The Art of Writing Medicine – Introduction

I think everyone gets a strange mixture of feelings when reading characters who do the same things we do. When a character in a piece of writing has the same hometown, or the same hobbies, I always get excited to see how true the details ring – never wanting the story to get bogged down with the shout-outs, mind, but interested enough to see if the writer knows what they’re talking about. It’s always the most fun, though, when someone has the same job as me.

You see, I’m a physician. And people love to write about physicians, about medicine; in fact, we’re one of the great tropes of genre fiction. Sci-fi, thrillers, even romance novels love to have physicians in them. It’s a perfect setup! If you’re writing a noble protagonist, who better to be selfless and caring, dedicated to healing the sick and doing good works for all? If you want a slick, smarmy villain, who better than the thoughtless physician who cares nothing for patients, deep in the pockets of the pharmaceutical agency or some other sinister cabal? We do half-crazed pretty well, with all kinds of pretensions to playing God; mad doctors have been a staple of science-fiction and fantasy since Frankenstein and Moreau. A dashing love interest for the romantic hero or heroine – who wouldn’t want to snag a rich doctor, probably good with kids and not too bad on the eyes? The physician is one of those great tropes in fiction that can go any way you please, hero to villain to anything in between.

Even when we aren’t the focal point, doctors make great Fifth Business, as Robertson Davies might have said. Physicians can be great plot propellers, even if they aren’t main characters – who better to provide exposition to a sudden health crisis, or be forced to reveal some terrible secret, or be a focal point that the heroes must find to heal an injured comrade. Really, a physician can be almost anything in the story, and done well, there’s almost no role that we can’t fill.

Done well, though – there’s the problematic thing.

As with any field, medicine can be a hard thing to write. There is a lot of detail involved, and getting something wrong can turn a knowledgeable reader into a ruthless editor. This is no different from computer science, or history, and it can depend on the scale of the error; getting the name of the surgical instrument wrong is a far cry from an unrealistic portrayal of childbirth or a head injury. As well, getting the details right doesn’t help if the scale of detail swamps the reader. I once wrote a story where a crucial plot point depended on the reader knowing how chromosomes divided during reproduction, and while I think I did a good job explaining the process, it still was nearly half a page of a cytogenetics lecture. It can take a lot of skill to do this properly – or to realize if there’s a better way to explain it altogether.

My next few posts will be dedicated to the art of writing medicine. Sooner or later most writers have some medical plot point or physician character, even if minor. In my next post we’ll talk about some of the common pitfalls that writers experience beyond just getting the medical science wrong. After that, we’ll take a look at how to write a good physician character, how to write believable medicine in your fiction, and we’ll even look at how to use it in “realistically unrealistic” ways for those of you who like your medical science mad. I’ll talk about other health professions in fiction beyond the physician – after all, multidisciplinary teams are the norm these days – and finally, we’ll look at some interesting ways that medicine could be used beyond the routine tropes of fiction.

I’m looking forward to this Grand Rounds of Fictional Medicine, and I hope you are too.

Character Study – It’s All About Soles – Building a Character from the Ground Up

The funny thing about sitting with your eyes at street level is what you notice first. The other day I had some time before court and was sitting at a local DC pastry shop. The shop is on a slight hill, and most of it is below grade. As a result, the first thing I see out its window are shoes and pants cuffs. I decided to play, “make-up-a-stranger’s-life-story” based on what I could see. Ask any writer and I suspect he’ll tell you that he plays a version of “make-up-a-stranger’s-life-story” every time he goes out. It’s one of the ways that I come up with character descriptions.

While playing the game using shoes and the edges of pants, I realized how often quick assumptions were accurate. The shoes often did predict the rest of the outfit. A pair of scuffed, mud-splattered work boots pushed a rolling cart up the hill. Frayed light blue jeans hid the boot tops from view. When their owner made it further up the hill, I wasn’t surprised to see a gray-haired stoop shouldered man behind the cart. His face was as creased and lined as his faded blue jeans. The pair of trendy black and white sneakers over pristine blue jeans, on the other hand, belonged to a 20-something student or tourist.

