Thursday, January 07, 2010

Medical Details In Fiction

This interview first appeared at the great website for writers, Writer Unboxed. It’s reprinted here with permission of WU and my cyber-friend, Dr. Michael Palmer.

My debut novel of medical suspense, Code Blue, will be published next April. Because of my medical background and the genre in which I write, I am often asked about medical details in fiction. Dr. Michael Palmer is a New York Times best-selling author of fourteen very successful novels of medical suspense. His fifteenth, The Last Surgeon, will be published in February.

Michael has graciously agreed to join me in answering some questions about medical fiction in general, and giving some tips to authors wishing to add medical details to their own fiction.

Michael, we both write medical fiction because that’s what we know. What do you think is the appeal of medical fiction?

MP: Readers love not only to be entertained, but to be informed, whether it’s about life on the high seas, in the courtroom, or in the hospital. They want to listen in to the back-room conversations, feel the tension, and experience the thrills. There is also the “natural” excitement of the life of a physician.

RM: I agree that readers like the thrill of vicariously experiencing the life of a physician. Flying has been described as hours of boredom interspersed with moments of stark terror. There’s not much terror in medicine, but there is tension, and if the boring parts are left out, the good parts can hold the reader’s attention quite well.

Not everyone can write a medical thriller, but some novels can definitely benefit from the inclusion of a medical problem or scenario. Do you think a non-medical writer can do this successfully?

MP: I do, but I would insist that at some point, non-physicians involve a doc as a consultant. I was able to write about the President’s doctor in The First Patient because my research led to a friendship with Dr. Connie Mariano, for 10 years the White House physician. I also recommend the book Writing Genre Fiction by M. Thomas Milhorn, M.D.

RM: Agreed. I would make two suggestions for a writer wanting to include medical details in a novel. First, since you’re writing from a patient/family point of view, don’t get too deeply involved in technical details. And second, do your homework so you know that information provided by the medical professional in the scenario is accurate.

What medical problems would you suggest a writer consider for adding depth to their novel?

MP: Don’t be afraid to write about any medical problem or issue. Just do your research thoroughly, be fearless, and check your facts with a doc. The Internet is amazing. In The Fifth Vial, I wrote a compelling scene that took place in Amritsar, India, complete with street names and descriptions of the city without ever having been to India. The Internet is wonderful!

RM: Again, I agree. Even though I’m a physician, I check the latest details of diagnosis and treatment on the Internet. And because of the wealth of information available, there’s no reason to shy away from any medical scenario. Let your imagination run wild. Read the papers. Follow health news on the Internet. Pick something that you think will spice up your writing and run with it.

When you’re writing pure medical fiction, more medical detail is necessary than when you’re just adding a dash of medicine to a novel. In your own writing, how do you find the fine line between just enough detail and getting the reader bogged down? Any tips for the non-medical novel?

MP: Character, character, character! Writing is all about people. Don’t get bogged down in medical details. Worry about story and conflict and spice your narrative up with well researched and checked medical information. Write illness from the viewpoint of the patient when possible.

RM: Yes, the medical details are just the seasoning in the recipe. How they affect the characters is the important thing. After research to be certain the information is accurate, present it through the eyes and ears of your characters as they learn it from a physician. And don’t forget that our characters—just as most of us do in real life—often hear or perceive information incorrectly.

How do you handle questions from writers about medical details they want to incorporate in their novels? Do you direct them to any specific resources?

MP: I frankly don’t have time to be anyone’s ongoing consultant. If the question is easily answered in my specialty, I will try and give it a go. Mostly I recommend Wikipedia (believe it or not).

RM: I’ll answer simple questions in my area of expertise, which happens to be ENT and allergy. Other than that, I try to give the questioner the search terms they need and direct them to—you guessed it—the Internet. Many of the questions that come to me can be answered through the use of Google or another search engine. But I warn writers that, just because it’s on the Internet, it’s not necessarily accurate. I suggest they stick with sites from medical centers, the NIH, or other reputable sources.

