Finding Inspiration in Your Profession With Heather Frimmer

by Heather Frimmer

 My writing journey began in the spring of 2014. Feeling a need for creativity to balance my heavily left brained work as a radiologist, I signed up for an introductory class at a local writers’ workshop. From the first session, I loved everything about the class—the cozy room where we met every Wednesday night, the camaraderie with the other writers, the feeling of freedom as I jotted my thoughts on the page. As we wrote in response to prompts, my writing kept gravitating back to medical topics. Subconsciously, I was drawn to writing about my profession, probably because no other setting provides such intrinsic dramatic tension. Life can literally be at stake at any moment and emotions run the gamut, from immense joy to unimaginable sorrow. With the popularity of TV shows like Grey’s Anatomy and House, and novels such as Cutting for Stone by Abraham Verghese and Still Alice by Lisa Genova, I knew there was an appetite for these stories. Because the world of medicine can feel so bewildering and impenetrable, people love peeking behind the curtain to see the inner workings. On the last day of writing class, my instructor challenged me to try my hand at writing a novel. After a few moments of self-doubt, I decided to take a chance and go for it. 

In my debut novel, Bedside Manners, a mother-daughter story, Joyce Novak, the mother, receives a breast cancer diagnosis and must abandon her caregiver role and become the patient. Her daughter, Marnie, just completed medical school and is looking forward to her surgical internship and upcoming wedding. But when one of her patients dies, she learns to strike a balance between doctor and daughter. 

Joyce’s story was inspired by the thousands of breast cancer patients I’ve had the honor of caring for. I used my observations to make Joyce’s journey as authentic and emotionally resonant as possible. Many of Marnie’s experiences during medical training are based on things either I or my friends encountered on the wards. This novel is a prime example of writing what you know. Because the topics and characters were inspired by my professional and personal experiences, no research was required. This comfort level allowed me to focus on figuring out how to write a novel. The learning curve was certainly steep, but I climbed the hill one step at a time and finally made it to the top. Bedside Manners was published in 2018.

In my second novel, Better to Trust, Grant Kaplan, a neurosurgeon hiding an addiction to prescription pills, decides to operate on his sister-in-law’s brain. As Alison fights for her life, she’s also harboring her own secret—an extramarital affair with a woman. Her close call with mortality spurs her to take a closer look at her marriage, explore her newfound sexuality and figure out what she wants for her future.

During medical school, I knew early on that surgery wasn’t a good fit for my personality, so I spent as little time in the operating room as possible. I preferred fields that prioritized thinking over doing. Neurology and psychiatry were high on the list, but radiology ultimately won the day. Since the topics in my second book are not directly related to my day job, I did a lot of reading on stroke, aphasia, neurosurgery and addiction. Stepping out of my comfort zone to write about things I haven’t experienced was exhilarating and scary at the same time. I’m still learning to channel that fear into my writing. To ensure I did justice to the topics in the book, I gathered a fantastic group of beta readers including neurologists, neurosurgeons, addiction specialists, and speech pathologists. I asked them to be honest about any parts that didn’t ring true and suggest ways to revise accordingly. 

In writing about the world of medicine, I aspire to highlight the inherent challenges, complexities and rewards of spending one’s life trying to heal people. My physician characters are complicated and fundamentally human. While they may be brilliant, skilled and well-trained, they are also flawed and fallible. I hope my stories compel readers to consider the difficulties and pressures of a medical career and to explore how an unexpected medical event can drastically change the course of a life, for bad or for good. I hope reading my books will stimulate lively discussion, as there is plenty of material for book clubs to explore. But most importantly, I hope readers to get lost in a compelling, page-turning story and close the book with a sense of satisfaction. 

Heather Frimmer is a radiologist specializing in breast and emergency room imaging. Her first novel, Bedside Manners, was published in 2018 and has received several awards including the National Indie Excellence, Reader’s Favorite and Independent Press awards. She completed her medical training at Weill-Cornell Medical College, New York Presbyterian-Cornell and Yale New Haven Hospital. She lives in suburban Connecticut with her husband, a trained actor and middle school teacher and their two children. Better to Trust is her second novel. Learn more at heatherfrimmer.com.

A Story about a Family that Made Mistakes: An Interview with Janet Sternburg

Interviewed by Adam O’Connor Rodriguez, Senior Editor of Hawthorne Books, in November 2014

I  hope my family's story will contribute to a much-needed conversation about mental illness in families.

–JS 

What did the writing process look like for this book?

White Matter took eleven years, and the number of revisions was in the three figures. I felt that life had given me an incredible story only I could tell, and I’d better honor it by going into it as thoroughly as possible. I needed history, neurobiology, psychology, philosophy, and family stories to begin to make sense of it.

