Do you want to write a medical thriller or mystery?

Has the nightly TV news made you think about writing a novel on an Ebola or measles epidemic?

#The first step in writing is a medical thriller is research.

This type of research needs depth and breadth. Not surprisingly, many medical and scientific thrillers have been written by physicians or scientists, like Robin Cook, Michael Crichton, Kathy Reichs, and myself.

Let me explain what depth and breadth means. Someone (If I tell you who it will ruin the mystery.) “poisons” a diet doctor in Murder: A New Way to Lose Weight. This toxin was the cause of a rash of real poisonings in New Mexico in the 1980s. I wove the information from two scientific articles into my tale of an intentional poisoning and set the novel in Albuquerque as an oblique clue.

To add authenticity to all my medical mysteries/thrillers, I reference key articles in the “Scientific Epilogues” of each novel.

How did I find such arcane articles? I read articles on science and medicine in newspapers and magazines and on line. I also read scientific journals, especially the journal Science, and look for trends. For example, the dead diet doctor had been studying ways to modify the bacteria in the guts of obese subjects as a way to help them lose weight. I thought this research had humorous aspects and is a promising area of research.

#The second step in writing medical mysteries is creating a filing system that allows retrieval of articles by several headings.

If you're not careful, all your research becomes a lot of clutter. So I cross-reference materials I stash in real and virtual files carefully. I note not only the medical or scientific issue discussed in articles but also the location (if outside the U.S. or in New Mexico) where the research was done and the possible social significance of the work.

For example, I’ve had files on Ebola and other tropical diseases for twenty years ago. No, I don’t plan to write a novel on Ebola, but I know these articles are good sources of information on the problems faced by health care workers during epidemics and the responses of citizens to quarantines.

# The third step in writing a medical novels is basically scientific education.

It’s finding clear ways to explain complex issues in human terms.

Among the propaganda spouted by Cuban tour guide in 2013 was the statement: Cuban scientists had patented a drug for cancer. When I got home, I investigated her claim and found researchers in Havana had patented a therapeutic cancer vaccine to treat a rather rare type of lung cancer (non-small cell). This drug revs up a patient’s own immune system to produce cells, which recognize substances found on the surface of tumor cells but not on the surface of normal cells. These immune cells then slay the cancer cells, but not the normal cells.

Okay that’s a heavy dose of science. What’s the social relevance? This patent demonstrates several Cuban scientists are doing competitive science, and the Cuban government understand the importance of commercialization of their research. I also discovered U.S. scientists were trying to augment existing scientific exchanges between the U.S. and Cuba, despite the embargo on Cuba. (Editorial in the journal Science on June 6, 2014.)

I thought Sara Almquist, as an epidemiologist and heroine of my previous medical thrillers Coming Flu and Ignore the Pain, would be the perfect protagonist to do a little “scientific diplomacy” in Cuba. The result is my thriller Malignancy. Of course, Sara gets involved in a lot more than science; it wouldn’t be a thriller without danger.

So are you ready to write a medical mystery or thriller?

Real Science Is Essential in Mysteries & Thrillers

Laboratory results, psychology, and computer analyses are essential for plot development in any modern mystery or crime fiction. Think of the TV shows—CSI, NCIS, and Criminal Minds. Many thrillers depend on technologically to provide innovative ways to trap or destroy villains. Big Bang Theory has shown science nerds can be funny. However, many authors (especially those who are not scientists or physicians) are uncomfortable about using scientific tidbits in their writing.

Essential considerations when adding science to fictional tales.

1) Use scientific details to create realistic scenes, but not so many as to slow the plot. As a biologist, who regularly reads scientific journals, I’m intrigued by cancer immunotherapy. (Scientists are making vaccines that trigger the immune systems of cancer patients to more effectively fight their disease.) That’s the scientist in me talking. The novelist part of me says the plot and character development rule.

In Malignancy, men disguised as police officers shoot at Sara Almquist twice in one day. Albuquerque police suspect Jim Mazzone, a drug czar who has tangled with Sara before, will order more hits on Sara. When colleagues in the State Department invite Sara to arrange scientific exchanges between the U.S. and Cuba, she jumps at the chance to get out of town. Soon, she realizes Cuba offers more surprises than Albuquerque.

That’s the plot. One of Sara’s surprises is Cuban researchers have patented a therapeutic vaccine for a certain type of lung cancer (actual fact). Another surprise involves her love interest, the shady Xave Zack. I can’t tell you about the others because that would spoil your surprises as a reader.

2)  Pick relevant science topics. Readers are more apt to be interested in facts that are relevant to real issues—global warming, fracking for natural gas, or curing cancer than in learning details about biochemical pathways.

I thought weights control was one of universal interest to Americans, but most want to hear something besides the obvious: eat less and exercise more. Scientist know fat animals (including humans) lose weight when their gut bacteria are altered, but scientists don’t know which of the 15,000 to 36,000 species of bacteria in the gut are important. Talk about a lot of red herrings. I thought descriptions of this research (based on current ongoing studies) would be intriguing, maybe slightly funny, to readers.

In Murder: A New Way to Lose Weight, a diet doctor is found dead after she charges her partner with recklessly endangering the lives of obese subjects in their clinical trials. Linda Almquist, the associate dean in the medical school, must protect the subjects in the clinical trial, while she searches for a sophisticated killer who knows a lot about poisons.

3) Be accurate. In Malignancy, I state the truth about the cancer vaccine Racotumomab developed by the Cubans. It triggers patients’ bodies to mount an immune response against of certain types of lung tumor cells because they have an unusual compound on their surface. It doesn’t prevent or cure cancer, but in it should slow the progression of the disease. It may be one of the first successes in cancer immunotherapy, but it’s too soon to tell. Many clinical trials, which require international cooperation of scientists and physicians, are need. Thus this is a practical example of why the State Department sent my heroine, a scientist, to Cuba to begin to set up exchanges Cuban and American scientists.

Why not pick up copies of Malignancy and Murder: A New Way to Lose Weight and see if you like how I incorporated science into my thrillers/mysteries?

I'll try to visit more often in 2015, but I've been busy preparing a collection of short stories.

# Main rule to include science in fiction. Use scientific details to create realistic scenes, but not so many as to slow the plot. http://jlgregerblog.blogspot.com