Many thanks to Louise Aronson for “tagging” me in the Next Big Thing blog book tour.

Many thanks to Louise Aronson for “tagging” me in the Next Big Thing blog book tour.

Louise is the author of the just published story collection, A History of the Present Illness, and she’s also a thoughtful physician who writes on medical education and the role of narrative in medicine. She lives in San Francisco and practices at UCSF and like me, a dog person. Her task to me: answer ten questions about something I’m either currently writing or soon to publish and “tag” five other writers to carry on the dialogue. It’s part of “The Next Big Thing” – an internet blog chain.

So then, I’m “it!”

1. What is the title of your book?

Open Wound: The Tragic Obsession of Dr. William Beaumontwas published in Fall 2011 and will be out in paperback this Spring. So I'm promoting the lighter and cheaper paperback. Yes, the ebook is even lighter and cheaper but try flipping its pages.

As for something I am currently writing, the working title of the next novel is The Underdoctors. Years ago, I stumbled on this term in this quote from Drummond of Hawthornden, a 17th century Scottish lawyer and poet, “That it shall be lawful for the school-boys to take the schools against their masters and, for the space of ten days, in their places appoint new doctors, under-doctors.” The term captures the idea that a once ordered world is now turned-upside-down. The professionals have become the laity and the laity have become the professionals.

The one sentence on this book …. “America’s greatest industry, whealthcare, has collapsed and the news reports give the angry and confused residents gathered in the Fox Run Retirement Community’s Commons Room someone to blame—Doctor Apsara Everett, a Vietnamese-American refugee—but what the news does not report, yet, is that one of their fellow residents, the quiet and solitary Doctor Robert Fane, is her father and that why her career crashed and Fane family fell apart are part of a larger story of the corruption of American medicine, freedom, and a nation seduced by risk and numbers.”

That’s all I want to say about that! Back to Open Wound….

2. Where did the idea come from for the book?

Open Woundis based on a true story of William Beaumont, the “father” of gastric physiology. A title he achieved by turning his patient into a research subject.

In June 1822, way up at the northern tip of Michigan, on Mackinac Island, a gunshot leaves Alexis St. Martin, a fur trapper, severely wounded. He is saved from almost certain death by Dr. William Beaumont, the island’s only physician, but his wound leaves him with a permanent hole into his stomach. Beaumont slowly started experimenting with his patient’s wound until he became a kind of American original, a self-taught physiologist. He’d take a piece of meat, secure it with a silk sting and pop it in the hole. Wait 15 minutes and then pull it out. Behold! Gastric digestion, live. And that was just the beginning of countless experiments on his patient.

I’m a physician-scientist and my research focuses on bioethics. The Beaumont-St. Martin case is among the cannon of oddities of research ethics. True, what Beaumont did to his patient seems part of medicine before an ethic of informed consent, but as I researched the story I came to see how Beaumont’s life and work were not some antiquated tale, but a timeless story about how ambition drives a man to desperate acts. His story is the dark side of American pluck and luck.

3. What genre does your book fall under?

It’s a novel, definitely a novel, but it’s based on facts, and also plausible facts. I was never in doubt that this should be a novel because I didn’t want the facts to get in the way of the truth. In the Afterword, I come clean on the major departures I made from the historical record, such as rearranging the sequence of some events and also event that I plainly made up, such as having Dr. Beaumont meet his fellow military surgeon Dr. Edwards and his personal slave, Dred Scott (yes, that Dred Scott). I have no evidence the two military surgeons ever met, but Dr. Edwards and Dred Scott traveled about the Illinois-Iowa territory at the same time Beaumont and Alexis were stationed at the malaria infested Fort Crawford. It was a plausible fact too good to pass up. Doctor and slave meet doctor and his patient turned employee, turned soldier and indentured servant.

4. Which actors would you choose to play your characters in a movie rendition?

Alexis? Jonny Depp. Definitely Jonny Depp.

And Doctor Beaumont? Who better to play a dark and angry and ambitious man than Daniel Day-Lewis. The part begs for him. He begs for it.

Aside from Doctor Beaumont and Alexis St. Martin, a key character is Ramsay Crooks, the Principal Agent of the American Fur Company, the profitable fur trading company owned by John Jacob Astor. Crooks was the effective ruler of the island where much of the first third of the book takes place. He fast emerged as the real leader of the place and a larger than life character. I struggled with making him real until the image of who he was came to me: John Goodman. With Goodman before me, the character came to life.

I get the walk on part of Major Pembroke of the Plattsburgh garrison, a small part but a fun part. He gets to tell Beaumont off.

5. What is the one-sentence synopsis of your book?

Open Wound is about how ambition drives a physician to use his patient to secure his own wealth and fame, and how his increasingly desperate acts cannot secure what he most desires, reputation.

6. Will your book be self-published or represented by an agency?

The University of Michigan Press will publish the paperback.

7. How long did it take you to write the first draft of your manuscript?

I wrote two complete versions that were tossed out before I finally settled on the published version. The first was 180,000 words!

8. What other books would you compare this story to within your genre?

I’d say Open Wound is Rebecca Skloot’s The Immortal Life of Henrietta Lachs meets Cormac Mccarthy’s Blood Meridian.

9. Who or what inspired you to write this book?

I’m a writer. The story came to occupy me and, in time, the characters came to me. I had a duty to bring them to life.


Now who else is “it”????  I tag…

Reed Farrel Coleman is big stuff – a three time winner of the Shamus Award for best detective novel of the year and author of the Moe Prager series. I met him at Frank Bill’s book event for his soon to be published novel Donnybrook (more on Frank in a minute). Reed and I got to talking. He thinks Moe is getting old and he’s ready to retire him. The geriatrician in me spoke up. Just let a few years pass. You’ll want to give the old man one more run. He’s already been tagged and done his part, but now he’s retagged. Check him out.

Frank Bill is the author of the awesome story collection Crimes in Southern Indiana and the soon to be released novel Donnybrook. I met Frank at the Great Lakes Independent Booksellers Association meeting when we were on the road touring our books. His writing is high octane, show-don’t tell fiction that makes sense of the lives of the rural poor of his native Southern Indiana. I just finished Donnybrook. It's a brilliant story of a painful journey to redemption through violence.

Thomas Pluck is a buddy of Franks and now a buddy of mine. He's a writer of "unflinching ficion with a heart."

Other writers to look out for include the brilliant David Casarett whose Last Acts is a thoughtful series of narrative esays that reflect on what people do with their last days and weeks of life. David is now working on a book about the many things we do to the dead and the dying. Austin Ratner’s The Jump Artist is a brilliant and moving debut novel, and, like me and David, a physician-writer. Jackson Taylor is one of the most thoughtful writers I know and his The Blue Orchard is an American classic. He’s also reticent to a fault and so while he’s working on a new novel, I know him well enough to respect his privacy and not to tag him. Just read The Blue Orchard. It’s prose is luminous and the story entirely captivating.

You need to get to know Jake Halpern. A wickedly inciteful and deeply talented writer of both fiction and nonfiction.