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Twenty-one years ago, Emma Shephard was sexually assaulted and forced to leave college. She has tried to forget the trauma, building a new life as a loving wife and parent with a successful marketing career. Then her world is rocked when her rapist buys the pharmaceutical company where she works.

Now it’s an impossible choice between keeping the safe life she’s created and pursuing justice. With her marriage at risk and her child in danger, Emma finds herself at the center of ugly secrets and scandals.

Author Elena Mikalsen took time out of her busy day to chat with The Big Thrill about her latest thriller, ALL THE SILENT VOICES:

What was the biggest challenge this book presented? What about the biggest opportunity?

The biggest challenge was learning about the pharmaceutical industry and understanding its workings. I had to invent a name for a new drug, for example.

What do you hope readers will take away from this book?

I hope readers will learn about college sexual assault, PTSD, and deceptions of pharmaceutical companies.

Was there anything new you discovered, or that surprised you, as you wrote this book?

I was excited to learn about the inner workings of the FDA.

Without spoilers, are there any genre conventions you wanted to upend or challenge with this book?

The book’s ending is perhaps not traditional with a thriller.

What authors or books have influenced your career as a writer, and why?

I am very influenced by Jodi Picoult, who tackles tough issues head on, making us care about characters and engage in conversations forever about topics that can feel uncomfortable. This book handles a sensitive issue but I hope it will also open people’s eyes on a topic that’s not talked about enough and help people start discussions and take action.

How can you help someone in your life who is struggling with PTSD?

Be sensitive to times or experiences that are difficult for them. For example, in the novel, Emma struggles to take stairs, because her assault took place on the stairs. Have conversations with that person, offer help, offer comfort and sensitivity. PTSD scars are often lifelong.


Elena Mikalsen is a women’s fiction author writing stories about women facing tough challenges bravely.

She is somewhat obsessive about travel, but when she is at home, in San Antonio, she can be found browsing through bookstores or hiking with her family and dogs.

When not writing stories, she is a medical school professor and a pediatric psychologist helping children with chronic medical illness.

To learn more about the author and her work, please visit her website.