A writer’s purpose

My writing career has been at a standstill lately, perhaps due to being distracted by various health concerns and family events, and discouraged by a couple of negative reviews. Looking back at my own advice about dealing with writer’s block, taken from my short ebook Wellbeing for Writers:

“Inspiration tends to come in waves. There are times when writers are full of ideas. At other times they may have none, which is always frustrating, and presents a major problem for those who earn their living from writing or have publishing deadlines to meet.

There may be an obvious reason for feeling blocked. I always find myself unable to engage with a new book immediately after finishing the last one, even though I am only really satisfied and happy when I have a writing project underway. I make use of such fallow periods to organise and de-clutter the paperwork in my office and the files on my computer, and to market the book I have just completed.

Some of the other causes for writer’s block, for example striving too hard for perfection, feeling upset about rejection or criticism, adverse experiences in another sphere of life, having too many other things to do, or suffering from a depressive mood swing, are discussed in other chapters.

Besides dealing with any remediable underlying causes, there are various strategies for overcoming writer’s block. If circumstances permit it can be a good idea to take a complete break from writing, and do something else for a day or two or even much longer. Preferably this will involve activities, people and places completely different from those encountered in your usual routine, which may provide new ideas. Other forms of creativity, such as painting or dancing, can help.

The opposite approach is to discipline yourself to keep on writing for a set period each day, but again try doing it with a new approach. Clear the clutter from your desk to encourage a fresh start. Write a short and simple piece instead of attempting the major work on which you feel stuck. Some authorities suggest inducing a relaxed state with deep breathing or slow music and then using your non-dominant hand to write something – anything – which even if it turns out to be nonsense may still stimulate the creative flow. Or try writing late at night or early in the morning, when you are half-asleep and more able to access the reservoir of images and memories in the subconscious mind.

Getting started again often presents the biggest barrier, and if you can get past that it will usually be much easier to continue.”

Fair enough, but I also find myself asking what is the point of writing at all? This is what I said in Wellbeing for Writers:

“The most fundamental and compelling motive for writing is for the sheer love of it. Some people feel they were born to write, in the same way that others know from early childhood that they were born to climb mountains, to heal the sick, to do scientific research or to make music. Writing is their vocation, destiny or soul’s purpose; the one activity which brings them ‘into the flow’ and if they are prevented from doing it they will feel frustrated and unfulfilled.

Even if you do not feel quite such a passionate commitment, you may find that writing brings other personal benefits. These could include making sense of your life experiences and challenges, expressing emotion, exploring new subjects, exercising your intellect, or feeling that you are creating something original to form a lasting legacy of your time on Earth.

These inner rewards of writing can be seen as doubly important when you consider that it takes long hours of solitary work to complete a book, and that the fate of the eventual product is unpredictable. Finishing your book, getting it published, receiving positive responses from readers, and receiving royalty payments are all worthwhile outcomes and not to be devalued. But not all writers will achieve these goals. Some books are never finished; others do get finished but are never published; many of those that do get published are seldom read or reviewed; and few authors make a good living from their royalties. The market is currently supersaturated with self-published books many of which, however good they are, will be overlooked. So it is highly desirable for the actual process of writing to be perceived as satisfying and worthwhile. In other words it is just as important to enjoy the journey as to reach the destination.”

I hope my inspiration for writing will return again soon. Meanwhile, remembering what I put in the section on writers’ health, it is better to spend time walking outdoors in the bright sunshine of the New Zealand winter than sitting down at the computer.

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Murder in the Library

Last night, along with two of the other authors entered for this year’s Ngaio Marsh Award, I had the pleasure of taking part in a “Murder in the Library” event in Takapuna. Besides describing our own books, we discussed some questions about crime fiction in general.

My husband came along for moral support but he is not a fan of this genre, and had asked me privately why on earth people enjoy reading novels about something so unpleasant as murder. I agree it is a challenge for writers to create entertainment out of such a serious subject. But crime novels are enduringly popular, and I think there are several reasons for this. They have a clear structure and focus, with a mystery to be solved and a solution at the end. They can provide insights into criminal psychology, and raise ethical and moral issues. The good ones have interesting characters and settings as well as convincing plots.

