by Beth K. Vogt, @bethvogt

It’s not that I don’t watch medical TV shows or movies with my husband. It’s that I know what to expect when we do watch medical dramas together. I know I’ll hear a “tsk” or a “hmm” from Rob. He’ll shift in his chair, laser-focused on the “I’m not really a doctor, but I play one on TV or in the movies” actor. 

Of course, his action prompts me to ask him, “What did they do wrong?”

I then get a concise explanation of where a writer’s need for tension ran afoul of medical reality.

The doctor is in.

“Many stories will say a person’s illness needs a specific treatment or a medication in 48 hours. And then in 48 hours and 1 minute, when the patient doesn’t receive the needed shot or pill, the person dies.” My husband shakes his head. “And that’s just not reality. The story has a ticking clock, but it’s a false ticking clock.”

Let’s talk books.

Yes, authors need to put tension in their novels, but the challenge is weaving in both a realistic and an accurate medical thread.

Are you using a ticking clock in your storyline when your medical illness calls for a “ticking calendar”?

“Part of what you could do is add the flavor of unpredictability more than a ticking clock,” Rob explained.

You create unpredictability by using a common medical issue and setting up several different “what could happen” scenarios. This creates tension.

For example: Your main character, a private detective, is in emergency surgery after being shot in the abdomen. There’s tension about the seriousness of the wound. (Is it superficial or life threatening?) There’s tension in the waiting. (Is surgery taking longer than normal?) There’s tension because he was already recovering from an earlier injury from a car chase. (Does he have the strength to recover?)

What are some questions you should ask when there’s a medical thread in your novel? These questions affect the level of tension in your book. 

1. Do you want your character(s) to survive?
2. How long do you want your character(s) to survive?
3. Have they been through something like this before – an illness, an accident, an injury – and survived? Just barely? Completely recovered?
4. Has someone else in the (fictional) family experienced this medical issue? 

It’s important to do what my husband and I talked about in our previous blog post, How to Write Believable Medical Fiction Part 2: Doing Your Research. You need to do your research thoroughly about your chosen medical conditions or injuries using reliable resources. 

Even if you’re writing fantasy, where you’ve created your beings’ or creatures’ physiology, you need to stay true to the world and the science you’ve established. When my husband answers an author-friend’s medical questions, he often begins the conversation by asking, “Is this a human being or a fantasy or science fiction creature?”

It’s also important to decide how crucial your medical thread is to your story. Medical issues affect people both in real life and in our fiction. People get stressed or chronically disabled or are unable to keep their jobs or face infertility. 

But are any of these struggles the point of your story? 

Perhaps the medical angle is more of a story layer to help explain or demonstrate your subplot character’s flaw or to allow your character to be a Voice of Truth to your main character. 

A final word of caution: If you’ve had a difficult or disheartening medical experience and you believe the health system failed you, don’t write your story in an attempt to get back at people. Be careful that your novel doesn’t become a literary vendetta. 

How does a medical thread fit into your novel?

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Unpacking Christmas: A Thatcher Sisters Novella

As Johanna, Jillian, and Payton look forward to celebrating the Christmas holidays with their families, they’re not prepared for an announcement that changes everything they’ve grown to love and cherish.

Their parents are selling their long-time family home. One change seems to lead to another, with Payton and Zach announcing their own decision to move, while Jillian and Geoff tackle the challenge of starting a family. The only ones maintaining the status quo are Johanna and Beckett—but romantic limbo is no place to be. Then their dad’s sudden health crisis spins life further out of control.

This Christmas, Johanna, Jillian, and Payton will laugh and cry together as they realize the true magic of Christmas isn’t found in gifts or decorations, but in the love of family.

Award-winning author Beth K. Vogt believes God’s best is often found behind the door marked “Never.” Beth revisits the Thatcher sisters in her newest novella, Unpacking Christmas: A Thatcher Sisters Novella. This holiday story released in November 2021 and is published by Never Door Press. Readers first met Payton, Jillian, and Johanna in Beth’s award-winning women’s fiction series published by Tyndale House Publishers. The Thatcher Sisters Series includes: Things I Never Told You, Moments We Forget, and The Best We’ve Been. Find out about Beth’s other books at bethvogt.com.