When we create a character we have to visualize everything about him. Our readers need to see the entire character. Outfits matter. Despite the popularization of an unsustainable media image, a warrior princess shouldn’t be in three inch heels. The successful business man shouldn’t be wearing grubby sneakers on his way to work. As writers we can add depth to our characters by upsetting common stereotypes- no, not the racial profiling ones, the ones like a lawyer always should be in a suit and tie.

Writers vary in how much detail they write down in advance about their characters. Some of us do detailed character bios and interviews. Numerous software programs create mechanisms for us to record the information. You might not consciously think about what shoes your character is likely to wear, but your readers will know if you got it wrong. If you deviate from expectations – say, lawyers wear suits and dress shoes to court- you need a reason your readers will accept for the deviation. The scene in My Cousin Vinnie where Vinnie shows up in Court in a purple prom tux is great because the outfit is so ludicrous. It provides additional humor. The audience accepts the sight gag because we know his suit’s been destroyed and Vinnie explains what he had to do to find something not completely objectionable for court that day.

In creating character, shoes are one of those little details that matter. It’s not enough to know that your main character wears sneakers. You need to know whether the laces still have their aglets. Does he tie his shoes or are people always telling him to do so? Will those details make it into your story? Maybe. The fact that your character is always stopping to tie his shoes might be a plot device or character trait that lends depth and reality to your story.

As a writing experiment, go someplace where your vision is restricted like the basement pastry shop I was in before court. Puzzle out the rest of the outfit from on that first limited view of the person. Once you have an outfit, flesh out why your character chose those clothes that morning. Is she out sightseeing? Is she in uniform? Is she taking her son to the playground? Now, what in her life brought her to the moment you saw her? What happens next?

Writers get inspiration from all sorts of places. Sometimes even a fabulous pair of shoes.

What I Learned from The Stand…a Blog in Two Parts, but Really One Big One.

I find it hard to believe that I haven’t talked to you guys since November. It feels like just yesterday we were strolling down Pumpkin-Head Lane counting all the piked up zombie heads.

My, but the year has flown. I haven’t made any New Year’s Resolutions to write more, or even write less. I haven’t made any false promises to myself. Truth be told, I never was any good at that sort of stuff.

Every promise I’ve ever made to myself I’ve broken. So, I’ve found it hard to write an advice column on writing when in all honesty, this is the first time I’ve put pen to paper or word to screen since my last blog.

But, I’ve found some minor successes inside of these past few months of barren word counts. It’s something I wish I did more of.

Not dishes, not chores, not even going outside to sing and dance and play in the rain…although, if we were to get some rain right now I’d probably do a cartwheel. Dry season sucks. Especially when you get the humidity of a mid-afternoon thunderstorm without the relief in the release of the pouring rain.

This is a little something that I’ve forgotten to do in the age of fancy whiz-bang toys and video games, in a world where entertainment value is measured by how much product we can place in a thirty second television spot.

That’s right. I picked up a book.

And then I picked up another book.

And another.

It all started with 11/22/63, I’d always much rather preferred my Koontz to King. For reasons I can’t even begin to explain. But, I picked it up on a promise to a friend. Stephen King was in town out in Hillsborough County where he’d been snowbirding since probably before I was born. Since he had a winter house on a private island out there, he decided to do a book signing at the local Barnes and Noble. It was my first book signing event for a big time author with a big time lead in.

I agreed to go with my friend, who was a much more devout fan than I. So, we piled into his trusty old Civic and drove the three plus hours over to the west coast of Florida. We got there reasonably early, considering we got up at like the butt-crack of dawn. I called the book store halfway there to make sure it wasn’t a waste of time, only to be told by a friendly book seller that people had been camping out all night.

All. Night. Long.

And that just blew my mind, especially considering we were there in the early days of November and there was holiday shopping and stuff still to come. I’d seen the crazy campers for concert tickets or Black Friday deals, but a book store? For a book signing? You’ve got to be kidding me. There won’t be a line.

I mean, don’t people just watch TV or play video games now? We saw all the video footage from the riots in London where electronic stores were smashed out and ransacked by looters. In that very same footage we saw the nearby Waterstones unscathed by the civil unrest.


