My featured author today is Gary Birken, MD. As a former full time pediatric surgeon, Gary puts his expertise to work in penning medical thrillers that blend hospital settings with heart-racing suspense. And for the writers and authors in the crowd, Gary offers a unique perspective on publishing, having published both traditional and indie.
In today’s interview, Gary and I discuss his two careers, the appeal of medical thrillers, traditional versus self publishing, and more.
Connect with Gary on Facebook, Instagram, Twitter, and his website. Sign up for his mailing list here. Click here to purchase Prognosis Critical, and click here to view Gary’s other novels.
Hi Gary, thanks so much for joining! Before you penned your first novel, you were a full-time pediatric surgeon. How has your career in medicine influenced and impacted your writing? Besides the themes of your books, are there any surprising similarities or differences between your two careers?
There’s no question in my mind that when I compare my careers as a pediatric surgeon and that of a writer, the similarities outweigh the differences. Interestingly, I believe the practice of one has made me better at the other. Both disciplines require paying extreme attention to detail, applying a logical approach to behavior and problem solving, and oftentimes, a sharp focus on “connecting the dots.” Whether as a physician in pursuit of an elusive diagnosis or standing at the operating table for many hours, my years as a doctor have provided me with a fund of knowledge and level of experience which have been a key contributing factor in helping me create what I hope have been seven realistic and entertaining novels of medical suspense.
One area where writing has had a significant impact on me as a physician has been stress relief. All physicians face the ever-present problem of day-to-day stress—the strategies they employ to combat it are as varied as the days of the year. For me, disappearing into Starbucks, putting on my headphones, and writing for a few hours has done wonders in recharging my stress resilience battery and improving my work-life balance.
In Prognosis Critical, protagonist Dr. Jacey Flanigan begins a new career in pediatric cardiology only to discover suspicious activity and questionable medical practices threatening patients at the hospital. What makes the medical setting and theme so perfect for thrillers? Are there particular advantages or disadvantages to this subgenre compared to other types of thrillers?
The medical environment is particularly well suited as a backdrop for a mystery novel. Serious illness and hospitals cause profound anguish, which can conjure up images of misery, the fear of the unknown, and helplessness. This perilous milieu takes the reader out of their comfort zone and creates fertile ground for a suspenseful book. The author is able to take the reader on a dramatic journey filled with rising tension and uncertainty.
The medical setting also provides the author the possibility of creating one of the most reader-satisfying conclusions: the end to pain and suffering and a heavy dose of justice to the conspirator. On the other hand, having a medical background for a novel oftentimes poses a unique problem for the story-writer: creating authentic medical scenes without confusing the reader with unintelligible medical jargon or flooding them with complex scientific information is a difficult task. Sidestepping this error is essential if the author hopes to keep their reader engaged. One literary technique that’s useful in avoiding this problem is to insert a character (such as a student or family member) in the scene whose inquiries allow the doctor or nurse to explain critical plot points in layperson’s terms. The result is added realism while at the same time allowing the reader to grasp the critical plot points, making them less likely to move on to a different book.
You published your first medical thriller over twenty years ago. Has your approach to writing medical thrillers changed since the release of that book? Has the market and/or reader expectations evolved over the years?
Over the course of the past twenty plus years that I’ve been writing, I don’t believe my general approach to planning a medical thriller has changed much. I continue to begin each novel by selecting a timely and controversial medical issue, and then fashioning a conspiracy plot around it. However, one area of change most authors experience is an improvement in his or her skills as a fiction writing. An example of this is the process of editing and revising. This endeavor can be a particularly difficult and challenging one. Cutting scenes and scrapping chapters from your labor of love isn’t easy, but it’s absolutely necessary. An editor once warned me, “Don’t let your writing interfere with your storytelling.” She was referring to a three-paragraph description I wrote of a lonely leaf floating to the ground. “While it may be inspired,” she told me, “it does nothing to advance the plot. I therefore recommend you place a trash can under the leaf before it strikes the ground.” The lesson learned? Writers of any mystery subgenre have to keep their readers wondering what’s going to happen next and create a desire that borders on a compulsion for that book lover to keep turning the pages to find out. If you write something that doesn’t advance the plot, well . . . you better have a darn good reason for keeping it.
Regarding changes in the reading public: I don’t think the time-honored reader-author contract has changed too much. It’s a rather simple agreement: the reader agrees to buy the author’s book, and in return the author agrees to entertain the reader. The advantage goes to the author—all they have to do is keep the reader engaged and happy in their choice, which is sometimes easier said than done. On another note, one interesting change I’ve observed has been a something new in the public’s interest in the novel’s main character. Specifically, the emergence of mysteries that feature a snarky unreliable protagonist (Gone Girl is a good example). It’s been an intriguing departure from the “likeable” main character that traditionally has been mainstream.
Five of your books were originally published by Berkley, and when your rights reverted, you established your own publishing imprint (Erupen Titles) and rereleased them. What are the differences between self-publishing your books and working with a traditional publisher? Given your experiences in multiple publishing paths, do you have advice for indie authors getting started today?
I think I could talk all day about the differences I’ve encountered between traditional and indie publishing. To begin with, just the decision to pivot to self-publishing was one I didn’t make lightly. But, from what I’ve experienced to this point, I believe the benefits of self-publishing in many ways outweigh the downsides and stack up favorably when compared to a traditional approach. If you consider the operational aspects of publishing, there’s no question that a traditional track is an easier way to go. Not having to deal with the many details of getting your manuscript between covers and then to market can be very attractive. Many authors have therefore chosen to confine their efforts to creative ones and leave the business of writing to others. But this choice does not come without a price—once you sign on the dotted line and publish through conventional means, the author oftentimes become a minor player in the future of their labor of love. If that’s okay with you, traditional publishing is probably for you.
There’s one other point worth mentioning for those considering self-publishing: It is of course possible to take on the entire project yourself, but another option to consider is working with a professional in the field. For me, the decision to partner with an expert in bringing my seven novels to the indie platform continues to offer strategic and operational advantages.
Lastly, what are your current projects? Are you working on more novels, do you have more plans for your publishing imprint, and/or what are you planning next?
Currently, I’m working on two manuscripts: one is a story of medical suspense that focuses on an ethical issue I’ve long wanted to write about. I’m pleased with the progress I’m making and have my fingers crossed its release date will be this summer. I’ve have also started work on a murder mystery that draws on elements of the cozy subgenre. There’s no question it resides a little outside of what I’ve written in the past, but it’s turning out to be an exciting project. Finally, it has more than crossed my mind that at some point, I’d like to try my hand at narrative non-fiction. I anticipate selecting five of my most interesting cases over the years (not necessarily triumphs) that have had a profound effect upon me and the families involved.
Thanks so much to Gary for the interview. Sleuths, I hope you enjoyed it! If you aren’t already subscribed, please be sure to sign up for the Cluesletter and get author features like this alongside other mystery goodies, delivered to your inbox every other Tuesday.