Writer 911: “Help, my character’s fallen and can’t get up.” (And Book Giveaway!!)

Good morning, Julie here, and I will be the first to admit that the last time I watched a medical drama was when I had a crush on Dr. Kildare. And yes, I am well aware that I am dating myself here with the younger set who have no clue who Richard Chamberlain even is. Nonetheless, there are two wonderful writers who are rapidly changing my clinical perception of medical romance—the Seekers’ very own Deb Giusti, of course, and … Candace Calvert.

Former ER nurse Candace Calvert gives readers a chance to “scrub in” on the exciting world of emergency medicine. Her new Mercy Hospital Series for Tyndale House (CRITICAL CARE, June 2009, DISASTER STATUS, April 2010) offers charismatic characters, pulse-pounding action, tender romance, humor, suspense--and an encouraging prescription for hope. Think “Grey’s Anatomy finds its soul.”

Trust me, when a book makes you tear up three times in the first 38 pages like Critical Care did to me, that’s a book you don’t want to miss. With true-life medical drama, magical prose and enough romantic tension to spike a high-grade fever, Critical Care is one of the best books I have read in a long, long time. So leave a comment or question and you’ll have a chance to win a signed copy and see for yourself. Without further ado, it’s my pleasure to give you … Candace Calvert.

In my three decades as an ER nurse, I answered countless questions and gave advice regarding illness and injury, often seasonally inspired: a sure sign of spring was the first lawnmower vs. toe incident (“I was wearing sandals. Do I need stitches?”). Lazy days of summer brought beestings and firework mishaps (“I got them from this buddy who sneaked them in from Mexico, and. . .”), followed shortly by autumn’s pumpkin carving trauma and acute turkey day indigestion (“Do you think it’s from that second helping of cornbread stuffing?”) Then, just when the first carols were sung, there was always that inevitable panicky and breathless phone call: “My baby ate a Christmas tree ornament! What should I do?”

Wear scrubs. Give advice. Answer questions. It was all part of the job.

And now, five years after retiring from the ER, I’m still doing those things, but in an entirely different capacity. I’m pulling on sassy red scrubs to sign copies of my new medical drama Critical Care (first in the Mercy Hospital series, Tyndale House), and the questions now often come from fellow writers: “I’ve got this character that I need put in a coma— a week would be helpful. Could you tell me how to do that?” Or, “My hero fell down a cliff. If I break his leg, how long until he could ride a horse?”

It seems that after striving all those years to control chaos and save lives, I’m now helping people stab, shoot, bludgeon and poison, give their characters heart attacks, strokes, asthma, pneumonia and recently . . . cholera. In truth, some days I feel like a hit man. But I’m glad to offer assistance and advice because the fact is that as writers we often have to deal with medical scenarios. And, thanks to TV shows like ER, Grey’s Anatomy, CSI, and House, our readers are becoming far more medically savvy. They expect details, and we need to get them right. It doesn’t mean that you’ll offer them from the focused POV of a medical professional, like in this opening snippet from Critical Care:

Don’t die, little girl.

Dr. Logan Caldwell pressed the heel of his hand against Amy Hester’s chest, taking over heart compressions in a last attempt to save the child’s life. Her small sternum hollowed and recoiled under his palm at a rate of one hundred times per minute, the best he could do to mimic her natural heartbeat. A respiratory therapist forced air into her lungs. Don’t die. Logan glanced up at the ER resuscitation clock, ticking on without mercy. Twenty-seven minutes since they’d begun the code. No heartbeat. Not once. Time to quit, but--he turned to his charge nurse, Erin Quinn, very aware of the insistent wail of sirens in the distance. “Last dose of epi?”

“Three minutes ago.”

“Give another.”

It’s more likely that your stories will have brief mentions of medical (or basic anatomical) material, from the POV of a lay person. Still, mistakes are made.

Like these very common flaws:

1) Describing blood vessels: emotional scenes where, “A vein in his forehead pulsed” (or throbbed). FLAW: Veins can’t pulse! Arteries carry the “pulse” from each heart beat. They are deep vessels, not easily visible. Describe instead, “A vein stood out on his forehead.”

2) Internal injuries: adding vague “internal injuries” to a character’s problems, as in “He had a sprained wrist and some internal injuries.” FLAW: True internal injuries are commonly a result of trauma to vital organs or large vessels. These can cause a person to bleed to death very quickly and require immediate surgery. Your character won’t be ready for a love scene the next day!

3) Skeletal injuries: writing “Thank goodness it was just a fracture not a break.” FLAW: A fracture and break are one in the same. And all require at least 6 weeks healing. Riding a horse would be tough.