The crime genre as broadly defined covers novels of many different kinds. The traditional whodunnit, often featuring a private detective who is more competent than the police, begins with discovery of a body and ends with unmasking of the killer – usually the most unlikely of suspects from a circle of middle-class characters. This format may now seem old-fashioned but the books of “Golden Age” writers such as Agatha Christie are still very readable. Modern sub-genres of crime fiction are many: cosy, hard-boiled, police procedural, courtroom, spy, psychological thriller, and “noir” from diverse places including Scandinavia, Scotland and New Zealand.

There may be an overlap with other fiction genres, as with my own entry Unfaithful unto Death which combines crime with black comedy, and touches on the themes of corruption in medicine and the pharmaceutical industry. It could almost qualify as a historical novel, because I wrote the first draft in the 1980s following a spell of working as a doctor in general practice in rural England. I had nearly forgotten about the manuscript until I found it among some old papers last year. Reading it through again, parts struck me as rather outrageous compared to my more recent work, and the practice of medicine has certainly changed a great deal since it was written. All the same I decided to publish it without changing the content too much.

The protagonist is Dr Cyril Peabody, who also made a brief appearance in my other two 1980s novels. He is a clever and hard-working doctor who means well but has developed a hefty dose of the arrogance and cynicism which besets his profession, and his bedside manner is appalling. Having failed to gain promotion as a hospital cardiologist because of his awkward personality, he takes what he considers to be an inferior position as a country GP. Predictably he soon clashes with his partners, his patients and his wife. He sets out to improve his status by mounting a trial of a new drug, but finds it has some unexpected side effects. One of the men who has been taking it dies, apparently from a heart attack. Cyril is called to his house in the middle of the night. Having examined the body and considered the history he decides that a post-mortem is indicated, but encounters vehement opposition from the dead man’s wife …

As discussed in a previous post the medical setting provides ample scope for murder both in fiction and in real life.

Writing a medical memoir

Regular readers of this blog will know that in 2015 my husband Brian had a near-fatal heart attack, and that this was followed by a whole series of medical and surgical emergencies affecting our family. I had spent many years working on the medical staff of hospitals and hospices, but experiencing serious illness from the perspective of patients and relatives was very different.

After recovering from the traumas I decided to write a short memoir about them, and this is now available on Smashwords, Amazon US and Amazon UK under the title Across a Sea of Troubles. The first part tells the story of what happened, and the second part is a review of various topics including life event stress, the mind-body connection, post-traumatic syndromes and the role of  the carer.

I wrote this partly for myself as a way of coming to terms with things. Whether it has actually been therapeutic I am not sure – revising the manuscript involved rather too much focus on painful memories. So even if it still not a perfectly finished book, I have decided to publish it and move on. I hope it will hold some value for people who are coping with illness, whether as patients or relatives or health care professionals. But as always when publishing something new, I feel apprehensive about its reception: have I revealed too much personal information about myself or others? does it come across as morbid and self-pitying? is the medical information accurate?

A memoir can be defined as “a record of events written by a person having intimate knowledge of them and based on personal observation”. In contrast to an autobiography, it describes one particular aspect of experience rather than a whole life. Naively perhaps, I have always tended to assume that both memoirs and autobiographies are historically accurate. So I was a little shocked to be advised on one on-line site that it is acceptable, even desirable, to alter the facts to make them more interesting or inspirational for the reader. Although I did wish there were more positive aspects to my own story I resisted any temptation to embroider the truth, and wrote it exactly as I remember, checking all the dates from my diaries. So, rather than one of those books about “illness as a precious gift that transformed my life” it is an honest account of a rather gruelling sequence of events. Here again are the links for Smashwords, Amazon US and Amazon UK. I will share a short extract in my next post.

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Top twelve books 2016

My reading for 2016 once again included mostly mysteries and psychological thrillers set in the UK, a few novels in other genres, and a few non-fiction works on medical and metaphysical topics. Here are the ones I enjoyed most. It was too hard to choose only a top ten, or to rank them in order of preference, so I have included twelve books and listed the titles in alphabetical order. The links refer to the pages on Goodreads.com.

A Dictionary of Mutual Understanding by Jackie Copleton: an original and brilliant novel about the aftermath of the Nagasaki bombing.

After the Crash by Michel Bussi: translated from the French, a mystery novel about the sole survivor of an air disaster.

