When doctors become writers

Several of my friends and acquaintances have, like me, exchanged a career in medicine for one in creative writing.

Some had to retire early from medicine because of illness or family circumstances. Some chose to leave the profession after becoming “burnt out” by the continual exposure to human suffering, the weight of responsibility for people’s lives and health, frustration with the administrative aspects, or the long hours. Others were simply driven by an overpowering desire to write. For me, after 30 years in medicine, the reasons were mixed.

Working as a doctor provides a wealth of material for fiction writing. Although the settings of my own three novellas are mainly non-medical, drugs and diseases play crucial roles in all their plots. The risks of breaching patients’ confidentiality, libelling professional colleagues or offending readers’ sensibilities must be kept in mind, and I am currently debating whether the satirical novel which I wrote while working as a junior doctor in a psychiatric hospital is too politically incorrect to publish.

Unlike such well-known figures as Somerset Maugham, Anton Chekhov and Arthur Conan Doyle, most “physician-writers” will never achieve fame and fortune as authors. They will usually experience a drop in income and status and, no longer having a structured work environment or daily interaction with colleagues, must become entirely self-motivated. Life coaching can help with adapting to the transitions and, in my experience, the freedom and stimulation of developing a new career in mid-life more than makes up for the losses.

Outside criticism, and self-criticism, may suggest that those who choose this path are no longer making a worthwhile contribution to society. This is only partly valid, for the written word can have marked effects for better or worse on people’s well-being. I am always delighted if someone tells me they have benefited from one of my medical books or enjoyed one of my novels. But while doctors have direct contact with their patients and are usually able to tell whether their treatments have healed or harmed, writers do not meet the majority of their readers and will never know the wider impact of their books.



Other writers: competitors or colleagues?

Writing is a solitary occupation. Most writers prefer to work on their own in a quiet room without interruptions from people, pets, phone calls and texts, or noises from the street. Such a peaceful environment is often unavailable, as I have been finding lately since having two mischievous foster kittens in the house.

Despite their wish for peace and solitude, writers do benefit from contact with the outside world in general, and with other writers in particular. But for a number of reasons they may not get very much. Members of most other professions can hardly avoid forming peer relationships whether through a shared workplace, a culture of teamwork, or requirements for continuing education and supervision. In contrast, writers seldom meet other writers unless they make the deliberate effort to join societies and groups, whether in person or online, and to attend events and courses. Many of them have introverted personalities and are not naturally drawn to social activities, perhaps viewing them as an added distraction from the serious business of writing. Also, they may regard themselves as in competition with each other for sales, or be wary of having their ideas stolen if they share them before publication.

Abuses can occur, but I think the benefits of contact with other writers outweigh the risks. Since making a serious commitment to fiction writing I have gained a lot through discussions in Linkedin groups, and occasional personal interchanges with the four other women writers in my circle of friends. We have reviewed each others’ manuscripts, exchanged tips about the self-publishing process, and provided encouragement when the going gets rough due to lack of inspiration, technical problems, or negative responses to our work. I have been meeting one of these friends, Jean, for coffee about once a month for several years, during which time both of us have self-published a number of books.  We met in Auckland, then discovered that we were brought up in the same English town, Gravesend in Kent, a few years apart; one of Jean’s books, Chalk Pits and Cherry Stonesgives a fascinating account of her wartime childhood there.



Choosing, and changing, the names of your characters

The important and enjoyable task of naming fictional characters is not always straightforward.

Most people find that certain names suggest certain features of personality and appearance. This reflects their own life experience. So, while the name Carol might remind me of the placid blonde in my class at school, you might picture Carol as a feisty brunette.

There is nothing to be done about these individual variations, but all names have universal associations too, and it is worth looking them up. Some names relate to particular ethnic, cultural or religious groups or periods in history. Some are intended to convey personal qualities such as courage or charm.

Names which belonged to well-known celebrities, Diana or Marilyn for example, are probably best avoided. It is also best to avoid using several similar names, such as Sara and Sandra, in the same book.

