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When Fact Matters in Fiction: What Writers Need to Know

How careful are you about getting your medical and psychological facts right?

When I am engrossed in a novel and come across a blatantly incorrect fact on a topic I know about, I cringe. Of course most readers probably don’t even notice the blunder, but even so, if you as a writer can get the facts right, isn’t it worth that extra effort? Writers of historical novels are often passionate about researching the historical background to their stories, down to the undergarments their heroine wears, and this not only enriches the story world for the reader but makes it easier for them to suspend their disbelief about plot points that would otherwise be hard to swallow.

This guest post is by Jenni Ogden. Ogden has an international reputation as a clinical neuropsychologist and was awarded the Distinguished Career Award by the International Neuropsychological Society in 2015. She is the author of Fractured Minds and Trouble In Mind. Her first novel, A Drop In The Ocean, is published this May. Visit her at

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Visit her on Facebook, on Twitter @jenni_ogden or at

For me, it is medical or psychological facts, reported incorrectly, that trip up my focus on the story. So many novels feature medical and psychological problems, sometimes affecting a major character, sometimes a minor one. As a clinical psychologist and neuropsychologist, I worked alongside many medical people, and even wrote books about my patients, both to tell their courageous stories and to delve more into how the mind works.

Your fiction writing, where it dips into your own areas of knowledge and expertise, will probably be beautifully accurate. However you may well find that a character takes you into the psychological or medical world and have you searching the Internet for articles on the relevant topics so you can give more credibility to your story. There are even books out there that are written specifically for writers to help them with specialist areas. For example, The Writer’s Guide to Psychology by Carolyn Kaufman, provides easy to read and well-organized information to help writers deepen characters who have one or more of the psychological disorders common in our society. Howdunit Forensics by D.P Lyle is a great resource for thriller and police procedural writers, and will intrigue you with the facts of forensic investigations including medical and DNA evidence, the effect of poisons on the body and so on, and help you—as a writer, not a criminal!— get it right.

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Neurological and neuropsychological problems are rich ground for novelists, sometimes as a central issue, as in Lisa Genova’s novels, and sometimes to provide a useful character quirk or plot device. Your writing might have just a glancing reference to a character with a brain disorder—a stroke, a head injury, perhaps dementia. It is in these cases that the cringe factor is often most apparent, because the author has written according to common belief and not taken the time to do the research. To put you on the right track, here are a few common myths and their corresponding facts for the brain disorders that occur commonly in fiction.

MYTH: Following a head injury a character loses his memory for his past. He can no longer recall his family, where he lived or worked, or who he murdered! So he makes a new life for himself until one day his memory comes back and he discovers he has another life.


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FACT: Losing past memories is very rare, and usually a result of dementia, not a head injury. People who gradually lose their past because of dementia will get worse, and won’t get those memories back. Their most recent memories disappear first and childhood memories later. Brain damage from a head injury may result in the events just before the accident being lost, usually because the events immediately before the brain damage occurred are not stored. Thus the man hit by a car and left in a coma for days will almost certainly never be able to recall the details of the accident, and no amount of hypnosis will bring those memories back. The ability to make new memories can also be compromised if the brain areas responsible for encoding or storing new memories are damaged. This type of damage is common after severe head injury, resulting in difficulty learning new verbal or visual information, but rarely resulting in forgetting family and past knowledge and skills.

MYTH: Following a stroke, Granddad is paralyzed down his left side and can’t talk.

FACT: Each of the two hemispheres of the human brain control movement and feeling on the opposite side of the body. Each hemisphere also mediates some specialist cognitive functions. For example, in most of us (even those of us who are left-handed) the left hemisphere is dominant for language, and especially for speech. So if Granddad loses speech, his stroke will be on the LEFT side of his brain and his RIGHT limbs might be weak or paralyzed, not his left.

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MYTH: After head injury, or being shot in the head (and surviving) your gentle giant turns into a violent madman and embarks on a journey of destruction.

FACT: Following brain damage (head injury, stroke, tumor) especially to the frontal lobes, a person’s personality can change. They can become disinhibited, have difficulty appreciating social niceties, and become irritable or angry more readily. But they might just as likely become more placid than before. However it would be rare for a brain injury to change someone from gentle to consistently violent. If the damage was so severe that it changed the person this much, they would likely have many other problems that would make it difficult for them to live independently.

MYTH: Grandma, usually well-groomed, stops washing her hair, bathing, and frequently dresses in clothes that don’t match. Her family fear she might have Alzheimer’s disease (AD).

FACT: Unless the family hadn’t seen or spoken to Grandma for years, this would be an unlikely scenario. The family (and probably Grandma herself) would have noticed Grandma had significant memory and word-finding problems and that she was losing her way on familiar routes well before any deterioration in grooming became obvious, such that she began to ‘look’ as if she might be suffering from dementia.

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Brian A. Klems is the editor of this blog, online editor of Writer's Digest and author of the popular gift bookOh Boy, You're Having a Girl: A Dad's Survival Guide to Raising Daughters.

Follow Brian on Twitter: @BrianKlems
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