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Psychiatry, Fantasy and Fiction
I’m often asked how I made a transition from psychiatry to writing fiction. As residents in training, we had to present case histories. To me, each case seemed like a mini-biography or short story. Some were stranger than fiction, and it struck me that psychiatry–of all medical specialties– emphasized the human dimension of living life. Each patient has a compelling story. It’s unique, but taps into a shared commonality. Really, we’re all different and we’re all somewhat the same, aren’t we?
Above all, psychiatry appealed to me because it aligned itself with creativity and the arts.
When I co-authored nonfiction medical books, we illustrated issues with case histories. This took some creativity, whether a story was about a man who broke down because he’d had a heart attack, or a woman was struggling with breast cancer, or a young girl was jealous of her newborn brother.
But once I began writing fiction, I could use imagination.
So, in a sense, I was always telling stories, whether they were psychiatric, medical or pure fiction. (Is there any pure fiction?)
The freedom to make stuff up provides a strange feeling of pleasure. There’s little to match the exhiliration when a patient suddenly “gets it” (that ah ha moment) or the incredible sensation you get when a novel’s plot twist suddenly falls into place, and the story assumes a life of its own.
It’s really an exploration followed by discovery and may mean finding the hidden clues within one’s self. Some psychiatrists would say it’s the revelation of the unconscious or the getting of wisdom.
When all is said and done, the very process of writing fiction is really a bit of a mystery to me. But the transition to fiction came easily.
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Fiction and non-fiction
Over the years, I’ve co-authored five non-fiction medical books for the lay reader. Now that I’m writing fiction, I’ve been asked to compare fiction and non-fiction.
I’ve been lucky in a very real way. When writing non-fiction as a physician, I often had to write case histories of patients (without revealing their identities, of course). These were always fun to do because each person is unique, and in dealing with psychologic issues, each has a unique story to tell. So, there was some inventive license in describing case histories to illustrate various points.
But one thing was certain in non-fiction: its purpose was to convey information about a specific topic (heart disease, breast cancer, psychotherapy, or child-rearing) in an informative, readable and reasonably entertaining way. So, the creative freedom was limited.
Fiction, on the other hand, involves a synthesis of experience with what the author knows of life, along with wholesale flights of imagination.
You just know when reading a novel that the author knows a great deal about certain subjects ( For instance, in Peter Heller’s “The Dog Stars,” he obviously knows plenty about flying an airplane, fishing, hunting and hiking, among other things). But he engages in wholesale flights of imagination that take the reading to another level of knowledge and beauty.
It’s that soaring imagination that propels the novel, and it’s much more difficult to capture those chimerical flights of ideas and fantasy on paper than it is to write effectively about a non-fiction topic.
Writing fiction is far more satisfying to me that non-fiction, after all, making stuff up is pure fun. Kids do it all the time.
To paraphrase what Saul Bellow once said, “When I was a child I was called a liar. Now, I’m called a writer.”
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The genesis of a novel
Readers often ask how an idea for a novel comes to an author. I’ve been asked how MAD DOG HOUSE (due October 23rd) came into being. It’s a very strange—almost dreamlike—process for me. I’ve found it the same way for the other three novels I’ve written which will be published over the next two years).
It’s as though my mind went through some semi-conscious period where things from the past and present seemed to coalesce and began building on themselves. In all honesty, once the story was on paper, I was unable to reconstruct its genesis. It seemed very strange, almost the way you feel when you wake up some mornings knowing you’ve dreamed, but the dream dissolves before you’re completely resurrected from a sleeping state.
Read more on the Huffington Post >>
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“The Caller” by Karin Fossum
Okay, this is a Norwegian mystery…one of the many Scandinavian novels flooding the market since the success of the Millenium trilogy.
The premise is interesting: A 17 year old boy with a deprived homelife sets about playing malicious pranks on people in and around his village. Some of them have dreadful consequences. Kids can be really vicious, for sure.
The novel’s problem is simple: there is very little suspense or tension. Much of it is written from the POV of the boy and you know his motivation and his objective. After a while, the only question is whether or not his pranks will escalate to something more serious.
I found the writing to be simplistic and naive, and have trouble understanding Marilyn Stasio’s good review in the NY Times. There was little to sustain my interest, and I think this novel proves the old saying that sometimes, less is more.
There is far more tension (at least for me) when the true culprit is unknown or unknowable, which is not the case here. This novel suffers from what is often called these days TMI (too much information). Two stars.
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“And When She Was Good” by Laura Lippman
Heloise runs a prostitution ring in suburban Baltimore. She comes from a deprived background with a verbally abusive father and a passive mother. Having escaped her beginnings, she has, by virtue of grit, brains and determination, made herself into a sophisticated woman who has a young son and who lives quite well. Unfortunately, her son’s father is in prison and is Heloise’s former pimp and ringmaster. He doesn’t know Heloise is the mother of his child.
Heloise (formerly known as Helen) leads an intricately mapped double life, not only because she’s in the business she’s in, but because she visits Val (the father of her son) in prison, and still pays him a substantial percentage of her earnings, because she must. He has connections on the outside, and peril awaits Heloise if she should meander from her incredibly successful business model, some of which she’s garnered from her former work for Val, and from businesses like Amazon and eBay.
Heloise is quite clever, is self- educated, (intelligent beyond her formal education) knows the ropes, and can read people very well. When a madame in another county is discovered dead (murdered) things become dangerous for Heloise, and the life she has so painstakingly constructed comes under threat of exposure. Or worse: she’s afraid that she may become a target as well. At 37, she must cope with a threat to her life and to the secrets she holds–from Val, from her son (who thinks his father died before he was even born) and secrets she holds from the entire community.