Modern word-processing technology makes it deceptively simple to change characters’ names. Such changes can cause problems, as I have found in my own work and when reviewing manuscripts for friends.  Sometimes the same person is called by different names in different parts of the book. It should be easy to avoid this by using the “Find and Replace” function, however this powerful tool can have serious unwanted effects if carelessly used. For example changing Amy to Katy, without matching the case or specifying whole words only, would cause and the word “dreamy” to turn into “dreKaty”.

My own over-sensitivity to being criticised or offending people has caused me concern around the choice of names. What if one of the several Roberts I know is upset if he finds that I have called one of my less attractive characters by his name? What if a complete stranger brings a libel action because I have unwittingly used his or her name in a book? Such fears led me to change a few names in my first novel just before it went to print. But I still thought of my characters by their original names, and when I wrote the second novel I used one of them by mistake. Fortunately, while writing the third, I realized what I had done and have been able to get round it by introducing a new twist to the plot.

In conclusion, it is best to avoid last-minute name changes, but if you do decide they are necessary be sure to follow up with a careful check of the whole text.


Marinading a manuscript

When writing a new book I often feel impatient to finish it. There is really no need for this, considering that I enjoy the actual process of writing so much, and know that I am likely to feel a depressing sense of anticlimax when it is done. Melodramatic though it sounds, perhaps I am afraid I might die before the book is complete.

Modern self-publishing technology makes it easy to rush into print too soon. The front page of the Amazon kdp website says Get to market fast … Publishing takes less than 5 minutes. What a contrast to the old days when writers usually had to wait several months for agents and publishers to respond to a proposal, implement any changes requested during the assessment process, and then wait several more months between acceptance and publication.

I try not to be impatient because I know most books turn out better if they are written slowly, going through several revisions with gaps in between. When re-reading a draft manuscript after several weeks or months, I often have new ideas about how to improve it, and discover mistakes or inconsistencies which I did not notice before.

Though this slow staged method works best in most cases, it does not suit everyone. Some of the most brilliant writers – and artists, and composers – have produced their best work through a single burst of creative inspiration, not needing to revise it at all.

This is all a bit like cooking. A skilled chef using top quality fresh ingredients can produce delicious meals in a few minutes, but for the average cook most dishes are improved by being marinaded in the raw state and then being cooked slowly, and taste even better if reheated a day or two later.

I’ve just finished the first draft of my third novella, which will form a trilogy with Carmen’s Roses and Blue Moon for Bombers. I intend to discipline myself to put the new manuscript aside for a few weeks before doing any more work on it, and in the meantime start writing something different, step up my marketing activities, or even clean out some cupboards at home.

A story about the long shadow of war

I’m pleased to announce that the ebook version of my second novella Blue Moon for Bombers was published today. Set in England 2007, with flashbacks to the 1940s, the story explores the psychological aftermath of World War Two interwoven with a modern romance.

The ebook is available from Smashwords, Amazon Kindle and various online stores. Amazon also carries a paperback version, which readers outside America can probably buy more cheaply through other websites, for example Fishpond and The Book Depository for those of us here in New Zealand.


Here is a short excerpt from the opening chapter:



Chapter 1: Multiple pathology

“I killed him!”

“Please be quiet, you’re disturbing the other patients,” said Phyllida. She reached out to give her father a soothing pat on the hand, but with a violent jerk he moved his hand away, and shouted louder than ever “I killed him!”

“What are you talking about? Who have you killed?”

“Leo. Leo.”

“Who’s Leo?”

“I killed him!”

Phyllida did not know what to do or say. She rang the bell above the bed and while waiting for it to be answered she turned away to look through out the window at the rain steadily falling onto the sodden flowerbed outside the ward. She was greatly relieved when a nurse, a young woman with a bright and confident manner, came in and asked her to wait outside the room while they gave her father an injection.

The drug was obviously fast-acting, for when Phyllida went back in she found that the old man had stopped shouting, though he continued to mutter and groan as he tossed his head from side to side on the pillow. He did not seem aware of Phyllida’s presence, and she thought that perhaps it would be alright to go home.

