Wednesday, March 18, 2009

22 Secret Agent

GENRE: Thriller

Dr. Julia Sinclair snapped on latex gloves, and peeled away the pus-soaked dressing to reveal one of the nastiest wound infections she’d seen all year. A shocker. The Infectious Diseases equivalent of graffiti on Michelangelo’s David. “Bet that hurts like a bitch.”

“Too bloody right.” The patient’s flushed cheeks contrasted with the white bed linen, and made him look younger than twenty-four. He glanced at his stomach, and jerked his head away. Pain shadowed his eyes. “I came in for so-called minor surgery and end up impersonating a shark attack victim. What is this place? An abattoir?”

“Your appendix burst during the operation, leaking all sorts of bugs. They had to open you up and wash you out. Standard antibiotics aren’t working, so your surgeon asked for my advice.” Julia kept her voice light and unworried, but a tingle of adrenaline crept up the back of her neck. No wonder the surgeon screamed for help. Maybe getting goose-bumps from the challenge of someone else’s life-threatening infection meant she was heartless, but hell, she needed a distraction. Was it wrong to use a patient’s suffering to hide from personal tragedy?

She palpated the reddened skin. Heat burned through her gloves.

“I’ll be gentle, but I have to collect some pus. We’ll analyze it to make sure you’re on the right antibiotics.”

She wiped the area with a saline-moistened gauze pad, then loosened a staple. The stench of decay caught in the back of her throat, making her glad she’d missed lunch.


  1. I really liked the opening paragraph here. I'm a total sucker for anything medical, and I loved the comparison to the statue of David.

    I can't really comment on the medical side because I'm not a doctor, but what did stick out to me was the third paragraph. Julia tells the patient what his condition is - but to me, it felt like this was just inserted to convey information to the reader. I mean, shouldn't this guy already be pretty aware of what's going on, particularly if his surgeon has referred him? And where's this guy's regular doctor?

  2. I thought this was perfect. I'd certainly keep reading, even though I generally don't read Medical-related works.

    Oh, and I have to disagree with Nikki -- I think the level of exposition in the third paragraph was about right, and pretty much exactly what I'd expect from a doctor.

    Sorry I couldn't find anything to nitpick!

  3. You have some nice descriptions in here.

    In the first paragraph, the sentence "A shocker." seemed redundent to me and detracted from the next sentence which was great.

    Maybe consider tightening up the dialogue in paragraph three to make the flow a bit punchier and less like an insert of information for the reader (could just be me). For example, "Your appendix burst. Standard antibiotics aren't working."

    Minor nitpick: I've worked in many medical settings and when a consultant is called in (as your main character is in this case) they always explain to the patient who they are and why they are there before starting the exam. Maybe work in that she is a consultant differently?

    Nice job and good luck!

  4. Random question - why did he have flushed cheeks if he's in a lot of pain? I always thought people turn gray or pale. :]

    Good detail here - ook. Reminds me yet again why the medical field never appealed to me. :P

  5. I should preface this comment by saying that, as a physician, I may read this differently than most readers.

    The first thing that struck me was the comparison of the wound to graffiti on David. This comparison doesn't work for me, unless the doctor has the hots for the patient. Graffiti on David is shocking and awful to picture not because the graffiti is so awful, but because David is a work of art.

    I like your patient's response. He's snarky and clever. And I like the little glimpse into Julia's personal life.

    But the backstory reveal through Julia's dialog doesn't work for me. A doctor would never start removing a dressing from a conscious patient before explaining who she was and why she was making a beeline for his wounded belly. And I agree with Nikki... Julia's dialog does not fit the scenario.

    If enough time has passed to determine that "standard antibiotics aren't working" then, it's been at least 24 - 48 hours, and the patient would certainly know that he'd had a ruptured appendix. So the first two sentences would be extremely out of place. She might say something like, "A ruptured appendix can be pretty serious." or something consistent with both she and the patient knowing what happened.

    The third sentence is an appropriate statement for an ID doc to say to the patient, but before she starts digging in to the actual wound. And it doesn't work in answer to the patient's question.

    Incidentally, if the wound was as infected as it seems, most likely they wouldn't have stapled it shut.

    Analysis of the pus isn't going to be especially helpful. What she'd want to collect here is a "culture" of the pus. And she would probably hedge that statement with the fact that cultures are much less reliable after a patient receives antibiotics. Even if the antibiotics aren't working well, they usually have enough effect to stop the bacteria from growing outside the body environment (it's much harder to grow bacteria in a lab than in the body).

