From Fact to Fiction: Medical Journalist–Turned-Author

This transcript has been edited for clarity.

Robert A. Harrington, MD: Hi. I'm Bob Harrington, from Weill Cornell Medicine in New York City. I'm here at theheart.org | Medscape Cardiology booth on the floor at the ESC meetings in London. I love to use the big meetings over the course of the year as an opportunity to catch up with friends and colleagues, some of whom I convince to come onto this podcast with me.

One of the things I've noted over the years is that I really enjoy interviewing authors who play a role in medicine, whether that's as clinicians or journalists. It has been one of the more fun things that I get to do, and it turns out they seem to be popular with you, the listeners, as well.

I hope that this is going to be an experience of walking through a book that's come out from a long-time friend and colleague, that hopefully you'll go out and buy because you thought this was such a great discussion.

I'm joined today by Shelley Wood. Shelley, thanks for joining us.

Shelley Wood: Thank you so much for having me.

Harrington: Shelley is the editor-in-chief of TCTMD. She does have a history with theheart.org.

Wood: I was a theheart.org original. Back in 1999 is when I started.

Harrington: You started around the same time I did.

Wood: Yes. I was still in journalism school at the time, by the way.

Harrington: It's been fun to follow your career over the years. The tables are turned here.

Wood: Absolutely.

Harrington: Over the years, you've interviewed me about a bunch of clinical studies or what's going on in the world of medicine. You're a fabulous medical journalist. I've always thought that you've been one of the best medical journalists that covers the field of cardiology.

Wood: Thank you.

Harrington: You have in-depth knowledge, and you write clearly in a way that even we cardiologists can understand. I've always appreciated that.

Wood: Thank you for saying that.

Harrington: Now, I get to ask you questions.

Wood: I know. I'm a little bit nervous, I have to say.

Harrington: The reason I get to ask Shelley questions is that she has a new book out. This is her second work of fiction.

Wood: That's right.

Harrington: The first one was a bestseller across Canada, and also an excellent book. This one, I think, will appeal to those of you who like a little bit of a medical mystery and a little bit of a medical background to try to explain why things happen. It's called The Leap Year Gene of Kit McKinley.

Wood: This is the final cover. Actually, you got an early reader copy. I think that's going to be worth something one day.

Harrington: First off, congratulations.

Wood: Thank you so much, Bob.

Harrington: I read the author's notes and the acknowledgements at the end. I didn't realize that this was a COVID book until I read that at the end. You certainly were influenced by COVID as you wrote it. Although COVID was largely a horrible time, there are good things that came out of it. One of the things is that you could, as you said, hole up at home in British Columbia and begin to think about the book.

Writing While Working Full-Time

Wood: That's right. I do thank healthcare professionals in my acknowledgments, not that they had a direct involvement in too many ways with the book, but I had this powerful sense that I was writing a book that had medicine in its DNA. That's sort of a pun, but I was able to do it because I wasn't a frontline worker. I wasn't seeing people die every day.

Now, none of that is in this book, but I was grateful. I'm grateful for physicians, generally. I have a career because physicians exist. Also, I just felt lucky to be able to delve into something like this while working full-time. I could do the two side by side in a way that physicians that were working during that period absolutely couldn't.

Harrington: We will get to the book, but what always amazes me is the statement you made that you were able to write this while working full-time. Many of the people that I do interview happen to be clinicians who have had this desire to write a book, and they do it while working full-time.

Wood: Let's just remember that I quit theheart.org | Medscape to write my first novel. I tell people that I think I went into journalism because I loved writing, but I didn't think I could make it as a fiction writer so I turned to journalism. I have had an incredible career, and I've loved it, but I just didn't think I could do the two side by side. I quit, I wrote my first novel, and then after a year, I went back working in an almost identical role.

I knew I wanted to keep writing, but I love what I do, so I really had to be very disciplined about how I carved out my day. I interview physicians who are writers, too, and I just think, How is this possible? Actually, it is possible, if you want it. I wanted it so badly.

I'm proud of my first book, but I knew I wanted to write something even bigger, and I would say better. I'm an early bird, and I would wake up very early in the morning to write and then start my day job.

Harrington: The morning for you was the early-morning creativity time?

Wood: Absolutely.

Harrington: Much of journalism, while there's creativity in it, it's more fact based, and trying to make sure you got the story right, and writing about it at that point.

