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Michael: “Hi there, Michael Palmer here with what I think is the week six Q&A. This is really a lot of fun for me—I could just keep doing this indefinitely because I love the immediacy of connecting with people who read my books. So, without further ado, let’s see what questions have come in.”

Davina: “How intense is your research for your novels? How did you get your first novel published? Do you have any degrees in literature?”

Michael: “I’ll answer the last one first. No, I never wanted to be a writer or ever thought I would be a writer—my degrees are in biology from Wesleyan and a degree in medicine from Case Western Reserve in Cleveland. My research is very, very intense. I work countless hours on the internet mostly, I read books, I send off to Amazon and get books. I try to become as expert in a field and an area that I write about as possible—and I follow up on things. That’s the biggest part of my writing: preparation to write. I got my first novel published just purely by luck. I contacted an old high school friend in New York, he sent my work to an agent, and the agent liked what I had done and helped me write it.”

Gina: “About how long does it take you to finish an average book? Also, do you have any tips for aspiring fiction writers and their search for the perfect publishing company?”

Michael: “It takes me a yea to write a book. There are various parts—the research, the decision on what to write about, the first draft, the re-writes—but altogether, it takes about a year. As far as the other thing, unfortunately no fiction writer can go directly to a publishing company or house. You really have to get an agent. Now I will refer you to my website where I have a number of ‘writers tips‘ and in there is quite a large section about finding an agent. I recommend you go and look at that. Trying to get through to a publishing house is technically impossible.”

Jason: “When getting drafts reviewed, the most common feedback I get is to spill the beans and reveal everything. How do you negotiate getting the right details in place for a vivid picture of what’s going on without giving the story away?”

Michael: “Jason, my suggestion is to write what you feel and don’t let people tell you what to write, unless it’s somebody you really trust or have faith in. There are as many different ways to write a book as there are people who write. Certainly, I’m not looking to pace out what I call ‘a reveal’ throughout the course of a book because that’s what pushes people to keep turning the pages. So you don’t want to give away everything at once. You want to as slowly as feels comfortable and I would look to make your chapters each have some sort of ‘reveal’ in the chapters as you move along. At three quarters through the book, most of the reveals should be out except for the big ones. That one comes during the choreography and the conclusion of the book. I wish you good luck with your writing and I hope that I answered that for you.”

Jaimie: “How did you get your agent? How long did it take?”

Michael: “I’ll just reiterate that: please check my website and the section on finding an agent in there. I got really lucky very quickly and found an agent who was interested. But most people it’s going to have to be a full-time project writing query letters to the agents. You need to have your book done or the agent’s not going to be very interested. So I think you need to start writing the book an then find an agent. There’s lots of books on how to do it, there are many, many courses that you can go to where you can actually make an appointment at the course with an agent. Sometimes it costs like $30 or $40 for fifteen minutes, but it’s well worth it. You get to sit there and pitch your book.”

Mary: “Do you ever find your characters taking over while you are writing and notice that you are writing things about them that you hadn’t really thought about?”

Michael: “It doesn’t happen as much as a lot of writers I’ve heard talk, but once in awhile a character, a minor character, suddenly becomes interesting and fun for me and they get bigger and bigger. I’ll give you a quick example from my book “Critical Judgment.” I created a hermit to come into the emergency room ward after being beaten up in the town. The reason I created him was so I could show what a good doctor the heroine is. He became so interesting to me that I gave him a whole persona and he became I would say the second main person in the book as I went along and he was great. He was fun to write about and I wish I could think of some more business for him.”

Michael: “Hi there, Michael Palmer here again with the fifth go-around with Q&A and I’m very pleased with the response and the number of people who are watching and sending in questions. I’ll do my best to get through the ones that I have here. If I don’t make it then I’ll carry some of them over. So let’s look at the list.”

Shirley: “How long does it usually take to finish a book?”

Michael: “That’s actually an answerable question. I’m under a contract, the same as many many successful commercial writers to write a book a year. I don’t expect to never honor that contract. So I work as hard as I need to, to get a book done each year. That means about maybe about two months of getting ready to write, four to five months of writing and then the rest of the time fixing the book. After it’s sent in, while I’m waiting for the edits, I’m already working on the next book. So I do a book a year, and there’s a carryover– I’m just about done with another one.”

Nancy: “Michael, I read about the McGuffin for the first time on your website. Could you explain it and how writers can use it effectively in creative nonfiction as well?”

