6 Rules for Writing a Medical Thriller

So you’ve decided to write a medical thriller. Your hopes are high. If Robin Cook, Michael Palmer, and Tess Gerritsen could do it, why can’t you? The answer is: you can. Medical thrillers appeal to a wide audience, and many literary agents and editors are looking for the next fresh voice in the genre. So go for it! See if you’ve got what it takes. But first, here are six helpful rules to keep in mind.

GIVEAWAY: John is excited to give away 2 free copies of his novel to random commenters. Comment within 2 weeks; winners must live in Canada/US to receive the book by mail. You can win a blog contest even if you’ve won before. (UPDATE: carolee1968 won.)


john-burley-writer-author          absence-of-mercy-novel-cover-burley

Column by John Burley, who worked as a paramedic and firefighter before
attending medical school in Chicago and completing an emergency medicine
residency at University of Maryland Medical Center and Shock Trauma in
Baltimore. His debut novel, THE ABSENCE OF MERCY (William Morrow,
Nov 2013), received the National Black Ribbon Award, which recognizes
a novelist who brings a fresh voice to suspense writing. Connect with him on Twitter.


1) Know what you’re talking about. The three hugely successful authors listed above have at least one thing in common: they were all doctors. Robin Cook was a surgeon and ophthalmologist. Michael Palmer and Tess Gerritsen were internists. They knew about the world of medicine—not just the technical aspects, but the training, culture, and politics—before they became authors. Such first-hand experience gives their stories credibility and makes them both believable and compelling. Writing a medical thriller when you don’t know anything about medicine is like teaching a cooking class when the only thing you know how to make is a peanut butter and jelly sandwich. It just doesn’t work. Do you have to be a doctor? No. But it does help to have some medical knowledge. You need to know what you’re talking about.

2) Understand your audience. Some of the people reading your book will be from the medical profession, but most will have little or no medical background. Why is this important? Because you don’t want to talk over their heads. Tell them what they need to know about the medical aspects of your story without telling them more than they need to know. Don’t get so technical that your reader’s eyes begin to gloss over. Remember: you’re writing a medical thriller, not giving a lecture to a bunch of medical students. Resist the urge to over-explain beyond what is necessary for the story.

(Query letter pet peeves — Agents Tell All.)

3) Keep the story moving. There’s nothing worse than a thriller that fails to thrill. The story should be fast-paced and gripping. If you lose your reader by Chapter 4, it doesn’t matter if Chapter 10 is amazing. You’ve got to pull them in and keep them riveted from beginning to end. Every time the story starts to slow down or gets boring, you’re at risk of having your reader close the book and move on to something else.

4) Populate your story with characters the reader will care about. Even the fastest-paced thriller becomes boring if you don’t care about the characters. Give your characters some texture, some background, some qualities that make them likeable (or despicable). Your reader should become emotionally involved in the fates of the people in your book. If a likeable character dies, the reader should feel a sense of grief. If someone triumphs, they should want to cheer. Every story is enhanced by great characters, and the ability to bring your characters to life will make your book worth reading.

5) Explore uncharted territory. The world of medicine is a continuous frontier. Many of today’s commonplace treatments were unfathomable eighty years ago. Cloning, stem cell research, and genetic diagnosis and manipulation are all areas of medicine whose applications and consequences are only now coming to light. A medical thriller is a great venue to explore the what-ifs in medicine. Pick something interesting and run with it. It’ll keep your audience thinking and talking about your book long after the final page is devoured.

(11 Frequently Asked Questions About Book Royalties, Advances and Money.)

6) Have fun. Writing is great fun. It’s the only reason why most writers continue to do what they do. If you’re focused mostly on landing a book deal or receiving a literary award, then a career in writing may not be the best choice for you. Those things can and do happen—at least for some writers—but the only way to sustain the vast amount of time and energy required for the creation of a novel is to have fun doing it. Ask yourself: If the only thing that comes of this endeavor is that I have a great time and I feel a sense of accomplishment at the end, is that enough? If the answer is yes, then you’ve come to the craft for the right reasons and you’re more likely to be successful. If you find the process tedious and you just want to sell a bunch of books so you can retire on an island in the South Pacific, then you’re in for a lot of disappointment. So, have fun. Be creative. Write with reckless abandon and lose yourself in the story. Take joy in bringing something to life. Your novel will be that much better because of it.

