learning and growing as a writer Dec 23 2013, part one

(updated for republication, Dec 2014)

Merry Christmas to every one (2013).

Now that I finished the manuscript for my second book, it’s time to pause and reflect. if I was still in the State of Maine I would sip on a cup of cocoa by the woodstove, dog at my feet, listening to the wind howl or perhaps the freezing rain as it grew a layer on every twig and branch. But – I am not there.

Of all the things to reflect on, I choose to think about my growth as a writer.  I think I have improved as a writer, since 2008. This is not a path I would have thought I would go down.  I love doing nursing, I love teaching, and I have lots of things to occupy my time. But I have found that of all the people who go to Nepal to do volunteer work, hardly any body writes about it, and those who do tend not to give a picture that is useful for other who wish to follow them there. So I think I am filling a gap.


Do you know the old saying “if it’s worth doing it’s worth doing well?” – a handy aphorism. something to help us become dedicated to our work and live up to our potential.

I have a corollary. “If’s it’s desperately worth doing, it’s worth attempting even if you do it badly.”   and I am sure people will cringe to read this, but it is also true. There are challenges in life that have not been tamed. The first few who take on a new challenge, will fail. But that does not mean they should avoid a challenge. Because of this, the first saying needs to be clarified and re-interpreted. “If it’s worth doing it’s worth dedicating ourselves to the best we can possibly do” – and not “if it’s worth doing it’s worth doing well therefore don’t even bother unless you can be perfect the first time.”  (there are people who interpret it this way).

The first book was The Hospital at the End of the World. I don't end it was perfect.

The first book was The Hospital at the End of the World. I don’t end it was perfect.

That kind of sums it up with my writing at book-length. The first book was not perfect and was never going to be a best-seller. I wrote it while I was having deep “re-entry shock”  into USA. I could not answer the simple question “Was this a success or a failure?” I was coming to grips with my first exposure to a low income country and the limitations of health care there.  I needed to reflect on the experience, and writing was my way to do so.

Snakes and snakebite

My process of writing The Hospital at the End of the World started in a simple way. I composed a series of looooong emails to friends and family to describe some of the events that happened to me in Nepal. I felt better to have gotten things off my chest. After awhile I counted about 40,000 words on the page. If I sequenced these into the proper order, and filled in the time gaps, I would have a book (usually considered to be about 80,000 to 100,000 words).


In The Hospital at the End of the World, the snakebite story came first. That episode was a howling and unexpected success and vivid. I wrote it in ninety minutes and the final version as it appears in the book is about 95% the same as the very first draft. At the time it happened, I knew it was a “lifetime story” and I also knew that a strange series of coincidences brought me to that situation. In retrospect I should have somehow ended the book there, because it was a “happy ending” and very upbeat. But, it happened very close to the beginning of the summer. What came after was more important but more difficult for me. If I was a better writer I would have found a way to position the snakebite story at the end, somehow. But – I was not.

page 42

In the first book, I also find that I have the “page 42 problem.”  I have since learned that I am not the first newbie writer who ever did this, but that is small consolation. Here is what happened. On Page 42 I described something that was a true event – the day that three children died in a short time span, and how we responded, and what happened.  Exactly what happened.

It was deeply upsetting at the time. Strangely enough, we never ever de-briefed about it.

Never discussed it.


It was actually one of the things I wrote about last. It was traumatic at the time, and it was at the core of my experience in Nepal in 2007, a turning point. In truth, I spent about six hours writing the three-paragraph description of what happened. If you had watched me during that time while I was writing,  you would not have seen me doing much typing. I was frozen at the keyboard, staring into space and truly trying to think about what happened, making sense out of it. Should I simply skip it? how should I write it? what did it mean to me?

I did write it.  And what I found was, many readers who might not have had a medical background, got to that part and decided to not read anything else in the book. They just stopped. Oh, maybe they picked it up again a month or two later. But for many – no.

I spoke to a person who put it down for a month then picked it up and did continue reading.  She told me:

“When I got to that part I had to re-read it three times before it registered with my brain. Was I reading what I thought I was reading? I had to overcome denial. Do such things happen in real life? You described the most horrible action, along with the most humanitarian action, and – it was two irreconcilable descriptions of the very same event done by the very same people.”

True that.

Yes folks, it was upsetting to me, even though at the time I had fifteen years of critical care nursing experience. But it was really upsetting to the readers. I wanted to portray the reality; but this was simply not something people can deal with. not possible. Not if I wanted them to continue reading. Again, I was not good enough of a writer.  We are left contemplating the mystery of when bad things happen that have no social redeeming qualities.

