A NEW TWIST TO WRITING AND MEDICINE IN THE COVID-19 ERA

The COVID-19 pandemic has turned life upside down in so many ways it's difficult to quantify. For me, it has touched on my writer-doctor career in special ways. As you probably know, many well-known writers have also been physicians, e.g. Sir Arthur Conan Doyle, Anton Chekhov, Robin Cook, and so on.

Medicine
Although I'm not "on the frontlines" anymore, having retired from medicine in 2018 to write novels full time, I have a particular sensitivity to the havoc wreaked upon the hospitals all over the world by COVID-19. ERs and ICUs shown on TV full to capacity remind me of my on-call days and nights at USC-LA County Medical Center when it seemed like there was no end to the relentless flow of patients. At the ungodly hour of 3 AM, exhaustion was so profound that sometimes I couldn't feel my feet as I went back and forth between the wards and ERs.

L.A. County USC Medical Center, the older on the left, the newer on the right     

(David Tonelson/Shutterstock)

 

 

COVID-19 has suddenly familiarized the lay public with words and phrases like N-95 masks/respirators, (removes 95% of all particles that are at least 0.3 micrometers in diameter, Not oil resistant); ventilators, or "vents" as doctors often refer to them; and intubation, the procedure of placing a tube into the windpipe in order to attach the patient to the vent; and perhaps above all, PPE, Personal Protective Equipment, vital to keep doctors and nurses safe.

Full PPE (Som Taste/Shutterstock)

 
As a physician, there will always be a tendency to feel like going back to the battlefield, and the call is so urgent that California Governor Gavin Newsome has waived fees for retired physicians to reactivate their licenses (a stiff $808). It's unlikely I'll return to brick-and-mortar clinics, wards or emergency rooms, but there's an appealing alternative. One result of the COVID-19 pandemic is a quickly burgeoning interest in telemedicine, i.e., the remote diagnosis and treatment of patients by means of telecommunications technology.

Long before COVID-19, I've been interested in telemedicine not only because I think not all in-person visits to one's physician are completely necessary, but also because of telemedicine's potential as a tool in developing countries, where the doctor-to-population ratio is very low and going to see a doctor could mean a day-long trip from the village to the nearest clinic/hospital. One of my specialties, chronic (non-healing) wound care, is particularly suited to telemedicine. If a nurse goes out to a remote area, he or she can transmit an image of the wound back to the office and the physician, who can recommend on-the-spot treatment from the nurse's well-supplied wound kit. But up until now, physician reimbursement has depended on seeing a patient in person in the doctor's office. In a large, traffic-choked city like Los Angeles, a medically stable patient may commute 2 hours to his/her doctor's office just for a routine visit lasting 10-15 minutes. Maybe COVID-19 can show us that a telemedical visit could have achieved the same thing effectively and efficiently.


Writing
I will wager that at this moment, writers are incorporating the new coronavirus (SARS-CoV-2) pandemic in their novels, or are writing medical thrillers based on COVID-19--not that it hasn't been done before. I consider Robin Cook (Contagion) a master of pandemic fiction, as is Michael Crichton (The Andromeda Strain). What's remarkable is that the scenarios in these fictional accounts are no longer unlikely or the stuff of mere fantasy. This doesn't necessarily make pandemic fiction any easier to write.
Although I will probably not write a medical thriller--it's funny, you'd think I could or should!--but the next Darko Dawson novel I'm working on will have COVID-19 as a backdrop.
A few scenarios have occurred to me in which the disease can add some interesting scenarios to mysteries and thrillers:

• How did the crime occur when everyone was on lockdown--the "impossible" crime?
• How does a detective investigate a murder when everyone is on lockdown? Is s/he morally obligated to investigate while the pandemic is swirling? What about  the investigator's family who might become infected secondarily?
• The victim had asymptomatic COVID-19; the prime suspect denies ever having been in contact with the victim, but then the suspect comes down with COVID-19 five days later. That might strengthen the case against him or her.
• The victim didn't have COVID-19. If traces of COVID-19 RNA are detected at the crime scene, who left it there, and can s/he be traced?
• The RNA of the virus can be sequenced. If the COVID-19 RNA of the victim and a possible suspect are identical, what does that add to the case?
• For an international thriller, what if an assassin (think The Day Of The Jackal) denies being in a particular country--let's say, Iceland--but his COVID-19 genome is typical of the Icelandic pattern? That's complicated, but thriller readers love a challenge!

There's any number of setups using the COVID-19 pandemic as an environment in which a mystery or thriller takes place, but its appearance in some shape or form is pretty much inevitable. In medicine and writing, it's the elephant in the room that can't be ignored.