    Good luck with this!

  6. I was hooked by the grossness factor at first. I also didn't like the "A shocker" line. If it's such a shock, show it don't tell it.

    I think you have great descriptions here. It sounds like you know what you're talking about with the medical related stuff, which makes me trust you and want to read more. I like Julia already.

  7. Hooked. Good luck!

  8. Nicely done :)

    You've done a good job of creating a personna for your MC very quickly - she comes across as intelligent and dedicated, but with a bit of a quirky side. Good job

  9. I'm with HL Dyer on this one, since I'm a physician. That's why I don't watch medical TV shows, cause I nitpick too much. In the opening I need less detail about the wound and more of the conflicts in the doctor's mind. There was a hint, but just barely.

  10. Gross! Yeah, I'd keep going, but gross! I don't like the line where she asks herself a question (or the narrator asks, or whatever). Show me her personal tragedy and trust that I'm smart enough to figure out she's a work-addict avoiding her personal life. Other than that, I really like your writing.

  11. Fabulously high 'eew' factor and a hint of personal drama. You've got me.

  12. That's good, by the way, did I make that clear?!

  13. Definitely hooked! Good voice, good tension, and I like the wave you wove in that something further was going on in Julia's life. I'd absolutely read on!

  14. I like how you open this, but the actual opening sentence didn't grab me--I like something a little more "global" or thematic, something that will set the tone for the entire book. This sentence seems kind of small and specific. But you get to the info right away and set up a nice conflict. I don't quite get the graffiti comment--is the patient attractive? Need more description of him vs. the wound if that's the case.

    Couple of small things: would she introduce herself? This seems like the first time they've met. What's an "abbatoir" and "palpated?" Did the appendix leak REAL bugs or "germs?" Would they know so soon after the operation that the antibiotics aren't working? Seems like the guy is just waking up after surgery, implying that not much time has passed. Would there be decay so soon?

    I like that she's hiding from "personal tragedy," but could use another line or two to tease us more specifically, since I'm thinking this is critical to the conflict/plot. Good luck in moving forward!

  15. Gnarly...but I'm intrigued.

  16. Sorry, but I'm in healthcare and I was totally turned off by the unrealistic protrayal of the MC. No real doc or nurse would think, say or react this way...not professional or clinical. I would immediately think, here's someone who needs to do a little research. I would suggest getting someone in the medical field to read it over.

  17. My first try at this was eaten by Blogger, so I'll try again:

    I am wary of this, given the issues that health care professionals here had with the language. I also thought it was verging on gross for gross sake (which can be fine, and has a long and respected tradition; but two uses of Pus in 5 paragraphs is at least one Pus too many!)

    I also want to know a little more context about the victim--particularly whether he's been brought to the hospital willingly or unwillingly. If this is viral-medical, OK, that's one kind of book. If he's there because he's been attacked because he's a spy, that's another. If this is a more conventional thriller, I think some of the gore can go--it's gratuitous. If it's a MEDICAL book, then it's OK.


  18. I hope it's okay for me to comment here. Thanks Secret Agent and other critters for your invaluable comments. Yes, it is a medical book - involving antibiotic-resistant bacteria.
    As for getting medical feedback - well, I am a doctor, specializing in the diagnosis and treatment of infectious diseases, who sees patients like this every week. Pus is my day job. LOL.
    Thanks again. It's a lot of fun, and extremely helpful.

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  20. Hooked (with pus blobbing out like a stomped on tube of toothpaste).
    Interesting is all the med. opinions here. I’d suspend disbelief if I saw your credentials on the back cover or in a query (I’m not an agent). I think the David reference can only lead to testing the romantic waters, or the doctor’s dr.-patient ethics. like your title says, "Unhealthy Obsession." You can have a lot of fun with this. Best of luck. I like your voice.

  21. Thanks Locksley. Suspend away! After all, this is fiction, not a medical textbook. If I described every little thing from the time Julia was asked to see the patient, you'd all be asleep before the end of the first page.

  22. Well, I'm NOT a doctor and am now in the middle of an inferiority complex! That said, here are my layperson observations:
    1. I don't like "A shocker."
    2. No problem jumping in and skipping the doctor/patient formalities.
    3. Why is it a wound infection? Didn't he have his appendix out? Is that really called a wound in the medical world?
    4. I agree that the first sentence in paragraph three doesn't work but i really liked the rest of the paragraph.

    This isn't my genre but I'd probably read this once I started - there's enough there to hook me.