5 Tips for Writing a Medical Thriller

Thrillers are stories that elicit excitement, surprise, anxiety, and fear, taking readers on a rollercoaster of suspense and creating a visceral reaction that constantly keeps them at the edge of their seat.

(Using Beats To Improve Dialogue and Action in Scenes)

The medical world is an ideal backdrop for a thriller for several reasons. It is bursting with life-or-death emergencies. Medical thrillers count on our fear of disease, something everyone has to face, and make us ponder our own mortality. Medicine is conducive to “what if” stories involving technologies and treatments at the edge of what may be possible, but not quite available yet, which enhances interest and suspense.

Here are my five tips for writing a gripping medical thriller. Some tips are specifically geared to medical thrillers, others are applicable also to thrillers with different backdrops.

It’s not an accident that the most successful authors of medical thrillers are doctors. A first-hand experience infuses the story with insider’s credibility. Obvious mistakes leap out of many medical thrillers: diagnoses without evidence, impossible recovery from lethal injuries, unrealistic response time to therapies. Belligerent patients suddenly fall asleep instantly after a sedative is injected into their jugular vein. (Do you have any idea how difficult is it to “stab” the jugulars?) Wondering how the writer can be so ignorant about the subject isn’t conducive to thrill.

As a Cardiologist, I’m well aware of the time needed for cardiothoracic surgery. Yet, in Dissection, I had difficulty fitting one of the surgeries into the story, having to choose between an unrealistically short time (one to two hours for a surgery usually taking four to five) or resetting the novel’s timeline.

Don’t indulge in the temptation to show your knowledge by describing every inconsequential detail. Nothing kills suspense like trying to understand abstruse technical language.

Dan Brown mentioned that a story must have 3 Cs: contract, clock, and crucible.

The contract is a promise the author makes to the reader that all mysteries and questions will be answered by the end of the novel. The pacing is crucial: not too fast, so that readers keep on wondering, and not too slow, so that they don’t lose interest. In a medical thriller, the mystery driving the story may involve an unknown devastating disease, or a doctor who seems to violate the “Do no harm” oath. The question can be what happens when life-saving technologies end up in evil hands.

The hero—a doctor, some other medical person, or someone with strange symptoms requiring medical attention—must struggle to discover the answer or the cure, fighting against the clock’s pressure, and boxed in by the crucible, facing increasingly harder obstacles, which propel them into dangerous actions. To keep the reader turning pages, control the pace—speeding up and slowing down the story—to achieve maximum excitement. A condensed timeline puts pressure on the hero, enhancing the tension. During fast action, describing the event in slow motion can add to the suspense.

Cliffhangers: Ending a chapter or changing a scene in the middle of a life-or-death incident will keep the reader hooked.

Plot twists: Introduce astute diagnoses of baffling diseases, astonishing cures, and/or unsuspected villains among trusted medical allies.

A satisfying climax: Plot twists and cliffhangers must build toward a climax that answers all questions and ties all loose ends, thus delivering on the contract mentioned above. The hero fights their ultimate battle, bringing all conflicts and problems to resolution.

Especially in medical situations, keep away from “Deus ex machina,” Latin for “God from the machine.” At the end of Greek plays, a crane lowered actors playing God onto the stage to resolve all problems and conflicts. The end has to follow from the actions of the characters, not from divine intervention or other fortuitus events.

At each step of the story, problems and obstacles must intensify, while the reward for success becomes more and more crucial.

Dissection begins with a heart attack, advances to more catastrophic cardiovascular events, escalates into an apocalyptic plot involving the entire U.S. government, and opens the door to WW III.

The characters must be well developed in many layers for the reader to enter their world and care about their destiny. They have to come across as real, not as cardboard props.

The hero doesn’t have to be superhuman. They can be a regular medical person who acts against all odds, despite their fear. Often the reader doesn’t know how a life-or-death situation is going to play out and fears for the character. Or the reader knows about some terrible danger the character is unaware of, and the thrill is in guessing the timing and outcome. For this to be effective, readers must end up inside the head of the character they care about, so they can live the same anxiety, fear, sense of doom, and triumphs the character is experiencing.

The villain is as important as the hero. They’re the power behind the crisis and the obstacles for the hero to defy—the mad scientist who starts a pandemic, the gangster who sells body parts for transplants, the criminal who turns lifesaving devices into lethal weapons. In medical thrillers the villain can also be a disease. Without the villain, the hero would be sitting comfortably at home, just like the reader. Show the roots of the villain’s evil motivations, and their reasons for choosing immoral actions.

IndieBound | Bookshop | Amazon
[WD uses affiliate links.]

“Show don’t tell” is especially imperative in thrillers. Readers have to feel part of the action and the journey. They have to draw their own conclusions and motivation from what the writer shows them. Only then can they feel the same thrill the characters are experiencing.

Click to continue.