Michael: “The McGuffin is not an easy concept. When I teach, sometimes it takes hours to explain it. It’s a word that Alfred Hitchcock coined and I’ll give you a quick example and then you’re going to have to go on Google and check it out. And also there’s a large section on my website. Basically, the McGuffin is the answer to the ‘what-if’ question, like in the case of ‘North by Northwest’ by Alfred Hitchcock. He started with ‘what if a man had a mistaken identity while he is on a train and people try to kill him for reasons which are not clear.’ That’s the question he asks when he wrote “North by Northwest’ and when you ask Alfred Hitchcock ‘why are they chasing him?’ he would’ve shrugged his shoulders and said ‘I don’t know, I’ll figure it out.’ What he’s figuring out is the McGuffin. It could be almost anything, but in this case it had something to do with spies. So I encourage you to read about it. It’s fun and you can use it fiction– I’m not sure about nonfiction, I’d have to give that some thought.”

Nancy: “Michael, you seem so comfortable in your videos. Do you have any tips to help writers get over their fear of public speaking?”

Michael: “Toast-masters is a great way– I didn’t do that– I’ve always been comfortable. I’ve done a lot of community theater and I embarrass very little now as I get older. So the truth is, I just do my best. I don’t care, I love talking to people and right now I love talking to all of you.”

Dorothy: “Do you think Twitter is a useful networking tool for connecting with new readers and generating interest? Do you have any creative ideas for new writers to use in jumpstarting their careers (using social media)?”

Michael: “I’m not an expert at social media by any stretch and I certainly feel like I’m connecting with a large number of new readers, but time will tell because I haven’t really had a book up for sale since I’ve started more and more to get tips from my publicists and to connect with people over Twitter and Facebook. So I can’t answer the question except that it makes perfect sense to me that the more I can connect with people, the more books I’m ultimately going to sell. I don’t completely know how Twitter even really works, but I’m trying my best to interact with people and until it becomes more work than it’s worth I’m going to try to keep doing it. As it’s sort of fun and it’s a great break for me.

Kimberly: “How did you decide which new media (Twitter, Facebook, etc) to pursue and do you plan to follow the crowd, adopting new social media sources as they become available? Have you noticed an effect on your sales or is it too early to tell?”

Michael: “I have publicists who advise me on what I should be doing and I keep in close touch with them and they’re terrific. They’re sort of ‘new media publicists’ who really understand this stuff and what they tell me to do I do, and I’m gradually catching on and soon I’ll be able to do more and more of this stuff by myself, because it seems like a natural way to connect with people.”

Nicoleta: “What’s your favorite book and by whom? What country do you want to visit that you have not had the opportunity?”

Michael: “I have a lot of favorite books, I really do. I loved, most recently, I really loved ‘The Curious Incident of The Dog in The Nighttime.’ I couldn’t put it down– I read it twice and I loved the book. It’s about a kid with Asperger Syndrome investigating the murder of dog. It was a wonderful, impressive book. I recently read a couple of books by my friend Lee Child who created Jack Reacher and he’s just good—he’s a really good writer. And I put him in a class with John D. McDonald– another one of my favorite writers. As far as where I want to visit, I’ve never been to Africa and I really expect that I’m going to go there someday.”

Michael: “Hi everyone, Michael Palmer here. It’s good to be back with you. I want to, before we start answering any questions, I want to remind you and introduce you to the paperback of “The Second Opinion” which goes on sale Tuesday the 29^th. So search it out if you haven’t read it before and I think it’s a great book. Also in the back of the book you can find the prologue for “The Last Surgeon” which is pretty scary and will be fun to read. So, without further ado, happy new year. Let’s look at the latest round of questions.

Lynn: “How do you choose your characters? After you choose a character, does it tend to develop a life of it’s own?”

Michael: “The answer is that I always start my books with a “what-if” question and then kind of an answer to the “what-if” question. The third thing I do is to ask ‘well, whose book is this?’ That’s when I begin the process of picking characters. Do I want a male to do this? If it’s a book about infertility I would almost always want to have a woman as the main character so that’s basically the way I begin to select my people. The ones who take a life of their own are more often kind of the ‘second-tier’ characters. They usually have a very well-defined persona and sometimes I like what I’m doing with them so much that I greatly expand their role in the book. The best example I can give is a hermit in the book “Critical Judgment” and I liked him so much that he became a main character in the book. So yes, it happens a lot but not as much as people might think with the main character. Those people I know them a lot before I even start the writing.”