Wood: Yes, and polishing because I do care deeply about the words in my journalism; fact based; it has to be fast. The writing you can polish as you get a draft, whereas the creative part, the fiction — for me that had to be first thing in the morning before I even looked at my phone.

Harrington: I'm always fascinated by how people do this. We were talking before we came on camera about my friend, Abraham Verghese. He's a very visual writer. If you go to his house while he's in the process of writing a book, he has it storyboarded. He draws pictures and he builds his characters, and in some ways, he's imagining this whole world and then he's transposing it. What's your style?

Wood: I do use a type of storyboard. I use a big roll of butcher paper, and I make what I call signposts. Both of my books have had strong historical elements, so I will sort of know the signpost that I'm writing toward.

I get a lot out of going away from my home life to do it. I holed up at my in-laws' cabin for much of this. It's taking me away from the day-to-day. It's taking me away from my loved ones, and it feels a bit selfish, but I can get into my imaginary world better if all the stimuli of friends and husband and household chores aren't a part of it.

COVID let me do that because I wasn't allowed to socialize. I could really take my time for myself and build those worlds without people knowing what I was up to most of the time.

Harrington: Let's talk a little bit about the process for this book, The Leap Year Gene, which is a really creative book.

Wood: Thank you.

The Creative Process

Harrington: When you had sent me the book and I read the title, I said, "What is this about?" You quickly figure out what it's going to be about, and you pick it up pretty quickly.

How did you come up with this? Did you know the whole arc of the story? Some writers tell me, "I knew how it was going to end," and other writers tell me, " I have to see where the characters take me." What's your style?

Wood: A bit of both. I came up with the idea of somebody who ages slower than everybody around her. I think the idea came because I was feeling my age. I'm quite an athletic person, and I felt I was slowing down, including physical changes and in mental ways as well. I felt that quite strongly.

How can you stay young, if you stay young? This really struck me because, at the same time, I'd gone through some personal losses. My mother had died, and I thought, Okay, you want to stay young for all the reasons that society wants you to stay young, but if you do, you will lose everyone you love. Those were the two forces working in my sort of fictional process.

Having written a first novel that has almost zero medicine in it, I thought, This is ridiculous. I really would love to draw on my medical experience, my knowledge of physicians, the relationships I have with doctors, my ability to research topics — all of that. I need to repurpose that for my fiction. For my second book, I decided that if there's a person who ages more slowly than everyone around her, let's make it a genetic condition.

That provided me with my signposts, because then I could think about, if we look back 100 years, how has our knowledge of genetics changed in 100 years? For me, what was even more attractive was our knowledge of eugenics, which, as you would know, is this very debunked and disgraced pseudoscience.

Harrington: That comes out throughout, sort of what I'll call the dark history, and some of the genetics words.

Wood: That's another way, I think, where journalism helped me. I love the aha moment in journalism. You've seen us pounce on this stuff, right? You see something and you think that's a story. In this case, when I started reading about some of the early eugenics stuff, I thought about how people don't know that our beloved suffragettes in Canada and the US were also quite vehement eugenicists. I thought, Okay, my story begins there. A child with this strange, rare, totally fictional defect will be born to a suffragette. What does that look like?

Harrington: I'm glad you pointed out that it doesn't exist because when I started reading it, I thought, This isn't real, is it? Much of the other medicine you have in here is real.

Wood: That's right.

Harrington: At the end, in the author's notes, you do reference some of the books you read on genetics, too, to give you a bit of a guidepost as to what was true and what was not true.

Wood: You're going to love this story. When I had this idea and I decided it was going to be a genetic defect, I called up Eric Topol. He was my old editor-in-chief, and he's a geneticist so he can help me here.

Harrington: He's a great writer.

Wood: He's a great writer. We had had other conversations about that. I called him up, and I was explaining what I was doing, and the line's going very quiet. I said, "So how could you get a genetic defect that would cause you to age more slowly? Would that need to happen right after conception, or could it happen later in the pregnancy? Could it be emotional trauma?"

He's very quiet, and then he says, "You're writing fiction, aren't you?" It was a really great reminder that I don't need to be a journalist. I don't need to get all my details right. I need to be imaginative. He totally gets credit for that.

Harrington: I don't want to give too much away because I want people to read the book. That is where the leap year comes in. The kid is born on February 29, a leap year. That's the theme that gets carried throughout. The leap year gene is not real, as best we know. As you point out, as time goes on, over the course of, I'll call it, many years, new knowledge is becoming available.

