Doctors just wanna write books

                         with michael palmer 

        Michael Palmer and me, with one of our doctor-students


Over the weekend, fellow thriller writer Michael Palmer and I taught an intensive writing workshop exclusively for doctors who want to write fiction.  Yeah, I know what you’re thinking: Doctors?  Don’t they make boatloads of money?  Why would they want to trade in their stethoscopes for a semi-impoverished life as a novelist?

The truth is, doctors don’t make boatloads of money these days.  Michael and I are both physicians, so we understand their lives.  They make comfortable livings, it’s true.  But their jobs are stressful, the hours are long, and there’s always the threat of a malpractice suit hanging over their heads.  Many of them want out of medicine.  And they want to tell stories.  They’re hungry to tell stories. 

They’re just like other budding novelists — except they’ve got the M.D. behind their names. 

Among agents and editors, though, doctor-writers have bad reputations.  Some doctors are indeed arrogant, simply because they’ve achieved so much in their careers and they’re used to getting straight A’s.  They assume that novel-writing is like any other intellectual endeavor: you study the guidelines, read a few books about writing, do the work, and of course some NYC editor will want to publish your 600-page masterpeice.

It’s a rude awakening when they get their first rejection letter.  They’re stunned.  Maybe they’re angry.  What’s the trick? they demand.  Whom do you have to kiss up to?  That’s the secret, isn’t it?  You have to know someone!

Over the weekend, Michael and I had to give them the sobering truth: getting published is hard.  Hell, writing is hard.  Even after years as bestselling novelists, both Michael and I admitted that we still get scared every time we start a new book.  We wonder how we did it the last time, and whether we can pull it off again.  We told them that just coming up with ideas for our next books makes us lose sleep. 

But surely that’s got to be the easy part, most students think.  Doesn’t everyone have ideas for a story?

Of course they do, we explain.  But not everyone has a great idea.  And so we take them through a what-if exercise.  We ask them to distill their books down to one or two-sentence questions.  I give them a few what-ifs that I’ve used: “What if a medical examiner encounters a dead woman who is her exact double?” (Body Double).  “What if a serial killer working in a medical lab uses patients’ blood tests to choose his victims?” (The Surgeon).  Michael and I ask our students to share their what-ifs and we critique them.  Many of them fall flat (“What if there’s an evil pharmaceutical company?”).  A few of them hit home runs.  We tried to explain why the good ones worked, but we couldn’t always come up with concrete reasons why they did.  All I could say was, “I know it when I feel it.  When I get that emotional punch.  That’s a good idea.” 

In short, knowing when it’s a good idea is subjective, not logical.  It’s what I feel in my gut. It’s also how I write my books — not with any sense of logic, but by feeling my way through it.  By instinctively knowing what’s dramatic and what’s not. 

And that is a pretty unsatisfying answer for people who’ve been educated in the hard facts of science.  They wanted formulas.  They expected algorithms.  They don’t like this “you’ll know it when you feel it” stuff. 

Halfway through the first day of teaching, Michael and I could feel their frustration.  They didn’t get it, and they were starting to despair.  They wanted to know the secret and we just weren’t telling them!  

But what we told them is the secret to good writing: you feel your way through this.  I don’t use an algorithm to create a character or write dialogue.  I don’t even know who my characters are as I breathe life into them; they take shape on their own, and I just coax them along, massaging color into their faces and their lives. 

By the second day, I think some of our students were starting to understand that writing books isn’t like earning a degree.  You can try and try for decades, yet never manage to write a decent book.  Some of them came with the mistaken belief that they could write three chapters of a novel, and an agent would take them on, just like that.  “Isn’t three chapters enough to show that I can do it?” they ask.

We told them: no, it isn’t.  Three chapters doesn’t tell an agent that you can sustain a story.  It doesn’t prove to her that you understand drama and conflict and pacing.  Write the whole book.  That’s the first step to proving you’re a writer.  

At the end of the weekend, they were exhausted.  And Michael and I were even more exhausted.  In those two days, we had tried to impart the wisdom we’d collected over a combined forty five years of writing experience.  You just can’t teach it all in two days.  But we did teach them the most important thing, and it’s this: writing is hard, and not everyone can do it. 

Even if everyone thinks they can.


22 replies
  1. wordworker
    wordworker says:

    Oh Tess, I needed to read this post right now! Thank you for the reminder – the beginning of a new novel is hard and it’s not just me! I signed on for NaNoWriMo for the first time and the last two days have been quite unproductive.

    Hey Tess? What if you were recovering from a trauma and your husband’s estranged and deranged mother moved in across the street and convinced her ‘cult’ of new friends that you are one of Satan’s own? Would you want to read about that?

  2. joe bernstein
    joe bernstein says:

    tess-i think doctors have to spend so much time learning their profession that they can develop a little tunnel vision along the way-not good for a fiction writer-you came to medicine by way of being an anthropology major-hardly a typical route,but one which gave you a broad exposure to other than technical subjects-maybe that’s why you are such a good writer

  3. wordworker
    wordworker says:

    Tess, just to clarify – I’m not asking you to read my work! I’m just wondering if my NaNoWriMo novel idea would sound interesting to anyone other than me and the people who love me even on bad-hair days.

  4. JanetK
    JanetK says:

    Interesting. Makes me wonder — if doctor-writers have a bad reputation with agents and editors, what’s the reputation of lawyer-writers?

    And I wonder if doctor-writers who stay in medicine feel that writing has made them better doctors?

  5. Allison Brennan
    Allison Brennan says:

    Fantastic post. It’s heartening to know that even the best writers out there, like you and Michael Palmer, don’t write books in your sleep, that you work hard for each and every story.