Then I had to figure out how to tell it—words, sentences, structure, white space, flow—all those things that require trying, and then trying again. Some people I know questioned how and why I kept going. I came up with an answer: The book presented the problems to me that were the most interesting ones to solve. At times I was in love with what I was writing, and like all kinds of love, it makes it impossible to stay away.  

White Matter required a lot of research, and some of that research is woven into the text. How did you research the book, and how did you make decisions about what research to include?  

I’m sure there are methods known to scholars with PhDs, but I’m not trained that way. Reading is what’s natural for me. I grew up reading books under the bedcovers; they were my security blanket. For research, I read, I read, and then I read some more.

I like what I wrote in my first memoir, Phantom Limb: “My husband says that I undertake research as a way to gain a measure of control. But I maintain that the coping mechanism, while useful, is secondary. Knowledge itself is the lure, the pursuit of it as if on a trail, ears perking, nose twitching, sniffing closer to the earth until I pick up first a strong scent, then the slow aromatic release of meaning.”

Many things trump research. When some piece of research-derived information sticks out, interrupts the story, proclaims in the author’s voice, “Aren’t I smart?”—these are signals to drop this piece. I put a lot of extraneous material in the book before I learned what I had to take out. And then I took out too much! I removed valuable essay material—facts and speculation—so my story would flow better, which was a mistake. It actually flowed better when it became fuller, when I became more of a thinking and feeling person on the page, capable of moving nimbly among kinds of material.                    

Writers like David Shields and Jonathan Lethem have popularized the idea that there’s fiction in all nonfiction. Did you have to make any leaps to fill in gaps of information, or take any literary liberties for the narrative’s sake?  

Much of White Matter takes place before I was born; how could I know what had happened? I couldn’t, so I made it up. But I came up with a criterion for myself: scrupulous imagination. I knew these people, and I had a strong sense of what they might have said and done. I tried to be true to that criterion within my invention, and not wander off into flights of fancy.

It’s very tricky territory. The scene when the family decides Francie’s fate is entirely fiction—I have no idea how the decision was made, whether all together in Minna’s apartment or in separate conversations that converged. While I was writing, I was aware of a suspicious delight, a delicious sense of expanding abilities, putting all these characters into play in deft strokes. That said, is it radically untrue? If they hadn’t all met in Minna’s apartment, might they nonetheless have acted in the same ways, given the inevitabilities of their personalities? To that last, I say yes.

You spent much of your life separating yourself from the decisions your aunts and mother made for their siblings. Do you feel any regret about the impact that distancing had on your life?  

That distancing was what helped me survive. Without it, my spirit would have been broken. So to regret it would mean that I regret living as a whole person. My cousins who were writers had to distance themselves—as did Tennessee Williams and Allen Ginsberg. Admittedly this is a pretty small sample of children of families with terrible mental illness, children of lobotomy. We escaped to write about it, not as observers but as people implicated in it. But the escape had to come first for the writer to come later.

Now to approach the question again: Do I feel any regret about distancing myself? The answer is yes. Distancing is a defensive stance, and that means I had to numb myself to what I’d left. There are kinds of closeness I wish I’d experienced and been able to give in those numbing years.  

The book began with another sort of distancing—blame. I began thinking that my family had been evil when they decided on the lobotomies; that lobotomy was, simply, always the wrong thing to do even then. At one level, the entire book is a story of drawing closer, of seeing many sides and many levels to the decisions my mother and aunts made. That drawing closer is a kind of honoring while remaining faithful to mistakes—to wrongs; to conditions of the times; to individual psychology; to all the human dramas played out in my family.

Early in White Matter, your aunt Pauline asked you why you were writing this book. Do you have an answer to her question?

An interviewer once asked the great French filmmaker Jean Vigo, “Why do you keep making films?” He replied that he had an itch, so he had to keep scratching it.  

In White Matter, one big itch was, “How could my relatives have done this terrible thing?” Another itch was, “I thought they were good people but they weren’t—or were they?” Those were the itches that didn’t let up. I had to go on scratching.  

I had wondered whether my relatives were the good, kind people I had always thought them to be. But nothing is ever one thing. We need a human vision that encompasses all the dimensions of the human being. We need to unite compassion with a moral vision that includes complexity. We can choose to understand knowledge as a lifelong venture without final answers.  

What impact do you hope White Matter has on its readers?

I’ve always wanted to move people, to move their hearts so they’ll be emotionally changed by reading this book and to move them into a greater appreciation of complexity and ambiguities.

I also hope White Matter will contribute to a conversation on what Nicholas Kristof has called “the systematically neglected issue of mental health.” As he writes, “All across America and the world, families struggle with these issues, but people are more likely to cry quietly in bed than speak out.” I hope my family’s story will rouse more people to speak out.

