The power of healing: Carol Cassella on being a best selling author, a mom, and an "invisible doctor"

If writing were like painting, Carol Cassella's prose would be an Edward Burne-Jones: luminous, reflective, and perfect even in the smallest details. Dr. Cassella is an anesthesiologist, a novelist, and (the most impressive task, in my opinion!) the mother of two sets of twins. Her first novel, the national bestseller Oxygen, was an Indie Best Pick for July 2008, and selected as one of the best first novels of 2008 by The Library Journal. Her books portray the humanity behind the world of medicine, where healing has to overcome ambition, greed, and weaknesses.

It is my great pleasure and honor to have Dr. Cassella as a guest on my blog today!

EEG: You worked for a while in publishing, before deciding to go back to school and study medicine. Looking back, how important was this decision in becoming the accomplished writer you are today?

CWC: I worked in publishing after graduating from college solely because I loved books and wanted to work around them and among the people who created them. I had harbored dreams of being a writer from the time I learned to read, and stumbling into a job with a publisher was the closest approximation I could find that actually paid my rent. Only problem was, the job I had was selling textbooks for an academic publisher--pretty far cry from my own goals. But I think it was a first step toward realizing that books are not spun in a vacuum. They are the product of many minds and many hands and there is a very concrete business model that underlies their production and distribution. That lesson has certainly stuck with me and helped me navigate some of the mysteries of being a published author. I do wish, though, that I had continued writing fiction more consistently from my childhood. Think how many more words I would have under my belt by now?

EEG: Oh, but books aren't made of just words, as I'm sure you already know! Even when you're not writing, you're experiencing the world as a writer...

I've read many novels about surgeons, medical examiners, ER doctors. Oxygen was the first book I read where the protagonist is an anesthesiologist, and I loved it: it gave me all these insights into a field I knew so little about. I'm curious: of all medical fields, what made you choose anesthesiology?

CWC: I have been an anesthesiologist working in a major hospital's operating rooms for more than fifteen years now, and I still find that work fascinating and uniquely challenging. Even after medical school I didn't fully appreciate all that an anesthesiologist does for their patient. In fact, I became an internist and worked in both public and private clinics for three years before I returned for three more years of training in anesthesia. We are "invisible doctors" in a way--we are usually assigned to our patients on the day of surgery, rather than being chosen by our patients in advance. We talk to our patients for only a few moments before they are sedated or asleep, so they often have no idea of all that we do for them while their surgery takes place. The trust and vulnerability of that role is mind boggling, when you really think about it. And most of us require anesthesia at some point in life; the average American has seven surgeries before they die. I chose the field because I wanted to focus on one patient at a time, which is impossible in most specialties. I love the procedures involved in anesthesia--it is a very tactile field that requires both intellectual decisions and precise manual dexterity for placing nerve blocks, epidurals, intubations, etc. There is also the benefit that I could have a little more control over my hours and with a young family that makes the combination of medicine and mothering more practical. I could work part time as an internist, but only by sharing my patients with another physician, who might not know them as well.

EEG: In your last book, Healer, your protagonists find wealth and comfort through a break-through blood test and then, just as easily, they lose everything. This dichotomy in medicine -- the moral need to heal versus the profit aspect -- is a topic I'm particularly sensitive to. My research is in HIV and vaccine development, and because of that I see with my own eyes the costs of vaccine research while trying to reach out to the poorest parts of the world, where HIV has the highest prevalence. Tell us about your new book, Healer, and what inspired you to write it.

CWC: Ooh. You are touching on a subject close to my heart. For several years I wrote articles for the Bill & Melinda Gates Foundation about vaccine trials and disease prevention in the developing world, and I know quite well the disparities that exist in health care. It is a conundrum--drug and vaccine development is phenomenally expensive and poor countries can't afford it. But those industries are also phenomenally profitable and invest mightily in lobbying our own congress. How do we incentivize medical breakthroughs but also realize the moral, equal distribution of those discoveries? And, of course, we face the same dilemmas here in the United States. We have very unequal access to care. In Healer I was also quite interested in wealth acquired by any means, and how it affects our view of ourselves, our rights, our relationships, and our expectations. In some ways I saw the story as a parable for what our country experienced in the nineties--money that flowed in too easily, seemingly unlimited loans with loose fiscal reins. And here we are. Redefining what is normal!

EEG: I hear you. And with the current budget cuts things are as hard as ever. My boss has a beautiful photo of two African children in her office. They are smiling and playing and you would never guess they are AIDS orphans. When I'm having a bad day at work I look at that photo. It puts things back in perspective.

Carol, thanks so much for taking the time to answer my questions! And thank you for being an advocate for these issues and raising awareness on the costs and struggles of medical research. Your books are amazing and I truly look forward to your next novel.

Dr. Cassella currently practices anesthesia in Seattle and has been a freelance medical writer specializing in global public health advocacy for the developing world. Her new novel, Healer, was released last June. Visit her website to find out more about her books and her public lectures.