by Beth K. Vogt, @bethvogt

I was talking with my husband Rob about how to approach today’s blog post and I said, “Maybe we try this …”

I reminded him how sometimes a patient will call the front desk at his medical practice and request an appointment. When asked what the issue is, they say they need a routine appointment for something like minor shoulder pain. 

Fast forward to the routine appointment with his patient: Often during the last two minutes as Rob is wrapping things up, the patient will say something like, “Oh, by the way, I’ve had chest pain on and off for the past month.”

That’s the end of the “routine” appointment. You don’t ignore chest pain. Rob might work up the patient for the rest of the day, wanting to ensure nothing serious is overlooked.

How does this tie into writing believable medical fiction?

The doctor is in.

In November we discussed How to Write Believable Medical Fiction Part 3: It’s Not All About the Drama. In that post, we briefly mentioned that it’s crucial to decide how important your medical thread is to your overall story. Today, we’re lasering in on that decision: how vital is your medical thread to your novel?

Going back to the medical problem mentioned earlier in this blog post, we all know shoulder pain affects you. Slows you down. May interfere with your sleep, which is bothersome. But usually, shoulder pain is not life threatening.

Chest pain, however, has increased potential for being an indicator of a serious health issue. Think: heart attack. But it could also be a sprained rib. Also bothersome, but not fatal. (Ask Beth how she knows.)

Before you give a medical issue to your fictional characters, you must decide if you want the problem to be minor or major. In real life, when someone we care about has shoulder pain or chest pain, this affects us, too. This indirect effect needs to play out in our novels, too. Think about everything from how pain can make someone irritable all the way to how long-term hospitalization affects family members, friends, and coworkers. What would this look like in your story?

Writing a full-on medical thriller? Then your story starts with a major medical issue – think infectious diseases or environmental contamination – that drives the story and significantly affects the lives of both the main characters, the subplot characters – and potentially also threatens lives across the globe in your fictional world.

One challenge when dealing with a global medical threat is balancing the big picture element without losing the up-close and personal dynamic involving the main characters.

One way to do that is to take time to plot out your stakes in your novel. Remember there are three different types of stakes you can utilize to create tension in your novel:

1. Public Stakes are things we care about as a nation or culture. Example: A worldwide pandemic or a toxin that is going to be released by the villain and threaten the world unless demands are met – or the hero or heroine stops them.
2. Personal Stakes are things or people that touch the heart of your hero or heroine. Example: Put your hero’s family at risk. Put your heroine’s love interest at risk.
3. Private Stakes are situations that force your hero or heroine to choose between two competing values. Example: Does your hero or heroine save the world or save the one they love? Do they save the day or save themselves?

Now consider medical fiction. You don’t have to use all three types of stakes in your novel. Not all medical novels are written about global threats. Some are personal, where a family member or friend struggles with a health issue. It’s still the dominant story thread, it’s just not Public Stakes.

---

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.