On her way out of the ward she was waylaid by the nurse, whose name badge read SALLY. “Can you pop into the office for a minute?”

It was more like a command than a request and Phyllida obeyed, though with reluctance. She felt afraid that she might be held to blame for her father being such a difficult patient and making so much noise. She was also worried about driving home in the wet weather, about being late with preparing dinner for her husband Barney, and about the guests coming for the weekend, not to mention the fear that the somewhat forward young woman might mention genetic testing.

“I’m your Dad’s named nurse today, and I’ve been reading up on his case,” said Sally.

Phyllida winced on hearing her father referred to as “Dad”, for she never used that familiar term. She called him by his first name, Desmond, when she had to call him anything at all. Sally went on “It must be hard for you, seeing him so distressed. What’s it all about, do you know?”

“No, I’ve no idea,” said Phyllida.

“From what the night staff heard him saying we wondered if he served in the war at all?”

“Yes. He was in the Air Force.”

“What, a Spitfire pilot or something like that?”

“I’m not sure exactly,” said Phyllida.

“My boyfriend’s making a model Spitfire,” Sally told her.

Although Phyllida realised that the girl was only trying to put her at ease, she considered this remark somewhat unprofessional.“Really,” she said.

“Well, whatever,” said Sally. “There’s obviously some stuff from the war which is playing on your Dad’s mind. He’s been too confused to tell us what’s troubling him but I’d say he’s got Post Traumatic Stress Disorder.”

“Well, I’m afraid I don’t know really anything about his war service,” said Phyllida. “He never talked about that aspect of his past.”

If you enjoyed reading this, please help my marketing campaign by sharing this post with your contacts. Here again are the links to the Amazon and Smashwords sites.

The older writer

Young authors with the potential for a long future career, especially if they are photogenic or have an unusual background, are the ones most likely to find favour with agents and publishers. But many wellknown authors have continued to produce new work of a good standard in old age. I have just finished reading Angela Bull’s excellent biography of Noel Streatfeild (1895 – 1986), who wrote numerous books besides the famous children’s classic Ballet Shoes, and who published her last novel when she was in her mid-eighties. Other English women authors who continued writing in their later years include Agatha Christie (1890 – 1976), Iris Murdoch (1919 – 1999), and P. D. James (1920 – ) who is, I understand, currently working on another book at the age of ninety-four. There are many more examples.

A few successful authors did not seriously begin their writing career until late in life. For example Mary Wesley (1912 – 2002) wrote the first of her seven novels for adults when she was seventy-one. Her books were original, sexy and regarded as slightly shocking and several of them, including The Chamomile Lawn, became best sellers. As the saying goes “It’s never too late to become what you might have been.”

Creative writing is one of those skills which is often well preserved, and may even improve, as age advances but there is a limit. It has to be acknowledged that books written by older people are not always of top quality, and sometimes only accepted for publication on the strength of their authors’ previous reputations. Mary Wesley knew when it was time to stop, and wrote no more novels after she turned eighty-three. Other older authors, in contrast, have continued to publish more books after they are past their peak. Linguistic analysis of the later works of both Agatha Christie and Iris Murdoch reveals signs of cognitive decline: a limited vocabulary, a vagueness of expression, and the tendency to repetition. Does this mean they should have stopped writing? I don’t think so; even if the later books by these remarkable women are not quite so good as the earlier ones, they still display outstanding talent and are valued by many faithful fans.

Older writers do possess certain advantages. They have a wide life experience to draw upon for material. If they are free of work and family responsibilities, they have ample time to write. They are likely to be driven by a genuine love of writing and the wish to create a quality product, rather than by the slim hope of achieving fame and fortune.

I had reached my sixties by the time I began to revisit my childhood passion for writing fiction, and I hope to find enough inspiration to continue for a good few years yet. Having no desire to produce best-selling books, I write mainly for my own satisfaction, however I only consider the activity worthwhile if at least some people read and enjoy my work. My second novella Blue Moon for Bombers: a story of love, war and spirit has just been published; I will post an extract of the text and details of purchasing options on this blog next week.

