writing about matters medical
A post in the forum made me realize that I've never talked about this subject in any depth. And it's a big subject. Unless you happen to be a medical professional who also writes fiction, writing a storyline that involves injury or illness requires research and a delicate hand.
This is especially true when it comes to historical fiction.
In the Wilderness books, I've dealt with fatal and not so serious gunshot wounds, internal injuries, cancers, tuberculosis, surgical methods, early laboratory science, psychosis, smallpox, thyphoid, Addison's disease, rabies, nerve damage, liver failure, syphilis, and a streptococcus epidemic that swept through a village in the form of scarlet fever, strep throat, childbed fever and necrotizing fascitis.
I think everybody will be healthy in the next book.
If you want to write about these things as they were understood and treated two hundred years ago, there's really no shortcut and few easy sources of information. It took me a long time to track down an affordable copy of The seats and causes of diseases investigated by anatomy; in five books, containing a great variety of dissections, with remarks by Giovanni Battista Morgagni -- written in the mid 1700s, translated from Latin into English, and full of the most intriguing case studies. Then there's Thacher's The American new dispensatory With an appendix, containing an account of mineral waters. Medical prescriptions. The nature and medical uses of the gases. Medical electricity. Galvanism. An abridgment of Dr. Currie's Reports on the use of water. The cultivation of the poppy plant, and the method of preparing opium. And several useful tables. The whole compiled from the most approved authors, both European and American (1813). My copy looks as though it was submerged and then trampled by horses, but then it is legible and I paid $75 for a book that usually costs in excess of a thousand. Thacher and I have spent a lot of time together. He taught me about experimental methods for treating tuberculosis, and I passed them along to Richard Todd.
One of the primary storylines in Lake in the Clouds has to do with smallpox vaccination, and the whole idea for that came from a single line in a Manhattan newspaper in 1802, about the opening of a smallpox vaccination clinic based on Jenner's research and methods, and dedicated to administering to the poor. Wow, I thought. Perfect. Hannah's going to spend some time in Manhattan, learning how to vaccinate ... except I couldn't find details anywhere on the mechanics. I consulted doctors and librarians and multiple books on the history of medicine and smallpox, I read Jenner's original monograph, no luck with the details I needed. I finally had to hire a graduate student in American History, from NYU. I paid him to go into the city archives and dig up the original notes from the kine-pox clinic, the details of how the vaccinations were carried out.
And even then, there were some details that I had to extrapolate.
You can see that after so much work, the urge to use all the information would be pretty strong. But that's just the problem. You can't dump all that on the reader when you're writing a novel. It just won't fly. You have to tuck things in here and there, carefully. Which is why medical detail is often badly handled in historical novels. Either there's too little or inaccurate detail (not everybody is as obsessed as I am about research), which detracts from the story's ability to convince the reader, or there's too much. I have read historical novels which were (supposedly) about epidemics in certain times and places, in which the author completely glosses over anything specific about the disease in question beyond the more lurid details of that particular death. Doesn't work for me, not if the idea is to get me to the point where I feel as if I'm standing on a Paris street in 1760, or New Orleans in 1840.
In contemporary novels medical matters are both much easier and much more touchy. You can get the information you need about cancer treatments, orthopedic surgery, the Ebola virus, strokes and aphasia, sure. I have found that physicians are usually happy to help you maim or kill off a character, and they'll even tell you what goes into healing them, though with less enthusiasm. And of course, the more information you have, the more interesting you find the topic, the harder it is to achieve the necessary balance between detail and story.
I'll try to come up with a list of novels that handle medical matters well, see if I can provide some examples.