Vida: “I would like to know how you got started writing these medically related books? What interested you about this subject? What is your inspiration? And how do you keep the excitement flowing?
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Michael: “Well, you may not know but I’m a doctor—an MD. I have boards in internal medicine and in ER and so when I started writing, the thing that I had to offer– the thing I had to bring to the table if you wish is my knowledge of medicine and of people as patients. So that’s basically the way I got started. I was trying to duplicate what Robin Cook had done with “Coma” and I’m still trying. Although I hope my own ideas are standing for themselves. So, ‘how do I keep the excitement flowing?’ Sometimes I just can’t keep the excitement going. Most of the time I’m very upbeat about getting to work, but sometimes I just have to push myself. I usually insist that I have to stay here for two hours before I can get up. After that, it’s whatever happens. Hopefully, I’ll be here a lot longer than that.”

Mary: “I know that Dimitri from ‘The Second Opinion‘ is very loosely based on a real life person you know – will ‘The Last Surgeon‘ have any characters in it that are based on family or friends?”

Michael: “Dimitri, for those who haven’t read “The Second Opinion” yet, is a character with Asperger Syndrome who was never really diagnosed and never really treated and now is in his forties and is having a tremendously difficult time with life. The answer is everybody in my books is based on people that I know. I get a lot of work with Asperger Syndrome because of my own son and have known a lot of adults with Aspergers and in fact, in “The Second Opinion” there’s a series of fifteen questions that I answered in association with the Asperger Association of New England. I encourage you to check that out. As far as “The Last Surgeon” goes, a lot of that main character is based on me– my own personality, the fact that I spent many years volunteering with a medical van driving around the streets of Boston and taking care of disenfranchised young people who were mostly out on the streets. So I knew a lot about that when I started writing the book. And a lot of the emotional stuff comes from my own personal experience although not all the war experience I wrote about with Nick Garrity.

Linda: “For enjoyment, what kinds of books do you read in your leisure time–other writers’ thrillers or novels that are very different (in genre, writing style)? What do you enjoy reading in the nonfiction area?”

Michael: “The truth is, I don’t have a lot of leisure time and it bothers me. I just finished reading a great thriller by Lee Child, one of my friends who writes the Jack Reach series and I couldn’t put it down. I had so much fun just relaxing over the holidays and reading it that I forgot how much I enjoy the pleasure of just reading a book. When I do read, which is continuously, I read new writers’ books in order to give them a blurb or quote to support their book. And I do that because when my first book “The Sisterhood” came out, a lot of very famous writers did it for me. John Saul, Mary Higgins Clark, DC Andrews, Clive Cussler. And I feel that I owe it to new writers. Most of my reading now is new writers’ stuff.

Ross: “Is “Fatal” the only book you have written that you drew from personal experience?”

Michael: “Fatal deals with vaccinations and I have very strong feelings about vaccinations, but mostly it’s my job to raise questions in a book and not answer them. So every one of my books deals with experiences I’ve had in my life– I mean where else do you get this stuff? A lot I make up, but I also base a lot what I write on things that happened to me when I was younger, things that happened when I was working in the ER and things that happened to me like yesterday. One of the great things about writing is the immediacy of having it happen and getting it down.

Mattie: “Looking forward to the next adventure– What city does this book take place in? Also, is the setting in a hospital, clinic or doctor’s office?”

Michael: “This book takes place in Washington, DC– same with “The First Patient” and it also takes place a little bit in Baltimore and in Virginia. I enjoy writing about things that happen in hospitals, but sometimes it limits me so much of what I can do that I end up keeping it more outside the hospital. But I can write about hospitals well because I’ve spent countless hours day and night working in hospitals.”

Michael: “Hi everyone, Michael Palmer here again. Merry Christmas and happy holidays– it’s great to be back. I want to thank everyone for all the response and all the questions to this Q&A experiment. I’m going to get right on to the new ones. We won’t get to all of them now, there have been quite a few, but I’ll go right through the list and the order that I have them in. The first one is from Michelle.”

Michelle: “Hi Michael, Do you write every day? Do you have an outline that you follow or do you just let the ideas come to you as you are writing? Also, do you use the computer to write or a typewriter?”

