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What's it Like to Write Fiction as a Physician

Updated: Apr 13, 2022


Note: transcription provided by Otter.AI, which is a technology company that develops speech-to text transcription and translation applications using artificial intelligence and machine learning.


Christopher H. Loo, MD-PhD: And so today I actually have a kindred guess, it's Dr. Debra Blaine. And we both met back in 2019. And, and since then, I've seen her grow as a fiction writer, and a lot of her writing reminds me of the authors, Michael Crichton and John Grisham. So she's the author of Code Blue: The Other End of the Stethoscope, which is published on Amazon, as well as her newest novel, Undue Influences. And what's interesting is, it takes quite a lot of skill to be good at writing fiction for people for mass consumption, and people willing to pay for the book and really enjoy it. So I brought her on. And she's going to talk all about her background, her story and her books. So, Debra, welcome.

Dr. Debra Blaine, MD: Thank you so much. I really appreciate coming on. And I've loved following your posts and watching you grow. And I just love what you're doing for all of us to help us find, find some passion and fulfillment in what we do, and not just slog away all the time.

Christopher H. Loo, MD-PhD: Yeah, I was mentioning that one of my passions is to find just diamonds and gems and just other undiscovered treasures, and just try and bring awareness to that. So tell us about your story and your background and how you got started and all of that.

Dr. Debra Blaine, MD: Okay, so, I have been practicing medicine for over 30 years, I'm kind of done. I'm now working part time because my son is off my payroll. But way back 100 years ago, when I was in college, I was more of a Liberal Arts Major. And I even started a graduate program in Comparative Religion at Temple University. And then I think I just gave in to the pressures of my family, because the only thing that was really acceptable for me to be was a doctor, lawyer, engineer.

So it's interesting, because now, I'm living for me and not for other people. But at the time, I wasn't really strong enough to say, no, that's not what I want. So I went back, and I went to medical school and became a doctor. And then I had a kid and I still had all these ideas about what I was going to do with medical ethics and all these, and I had a kid and became a single parent. And I think life just became about survival for a long time.

And I ended up doing urgent care, because I didn't have to take calls in the hospital, I didn't have to be getting up at the crack of dawn to go round patients coming home late. And I had sort of regular hours. And that's what I needed for my son. And then I kind of lived for my son, I think, which I think is something that women especially do, and then he left the nest. And I always say that the most important thing we can do for our children is teach them to live without us. And I have excelled tremendously. My son is now off on his own, doesn't really need mom, and then I was sort of like Okay, now, what do I want to do? Who am I? What do I want to be when I grow up?

I started writing Code Blue, more out of just complete frustration and a kind of anger at the way that the American healthcare system has led us physicians down. And I really started to see that as medicine’s, failure to physicians as opposed to physicians' failure in medicine, which is how we were sort of taught to think of ourselves as Oh, you can't cut it, you can't do it. What's wrong with you, you're not tough. I think that medicine has become very unreasonable.

So I started writing this book, I also started looking for options. I talked to this wonderful coach, Heather Fork, which I think a lot of people know. And she pointed me in several directions. One of them was to Seek and I went to the physicians writing conference there. And I had started writing, but the thought of writing a whole book was so daunting and overwhelming. How do you do that? But I saw someone who spoke at our synagogue and he had a book and he had little vignettes about his life. And I said, Well, I could do that. I could write little patient encounters and I started doing that. And each one was taken in Code Blue, every patient encounter is based on reality. But of course, I changed names and ages and sides of the body and whatever. But first of all, I enjoyed writing about it. And also, it made it so much more palatable.

Because when somebody was being so obnoxious and so difficult, instead of getting like, my stomach will be in knots, it would just think, I'm gonna write about that. And the more outrageous the story, the better it was for the book. So it puts a whole different spin on difficulties in the office. And then I, but then I went to Seek and I met this guy, Rich Krevolin, who's actually a screenwriter, he's a retired faculty from University of Southern California. And he came around and gave us a few minutes of his time for free, and then I hired him as my mentor. And he really helped me with Code Blue.

So I went to his workshop. And he said, well, so I had to decide, do I want this to be fiction or nonfiction? And I didn't want to be nonfiction, because then I could be liable. Like, well, what office are you working in? And what are you saying about our office? And what are you saying about our practice, so I didn't want to have to deal with any of that. So I made it a fiction. And as a fiction, then you need a plot, you need a hero, you need a villain, obstacles, there's all these things that you need. And so that's where the rich came in. I worked with him for probably six months. And he taught me so much about how to write in a way that was compelling. Hopefully, I succeeded. So I wrote this thriller, about the Russian Oligarchs, sorry, anyone else there who's Russian, somebody wants to complain about that. But somebody's got to be the villain.