Janet Sternburg was born in Boston, Massachusetts. She is an American writer of essays, poetry, and memoir, as well as a fine art photographer. Her most recent work is I've Been Walking (September 2021, Distanz Verlag) a book of photographs taken in 2020 Los Angeles during the city's shutdown due to COVID-19. This monograph applies Sternburg’s attention to perception, memory, and layered experience to the unprecedented landscapes of the pandemic. Sternburg lives in Los Angeles and San Miguel de Allende, Mexico. She is married to former CalArts president Steven Lavine.

Self-Publishing A Novel In A Locked-Down World

by Brian Finney

My new novel, Dangerous Conjectures, ends on March 13, 2020, the day the lockdown began. That’s roughly when I opened my computer and began writing the book. In my case the lockdown was a blessing. It offered me endless uninterrupted time in which to work on the novel. Not everyone had this experience. A writer friend of mine had writer’s block and could only do weekly podcasts throughout 2020. In my case, after constructing a brief outline, I found the novel more or less wrote itself. I positively looked forward to writing each bit of it.

The spread of the coronavirus plays a major role in my novel and causes the major female character to become so afraid of it that she commits a number of errors that drive the plot and almost destroy her marriage. While I situate the novel in Oakland, California, I live in Venice, Southern California. My experience of living through the pandemic in Venice is relatively unusual, in that most Venetians showed respect for one another by wearing masks and maintaining a safe distance from each other. Elsewhere in Los Angeles this was not necessarily the case. Feeling safer in this community probably influenced the way I portrayed my principal male protagonist, a professor of computer science who remains unfazed by the rise of the virus.

Writing the book was the easy part. Next came the editing. As Stephen King observed, “Only God gets it right the first time.” I had written the narrative over a period of days, each day a separate section headed by the date and narrated in the first person alternately by one of my two leading characters. My line editor thought this read more like a diary and persuaded me to drop the dates and change to a third person omniscient narrator. Interestingly this made the narrative more personal than if I’d used third person in the first place. Still, for weeks I kept on coming across an “I” left in place, instead of a “he” or “she.”

Next came the vocabulary. I was born in Britain and, despite immigrating to Southern California 34 years ago, I still speak with an English accent and use English expressions. My characters are all Americans. It took five different readers to identify and eliminate those Anglicisms.

Additionally, some of my readers thought (rightly) that I allowed my two major characters to become reconciled after a near break-up too easily. I was reminded of Hemingway’s famous quotation from A Farewell to Arms: “The world breaks everyone, and afterward, some are stronger at the broken places.” I had to rewrite those sections making both characters much less reasonable and more angry with each other. Similarly, my readers got me to rewrite how the nine-year-old daughter spoke, as I had initially given her too advanced a vocabulary.

As this is my second self-published novel, I knew not only how important it is to get professional help with marketing the book, but also to allow my publicist several months prior to publication to launch the novel successfully. I enlisted the services of Nanda Dyssou who heads Coriolis Company, which had handled the launch of my first novel. She directed me to a gifted book designer in Mexico and arranged an online pre-publication campaign via social media. She sent numerous copies of the book (as pdfs or as paperbacks) to potential reviewers. I entered some half a dozen fiction competitions (most up to a year away).

She also tried to get me to persuade another author launching a novel around the same time to agree to a joint local bookstore reading, something bookstores were requiring during the pandemic. The most promising writer in my locality (Venice, California) was being published by one of the big five publishers. Although he was inclined to do a joint reading, his publisher didn’t like the idea and so this came to nothing. Another major bookstore in the Los Angeles area wasn’t making any dates for in-person author readings until May, two months after my book was published, and is still only doing online readings and interviews.

Instead Nanda turned to podcasts and blogs. To date she has arranged some dozen zoom-type interviews with me, focused principally on my latest novel. While a great way of making my book known to readers, such virtual meetings have only a limited effect on book sales. Next we are trying out free days on Kindle and an initial paid advertising campaign on Amazon.

Of course I would love to see more sales. But, as Vladimir Nabokov said, “Readers are not sheep, and not every pen tempts them.” It is early yet. Still, you can see how difficult it is to get your self-published book noticed, read, reviewed and sold these days. Despite these obstacles, I still think it is well worth it.

Brian Finney has won awards for his biography of Christopher Isherwood and for his debut suspense novel, Money Matters. His writings have appeared in The Los Angeles Review of Books, The New York Times Book Review, The Los Angeles Times, The LA Weekly, The Irish Times, The Chicago Tribune, The San Francisco Chronicle and numerous other journals and anthologies. He has published seven nonfiction books and two novels. Money Matters (2019), his first novel, was a finalist for the American Fiction Awards in the Best New Fiction category. The second is Dangerous Conjectures (2021), a novel featuring a couple living in the Bay Area whose lives are threatened by the spread of the coronavirus and the rise of conspiracy theories. In his former life he was a literature professor in London University and several universities in Southern California. He now calls Venice, California home. You can visit him at www.bhfinney.com