4) Lapse of consciousness: giving your character a “convenient” extended period of unconsciousness for hours, days or weeks to aid in the story plot. “She fell and hit her head and when she awakened the next day, she found that her husband had cleared out the house and run away with her best friend.” FLAW: A prolonged loss of consciousness indicates a serious brain problem, often with a less than ideal outcome. Usual time expectation for loss of consciousness:

· Fainting (from emotional upset): sudden slowing of pulse/ drop in blood pressure robs brain of blood flow and person faints--lying down “cures” him and he is awake in less than one minute. Fainting from blood loss--person will regain consciousness lying down, but may need fluid resuscitation.

· Blow to head--concussion, brain ricochets against inside of skull--loss of consciousness is brief (few minutes) but person may be mildly disoriented, nauseous, for hours and have headache for days.

· Coma--prolonged unresponsiveness to voice, stimuli--indicates critical problem from head injury or disease process.

·Amnesia: Sorry, but true amnesia (though very handy plot-wise) is actually quite rare.

5) Pronouncement of death at trauma scene (seen often on TV shows where a young cop is shot and dies in fellow officer’s arms). FLAW: Everyone assumes death and no one tries to resuscitate! Someone should at least check for pulse, breathing and call 911. If transported to a trauma center (even under CPR) there may be a chance for survival. Don’t let your characters assume death unless the victim is cold and stiff, with vultures circling-- and out in the middle of a desert! Have someone call for help!

Medical Imagery

Even if you’ve never worked in a hospital, the sights, sounds, scents of that world are familiar to most people. Integrate brief passages of imagery to put your reader in the scene:

“The essence of Sierra Mercy ER hit Claire’s senses like an assault. Sounds: anxious chatter, a burst from the overhead PA speakers, beeping of electronic monitors, inconsolable crying, and painful screams. Smells: nervous perspiration, stale coffee, surgical soap, bandaging adhesive, the scorched scent of sterile surgical packs . . .

She took a slow breath and walked farther into the room, searching among the eddy of staff in multi-colored scrubs— technicians, nurses, and registration clerks. She forced herself to note the glassed-in Code Room, a small central nurses’ station and its large dry-erase assignment board, the semi-circular arrangement of curtained exam cubicles with wall-mounted equipment at the head of each gurney, and huge surgical exam lights overhead.

She tried desperately to avoid the anxious faces of the family members huddled close to the tiny victims. Because she knew intimately how much they were suffering. No, much worse than that. I feel it. I still feel it.

When she’d agreed to do this for Merlene, Claire had hoped this smaller ER, miles from the Sacramento trauma center and nearly two years later, would be somehow different, but nothing had changed.

Resources

So where can you go to find information that will enhance your medical scenes if you “don’t speak medical”? There are several basic information sites that I use:

1) Webmd Easy to understand, loaded with information:

http://www.webmd.com/

2) Wikipedia Don’t discount this very familiar source, great stuff there. http://en.wikipedia.org/wiki/Main_Page

3) Physician and medical suspense author CJ Lyons has a good reference page. http://cjlyons.net/for-writers/medical-links/

4) RWA medical romance chapter HeartBeat has information and members who are glad to share. http://www.heartbeatrwa.com/index.html

5) If your character’s “fallen and can’t get up,” you can always drop me a note via my website. I’ll be happy to answer your question or point you in the right direction.

Medical characters

Lastly, I thank you for not using stereotypes as medical personnel, even for your “walk on” characters. It’s so tempting to re-create a “Nurse Ratched,” snarky “Dr. House,” or M*A*S*H’s “Hot Lips Houlihan,” but those personality types are few and far between in these caring professions. Trust me; I know firsthand how many prayers are sent up from hospitals—by staff, too. As shown in this scene:

Claire’s stomach sank and she nodded, understanding all at once the source of her patient’s pain. She exhaled softly, then rested her hand on Jada’s shoulder . . .

“I was young and scared, and I made an awful mistake . . .” Jada’s tears spilled over, her dark eyes searching Claire’s. “Would you pray with me, Claire? It’s not against hospital rules, is it?”

“No,” Claire whispered as best she could around the lump in her throat. “Not against any rules at all.” She smiled and patted Jada’s shoulder. “And better than any medicine we have.” She glanced quickly at the drip chamber of the IV, feeling completely humbled; this moment had nothing to do with clinical skills. Yet it had everything—everything—to do with care and healing. Thank you, Lord.

And now your turn, please.

Have you included medical detail in your stories? Do you find the idea intriguing, intimidating? Do you have additional resources to share in this area? I’d also love to know how those of you who write historical fiction find the necessary information to describe medical care from past eras. Do tell.

And everyone who leaves a comment or question will be entered in a drawing for a signed copy of Critical Care, so be sure to sign in … STAT!

Candace