Black Widow by Chris Brookmyre: a woman surgeon, nicknamed “bitchblade”, is on trial in Scotland for murdering her husband …

Do No Harm by Henry Marsh: reflections of a British neurosurgeon, with numerous case histories.

Exposure by Helen Dunmore: London 1960, the Cold War at its height and a secret file goes missing …

One Mind by Larry Dossey: evidence for the Jungian concept of the collective unconscious.

Spare me the Truth by CJ Carver: a man recovering from a breakdown is challenged to remember the circumstances of his son’s death.

The Light between Oceans by ML Stedman: set in Australia after World War 1, a rather harrowing novel about a lighthouse keeper and his wife.

The Widow by Fiona Barton: should a woman remain loyal to a husband accused of child abduction?

You are the Placebo by Joe Dispenza: neuroscience and self-help are combined in this book about the mind-body connection.

You Belong to Me by Samantha Hayes: a psychological thriller about a woman and her stalker.

When I was Invisible by Dorothy Koomson: two girls, once best friends in ballet class, have become estranged as adults due to a secret from their past.

I hope you enjoy some of these recommendations.

“What are you writing next?”

I recently updated my author interview on Smashwords and one of the questions What are you writing next? made me review my future aims.

I am currently working on a short memoir about the catastrophic series of medical events that affected my family in 2015. There were two reasons for starting this project. First, I hoped that writing about what happened would help me come to terms with it better; as I discussed in an earlier post there is evidence that writing about illness and trauma can be therapeutic. Second, other people who are faced with the challenges  of cardiac surgery, bereavement, and stress-related symptoms in themselves or their families might benefit from reading about what helped me to cope, or otherwise.

Writing this memoir is proving quite hard going. Perhaps I have reached the point of  wanting to move forward in life rather than keep dwelling on what happened. I am also wary of conveying the negative and self-pitying attitudes which can so easily mar this kind of book. I look forward to writing something lighter, though my only recent effort has consisted of some sentimental poetry about cats.

What I would ideally like to write next is a really substantial novel. I have already self-published six short ones, and I think that like the vast majority of the thousands of new books coming out every day they are good enough to provide readers with a few hours of entertainment, but will prove to be ephemeral.

Nobody knows which, if any, modern novels will become classics but it is my personal experience that only the occasional book creates a lasting impression. For example, one that I have just finished reading is A Dictionary of Mutual Understanding by Jackie Copleton, a drama set in wartime Japan. I am never going to write a book of comparable quality, and the ambition of producing my own “magnum opus” seems likely to remain unfulfilled in this lifetime, but I do hope to be inspired towards something new. Meanwhile Blue Moon for Bombers, the middle volume of my Three Novellas trilogy, is free from Smashwords till the end of this month. To download a copy click here.

“Unfaithful unto Death”

My latest novel is a black comedy called Unfaithful unto Death. Here is a short extract:

Chapter 1: A Doctor’s Lot

Somewhere in southern England around 1980

Evening surgery was running late, and Dr Cyril Peabody wanted his dinner. He tried to ignore the rumblings of his empty stomach and concentrate on his work.

His tenth patient, the village postmistress, waddled into his consulting room with maddening slowness. “Evening, doctor.”

“Yes, Mrs Bream, what’s the trouble?”

“Just a touch of indigestion, I shouldn’t wonder,” she replied complacently.

Cyril did not consider this an adequate reason for taking up his time on a fine Friday evening. He said “You’re grossly overweight, you know.” Mrs Bream looked so indignant that he tried to make a joke of the matter by rubbing his hands together and adding “Don’t worry, my dear madam, we’ll soon have you looking as sylph-like as a schoolgirl once again.” She gave him a hostile stare.

“Now. What exactly do you mean by indigestion?” asked Cyril.

Mrs Bream looked at him as if he was a backward child. “Dr Greatorex used to give me some white medicine,” she informed him.

Cyril murmured “Curse these country bumpkins” to himself as he wondered how far to investigate her case. He wrote in Mrs Bream’s file “?Indigestion?” enclosed by prominent quotation marks, and added “Low IQ.” He recalled with nostalgia his time as a hospital doctor, when there would have been a student nurse to undress this old biddy ready for him to carry out a physical examination, and to write out the cards for the relevant tests: chest X-ray, barium meal, cholecystogram, full blood count, urea and electrolytes, liver function, ECG. As it was, doing it all himself did not seem worth the effort.