I don’t want to sound flippant, but I have since learned that there is an unwritten rule that says, if you want to sell books, don’t ever write about the death of a child. Louisa May Alcott could get away with it. Maybe she is the only one. One of the Harry Potter books approached this taboo as well – the scene took place after a contest going through a maze and meeting the Dark Lord.  I do not have the skill of Alcott or Rowling. Alas.

beta readers

One takeaway for me was to carefully gauge who the intended reader of a story may be, and to see how it is perceived. For the second book, this is what propelled me to enlist the aid of two dozen “beta readers” – people who would test drive the manuscript.

Death of children?

Then in 2007, after the snakebite incident, I spent a month supervising students doing pediatric burn care. That occupies a quarter of the book. As I say, any hopes that this book would have an uplifting message faded quickly.  I had taken care of burn victims in USA, but not victims like the ones I now met. So – the book addresses a very serious issue of health care – thermal injuries.

There were two pediatric patients in particular that we worked with a lot. It wasn’t until eight months later that a Nepali nurse-friend went out of her way to find out for me what their long-range outcome had been ( they were both still alive at the time of my departure in 2007.) and she told me in May 2008 that each of them died despite all our work to heal their burn injuries. I had finished the manuscript by that time. I decided not to include an update because I knew the book was depressing enough already.


There are other things that have gotten me more attention than I expected. Yes, Virginia, the book uses the “F word” which is a big no-no for a lot of people. three times. at the time my rationale was “that is what was said at the time.” This offended people. I decided to edit this out after original publication, but – the damage was done.

And also, the book tells about when I went to the tourist town, drank more than I should have, and – then what happened. ah yes. I don’t pretend to be perfect, or to present myself as a fake role model. I do what I do. I try to be a good person.

There was a certain readership that was okay with the death of children, but to use the F word? or to hook up with somebody? OMG!

Anyway, despite it’s flaws, the book has helped me to find the people I wanted to find, for which I am grateful.  The idea here is to launch a dialog that will help people from the west be more prepared for the experience of going to Nepal and volunteering…….

thank you for reading this far. Tomorrow, or some future time, I will continue this by describing how my experience with the first book  led to choices I made for the second book.

stay tuned for part two….. I will write about the decisions I made with book two that will make it a better reading experience…


Using Twitter limits to write a blurb for a novel

Twitter and the 140-character challenge

So while I await feedback from my editor and a couple of new beta readers, I still try to think about writing every day, and on a blog I found something that’s been making the rounds – pitching your novel in Twitter length. 140 characters. Maybe slightly less, but definitely not one character more. (as in certain card games).

this goes with the back-of-the-book blurb, sort of.

Version #1

This was my first entry into the realm of 140-character pitching:

Matt returns to Nepal as a missionary to search for the love of his life. Will he find her or will the civil war keep them apart forever?

One reader of the blog, who did not even read the book (yet) submitted:

“The thrilling story of young love set against the backdrop of the majestic Himalayas.”


Heck, even if that is not the official 140-character pitch, it might as well be. who can dispute the universal nature of love?

every book needs a back cover blurb

How does the physical appearance of a book entice the potential buyer?

In a bookstore, a patron looks at the cover, then reads the back cover, then the first few lines of the first page. or so they say. The blurb on the back needs to tease the casual browser into exploring further. It’s also used in a summary on Amazon and other places where a tease is used.

Back cover blurb #1


Heart-pounding medical thriller from the majestic Himalayas

As a college student on a trek during summer break, Matt was wounded in the crossfire of a mountain ambush during the civil war in Nepal.  A team of missionary doctors heroically saved his life.  While he recuperated in a remote hospital, he tutored Kali in English.  Soon it became a courtship that transcended cultural barriers to culminate in a night of passion.

He lost contact when the CIA sent a helicopter to bring him to safety.  Unable to get her out of his mind, Matt returns to Nepal years later, determined to find Kali or her story since she seems to have disappeared without a trace.

Something happened during the battle that swept through the town, and Matt must unravel the mystery.  He is now a missionary surgeon, working alongside the doctors that saved his life, earning their trust.

As Matt searches for Kali he is challenged to the utmost level of his skill and courage.  Will the consequences of Matt and Kali’s first meeting shatter the lives of everyone on the team?

naturally, the idea is to convey what a gripping page-turner this is.

At the same time, not to reveal the ending.

Oh heart break! O unrequited love! O destiny!