    I remember a friend of mine who was so impressed when I told him I sold a book. It’s true, most people think that they can easily write a book “if they had the time”. My friend, a high level attorney in the state, gushed. “Everyone wants to write a book, but you actually did it, Allison.” I found out chatting with him that he’d been trying to write a book for years and admitted to me that it was hard work. Few people who haven’t actually finished a book get that.

    SSHHELL says:

    Successful authors are those individuals that people just enjoy listening to when having a conversation. Also, you know the person that explains something to you and you actually understand what’s being taught?–that’s a good author. Some doctors are just boring when they converse, or they speak in quips(corny). The real truth is you can’t teach anyone to be a good author/writer–you can only provide the mechanics, the real success comes from the talent within. Sorry, docs, but if your patients seem to want to stick with medical questions and answers, give up the writing dream. (your family, friends and peers are a captive audience, they don’t count)

  7. Tess
    Tess says:

    Woodworker, you betcha I’d read a book with that premise! But I’m seeing it as a black comedy…

    And for all you aspiring novelists out here, whether you’re doctors, lawyers or whatever, I have one piece of advice: READ. Read good novels and bad novels. See how other authors have done it. It’s the best training I can think of for learning how to write.

  8. struggler
    struggler says:

    “Cece Says:
    I’ve always said writing is like learning to play a musical instrument”

    So do you blow it, pluck it, or just bash the hell out of it?

    As for me, well, it’s probably going to be a mixture of all three….same could be said about how I feel about my therapist

  9. BA
    BA says:

    Hey – all you authors on here: I am not an author, but my friends and I are all waiting for anyone who can write AND appreciates Tess’s style and talents. So, we’re waiting for YOUR style! We’re sitting here in our reading chairs, palms up, ready for your work! Bring ’em on!

  10. NewMexicanAnn
    NewMexicanAnn says:

    Please pardon me for changing the subject some, but, boy, I just saw Tess on Travis Smiley. Good thing I had insomnia otherwise I would’ve missed it.

    WELL DONE, Tess!!!!

  11. Trace_ZBullet
    Trace_ZBullet says:

    New here, just would like to say that you give great advice! As Miss Snark says “Good writing trumps all.” I’m writing my second novel for NaNoWriMo and it’s been tough! Writing definitely isn’t easy but it’s exhilarating when your characters start to get lives of their own and your plot blossoms.
    Still unpublished, but hopefully not for long!
    Trace a.k.a Lydia
    P.S. Tess, I love your books. If I can ever write half as well as you can, I’ll be truly blessed.

  12. NewMexicanAnn
    NewMexicanAnn says:

    Wow! You folks are terrific! I was going to sign up for NaNoWriMo, but I’ve been going through some upheavals in my life. Also, I wrote a humongous “short story” for a Halloween Invitational and now have another short story to write for a competition. As with me, I bet writing has put some fire in you folk’s bellies, too, lately.

  13. lynnh32
    lynnh32 says:

    LOL…and I thought that it was the HMO Insurances that drove you to writing:) I work for a psychiatrist…and they drive me nuts with insurances:)

  14. Mikal
    Mikal says:

    As a college student, I find that many pre-med, science oriented kids are very into algorithms and formulas.

    It gives me hope as a not-really science kid that those damned smart kids will not succeed at everything in life. =]]

    By the way, I love your books. Looooooove!!

  15. h2ofilic
    h2ofilic says:

    I am encouraged to try writing after reading your blog. I can’t tell you the number of people who have suggested that I write–but I am CHICKEN! But, I’m not teaching at the moment, on unpaid disability, and there probably won’t be a “better time” than now. And, I am one of those people who can explain difficult things which my science and health students greatly appreciated! I am also a voracious reader of all sorts of books; I check out 9-10 books from the public library every two weeks!

    I love your books, especially the medical thrillers although I also enjoy the Surgeon series. It’s one of the few series that my adult daughter and I both like…

  16. putney1968
    putney1968 says:

    First time I’ve run across your name…and I am intigued. I graduated from medical school in 1979 also. I harbor a fantasy to become a published writer ( who doesn’t?)and admire your talent and drive. I keep telling myself, OK, one of these days my career will stop consuming my time and I can get serious about writing. More on this later.

  17. kanaka52
    kanaka52 says:

    As an alumnus of the recent writing course on Cape Cod, I highly recommend it to any physician who is, or thinks he or she wants to be, a fiction writer. As Tess pointed out, judging from the large crowd at the course, a lot of doctors want to be writers. To get the maximum benefit from the course, you really should have a completed manuscript you can pitch to the many agents and publishers who attend, but it’s not essential. I didn’t have a manuscript, so there was no point in me meeting with the agents. Michael Palmer and Tess presented a thorough, honest picture of the writing process and the publishing business, which can be a bit discouraging. You have to analyze your own motivation. Do you expect to be able to quit your day job and support yourself and your family by writing? Obviously, a lucky few can do that, but the odds are against you. Or, is writing a creative outlet that makes your life enjoyable, or at least more bearable? I just read an interview with Kurt Vonnegut, Jr., who recommends that you write a six-line rhyming poem, read it to yourself, then tear it up and distibute the scraps in different waste receptacles so no one else will ever see it. In this way, you have the satisfaction of having created something, without suffering the agony of trying to get it published or the sting of criticism.

    One maxim that came out in the course was, “You can’t fix it until it’s down on paper.” As I recall this was from Tess, who was quoting another writer. So whatever your goals may be, if you want to write, start writin’.

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