The art of writing a sequel

Although the logical and efficient way of writing a series of two or more books is to outline the content of each in advance, I don’t have enough foresight or organisational skills to use this method myself. In any case I would rather be free to go with the flow of inspiration than have to stick to a prearranged plan, and I imagine many other authors feel the same.

While I was working on my novella Carmen’s Roses the possibility of a sequel did not even occur to me. This was my first venture into independent fiction publishing and I found it a very positive experience, so much so that I went straight on to write a second novella, featuring different people and places. Now this is almost finished, and I am wondering – what next? Having already created quite a varied cast of characters with the first two books, it could be interesting to have their stories continue and interlink in a third, rather than starting afresh.

I realise, however, that writing a sequel can be a bit tricky (and a prequel probably even more so). Here are a few points to consider.

If there is even a faint possibility of a sequel to the novel you are currently writing, be careful not to tie up the loose ends too tightly. For example, if you killed a person off in the first book, it will be difficult to introduce that character again unless you can arrange a flashback, a spirit apparition or a resurrection from the dead.

When writing a sequel remember that some readers will not (yet) be familiar with your first book. But you want to encourage them to read it later. So, while you do need to give some background information to introduce the characters, beware of “spoilers”. For example, if the previous book contained a mystery, don’t reveal any clues to its solution.

Pay attention to continuity, especially if the dates of events or the ages of the characters have been specified anywhere in the text. It is a good idea to draw up a detailed timeline. Although many readers will not notice or care about minor factual discrepancies, it is preferable to get these details right.

Ideally each of the books will be self-contained, so they can be understood and enjoyed even if not read in chronological order.

If you have any other tips on sequel-writing technique, please leave a comment below.

What is the best length for a book?

Like ‘How long is a piece of string?’ this is a question without a definitive answer.

Long books, with word counts around 200,000 or even more, seem to be in fashion lately. The last two winners of the Man Booker prize for fiction – Bring up the Bodies and The Luminaries – are both heavyweight tomes, as are many recent autobiographies.

For ebooks, too, it seems that bigger is better in the popularity stakes. In the latest analysis published through Smashwords.com, the best-selling length was calculated as 115,000 words.

I am personally out of synch with this trend because, both as a reader and a writer, I prefer something shorter. Although I truly admire authors who can write long books of good quality, I must admit that I often find it a challenge to finish them – I don’t have enough time or patience. And, to my mind, a great many long books are not of good quality because they contain far too much irrelevant detail and repetition, and would benefit from radical editing.

The average novel today apparently has between 80,000 and 100,000 words, whereas I remember from years ago that the average was around 70,000 which still seems to me a good length. The books by Agatha Christie, who ranks second only to William Shakespeare as the best-selling author of all time, were mostly between 50,000 and 70,000 words. However there has always been huge variation and many classics, such as War and Peace and Gone with the Wind, are long.

My own books seem to have grown shorter as I have grown older and Carmen’s Roses, at just over 30,000 words, is technically a ‘novella’ rather than a ‘novel’. A couple of readers have said they would have liked it to be longer, which I take as a compliment – I would rather have people wanting more than getting bored before the end, and one kind reviewer wrote ‘A short book but you don’t feel cheated’. My next fiction book, provisionally titled Blue Moon for Bombers, is also going to turn out around 30,000 words, so it would seem that the format which best suits my own current style is the novella.

Longer than a short story, but shorter than a novel, a novella is between about 20,000 and 40,000 words. Many well-known titles such as Death in Venice, Heart of Darkness and The Turn of the Screw are written in this concise and elegant format, which has been described by Ian McEwen as ‘the perfect form of prose fiction’.

So, even though the writers and readers of today seem to favour long books over short ones, there is a place for both. Unless you are writing for a publisher which sets specific requirements, I would suggest that instead of aiming for a predetermined word count it is best to make your novel whatever length is needed to tell the story.