I couldn’t have been more wrong. And it was one of those little moments where the light bulb goes off and the heavenly choir sings. I felt good.

I felt home, even though I was three hundred plus miles away and standing in line for hours on end.

Truth be told, I had thought that humanity was lost and truly for a moment believed that arts were a dying life form.

When I got there though, it was amazing.

For those that have never gone to a book signing, don’t be afraid. This was my first too.

In the Superstars Seminar where I met my fellow Fictorians, I remember hearing a topic of discussion on the anatomy of a book signing from the author’s perspective. To see it from a reader’s perspective was a whole different game. I think I was able to appreciate it more for the event it was because I had not been one of those die hard fans.

But, the line was through the building and wrapped around the store twice. There were literally hundreds of people there.

And like three cops to keep the peace.

But, it was the most peaceful setting I think I had ever been in for a major shopping frenzy. I mean, people were jovial and on their best behavior. Neighbors in line were striking up conversations like old friends. And living here in South Florida, it was a rarity to see people actually get along.

In the midst of all the chaos and violence, hundreds of people had found their peace in a common interest. And it was like kumbaya campfire tales.

Seriously. For being herded like cattle through all the hot new best sellers and teenage vampire and angst lit, it was the best experience of my life. The two to three hour line really didn’t seem so long. People were reading on their kindles and nooks, sonys and hardbacks. And it was just this great…almost comic-con like atmosphere.

B&N get my respect for having it down to such a controlled science. Early people get one color, other people get another, line up here, stand there. Go this way, now go that way. Hand your book to a bookseller who runs the assembly line down to Mr. King to another bookseller then to you.

And Stephen King wasn’t doing a Q&A or interview or speech or anything. It was just a strict book signing. And halfway through, we found out the poor guy had the flu. And was there to keep his prior engagement to his fans. He didn’t cut the line short or end it at like 100 people. He swore he would stay until the last fan got their book signed.

And he sure did.

For that, I respected the man that much more. I gave him another look.

It was a truly inspiring event that I probably wouldn’t have even considered if my friend didn’t twist my arm and make me go.

But I read 11/22/63. And I enjoyed the hell out of it. As I was reading, characters and events from other books popped up randomly like King had woven this one giant tapestry of a world. And it made me curious for more. So I went back in and re-read The Dark Tower. And saw more references pop up.

The Dark Tower was a book I really hadn’t read in….wow. Close to fifteen years. All I remembered was it was a “weird, gothic western”….and when I envisioned Golden Hills, the memories of my childhood under an old sycamore came flooding back. And the first thing I thought of was The Dark Tower brand of weird western. And even though I hadn’t read the book in close to fifteen years and probably forgot more than I even knew in the first place, the atmosphere just kept creeping back to me.

And I wanted it. Bad.

So, when I finished The Dark Tower (No, I didn’t read the whole series. Come on! I still have to finish the Wheel of Time), I turned my attention to a book I had never read before, but had always been told to look into.

That book was a little novel called The Stand. You may have heard of it? Seriously. It’s little. Like, maybe only 100 pages. Go ahead, you can get through it in an hour.

And I did this weird stutter-stop when I read it. I’ve been slowly paging through, I think I made it to like 33% of the book and now I’m definitely hooked again.

The one thing that kept sticking out as I read it was how familiar it all SOUNDED.

That’s a key word, folks.

I’ve written the way I’ve written for close to six years. And every time I’d write something, I’d be told all sorts of nasty things about POV and how you SHOULD DO THINGS!

And if it’s not proper english with proper sentence structure and proper thoughts and proper this that and whatever…

Truth is, the only thing proper is what’s proper for your story.

Cormac McCarthy, one of the literary darlings of the 21st century absolutely despises punctuation and quotes.

But everyone loves his stream-of-conscious style writing.

And as I was reading The Stand I kept coming back to my own books.

I noticed a simple stylistic similarity that I never would have picked up if I didn’t read my own books fifteen times.

Me and Stephen, you see, we’re a lot alike.

When he writes a POV, he writes a POV. That’s all there is to it. You can’t get any farther into that character’s skull without worrying about how you’re going to get your head out of his nose.

And I loved it. Every moment.