So anyway, they hack into our EMRs. And they, they steal information, and they use it to extort millions of dollars from the patients, and then they murder them. And the doctor that you follow around, during the course of her day becomes a target for the Russians. And there's more detail in that, but I don't want to give it away. But at one point I was told you did such a great job with this thriller part, you don't really need all that office stuff. And I was like, No, that was why I wrote the book, I wrote the book, because I needed to say, what I was saying, I needed people to be able to read it especially people who are not in medicine, to be able to read it and say, Wow, that really happens to you, wow, you can't just prescribe a medication or order a test or, this people are that demanding some time so I needed, I really needed to do that. And it was a lot of fun or cathartic in a lot of ways.

So after that, I looked at the book, and I, and I said to myself, self, I said, I don't like what I'm doing, I hate my life. I hate my day job. And I don't want to do this anymore. And that was really, a lot of your posts are about authenticity. And that really kind of brought it home to me that, why am I doing this? Why am I spending day after day after day, doing something that not only doesn't resonate with me, but I'm suffering from it. So, I left. I took 11 months off. I became certified as a coach. And I do coaching, and I kind of ramped that up a little bit. And then, I started working on the second book, because I discovered I really like to write. Yeah, and then the pandemic happened. And I think it was my grandchildren asking me one day. So Grandma, what were you doing during the pandemic, and my saying, Oh, I had taken off. I felt sort of embarrassed by that. So I went back part time, because I wanted to help out, I'm completely over that, I did my assistance. And, and now I'm, I'm looking more in a permanent fashion to get off the hamster wheel.

But then, for me when I write a book, I think the second book is so much more polished and mature. I just feel like I grew as a writer. And my second book I had, I only started with three things. I had an opening scene in my head, because Rich taught me that you always want to start with something that grabs the reader, that pulls them in. And you also want to make your reader care about your characters, like has to be like why should I care? What happened to this kid, Joshua? Who cares? Who's Joshua? So I had this opening scene in my head. I knew I wanted to do something with the flower, the devil's breath, which Vice called it the scariest drug in the world. And I kind of knew where I wanted. I wanted to talk about extremism in this country. And as I'm very much a moderate. I mean, do you remember Chris, we were just a time we could have gone out and had a whole heated debate over political things. We could have disagreed on everything. We could have argued and argued, and I am taking this into account. And then afterwards, we could say, Okay, where are we going for lunch? Yeah. Right. Yeah, it was like, okay, so we don't agree so much.

But something has happened in our culture. And nobody can do that anymore. Nobody listens to each other. Nobody respects each other if they have a different opinion. So that was what I wanted to write the book about. And then, in the first case, I had an outline, because Rich made me do an outline, in the second case, I didn't really have an outline and knew exactly where I was going. And when I finally realized I couldn't solve the problems of the world in one book. And I was able to kind of close it up, and I'm writing a sequel now. And so my goal is really to write and to do more coaching.

So I coach medical professionals, but I also am starting to coach writers and, and not for tips and things I can't. I just writers are like, like disenchanted physicians, very, very supportive of each other, and somebody wants some tips on characters or things like that. I can't charge them for that. But if somebody wants me to follow them as they write their book, which means I have to read their stuff, and we talk about it, I would have to charge for that, because it's a lot of time. So that's the other thing I'm starting to do. And I'm starting to increase my coaching practice. And I am determined to be out of the clinical sphere in the next 12 months. Because I'm just done.

I had two days back to back where I saw, I mean, I’m doing urgent care. I mean, it's like they want you to see 70 patients an hour, and they're not all nose swabs, you know? And I just asked myself, because I talked to myself all the time, I asked myself at the end, I said, Have you had enough yet? And, and I realized there were like two parts of me, there was the part that said, yes, I've had enough and I want out. And there's that other part that was like, No, I can do it, I'm tough, I can do it. I'm strong and no. Like who's talking here? And I realized the reason I'm still doing clinical medicine is because some part of me still sees myself as a clinician. And so I'm really working on a transformation of sorts, so that I can get out and be productive and be lucrative, and, and help other people like you do.

Christopher H. Loo, MD-PhD: Like, like all of us, so. But what's interesting is, I'd like your journey, where you just use creative writing as an outlet like, like John Grisham, when I was reading his bio, he just, he was doing it. And all of a sudden, he has his first bestseller. So, and what's interesting is that a lot of people think creative writing is just scattered and all of this, but there's actually a structure to it, and there's actually plots and there's how to write, so, that's quite interesting and compelling. So, what sort of resources besides mentoring and coaching did you take advantage of to help write your book? And how can physicians who are interested in Creative Writing start?