GIVEAWAY: John is excited to give away 2 free copies of his novel to random commenters. Comment within 2 weeks; winners must live in Canada/US to receive the book by mail. You can win a blog contest even if you’ve won before. (UPDATE: carolee1968 won.)


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by Ronald Tobias, 20 Master Plots.


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17 thoughts on “6 Rules for Writing a Medical Thriller

  1. Tori Nichols

    This great advice comes at the perfect time for the seed of an idea that may now start germinating. Perhaps I can forge ahead with #6 in mind, love #6! Better get on it, STAT!

  2. carolee1968

    #2 Educating the reader draws a fine line between the medical thriller’s plot and the reality of hospital/medical settings and technical details. I learn so much from great medical thrillers especially about ethics and disease issues. Medical thrillers influence me as a reader and consumer. Three years ago, after reading Robin Cook’s novel “Toxic” I gave up eating meat. Not exactly because of the story but I researched some of the author’s recommended readings which made me even more knowledgeable about the meat industry problems and associated health issues. I believe I’m a healthier person for reading that book.

    Thank you, I enjoyed the column!

  3. rncarst

    Thank you for a great reminder. I am writing a book that involves a significant amount of medical terminology. Fortunately my co-author is a medical doctor and also my son-in-law. I was especially drawn to Rule # 3. Moving the story is all important. Thank you, John.

  4. dabester

    Thanks for the tips. The first two are the most interesting. While it clearly would be advantageous to have medical training, I wonder whether there are any successful medical thriller authors who did so without such training. The second tip is good advice, especially for a trained medical professional. It’s critical to write in a way that the reader can relate. Thanks again.

  5. kmmutch

    Just finished reading John’s book, looking forward to the next one. Readers want that insider view, but don’t want to be overwhelmed by jargon or to get lost in irrelevant technical details. I agree the advice is useful across genres. Thanks, John for writing, Chuck for posting!

  6. Vicky


    Thanks for the excellent advice and tips! My daughter, an anesthesiologist, and I are just beginning our writing “careers”, so your column is very much appreciated! Hopefully, we will attain some success in the future. Look forward to reading your book!

  7. setranum

    Thanks for the article, John (and Chuck for including it on the site). The advice you offer would definitely benefit authors beyond the medical-based genre…a little research goes a long way! One of the best pieces of guidance I was given by a professor was to “write what you know.” That said, I wonder medical providers (myself included) are often some of the most critical readers, perhaps from the nature of our training? I find nothing robs the enjoyment of a good story like completely incorrect actions or statements. Take #1 to heart, future authors and screenwriters!
    Thanks again, John and best of luck!

  8. MG-L

    I have been involved in the medical profession 35 years. The realism and the frightening parts I have brought to my manuscript is the idea that not everything works in medicine, and not always smoothly. There seems to be a general impression by the lay public that medicine has all the answers, or that a truly gifted medical professional can sift through the morass of similar, or worse conflicting data points and pronounce the problem and the cure in 30 minutes or less, just like they do it on TV.

  9. vrundell

    Truly, I cannot stand when I come across a “fact”–or happenstance–that is completely wrong. I’m a scientist, and used to teach in medical/dental and pre-professional programs, so it matters to me when I read about medicine, or science, that the prose be accurate, or plausibly accurate. Thank you for taking a stand! No BS-ing the audience, please! Google is a click away, authors! And, it is your friend if your VERIFY your information. Heck, talk to a physiican if you want. Most are pretty eager to share their knowledge.
    Thanks John, for your insights!
    I wish you all the best luck with your book.

  10. Katie

    Excellent advice, because really, you can tweak each of those points to apply to your genre of choice. I especially relate to #6, because while being a successfully published writer would be great, I’m not counting on it. So I do it just because I love it! Thanks John.


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