I’ve always said that the reason I write is because these are the types of stories I want to read.

Had I known there was a multi-million dollar author out there doing the exact same thing.

Well then.

Maybe I wouldn’t have started writing!

It’s really amazing to look at the different styles of writing out there. Patrick Rothfuss has a very literary style. His words are like honeyed words on a lover’s lips. R.A. Salvatore has a nose for a good adventure yarn. Stephanie Meyer, vilified in the “circle” has a great knack for being able to connect to a teenage voice.

My advice to you this month is to read more. Stress less.

If you get lost in your own story, go pick up someone else’s. There’s plenty out there that just might light the fire in your pants. I can’t read books to study them. I hate that word, study. It’s nasty. Like eating mud pies. And not the good chocolate kind. I read to enjoy myself.

I write for the same reason.

You never know what you’re going to learn on the road less traveled.

And be careful about that guy sitting next to you hocking up a lung at work. He just might have Captain Tripps.

Seriously, for the first three weeks after reading the first part of The Stand, I was jumping at every sneeze and cough.

*Sneezes* Oh…er… Excuse me. It’s just allergies. 😉

Happy Reading!


Checking In On Those New Year’s Resolutions

Last year was spectacularly unproductive for me. I started on a roll but the unexpected death of someone close to me left me shattered and barely functioning for the rest of the year. So on New Year’s Eve, I set myself some goals for 2012. I do this pretty half-heartedly every year. After all, nobody ever sticks to their New Year’s Resolutions, right? Only this time I meant it. Really, really meant it.

I had a big goal in mind when I set my resolutions: to finish the current WIP before World Fantasy in November. That meant some serious edits. As of New Year’s Eve, I had a mostly complete first draft. It had issues – some big ones. A flabby middle (which I’ve christened the FM), lack of relationship building between key characters, some subplots were little more than a suggestion. I had two viewpoint characters but most of the manuscript was written from the perspective of one of them. It had been suggested that I needed a third viewpoint character and although I knew exactly what I wanted to do, it was difficult and very unlike anything I’d ever attempted so I had been putting off starting. In short, I had a lot of work to do.

So with the new year, I had a renewed focus. However what bothered me about focusing on edits for the next ten months was that I wouldn’t actually be writing during this time. Although the edits were necessary, it seemed I was facing a year of lots of writing work but few new pages.

So my New Year’s Resolution was deceptively simple: write a page a day. Something. Anything. Even while editing. Regardless of how it happened, I would produce a page a day of new words, be they new scenes in the WIP, blog posts, short stories, whatever. An additional benefit was that I’d be learning to keep two projects in my head at once, which is something I struggle with.

For a 31-day month, one page a day – assuming a standard 250-word page – comes to 7750 words. Doesn’t sound like much, does it? But if I could consistently produce a page a day through 2012, it would give me 365 pages of new writing. I figured it was worth a try.

So four weeks into the new year, here’s how my resolution is panning out…

Week 1: Motivation levels are high. I’ve just had a week off work so I’m feeling somewhat refreshed. I’ve achieved my goal of one page a day every day this week. Word count: 3189 words, almost half of my goal for the month.

Week 2: Motivation is still high although I’m starting to flounder a little. I’ve spend some time this week on a new short story and a couple of blog posts. Not as much time on the WIP as I should have. Word count: 2616.

Week 3: This week has been almost easy. I feel like I’m developing a habit and I’ve worked on the WIP every day instead of letting myself get distracted with writing other things. Word count: 2988.

Week 4: Now it’s getting tough but I’ve not missed a day yet. Work count is 1974 and the week isn’t over yet. I’m surprised I’ve lasted this long and am starting to think that maybe I can actually achieve a page a day for the whole year.


The big lesson I’ve learnt is that I can write every day, which I didn’t think I could do. My usual pattern is four days on then one or two days off, and I’ve never really tried to push past that before. I might be tired and a bit brain dead or, like tonight, ill and having trouble concentrating, but I’ve found I really can do it if I want it bad enough. And I think this is the first time I’ve ever had a New Year’s Resolution that lasted four weeks. Bring on February!

Okay, ‘fess up. What’s happening with your New Year’s Resolutions?