Wood: You asked me about my process. I did not have the whole story in my mind. I knew I wanted it to span the history of the eugenics movement, but I knew I wanted to bring it up to modern day because we've reached the point where we actually can edit our genes.

Harrington: We're doing CRISPR technology and gene editing.

Wood: Exactly. I knew I wanted it to end there. This was a tip I got from another writer — that you might not know what you want your ending to be in terms of plot, but you may want to know how you want to leave people feeling. I had a very strong sense of how I wanted people to feel at the end of the book. It almost was this beacon to write toward. That took a while.

Harrington: When you write a book of that length, in terms of the years, it becomes a long book.

Wood: Too long.

Harrington: When did you know it was going to be a long book as opposed to "you know what, I'm going to cut this up here." You couldn't do that with the approach you took.

Wood: No. The reason I knew it was going to be a long book was because it became long. Then my writing group told me it was too long. Then when my agent tried to sell it to publishers, they said they wouldn't take it because it was too long. This final book is half the length of what I wrote, which is so awful because I'm an extremely efficient person, but this was an inefficient process.

Harrington: Was that the work of your editor plus you? Mostly your editor?

Wood: Mostly my agent when she was trying to sell this book. Yes, I worked with different editors along the way to get it shorter.

Harrington: That's remarkable.

Wood: It's awful. It's a terrible process. I mean, I edit people's work all the time. I'm ruthless. With my own work, it was very, very hard. You need to lose characters that you now know well, as if they're friends. You need to take out whole plot arcs. That's hard.

Harrington: Abraham told me something very similar. As you know, his books are very long. He has a hard time leaving pieces out because of what you described. You become attached to the characters.

Wood: I was reading his latest book at the time that my book was being widely rejected. I just kept thinking, Abraham got to write a long book. How come I can't? An editor who was really helpful for me, said, "This book isn't meant to be that long. It's too much."

I had a huge portion about the Human Genome Project. She said, "It's too much. That's a different book." I had a huge amount of it set in apartheid South Africa because whenever has there been a eugenic experiment on such a scale? That is really not in the book anymore.

Yeah, the editing process is hard, and I apologize to every journalist whose piece I've ever hacked up before, as I've got a taste of it now.

A Sense of Place

Harrington: You made reference to South Africa. This book, in addition to taking place over time, takes place around the globe. I had mentioned to you that I'm a big fan of Southern writers, in part because I love their ability to evoke a sense of place. I was amazed at how many places you described.

Wood: Did they feel authentic to you?

Harrington: They did. Many of them I've been to, including Germany, Paris, and India, so I felt like I knew where you were going. I was really impressed. I've been to these places, but I'm not sure I could evoke that sense of place. How did you do it? Did you have to go visit them again?

Wood: Well, I couldn't because of COVID. I even got a grant from an arts council to pay a visit to Berlin because I've only been to Berlin once. Actually, a huge part of part two, which is set in Berlin, had originally been set in Paris. That was one of the big rewrites I had to do. I have spent quite a bit of time in India. I have spent a large amount of time in France.

I really wanted this book to feel international because my first book was very much a Canadian book, about the Dionne quintuplets. It's a very Canadian story. I think the themes in this book affect everyone.

This isn't something that's unique to one population, although different populations have been subjected to the kind of othering that I was concerned about in this book. I like to think that this is a gene that any one of us could have been "afflicted with," and what that might be like for anyone to imagine themselves in Kit's shoes.

Harrington: She moves, in part, to stay one step ahead of people knowing about her. Her family is very conscious about — what's the phrase you use — bringing them into her secret. They move, in some way, staying one step ahead of the law, if you will. She does also have to stay a step ahead of the law with things like birth certificates.

I was really impressed by the amount of detail that gave me both the sense of place and her being in that place, and particularly, being in places you couldn't possibly have visited, like Berlin in the days of the Nazis.

Wood: That's research, right? That's immersing yourself. When you're doing all that research, you're just absorbing, and you wonder if this thing is even ever going to get written. I find that part really hard. Other writers, I think, come to make peace with that, that it will pan out for them if they just lie around reading for months on end — that this will become art at some point.

I did so much reading and research that never made it into the book, but hopefully it absorbed itself somehow into my mind that gave those places a sense of realism.

Harrington: For the next book.

