10 decisive steps to write a good medical thriller
For many physicians and other professionals, aspirations to create a work of fiction are not uncommon – and with good reason. We are, after all, a generally well-disciplined bunch capable of taking on complex tasks, and there’s certainly no shortage of excitement and drama in medicine and surgery – enough to feed some compelling stories. Nonetheless, writing a novel is a major undertaking, and it requires persistence, patience, and dedicated time, especially for one with a busy medical career.
Getting started is not easy. Writing workshops are helpful, and in my case, I’ve tried mentoring some of the best. Before writing my novel, I attended workshops for aspiring novelists, given by renowned physician authors Tess Gerritsen (Double Body, The Surgeon) and the late Michael Palmer (The company, the fifth vial).
Writers are often advised to “write about what you know”. In my case, I combined my medical knowledge and my experience with the thoroughbred racing world to create a thriller that one reviewer described as “Dick Francis meets Robin Cook”. For those who have never read the Dick Francis series, he was a renowned detective writer whose novels centered around horse racing in England. Having been an avid reader of both authors, this comparison was the ultimate compliment.
So, in that context, here is my distillation of 10 key points about the craft of writing a great thriller, based on my own experience in writing the novel. Shedrow, with a certain wisdom shared by a few legendary writers.
1. Start with the big “what if”. Every good story begins with this simple “what if” question. What if a series of top executives in the managed care industry were serial murdered (Michael Palmer’s The society)? What if a multi-million dollar stallion suddenly died under very mysterious circumstances on a supposedly secure Kentucky farm (Dean DeLuke’s Shedrow)?
2. Put a MacGuffin to work in your story. Popularized by Alfred Hitchcock, the MacGuffin is that essential plot element that animates virtually every character in the story, although it can be rather vague and meaningless to the story itself. In the iconic film pulp Fiction, the MacGuffin is the briefcase – everyone wants it, and we never find out what’s in it.
3. Rhythm is essential. Draw the timeline of emotional ups and downs in a story. It should look like a series of ups and downs that escalate until the ultimate crisis. Take advantage of the fact that after one of these emotional peaks you probably have the reader’s undivided attention. This would be a good time to provide some backstory or fill in the necessary information for the reader – information that may be essential but maybe not as exciting as what just happened.
4. Torture your protagonists. Just when the reader thinks the hero is finally home free, throw in another hurdle. Readers will sympathize with the character and be drawn to the unexpected obstacle.
5. Be original and surprise your readers. Create totally unexpected, yet believable twists. It’s easier said than done, but it will go a long way in making your novel original, compelling and unpredictable.
6. As a general rule, consider short sentences and short chapters.. It’s strictly a personal preference, but who can argue with the short chapters of James Patterson or the short, engaging sentences of Robert Parker? The length of the sentence can also be changed for effect, with shorter sentences serving to intensify the action or increase tension.
7. Avoid the passive voice. Your readers want action. This is an important rule in almost all types of writing.
8. Keep descriptions brief. Long, drawn-out descriptions of character appearances, or even set descriptions, are easily exaggerated in a thriller. The thriller genre is very different from literary fiction in this regard. Stephen King advises writers to “just say what they see, then go on with the story.”
9. Maintain the reader’s interest throughout. Evaluate each chapter end and determine if the reader has enough reasons to continue reading. Ask a question, end with a minor cliffhanger, or at least make sure there’s enough tension built up in the story.
10. Edit aggressively and cut the lint. Ernest Hemingway once confided to F. Scott Fitzgerald: “I write a masterpiece page for 91 shitty pages. I’m trying to put the shit in the trash.
Dean M. DeLuke, DDS, MBA, is Emeritus Professor of Oral and Facial Surgery at Virginia Commonwealth University and author of the novel Shedrow.