He reached for the prescription pad, saying in a bracing tone “Jolly good. I’ll give you some more white medicine. Come back and see me if by any chance it doesn’t do the trick. And we need to get rid of a stone or two.”

“Evening, doctor,” said Mrs Bream, and before she was out of the room, Cyril firmly pressed the bell for his last patient: Sebastian de Winter, age forty-four, of Easton Green Manor.

Sebastian de Winter was a giant of a man with a thatch of black hair, a jutting forehead and a worried expression. He glanced suspiciously at the notes on the desk. Cyril asked briskly “Well, Mr de Winter, what’s the trouble?”

“I had another bout of chest pain after lunch today. Scared the hell out of me. My blood pressure’s way out of control – you know that I suppose? Garth Greatorex has been handling the problem but he’s off duty this evening. Well, you know that too of course.” The patient leaned forward and continued earnestly “Frankly, Dr Peabody, I want a second opinion. They tell me all this is due to stress. It’s a month since I had a full physical checkup, and I’d like you to give me another ECG.”

Cyril’s interest was aroused by talk of chest pain, blood pressure and ECGs. He decided to ignore the mention of “stress”, for it would be too bad if this case turned out to involve one or both of his two pet hates, “social problems” and “psychiatry”. Cyril was interested in human bodies; he enjoyed finding out what was wrong with them, and gained satisfaction from putting them right. He was not at all interested in the human mind. He replied “By all means, Mr de Winter, delighted to oblige. As you may know, I had a great interest in cardiology in my most recent hospital post. We’ll give the problem a thorough review.” Fatigue forgotten, he rose to the challenge of demonstrating his medical expertise and, with any luck, outshining his senior partner Garth Greatorex in diagnostic skill.

Sebastian de Winter gave a history of chest pain occurring after meals and accompanied by a sensation of dread. He also complained of headaches and disturbed sleep. Cyril did not ask about his personal circumstances but the patient volunteered an account. The symptoms had started soon after his father’s sudden death from a heart attack. Sebastian had inherited the Easton Green estate with two hundred acres of farmland, and a vineyard just starting production. The burden of managing these assets was a heavy one, and his wife did not give much support. He was drinking up to half a bottle of Scotch every night in an attempt to relax and get a few hours’ sleep. He worried about his high blood pressure; Dr Greatorex’s various prescriptions had either failed to bring it down, or caused unacceptable side effects.

Physical examination revealed no abnormality except a raised blood pressure reading of 175/95. Cyril fetched the portable ECG from the clinical room. He took pride in this machine, which had been out of order when he arrived at the practice. He had got it working properly and used it on many of his patients, though none of the other doctors showed any interest in the tracings he obtained.

Sebastian de Winter’s ECG showed mild left ventricular hypertrophy, but Cyril felt able to give an honest reassurance that it was “essentially within normal limits”. The patient replied “Thank God.” Cyril wondered what to do about the raised blood pressure. The man had already been tried on many of the standard drugs: frusemide, propranolol, bethanidine, methyldopa. In the drawer of Cyril’s desk there were some free samples of a new drug called Amaz. It was claimed to reduce blood pressure by some novel mechanism that Cyril could not remember. Recalling the excellent lunch at the Angel’s Arms which Millford Pharmaceuticals had given to celebrate the launch of this new product a week or so before, Cyril announced “I’m not too happy about the blood pressure, but I’ve got some splendid new tablets here which should bring it under control. Come back next week and we’ll see how they’re suiting you.”

“The stuff Greatorex gave me made me feel sick as a dog all day,” said Sebastian de Winter mournfully. “I suppose I’ve got to expect the same with these.”

“Nausea is a common side effect from medication of any kind,” Cyril told him. He added an opinion of his own “Mainly psychological in origin – don’t think about it and you won’t get it, in other words.”

The patient made no move to leave. He asked “Couldn’t you give me something to help me sleep?”

“Never prescribe sleeping pills. Deplorable things,” said Cyril, who never suffered from insomnia himself. He had had enough of the consultation, and was determined not to be drawn into anything that smacked of psychiatry or social problems. Defeated, Sebastian de Winter put the bottle of Amaz into his pocket and shambled out of the consulting room.