Heloise’s situation becomes more tenuous when another prostitute (and former worker for Val) is found dead. Heloise must decide what (if anything) to do, especially when a former employee attempts to blackmail her. The tension mounts and Heloise’s dilemma reaches frightening proportions.
The story, told in a hip, contemporary style, moves toward a harrowing conclusion and the reader comes to the conclusion that this is not so much a story about prostitution as it is about a bright, self-sufficient woman who rises above her humble and degrading origins and is a master at finding creative solutions to seemingly insoluble problems. Heloise is a true entrepreneur and at heart, a person with a conscience and a soul. Four and a half stars.
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Writing about what you know
We’ve all heard the old saw, “Write about what you know.”
In a general sense, that’s probably true, but there’s much more to writing than just sticking to those areas with which you are most familiar.
With my background, it’s easy for me to write about medicine, or psychiatry, or certain aspects of the army, or about courtrooms, or business matters–all of which are, or have been, part of my life. But I can’t limit myself to just those areas, easy as they may be to write about.
So the next logical question is, “If you’re going to write about what you know, what do you know?”
We all know much more than we may think we do. We’ve all had experiences in life.
Haven’t we all felt lust, or envy, or love, or anger, fear, anxiety, or sadness? And haven’t we all experienced loss, or a sense of triumph, large or small? Haven’t we all quested for something, or been scared, disappointed, or felt unsettled, worried, exhilirated, or encountered people of every stripe–those who are kind, gentle, caring, or mendacious, manipulative, even evil? Or people who are naive and childish, while others are braggadocious or intolerably overbearing?
We’ve all been to school, to parties, movies, concerts, business or professional meetings, and we’ve all had experiences as kids, as teens, as young adults, and we’ve encountered illness, threats, feelings of helplessness, hopelessness, or guilt, or shame. And at some point in our lives, we must deal with the death of a loved one, and eventually with the realization that we ourselves are mortal.
In other words, we all live life, and that’s what we know.
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“One Breath Away” by Heather Gudenkauf
Given the spate of school shootings over the past few years, you would assume a novel about a gunman taking children hostage at a school in a small town would be as suspenseful as it is timely. Unfortunately, I found the suspense lacking and the tension watered down by the novel’s construction which was skillfully done, but slowed the novel’s narrative drive.
The story is told through the eyes of five narrators, all experiencing the horror and processing it in different ways. They are a mother of two student hostages, their grandfather, a teacher (also held hostage), a police officer,and the mother’s 13 year old daughter who is in the school when the gunman appears.
The different perspectives offered by each narrator (either in the first person or third person, in the present or past tense) are interesting, though the first part of the novel can be a bit confusing until the reader sorts them out. Once things fall into place, the story should flow to a furious and compelling conclusion. But the author delves into far too many cul de sacs about each narrator, and bogs down the story’s natural flow, which waters down the tension.
Some people would call this a “thriller” because of the subject matter. I think it’s more a portrait of a small town, and the dynamics of people involved in a terrifying situation, but the read itself is neither terrifying nor thrilling.
While character development in a novel is very important, it should not feel to the reader like some sticky adhesive holding back the story. After all, when you get down to it, the story is what counts. Three and a half stars.
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“Vengence” by Benjamin Black
Under the pen name Benjamin Black, Mann Booker winner John Banville has written a series (five or six novels) about Quirk, an Irish pathologist who tends to get caught up in helping the police solve crimes.
While it helps to have read the earlier novels, “Vengence” can stand alone as a mystery with holding power. The earlier novels set Quirk’s character in the context of a traumatic childhood which explains some of his aloofness, and sheds greater light on his relationship with his daughter Phoebe.
“Vengence” begins with an interesting set-up. A successful businessman in his mid-50s invites a 25 year old man, the son of his own business partner, to join him sailing on an Irish bay. When they are far from land, the older man stands up and relates how his own father left him in the street when he was about seven years old, just to test his mettle. After mentioning how he learned to rely on himself, the older man produces a pistol and shoots himself in the chest as the young man looks on in horror.
At that point, the mystery is what made the man do what he did. Things become more ominous when a few nights later, the dead man’s business partner (the 25 year old man’s father) is found drowned in the same bay. There are indications that violence may have been involved. Are these events tied to each other?
While the mysteries involved aren’t earth-shattering, they hold the reader’s interest. More intriguing is the author’s attention to detail and his ability to describe the most quotidian events with an uncanny eye–the smell of the streets, the look of sherry in a glass on a sunlit day, and other beautifully rendered word pictures. Again, if you get the chance, read Benjamin Black’s series of novels about Quirk. They’re well worth the read.
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Gillian Flynn: The Evolution of an Author
I just finished reading “Dark Places” by Gillian Flynn, the author of the current best-seller, “Gone Girl.”
I’ve commented on how much I enjoyed “Gone Girl” and why it was such a compelling read. The most valuable thing (for me) about reading “Dark Places” was the chance to see how far Gillian Flynn has evolved as a writer with the publication of “Gone Girl.”
While I would give “Dark Places” a solid 3 1/2 stars, it can’t compare to the masterful storytelling of Flynn’s latest novel. It’s interesting to see how the author’s writing matured between the two novels. It shows that we tend to get better at doing things by simply doing them.
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