Dr. Debra Blaine, MD: So, as far as researching my topics, I use the internet a lot, which is something John Grisham might not have been able to avail himself over 30 years ago, at least not as easily. So so researching the devil's breath flower, and where it grows, and what it does, and who used it, and what did they mix it with? And what else was that drug used for in this country? And what the Nazis used it for? So that stuff is whatever was available on the internet. I was able to grab and incorporate it.

I think I've just always enjoyed writing. I had a professor in college, an intellectual history professor, and he was fabulous. And, and one of the things he used to do with my papers, though, was he used to, like draw lines through it. He used to break my heart. It was like, Occam's razor like, you don't need this, you don't need this, but I love that paragraph. I love that sentence. And, and it but he got me over that idea. And I think it's something that a lot of writers go through is like you write something and now it's yours and it's your baby and you don't want to get rid of it. But it gets easier to say, Okay, I really like that, but it doesn't add, it's not, it's kind of taking things in a different way I'm not focused with that. And what I did, sometimes I would take that piece and I had a whole folder on My computer that was like bits and pieces, I think I called it bits and pieces. And I would put stuff in there that I wasn't ready to part with. I might want to use this sometime. So the beauty of, of having software, like to have a word, a word document or a word program, if you can save it, you can save it forever. But it doesn't belong in your book right now.

And Rich taught me things like, how do you keep suspense going? Like he told me never to end a chapter in a soft way where you feel like you're done for now. Like, always end the chapter with a question. Always end the chapter, wanting your reader to wonder, okay, what happens next, and then flip the page and so that they keep on reading and so that each, at the end of everything, is still getting you to want to read more. And another thing is, I think that, characters, and I don't really know who taught me to do this, I think I just did it. But I become my character when I'm writing and each character is different. So maybe I'm a little schizophrenic. And that's what I can do. It's like, I just, I sort of enter that character and their persona.

And then I can talk the way they talk, or I can think, oh, no, they, they wouldn't do this. I have one character and two influences who I like. I wanted things to go one way, and the character told me no, I didn't do that. And I was like, and then it took me so long at the end of the book to get that all worked out. Because that character was now in trouble for something that the character said that they didn't do. So. But I think just sort of entering into them, and seeing how they would interact. It's a lot of fun. I mean, it's so much fun, you create these people, and they become real real. And I think that medicine actually helps, because we've seen so many personalities. And we've seen so many how people have had to deal with things and why, and what their strategies, their coping strategies are and we can draw from any number of those and create a whole person around it.

Christopher H. Loo, MD-PhD: Yeah. Sometimes writing is just very, it's therapeutic. It's cathartic, it's very productive. And writing serves so many different purposes. So, one question I had is, how do you know, is it a feeling, when you're at the end of the book? Is it something in the book, you plan the ending? Or is it just sort of something it's like you sort of like a project and you sort of feel it's, tied up loose ends? And that's the completion of this. I'm just curious for my own sake.

Dr. Debra Blaine, MD: So I think it's really important. I've been reading masterclass stuff, and they tell you if you make a promise to your reader that you're going to answer certain questions, you better answer the questions. My first book, I knew exactly how I wanted to end like I had. I had the last sentence of the book, my second book, I had no clue how it was going to end. And when I finally got to it, because I had to get somebody out of trouble. And it was like, oh, yeah, that's perfect. And I was really happy with that ending. It's just, I think it's really important, though, that you can kill off people, but you have to give the reader a feeling of things and in a good way for them you don't want them to be so disappointed. Like Game of Thrones, season eight, I don't know. I mean, I was not, that was not an ending we got through all those seasons. And even so many things that weren't addressed. I mean, you don't want to do that. You want things to be tied up neatly, and you want it to be there to be some emotional satisfaction for the reader even if, even if somebody has to die for it but it's like, it's an understandable part of life, maybe, or and some of the bad guys can be killed. And even some of the good guys can sometimes get killed, but you have to, you have to sort of satisfy the reader. Yeah. Or they'll never pick up another one of your books.

Christopher H. Loo, MD-PhD: And what's interesting is that it sounds like creative writing is just, it's a passion and it’s a skill that can be honed and developed. From your voice and your facial expressions I can tell it's like very, very therapeutic and, it's something that physicians can do in their spare time and, and it contributes to their overall happiness.

Dr. Debra Blaine, MD: I think we all need to have something we really enjoy. Unless you love slogging away in the office. And some people are doing things that they really do love. But for those times when it's just really like, it's just really repetitive busy work and you feel that the leadership's coming down on you, and the patients are all reviewing you and whatever. And the insurance companies aren't cooperating. And so I think you need to have some outlet that's just for you. And, and something that you can feel like, okay, I can just get away, whether it's painting or writing or horseback riding, or I think we need to, we need to have it for ourselves.