Michael: “We let me start with the last question which is the computer one. I definitely use a Mac and I started my first two books on a $78 manual typewriter which I don’t think I have anymore. I only type with two fingers and I’m good with those, but just two fingers. And let’s see, the answer is I write every second I can I’m relatively slow, I don’t think very fast, so I write every chance I get. I do have some other business. I still have a job as a physician working in a program that takes care of sick doctors. So I do as much as I can and ‘do I use an outline?’ Yes, the answer is I used to really outline my books in great detail, but now that I’m working under a contract that requires me to write one book each year, I’ve found that I just don’t have time for an exhaustive outline. So I outline about five or six chapters at a time– I go over those outlines which are about maybe a half or one page per chapter and then I work on those. I’m also writing more and more and trying to work in shorter chapters. But I’m not used to it completely so that takes extra time and extra work for me too.”

John: “When you write a book do you have a schedule? Do you get up at a certain time, write for so many hours then do other things? Or do you just write non-stop until the book is finished?”

Michael: “I write all the time but I don’t have a schedule like ‘I have to finish chapter one the next day’ or ‘chapter two…’ sometimes it’s very very easy, sometimes it’s very very hard and I’ve kind of gotten used to it after almost sixteen books, just going with the flow. I get up around six every day, meditate, do some stretching, get some coffee, sit around, look outside, get ready to write and then finally just start going.”

Scott: “Do you write a book from beginning to end or do you jump around and write different parts at different times?”

Michael: “Yes. I can’t do anything else but write linearly and there’s a couple of questions about that.”

Linda: “In your opinion, how important is it to create a sympathetic villain, and how much space (compared to the protagonist) should he get in the book?”

Michael: “One of the criticisms my editors had of me and my early days of writing was that I was so ‘nice’ that I felt I had to justify the actions of my villains by making them be a zealot. We just carried whatever their beliefs were over the top. And then I couldn’t understand the existence of evil for evil’s sake. I’ve changed a lot in that area over the years and now I do believe there are people who are just plain evil. We don’t have to go any further than the people who are dealing drugs in schoolyards to appreciate that– I consider that about as evil as you can get. With no redeeming value except to make money for somebody who has no consideration of the victims. So I’m not afraid now to write a purely evil villain. In fact I think even readers enjoy it– and they enjoy seeing such a character get his comeuppance through the story. Obviously there are exceptions to every role and I’ll leave it at that.”

Keith: “Do you know the ending when you begin writing first draft?”

Michael: Let’s see, yeah, I sort of know it. I mean, I know who’s going to do what and who’s going to live and who’s probably going to die. Every once and awhile it all changes. But I just try to work on the book and not worry about the ending until I get to what we call the ‘choreography’ of the ending, which is where we begin to prepare and move characters towards the denouement of the novel, or the ‘climax’ of the novel. So I have a pretty good idea by the time I reach the choreography where I’m headed and how the book is going to end. Once in awhile there is a huge surprise, but most of the time it’s pretty well planned out.”

Jeff: “Would you consider, or have any interest in writing a Non-fiction book that would be very ‘revealing’ … so much so that you would be pressured to reveal your source of information?”

Michael: “I’m not afraid to reveal my source of information but I’d be a little apprehensive about revealing things about myself. There’s been articles written about me, I’ve had a pretty colorful up-and-down life and that’s fine. But I don’t think I’m ready to sit down and bear my soul to the world in a non-fiction memoir type of book. Maybe someday, but the at the time being, what my kids know is enough and what my friends know is enough and what my reading public knows is probably more than enough. So, I have no plans to write a memoir—but you never know.”

Michael: “Hi everyone, Michael Palmer here again with Q&A. I’m really enjoying this, I’ve gotten a lot of questions and I’ll go through several of the newest batch now and I hope who doesn’t have his or her question answered won’t be too upset– I’m doing the best I can. Let’s start with Ross.”

Ross: “I know that you wrote the book “Fatal” from personal experience, so in light of this, is this the only book you have written that you drew from personal experience?”

Michael: “The answer is all of my books are drawn from personal experience in one way or another. The book Fatal (which was about vaccinations and my position that vaccines are not tested to the same standard as other drugs) was written due to a lot of research that I did around Asperger Syndrome and around my child who has Asperger Syndrome. But there are pieces of every book I write about that come from someone else’s or my own experience.”

Nicoleta: “How do you find the perfect subject for the books you write? How long did you spend writing “The First Patient?”

Michael: “The answer is finding out what to write about is the hardest thing for me. I don’t have a batch of ideas sitting in the cupboard like some authors I know. So the hardest part is sitting here at the beginning trying to figure out what to write about. Fortunately, I try out my ideas on my agent and also my editor, and when we hit on something that seems good I start to move forward with developing the idea into a “what-if” question.”

