Most people are surprised when a doctor writes a novel. I was surprised that more of us do not. After all, doctors are trained to be pretty good storytellers. Just think about it for a moment. Every time we see a new patient it is the start of a new story which we narrate. We weave a tale from signs, symptoms, and laboratory tests, and at times write an entire novel at one sitting. Read a hospital discharge summary on a difficult case and you will see a mystery novel unfolding right before your eyes. You don’t believe me? Read on.
Almost all mystery novels open with something unpleasant happening to the victim (read, patient). The perpetrator (disease) causes harm, but does so in such a sly and covert fashion that the protagonist (doctor) is left in the dark. Through diligence and careful observation, new clues (symptoms, signs, laboratory tests) are discovered and the villain (disease process) begins to take shape and structure. If it is a good novel with a happy ending, the perpetrator is uncovered by the protagonist and is punished or eliminated (treated successfully). As you see, there is not a whole lot of difference between mystery novels and complex discharge summaries. Thus, in a sense, doctors are trained to be writers and storytellers. Would you like some shining examples? Try Tess Gerritsen, Michael Palmer, Robin Cook, and Michael Crichton.
When it comes to medical mysteries, no one can compete with physicians. Some non-physicians try, but their efforts are usually unconvincing because they lack authenticity. Doctors, on the other hand, know a great deal about the subtle clues and esoteric tests and human dramas that are present so often in medicine. They are expert at seeking clues and integrating them. Physicians are truly detectives and it has always been that way. The greatest detective of all was Sherlock Holmes who was based on a real-life physician. Holmes’s creator, Sir Arthur Conan Doyle, was himself an ophthalmologist who trained at Edinburgh Infirmary. It was there he encountered a brilliant professor of medicine, Dr. Joseph Bell, who could tell so much about a patient on a single glance. And thus Sherlock Holmes was born.
So, if you are a physician contemplating writing a medical mystery, by all means begin, for you have a distinct advantage which will serve you well. If you are not a physician, I doubt you will be inclined to write a medical thriller, but then again your mystery novel is almost certain to contain aspects of medicine which have to be accurate and authentic. Here is a short list to illustrate that point. (1) Take murder covered up as suicide. An elderly woman dies of an apparently self-inflicted gunshot wound to the head, with the weapon still clutched in her hand. Her fingerprints are all over the revolver. An open and shut case, you say. Whoa! The investigating detective noticed the victim’s swollen fingers and questions her physician. The poor woman had severe rheumatoid arthritis involving the interphalangeal joints which rendered her totally incapable of squeezing the tight trigger on the weapon. Thus an apparent suicide becomes obvious murder. Or consider (2) death caused by a single icepick wound to the chest. Anyone could have done the deed. But wait! The wound had to be perfectly placed in the substernal area and directed upward through the diaphragm, so as to shred the heart’s left ventricular wall and cause massive hemorrhaging. Who could have performed such a delicate murder? A surgeon? An anatomist? A nurse? Or the medical student who rented a room above the victim’s garage? And finally, let us dwell on (3) a case of chronic arsenic poisoning. Who would know its signs and symptoms and perhaps the cleverest way to administer its unpleasant tasting toxin? A physician, of course, who had to spend long hours attempting to discover why a nice, little man was slowly wasting away with nausea, abdominal pain, and peripheral nerve damage. And this is how the good doctor came up with the diagnosis. On an afternoon visit to see his patient, the doctor examined the man’s hands which had lost feeling and discovers there are now transverse, white lines across his fingernails. These are Mees’ lines which are characteristic of arsenic poisoning and would account for all the patient’s signs and symptoms. Careful detective work by a forensic specialist uncovers the manner in which the arsenic was administered. The patient’s sweet wife had been lacing her husband’s spicy fish dishes with the poison in order to bring about his demise, so she could collect on his huge insurance policy and run away with the gardener (who supplied the arsenic).
I think the reader gets the gist here. When it comes to medicine in a mystery novel, one needs to be a physician or have a professional guide to assure authenticity, for without it the writer can never transport the reader into the world where there is suspension of disbelief. How then could the non-physician writer go about finding such a helpful professional? I suggest visiting a nearby university medical center and speaking with someone in the public relations office. You would be amazed at the number of doctors who are currently writing or contemplating writing a mystery novel. They will be happy to lend a hand because after all they are by trade pretty good storytellers.
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