And I remember when I was in medical school, we started off with a week between rotations, and then it was a weekend and then it was hardly anything at all. And there was a certain point where I was like, what are they used to do to have fun? and that carried over for a long time. I couldn't remember. I've done some interesting things. I went rappelling, rock climbing, scuba diving, skydiving, I mean, I've done some really cool things that I enjoyed, but then it was like, What did I used to do? Like, can I just rent a kayak? Oh, yeah, I guess we could do that. It's only an afternoon. I can do that. You know?

So but the other thing, just to say is that I didn't completely do it out of the blue, even though I had this history, but it was 30 years old. When I started writing Code Blue, I did take an online writing course, beginner's writing course, it was $89. And it was like two lessons a week for eight weeks, or 12 weeks. It was the best $89 I ever spent. It was just sort of a review of grammar. How you write things like how do you like, you're not supposed to change voice in the middle of a paragraph. Okay, even if I'm writing a paragraph in your speech, then I can't. I have to make a new paragraph for somebody else to speak. Otherwise, it's confusing to the reader. So thanks that I had never thought about, but it just gave a lot of those little things that were really helpful.

Christopher H. Loo, MD-PhD: Wow. Interesting. So what are you working on now. I know, you mentioned coaching, you're writing, you're working on, you're thinking about your next book, and let the audience know how they can contact and reach you?

Dr. Debra Blaine, MD: Oh, sure. So you can contact me through my website,, I am writing a sequel to the second book. Because as I had discovered, I can't solve the problems of the world and one book, I can't solve the problems in the world, two or three books, but I can't, I kind of came to a closing state now. And moving on this next book takes place about 12 or 13 years in the future. And so I'm thinking about getting into medical writing. But I'm also considering just really developing my coaching practice and focusing on writing. So this time around, I used the same publishing company. And this time around, they've got some new people doing marketing. And so I have a lot of hope for that. So I got myself into a couple of cool bookstores, and I'm going to do some speaking events, but everything got shut down during COVID. So that was kind of tough. And I'm finding that the second book is helping sales in the first book. And I feel like if I could get five or six or seven books out there and a coaching practice, then I could say, sayonara.

Christopher H. Loo, MD-PhD: Well, that's, that's wonderful. It's great to see your progression since 2019. And you get a lot of book signings. So I know once this pandemic is over all these in person events so I think your practice, and your writing is going to take off. So thank you for any last parting words of wisdom before we say goodbye?

Dr. Debra Blaine, MD: I would say, if you're interested in writing, you should write. And don't let it intimidate you. You don't necessarily think about writing an entire book, it's not gonna happen in an afternoon and don't even think about the whole project at once. Think about doing parts of the project. And, don't edit while you're writing. like, if you write a paragraph two, oh, that's not exactly the word I meant. And you just bog yourself down, you won't get anywhere, just really call it a word dump, just write, write whatever comes to mind, and then later, you can go back and edit it. Sometimes I'll put things in red. Because I know that's not really what I wanted to say, I use a thesaurus a lot when I write. Because I know that I know, there's maybe I'm just losing my mind because I'm older. But I know there's a better word for that but instead of spending time thinking of it I put it in read and I'll come back later. And we want to look that up. So I'd say, not just for writing, but to spend time on yourself. Time is going by and we always think we have tomorrow but tomorrow, tomorrow's is elusive. It's not. It's not for unfortunately, we've learned that with COVID that for some people there isn't tomorrow. Yeah and we have to, our lives are precious, and we need to make the most of it and enjoy it the best that we can.

Christopher H. Loo, MD-PhD: Yeah. You said it so well, and nothing's guaranteed in life. And thanks so much for being on the show. Congratulations on the book, and all of your success, and we will have you in future episodes to talk about choosing a publisher and hybrid publishing, self publishing. So we look forward to that. So thanks so much, and we'll see you next time.

Dr. Debra Blaine, MD: Thank you so much. I really appreciate it.

Christopher H. Loo, MD-PhD: Many thanks again for being here. If you’re new, you can find me online at Christopher H. Loo, MD-PhD, where I have links to other episodes or links to online resources that will support you on your financial literacy journey. I’ll see you there in on next week’s show. While I bring you thoroughly vetted information on this show regarding a variety of financial topics, I cannot promise you a one size fits all solution. This is why I caution you to continue to learn. Educate yourself and seek professional advice unique to your situation. If you want to talk to me, I welcome it. Please reach out via my website or email at I read and personally respond to all of my emails. Talk soon!


Editor's note: This transcript has been edited for brevity and clarity.


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