Emma: “Out of all the books you have written, which was your favorite to write and why?”

Michael: “All authors who have done more than one get that question frequently and we all answer that it’s a little like deciding which one of our children is our favorite. But the truth is, I do have some favorites. I love the book “The Patient”– the heroine Jessie is one of my favorite characters to have written about. I really enjoyed writing “The Second Opinion” which deals with Asperger Syndrome, and my new book “The Last Surgeon” is possibly the most fun of all to have written about and I’m really excited to start getting some feedback from people which will begin to happen now that the review copies have gone out. So those are my favorites– but I like the other ones too, don’t get me wrong.”

Mary: “For your book the “Second Opinion”, did you know anyone specifically with Asperger Syndrome? how much research did you have to do for this topic?”

Michael: “Well, I sort of answered that. One of my son has it and has done very well with it. ‘How much research did you have to do?’– not so much, I’ve been doing it since he was four years old. And finally, the same thing, my son has it and he’s twenty-one now and manages it quite well. He’s also very intelligent– and well all know that kids with this problem are intelligent and they need work on their social pragmatics more than their academics. Fortunately if you look at the dedication in ‘The Second Opinion’ the book is dedicated to the school my kid went to that made an incredible difference in his life. But there are other schools– it’s just a matter of work, work, work.”

John: “Is it easier to just write a story around set characters or to write a story with new characters every book?”

Michael: “Excellent question. We call that “stand-alones”– there is no continuity from one novel that we write to another. I’ve never written anything other than stand-alones and there’s a reason for that: it’s that each of my characters in each of my books– the main characters have issues that feed into the fact that all they want to do is be happy. The issues are deadly ones– they’re difficult ones– and for me to put the same character in a difficult, deadly situation twice would be too much of coincidence. I keep searching for a recurring character but so far I haven’t run into it. And I think it would be just as tough to write that as it would be to write a standalone.”

Michael: “Hi everyone, Michael Palmer here. First I want to thank you all for the questions that you’ve submitted. It’s fun for me, I’ve never done anything like this before– so if it’s okay we’ll get right on to some of them. Those of you who don’t get your questions answered this time, tune in again, I’m going to do this at least once a week and see if we can cover most of the questions that come in. The first one I have here is from Richard.”

Richard: “Glad to see you’ve showed up on Twitter and Facebook more regularly! You’re apparently on (relative) hiatus between books right now. Is one a year about right for you?”

Michael: “The answer is that I’m never on a hiatus and one a year is about what the publishers require of a commercial fiction writer. So by the time one book comes out, I’m already well into another book. The whole idea with Facebook and Twitter is my attempt, with some professional help, for me to get more people aware of my books and what I’m doing. I work very hard on them and I love it when people read them, so I’m taking a chance on bringing in more people on these social media things. If it works, great, if it doesn’t work, I’ll just go back to writing.”

John: “Will there be a book on CD and if so, who will be the reader?

Michael: “The truth is there will definitely be a book on CD. McMillan, who is a branch of my publisher St. Martin’s, is now going to take care of the recording but I have no idea who is going to do the reading. That’s one of many things they don’t clear with me. But I’m excited to see it and I enjoy at least listening to a few pages once the book comes out. I’ve never heard one of my books in its entirety– there’s just too much work for me going on to spend time listening. And when I’m in the car I’d much rather listen to music, but thank you very much, John for your question.”

Vida: “I would like to know how you got started writing these medically related books? What interested you about this subject?”

Michael: “Well, as you may or may not know, I’m an MD. I graduated from Case Western Reserve University in Cleveland and trained in internal medicine and later in emergency medicine at Harvard and I practiced on Cape Cod for a long time. I still work as a doctor taking care of sick doctors. So I started writing in 1979 because my college buddy Robin Cook did it and so far things have worked out incredibly well. My first book was called The Sisterhood and you can read about it on my website. I’ll do one more question and that will be it for today.

Mary: “Hi Michael! I really enjoyed ‘The Second Opinion.‘ In fact, there are days when I feel very ‘Thea-esque’, even though I do not have Asperger’s Syndrome.”

Michael: “That book is turning out to be a lot of people’s favorite of my books mostly because of Thea, who’s a really fascinating character and based on a lot of people I know with Asperger Syndrome. For those who want to learn more about it, at the end of ‘The Second Opinion‘ there’s a rather lengthy question and answer note from me and also from the New England Asperger Association people. So that’s it for now, come back and I’ll have more answers to more questions.”