How to Write a Hospital Scene in Your Novel

As a doctor, I don’t like reading books or TV shows about doctors. Not because I’m jaded and think I’ve heard it all before (quite the contrary) but because often it feels like the writers just haven’t done their research. I’m not talking about highly involved medical researchit’s the basics that can trip you up.


Guest column by Amitha Knight, former
pediatric resident turned writer of middle
grade and young adult fiction. She’s also a
blogger, a book lover, an identical twin,
a Tweeter and a new mom. See her website here.

 

Here are a few questions to think about when writing a character’s hospital scene (please note that some of this is for US hospitals only):

1. IS YOUR CHARACTER ON THE RIGHT FLOOR?

As many people know, hospitals are set up with different patients in different areas of the hospital. There are pediatric floors, adult floors, surgical floors, maternity floors, ICUs, etc. Knowing where your character/patient would be placed in the hospital depends a lot on the type of hospital you’ve chosen for your story. Is it a small community hospital in a small town? Or a large teaching hospital in a major metropolitan area? The smaller the hospital, the fewer wards there will be (and often the really serious cases would quickly be sent over by ambulance to a bigger hospital). In larger hospitals, the wards will be more specialized so you shouldn’t expect to see mixing of patient types (i.e., adult surgery patients in a medical ICU ward).

Why does this matter? It has to do with your setting details. For example: If your character is in the ICU, he/she won’t see a lot of patients walking around with IV poles in their hands. And the rooms in a maternity ward have more privacy than in an ICU setting. If your character is the doctor rather than the patient—they won’t be wandering around random hospital wards. Your medical intern isn’t going to be regularly wandering around the pediatric wards and playing with kids there.
2. WHO WILL BE TAKING CARE OF YOUR CHARACTER/PATIENT?

This can be confusing and again, depends a lot on the type of hospital in your story. Let’s say you choose a teaching hospital. Who will be taking care of your character? I’m going to focus on the different types of doctors and doctors-in-training because that’s what I know the most about.

Medical students: These are students in medical school. They have not yet earned their MDs so they are not “doctors.” Medical students are often allowed to see the patient first and ask questions—but not in an emergency situation. They do not make medical decisions for your patients.

Resident and Interns: These people have graduated from medical school and thus are “doctors.” They see their own patients and make some medical decisions, but are still in training and run major decisions by an attending physician (see below). Interns are what residents are called when they are in their first year of residency (in some specialties, residents have to do a separate intern year at a different program before beginning their specialty training so that’s why this distinction is made).

Fellows: These are people who have finished their residency but are doing further specialization and are also overseen by an attending physician, though less closely than a resident.

Attending physicians: An “attending” is the doctor who is ultimately in charge of your patient during their hospital stay. All major decisions will have to be run by him or her.

This hierarchy can make a huge difference to the believability of your story. For example—a medical student or an intern will not be in charge of breaking bad news to a patient unless they have forged some strong bond with your patient. This is generally the role of the attending physician. Likewise, the attending physician will not be doing “scut work” (i.e. tedious hospital work, ordering tests) unless they are in a hospital where they don’t have interns and residents around.

3. WHICH PATIENTS WILL YOUR DOCTOR CHARACTER SEE?

This is one of the reasons I can’t watch Grey’s Anatomy. If you are a surgery resident, you will not be delivering babies. If you wanted to do that, you would have done ob/gyn. If you are an ob/gyn resident, you will not be taking care of babies in the neonatal ICU. If you wanted to do that, you would have done pediatrics. And if you are a pediatric resident, you will not be doing surgeries. Please get it right. Your doctor characters really can’t do it all! (Sorry for the rant.)

Have medical questions about your story? Direct them at me (amitha[at]amithaknight[dot]com); or send them to H.L. Dyer, a writer and pediatric hospitalist who answers questions over at the QueryTracker blog.

Writing about hospitals and suspense?
Perhaps your character was poisoned?
Do you know your poisons inside/out?
If not, check out the ultimate guide.

 

 

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7 thoughts on “How to Write a Hospital Scene in Your Novel

  1. Michael Goodell

    Good post. I was disappointed to learn that "Grey’s Anatomy" isn’t realistic, because I was planning to go to medical school based on the show. I thought it would be cool to work in an industry where everybody slept with each other all the time. I suppose that part isn’t realistic either.

    Rats. Now I’ll just have to stick to my first career, that of writing not-yet-published detective novels in which the protagonist keeps getting beaten up and spending, no doubt unrealistically portrayed, time in hospital.

  2. DJ

    Great timing for me on this post. My protagonist is a nurse in a hospital, and though not many scenes take place there, the ones that do need to be right. Thanks for your viewpoint.

  3. Amitha

    I’m glad you enjoyed the blog post!
    Kristan — You’re right, a lot of people think Grey’s is amazing and don’t care about the errors. I think the reason is that the characters are so compelling that fans forgive the overblown/unrealistic story lines. Once you have your viewer/reader hooked, you can get away with a lot more than you can when you’re starting out.
    I can’t watch medical shows but I CAN watch detective/lawyer shows. Probably because I know next to nothing about how real cops/lawyers work 🙂

  4. Kristan

    LOL I was wondering if you were going to mention Grey’s. I think Grey’s is a perfect example of how much liberty you can take with a setting and still get away with it if your story is strong. Of course there will be people in the know (like you!) who can’t stand it, but the vast majority of us don’t really know better and (even if we knew or suspected) don’t really care. That doesn’t meant writers can ABUSE this privilege — liberties are different from straight-up lies, IMO — but it does give them some wiggle room to make things happen the way the story needs to.

    All that said, I think it’s VASTLY more impressive when a writer can be both accurate AND good at storytelling.

    Thanks for all this information! It’s good to know, and your point is well-taken (even if I sort of gave it a caveat… maybe I just love Grey’s too much, lol).

  5. Maryann

    What a helpful post. Thanks so much. You are so right about getting the details correct. I worked in a hospital for a number of years and I am often catching little mistakes in novels.

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