You’ve addressed several medical problems in your books. Which is your favorite? (I think I know the answer to this one).

MP: Each of my books deals with a medical ethical issue. However, the issues are not as important as the characters—what they have at stake in the book. As you have guessed, I love having written The Second Opinion, but more because of the character of Thea than the information about Asperger Syndrome.

RM: And in my novels, there’s usually some medical situation that has proven to be a Prescription For Trouble (shameless plug for the series) for the physician protagonist. My favorite problem is one I wrote about in a book that hasn’t yet been published, a combination of medications taken by a patient without the doctor’s knowledge, with terrible consequences.

What can you tell us about your forthcoming book, The Last Surgeon?

MP: Nine people are in the OR for a botched case where the patient, a renowned Arab terrorist, dies on the table before the procedure. Three years later, those in the room begin dying one by one of “natural causes,” accident, or suicide. The medical theme is post-traumatic stress disorder in a trauma surgeon. I love the way it’s come out. The publication date will be February 19, 2010.

RM: In my debut novel of medical suspense, Code Blue, Dr. Cathy Sewell comes back to her small hometown looking for healing after her world falls apart. She faces opposition from the “old boy network” among the town physicians, and one of her prescriptions triggers a malpractice suit that may end her career. But her biggest worry is that someone in town doesn’t just want her to leave…they want Cathy dead. Code Blue comes out in April, 2010, to be followed in the fall by book two in the Prescription For Trouble series, Medical Error.

To learn more about Michael Palmer, visit his website. And, of course, if you'd like to know more about my own writing journey, check out my website. My thanks to Michael for taking the time to provide expert answers, and to my friends at Writer Unboxed for letting me participate in the original interview.

Late-breaking news: Leave a comment on this blog between now and 9:00 PM Central time on Sunday for a chance to receive a copy of The Last Surgeon. Check this blog Monday morning for the name of the winner. (If you've already commented, you're already entered).


BJ Hoff said...

Great interview! Informative, and not for medical fiction writers only, but for any novelist.

Enjoyed insights from both of you.

CandaceCalvert said...

Excellent, informative interview, gentleman--thank you. I particularly liked the mention of Wikipedia as a "medical source"--I use it often as a reference for my Mercy Hospital series. Wonderful too, was Dr. Palmer's reminder that it is character and conflict that carries a story forward--not research detail, even exciting medical tidbits. I agree completely that it can be especially effective to show medical scenes from the point of view of the patient or trauma victim. This feels so immediate to the reader and nicely "filters" the need for highly technical medical detail. Thank you again for sharing your expertise here, and I look forward to Dr. Palmer's newest novel as well as the upcoming release of CODE BLUE!

Candace Calvert

Mark said...

Sounds like a great book

Andrea said...

Dr. Mabry -

Nicely done! I look forward to reading 'Code Blue' soon! And I would like to read Dr. Palmer's as well.

Blessings -



I am hosting a giveaway of Ronnie Floyd's latest on my blog. Here's the link:

Please come by to comment and follow. I'm also on Twitter and Facebook! Thanks!

Carol J. Garvin said...

Having inside knowledge of your chosen subject matter helps to keep facts and dialogue authentic. Even researched material can be presented with small inaccuracies that would leave knowledgeable readers raising their eyebrows, so it really helps to have someone "in the know" as a beta reader to catch them. Thanks for introducing me to Michael and his books... more good reading awaits me. :)

Cynthia said...

Haven't read a Palmer book in a while, I'd love to win this one

carla stewart said...

Thanks, Richard and Michael, for an informative post. As an RN, I don't shy away from medical scenarios in my novels (after double-checking and research of course), but I'm toying with going a little deeper in the medical waters with my next novel. This is very timely for me.

Would love to read Michael's next book.


Cynthia said...

Haven't read a Palmer book in a while, I'd love to win this one

Mark said...

Sounds like a great book