. From the beginning of the novel, Leslie is portrayed as a competent and caring psychiatrist. How does the accusation of stealing opioids challenge this perception, both for the reader and for other characters in the book?

2. Damon Grady's death is a pivotal moment in the story. Before his death, what were your impressions of him? Did you suspect he was involved in the clinic's dark secrets?

3. Bryce Nelson is a complex antagonist. What do you believe are his primary motivations? Are his actions driven by greed, a desire for control, or something else entirely?

4. Michelle Wichim's character undergoes a significant transformation. What were the key factors that led to her actions? Do you see her as a victim, a villain or both?

5. Sloan Mannon is a seemingly peripheral character who is deeply entangled in the clinic's illegal activities. What role does his character play in the broader narrative?

Connecting to Personal Experiences

1. Leslie's struggle to be honest with her wife, Izzy, about the medical board investigation is a central conflict. Have you ever found yourself withholding information from a loved one to protect them? What were the consequences?

2. The theme of recovery is central to Leslie's character. Do you have any personal experiences with addiction or recovery, either your own or that of someone you know? How did these experiences shape your reading of the novel?

3. The workplace dynamics at the clinic are fraught with tension and mistrust. Have you ever been in a professional environment where you felt something was amiss? How did you navigate that situation?

4. TANGLED DARKNESS explores the idea that past traumas can resurface unexpectedly. Have you ever had an experience where a past event had a significant impact on your present?

Genre and Setting

1. How does TANGLED DARKNESS fit within the psychological thriller genre? What are some of the classic elements of this genre that you see in the novel?

2. The story is set in Portland, Oregon. How does the author use the setting to enhance the mood and atmosphere of the novel? Do you think the story would have been different if it were set in another city?

3. The author, MM Desch, is a former psychiatrist. How do you think her professional background influenced the writing of the novel, particularly in the portrayal of the characters and the medical setting?

Broader Conversations

1. Compare TANGLED DARKNESS to other psychological thrillers you have read. What makes this novel unique?

2. The novel touches on several contemporary issues, including the opioid crisis and the challenges of the healthcare system. How does the story's portrayal of these issues reflect or challenge your understanding of them?

3. The characters in TANGLED DARKNESS grapple with moral dilemmas and make choices with significant consequences. Discuss a moral dilemma from the book that you found particularly compelling. What would you have done in that situation?