Wood: Maybe. I like to think that it wasn't a waste. It helped make me better. It helped make me stronger.

Harrington: Your sense of place is one of the things that definitely stuck with me, and for places that I knew.

Wood: Oh, good.

Harrington: I mean, you threw Stanford in there a few times.

Wood: Importantly, because that's where CRISPR was getting off the ground.

Harrington: It was good for me to see the different places that I knew well.

Wood: I hope you didn't think I was just planting that so that I could get on your podcast.

Harrington: So that I could read it? Well, the clinical trials world, working with industry, doing clinical trials — as I was reading it, I was smiling, like, Oh, I know about this stuff.

Wood: Good. I'm not a physician. For me, to learn about genetics was very difficult. I think I took grade 10 biology or something. I managed to scrape through on chemistry to get through high school. I don't have that background. I was doing things like Coursera courses to learn about DNA again. It's lost in my head if I ever knew it. Other things could come through with a little more authenticity because I understand how clinical research works. I understand the jeopardy in there as well as the yield.

Harrington: You also understand the conflicts, the commercial vs science, and how that goes. We're coming near the end here, but I have to ask, what's next? You have to take a break for a little bit and promote your book. Obviously, that's critically important. Is there another idea that you want to work on?

Wood: I have a couple of ideas. I'm not about to tell you what the book is about, but I had to spend too much time at my computer with this book. It took 5 years to write. As you know, I work full-time. It's too much time sitting. One thing I really want to do is see if I can write a book not on my computer — so, longhand, or at least taking notes. That's one goal. I also want to write a book that covers a much shorter period of time because 100 years… I really bit off a lot there.

Harrington: It is a lot because you have to think about the place 100 years ago vs the place today.

Wood: You need to jump your reader through time; some of that I wrote to connect those and then threw a lot of way. When I read a book and the author drags me forward a couple decades, I do feel a sense of loss for the knowledge I will never have of what happened in between. I hope I did connect that in this book, and it was intentional, but it is hard to do, and I think it's hard as a reader. Some readers won't stand for it. They don't want to be yanked through history.

Harrington: One of the things I thought you did really nicely was the obituaries. I started realizing that what you were doing is helping me go forward by marking the death of a character.

Wood: Also, I liked the idea that Kit, the principal character, collected these over her long life. For her, they were a way of putting a marker down. Some of those would have been ones she collected. I had to cut a lot of obituaries. I had so many other ones in there.

Harrington: Oh, there were some good ones. I won't give it away, but there are some terrific ones in there with little quips. I'm an obituary reader.

Wood: I must say, I've started becoming one myself.

Harrington: It's what we call the Irish sports page. I started doing it as a young person. In fact, one of my patients gave me a book called The Times Great Lives, if you've not read this. These are obituaries that are in one of the London papers, and it's regular people as well as famous people. Sometimes the regular people's obituaries are much more interesting.

Wood: I'm amazed that I can get misted up over the obituary of a person I have never met and never would have known.

Harrington: I read them every day.

Wood: It reminds us of our mortality and of the people we ourselves are going to lose at some point.

Harrington: Shelley, thank you. Thank you for joining us here on theheart.org. It's a fabulous book.

Wood: Thank you so much, Bob.

Harrington: I hope people will read it. I'm a big reader. I have to read to separate myself from everything else I'm doing all day long, and it gives me great pleasure to read, usually at the end of the day. I really appreciated having this, so thank you for producing it. Good luck with the book tour and good luck with what you're going to do next.

Wood: Thank you. I really appreciate you inviting me on here.

Harrington: Thank you to Shelley for joining us here and talking about her book, and thank you for joining us today on theheart.org | Medscape Cardiology.

If you've enjoyed the podcast, please take a moment to like and subscribe, or even better, write a review for us. This gets us to meet and reach more healthcare professionals. If you didn't enjoy it, tell us why. We're always looking for new ways to bring things onto the podcast. Your feedback and engagement are really appreciated. Thank you.

Robert A. Harrington, MD, is the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine and provost for medical affairs of Cornell University, as well as a former president of the American Heart Association. He cares deeply about the generation of evidence to guide clinical practice. When not focusing on medicine, Harrington dreams of being a radio commentator for the Boston Red Sox fan.

Cite this: Robert A. Harrington, Shelley Wood. From Fact to Fiction: Medical Journalist–Turned-Author - Medscape - Oct 03, 2024.