Eight o’clock. Cyril put his stethoscope into his medical bag, snapped it shut, and was striding out of the Health Centre when Linda, the young receptionist with the fluffy blonde hair and curvy figure, waylaid him. “Dr Peabody! There’s two late visits come in!”

He cursed his bad luck under his breath. “Not your day, is it?” remarked Linda brightly.

“I sometimes think a doctor’s lot is not a happy one, Linda. Are these visits really that urgent?”

“Well, I should think the first one is. Poor Mr Harland, he only lives up the lane there, he’s got lung cancer and he’s very bad. His wife’s a nurse at Harphamstead Hospital – she wouldn’t ask for a visit over nothing, I’m sure.”

“Suppose not,” said Cyril. “And what’s the other?”

“Old Miss Gray from Cottage 2 by the duck pond. Says she wants to see one of the male doctors urgently. She’s a little bit eccentric, you know,” said Linda. “Actually, between you and me, she’s plain batty. Don’t tell anyone, but she came round here one day and told the whole waiting room Dr Greatorex was a brazen libertine – whatever that may mean. He was awfully cross.”

Cyril smirked with relish over the anecdote. He asked “And what’s wrong with this Miss Gray?”

“She wouldn’t say. She wants to speak to you in confidence.”

“And where is this duck pond?”

“In the dip past Graves Farm. At least it’s on your way home.”

Cyril did not appreciate the tranquil summer evening scene as he drove away. He was beginning to suspect that his recent career change had been a big mistake. His only previous experience of family medicine had been as a single-handed locum in a quiet West Country practice during his summer holiday. He had rather enjoyed that, and considered he had achieved several significant diagnostic triumphs. But working as a dogsbody at Market Beeching Health Centre, with the senior partner breathing down his neck, was what his mother would call quite a different kettle of fish.

***

Unfaithful unto Death is available for Kindle or in print from Amazon.com or your local Amazon site, and as an ebook from Smashwords and other online retailers. Please share this with any of your contacts who might enjoy it.

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Medicine in memoir and fiction

I’ve been staying up late to read Do No Harm – a compilation of clinical case histories,  interspersed with personal memoir, by British neurosurgeon Henry Marsh. It gives a riveting, though sometimes gruelling, account of the challenges involved in operating – or deciding not to operate – on patients with life-threatening conditions such as brain tumours, brain injuries, and strokes.

Henry Marsh writes with honesty, thoughtfulness and compassion and his book would seem equally accessible to healthcare professionals and general readers, though it is not for the squeamish. I would strongly recommend it to anyone considering a career in neurosurgery, for it can be difficult to find authentic accounts of what working in this or any other medical specialty is really like. Although my own ambition to become a doctor was partly inspired by the library books I read as an impressionable teenager – The Healing Knife by George Sava was one, and another was about a leper colony in Africa – they were already out of date, and I suspect conveyed a romanticised picture. When I got to medical school and was confronted with the reality it became clear that I had little interest or ability in either surgery or tropical diseases, and chose quite a different career path.

Why don’t more doctors write books along the lines of Do No Harm? One reason must be the risk of breaching confidentiality and causing distress to patients themselves or to their relatives. The books by the late neurologist Oliver Sacks – for example The Man who Mistook his Wife for a Hat – are among the best-known examples of the genre, and won wide acclaim from many sources, but have been criticised in some quarters for exploiting vulnerable people.

Another consideration is that any realistic and balanced account is bound to expose the limitations of medicine, and the vulnerability of its practitioners. Perhaps this is not so important now that doctors and hospitals are no longer regarded with unquestioning trust and respect. Henry Marsh makes no attempt to gloss over the fact that some of his cases had a bad outcome, whether because the prognosis was hopeless to begin with or because he or his colleagues made mistakes. He clearly feels these failures keenly, agonising over them even if they were not his fault, giving parts of the text a confessional quality. He is also remarkably outspoken about his frustration with hospital management and the ways that modern NHS bureaucracy can hamper patient care. His frankness about these negative aspects is refreshing, although if I had the misfortune to be needing neurosurgery I think I might regret having read this book and realising how much can go wrong.

I have no intention of writing a factual account of my own medical career, partly for the reasons given above, partly because I don’t remember the details well enough. But writing is therapeutic and when channeling my work experiences into fiction I often find myself emphasising the darker side of my former profession. Readers may find my books unduly cynical unless they appreciate the role of black humour in defusing the stresses of working in medicine.