Finally, a note for readers in New Zealand and Australia: the closing date for the Goodreads Giveaway of Carmen’s Roses is 29th June (U.S. time). To enter the draw for a free print copy click here.



Choosing the title for a book

A good title is perhaps even more important than a good cover image for marketing purposes.

For my own books, I usually write a first draft of the text before giving serious attention to the title. I make a list of possibilities, look them up on Google to see whether they have been used before or contain any unsuitable double entendres, and may ask some friends for their opinions before reaching a final decision.

Here are some questions to consider when choosing a title.

Is it relevant? There is something to be said for factual titles which clearly indicate what the book is about: Murder on the Orient Express, Seven Years in Tibet or A Street Cat Named Bob are good examples because they sound interesting as well as being informative. More subtle and abstract titles sometimes work extremely well: Gone with the Wind, Heart of Darkness, Catch-22, A Clockwork Orange. But a book with a title which has little relation to its content may escape the notice of potential readers; and even those who have read and enjoyed it may have forgotten its name by the time they want to find it again.

Is it easy to remember and locate? Long titles, and those containing words which are difficult to spell, can be difficult to discover online or to reproduce accurately, so are best avoided. Short snappy titles, including single-word ones, which easily ‘trip off the tongue’ are more memorable and can be very effective.

Is it eye-catching and distinctive? Years ago I picked up a book called Excuse me, your life is waiting because the combination of its quirky title and garish cover made me curious to see just how ghastly the content would be. In fact I really liked this book, which introduced me to the Abraham-Hicks teachings on the Law of Attraction. A title which is different, even slightly outrageous, will stand out from the rest.

Is it intelligent? In this category I would include titles such as Enigma and The Path to Rome, which have both literal and metaphorical meanings. But not all writers can hope to find such clever titles, and not all readers will understand their ambiguity.

Has it been used already? There is no copyright on titles, so it is not unusual to find several different books with the same name. Personally I always prefer to choose something original, which is why the novella I am currently writing will not be called Bomber’s Moon.

A subtitle, used mainly for non-fiction, provides further scope for summarising the content of a book, distinguishing it from others with the same main title, and increasing its visibility to search engines.

Planting the seeds of a novel

There is no right or wrong way of starting to write a novel. Some successful authors of fiction make detailed plans in advance: researching the background, writing summaries of the plot, biographies of the characters, descriptions of the setting, the contents of each chapter, perhaps a chronology of events if it is a complex narrative shifting back and forth in time. Others just start working with a vague idea and see what happens, often finding that inspiration flows more freely as they write, perhaps feeling the material is being ‘channelled’ from a source outside themselves. Even some writers of crime fiction do not plan ahead, keeping themselves in suspense as much as their readers, not knowing ‘who done it’ till the end of the book.

I use a mixture of these logical ‘left-brain’ and intuitive ‘right-brain’ approaches. My novel Carmen’s Roses took me about ten years to write and I don’t remember when or how the first seed was planted. The story was not systematically planned at all, but developed in fits and starts, informed by diverse sources: a case history in the British Medical Journal, the beauty of the land and sea around my New Zealand home, finding an Italian vase in the street, plus fragments of autobiography. It took many rewrites to weave these different elements into a reasonably coherent whole. With my non-fiction books I have been a little more organised, but these too have tended to develop in piecemeal fashion.

Whatever method is used, the project has to begin somewhere. The writer may start on an abstract level, wanting to explore a certain theme or conflict, convey a message to the reader, or develop a plot with an original twist. Or the story may be inspired by a particular place, a memorable incident, or one or more characters whether real or imaginary. (See also my previous blog posts Novels with a message and Where ideas come from.)

My friends say they have enjoyed my first novel and are encouraging me to write more fiction, which I certainly hope to do. At present various memories and ideas are floating around in my mind: a flooded river in England, a healing retreat in a country house, fragments of wartime aviation history. Perhaps a story which connects all these already exists in some unconscious realm, but I can’t see the missing pieces of the jigsaw at present. I hope I will be able to find them, and that it won’t take as long as ten years next time.