Debunking myths on genetics and DNA

Wednesday, April 9, 2014

Medical care, genetics, and love -- a perfect blend in Carol Cassella's latest novel Gemini

My guest today is a practicing physician, a Wall Street Journal Expert Panelist, a member of the Global Burn Care team of volunteer doctors who travel yearly to Bhutan to provide reconstructive surgery and local training, a national bestselling novelist, and the mother of two sets of twins, one fraternal and one identical.

I interviewed bestselling author Carol Wiley Cassella the first time in 2011. I had just read Carol's first novel, Oxygen, a suspenseful medical mystery that keeps you turning the page, and I was instantly captivated by Carol's writing.

Carol is now back with a new compelling novel, Gemini, the emotional story of two women whose lives are bound to intersect in the most incredible way. But what's really incredible is that, despite her numerous commitments and jobs, Carol is extremely generous with her time and, once again, she graciously accepted to be my guest here on CHIMERAS.

Welcome back, Carol!

EEG: From the first pages of Gemini we are confronted with one of the worst nightmares from both a patient's and a physician's perspective, as intense care physician Charlotte Reese struggles to reanimate an unconscious, unidentified woman under her care. Carol, you said about Gemini that one of your goals when writing the book was to "make medicine realistic but also comprehensible," and that you wanted to narrow "the gap between translation of medical care from doctor to patient." In your experience, how big of an issue is this gap? Is medicine too complicated or are humans too complicated?

CWC: I think the gap is huge! Yes, humans and medical science are both complicated, but the bigger problem is a lack of time in our often frantically paced healthcare system. I see two things happen over and over: first, doctors don't have time to thoroughly explain the disease, the causes and likely outcomes, the alternative options for treatments, and then listen to all questions and address them. I think most doctors do their best, but there is often a huge amount of material to cover. Second, patients are often distressed and not able to fully comprehend, process and remember what they are told. Studies have shown that a relatively small amount of provided information is retained by patients. It's a good idea to take notes or, with permission, record conversations with your doctor. Go to appointments with questions written out in advance, so you don't forget to ask them. If possible, ask if a nurse or physician's assistant is available for extra time to explain all options, risks and benefits. Our health is so critical to our well being and sense of fulfillment in life, and when it fails we want explanations and a sense of realistic hope. While the Internet has plenty of information, it is very hard to apply it to your own situation with any real perspective, and I often see it lead to more worry than resolution.

EEG: As an anesthesiologist, despite being so incredibly important in the OR, you end up spending probably the least of time with your patients, compared to your fellow physicians. I wonder if, among all other things, this shortness of time with your patients has endowed you with a longing that inspires your stories... Is that so? As if your imagination tried to fill in the gaps?

CWC: That's a fascinating question that I'd never really considered. I do pack a lot into the ten or fifteen minutes I spend with a patient before they go to sleep for surgery, and often find myself wishing I knew them better. I was an internist before I was an anesthesiologist, and I really enjoyed having a deeper, ongoing relationship with my patients and their families. However, I found it frustrating and stressful to be managing hundreds of patients at the same time. As an anesthesiologist I'm only responsible for one person's life at any particular moment, so I'm able to fully concentrate on their care and end the day knowing I accomplished something good and completed my task. But I do find myself imagining more about their backgrounds and their lives than I'm able to learn in my brief visit with them. I don't use any real patients in my novels, but as writer I'm constantly trolling for ideas--bits of real life--that I can weave into my novels. More often than not I get them from news papers, my own life, or (every writer's secret source) eavesdropping!

EEG: Your writing is flawless, with a special attention for details. You often have words for ordinary things that have me pause in awe because I wouldn't even know how to describe such everyday details. Whether it's a landscape or a dialogue, your writing feels very intimate, and your characters very real. You are such an attentive observer that I can't help but wonder: do you do any kind of visual arts besides writing?

CWC: Thank you--I value that comment more than you can know! I barely have time to brush my teeth, so, no, I don't do any other kind of visual art. I would say that I enjoy observing nature and people keenly, and I love the puzzle of capturing that in words on a page. That, to me, is one of the most enjoyable parts of writing. But even if I can't perform any other artistic feat, I get both great pleasure and inspiration from theater, dance, film and music.

EEG: You wrote Oxygen in first person present, Healer in third present, and Gemini in a very intimate, omniscient voice. Is the POV/tense something you plan ahead or do you go with whatever wants to be written on the spot? If it is planned, do you like to challenge yourself with something different with every story?

CWC: With each book I have written an early draft from a different POV than the final, published book used. I seem to need to experiment by attacking a story from different angles, then "listening" to how the voice sounds on the page. Ultimately the story dictates what POV I use. Oxygen was such an immediate, personal story that I chose the less common first person present tense, which allowed the reader to discover the story along with the protagonist. With Gemini I wanted to show too many "off screen" facts and details to use first person, but I still wanted it to be intimate, so I stuck with close third. It is fun to challenge myself with different voices--I wouldn't want to repeat the same craft technique with each novel.

EEG: What are you working on right now? What's next in your writing goals?

CWC: My next novel is set in the world of global public health. I love writing about medicine and don't feel anywhere close to exhausting that enormous topic, and global health has been a personal interest most of my professional life. I'm particularly interested in how some of our most noble, magnanimous ideas can become hindered when we apply our logical and historically successful western health models to other cultures. Sometimes we fix one problem only to create two more. But still, the world is so small and closely connected these days, and health problems on the other side of the planet ultimately affect all of us in one way or another. We can't just stand by and wait while people in other countries needlessly die.

EEG: I hear you and I greatly admire what you do. Making sure we don't forget that there are parts of the world where children still die because of poor or inaccessible health care is our mission. My supervisor gives talks around the world about HIV, and she always begins showing pictures of the AIDS orphans in Africa. We can all make a difference and the first step is to raise awareness.

Thank you so much, Carol, for stopping by today, and thank you for enriching our lives with your suspensful and thought-provoking books. Find Carol on Facebook and learn more about her books by visiting her website.

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