Peter Clement Author of the Month
Peter Clement [March 2009]
Chosen by reviewer Janie Franz, MyShelf.Com


Peter Clement writes from experience. A physician for three decades, Clement spent twenty years in the ER and the last ten years as Chief of Emergency Medicine at a major metropolitan teaching hospital. He writes well-plotted medical thrillers that keep readers chasing one red herring after another. His latest, The Inquisitor, is the fifth in the series about Dr. Earl Garnet, who also is an ER chief.

Clement has written seven books in two series. Beginning with Lethal Practice in 1998, readers have found Earl Garnet in a variety of murderous scenarios, from deadly doctors to deadly diseases. Mixed in with these lethal ingredients is a serious portion of ethical dilemmas. Some of the topics he’s tackled have foreshadowed what appeared months later as newspaper headlines. His second book, Death Rounds (1999), dealt with drug-resistant Staphylococcus bacteria, and The Mutant (July 2001) dealt with bioterrorism involving modified organisms before the horrors of anthrax after September 11. The Mutant and Critical Condition comprise the second series involving an ER doctor and a TV personality.

Clement’s fourth book in the Earl Garnet series, Mortal Remains (2003), divulges the back story about Earl Garnet and is crucial reading for anyone who has been following Dr. Garnet’s exploits. That book introduces a new character, Dr. Mark Roper, a country doctor who is also the local coroner. These two physicians capture Clement’s own dual personality. He works and lives in the city but retreats to a log cabin nestled next to a mountain lake. This setting was the locale Clement's chose for the climax of his first book, Lethal Practice.

I caught Peter Clement at his cabin and we chatted by phone about his work.

Janie Franz: Could you describe where you are?

Peter Clement: This was a place that I discovered a quarter of a century ago, in the mid 70s. It’s a mountain lake, about a half a mile by a third of a mile. It’s a valley that’s surrounded by what’s locally called mounds. They are really hills but they’re enough that you’re enclosed. And that’s all that you see. It’s a valley that has been undisturbed except for the corner that we built our home on. It was laid down by glaciers about 10,000 years ago.

It came with a log cabin that had been built in the 30s, but it’s now been expanded into a 14-room log home with all of the indoor amenities added as opposed to what was there in the beginning, which was a mile-and-a-half walk up the hills through the woods to an outdoor facility. Just to give you an idea, we drink the lake water. It’s all spring-fed. At about its deepest, it’s around 55-60 feet deep.

It’s full of speckled trout. I don’t fish; I eat them. They’re really healthy and tough to catch and only the best fisherpeople can. They [the fisherpeople] are most welcome because we always have great meals from them. It’s a very special place. It’s sort of been the heart of a busy family, but this is where we have our family times. My kids were raised knowing this, and to the point that, when we went to other lakes and rivers, I had to teach them, "Look, you can’t drink the water."

Looking out, it’s what you see is just as it was. It’s in the wild. There are bears in the valley beyond, but they don’t come near us. The animal husbandry is done by our two large poodles. They kind of bark up, and the valley is theirs.

JF: They are kind of your security force there.

PC: Yeah. It’s all that works. All the signs and postings in the world don’t take care of things like they do. It’s a very special place.

I’m a very schizophrenic person and I wouldn’t be OK all the time here. I’ve got to have my dose of major urban center, and yet I wouldn’t want all that either. So that’s what I’m looking at, and it’s a gorgeous fall day. It’s especially special in winter where we get heavy snow. Everybody knows woods are natural in the summer, but when it's really winter, I find it spectacular. Sometimes silent and cold.

Being log, the cabin is built just the way our ancestors lived in this northern part of the continent. It’s cozy, but, boy, it can it get cold and windy outside. But it’s a special place to be.

JF: It sounds like something that would appeal to me. I like being out in the wilderness.

PC: I decided to come here today just because it was such a great day. This is a good excuse because I knew we wouldn’t get phone calls interrupting us here. It’s just a perfect day up here.

JF: So, this is where you write, for the most part.

Lethal Practice by Peter Clement PC: I certainly do a good part of my writing here. I also do a good part of my writing at home in Montreal. Before I left medicine to do writing full-time, I used to come up here on the days I wasn’t doing medicine and just really be alone and get lost in it. Sometimes, I’d do that for a day and a half and would get a lot done.

When it began to be full-time, it was in a different kind of mission. It was almost too quiet up here to do it full-time. It became more 9 to 5 or 8 to 5. It was just good to have a family and everybody coming home after school, after work, sort of putting a period at the end of the day. As opposed to my other profession that I couldn’t take home with me, writing was hard to stop, at least to get free of it, get away from it. The normal routine of getting up and having breakfast and everybody going off to school and work and whatever, and then having the writing time, and then at the end of the day where I had to stop and go and eat with everybody... I write both places. I do sneak up here just because it’s so great.

JF: I think this is the biggest challenge as a full-time writer... But it looks like you’ve found the key to balance.

PC: Well, it’s never perfect. When I was writing my second book, I was still practicing medicine. The first book I wrote— initially to get started—in the space of vacations, Christmas, summer holidays. Over about a year, I got about fifty to sixty pages, enough to sort of say, “Well, that’s interesting.” Then I reached a point where I was finishing a twenty-year mark in ER. I was dividing my time in ER with private practice, family practice. My term as chief had come to an end. Death Rounds by Peter Clement In my mind, it was really time to say, “Ok, if I'm serious about writing, it’s time to do it or forget about it”. So instead of going back to the ER as an Indian, because the Chief work was done, I took a two-year sabbatical from ER to see if I could write a book. I had a week that was half writing, half my private practice. That was nice and I was writing on my own. It took two years to get the book done that way.

That’s when I showed the book around. It was published and did very well. And they wanted the next one. In fact, they wouldn’t publish the first one until we had agree on the next one and I was writing the next one. Because, basically if I was writing a series, they wanted one a year.

When I did the second book that really was on deadline. Also, I wasn’t willing to stop my practice because I wanted to make sure I wasn’t a one-book wonder and make sure I could do a second one that would be accepted, etc., etc. So, for that one, I almost went back into a residency set of hours. I mean I was doing my practice half-time. To write the book— and it was a literal year from July 1st to July 1st— that meant I was writing evenings and weekends and holidays. I’d be writing in the evenings and I’d look up, and it would be two in the morning and I had rounds at seven.

I knew I could do it for a year because that’s what we do as residents, but it’s not a life style. Nobody was happy. But it had to be done because I had to find that out. I knew that if this goes and I’m continuing to do this, I would make the changes. And I did. I didn’t quit at that point, but I shaved back my practice, rather than half a week, to four half days. I didn’t have to do it on weekends, and I didn’t have to do it in the evenings.

My deadline—I was able to squeeze it a bit or extend it a bit because of their own publishing problems. It really turned out to be more like 16-18 months—and that worked. But then, they really did want them one a year when they went hardcover. By then, it was three books. By then, I knew to really do it justice, at that time I really wanted to have the year at a time. That was when I made that switch. Deadlines are important. They keep you at it. You don’t have time for writer’s block when you have a deadline.

JF: Absolutely. You’ll write garbage until something comes.

PC: You’ll just write the garbage. It’s better to have garbage and you wake up and it’s morning and you have something to correct. It’s better than the blank page.

JF: It sounds like it’s really evolved over time, your schedule and what can keep you creative and keep you sane. How did you job your first book around to get it picked up? What was that process like?

PC: It was really naive. I cringe about it now. During the process of writing my first book, someone told me that I might like to read a book by Jonathan Kellerman. The Procedure by Peter Clement He is a child psychiatrist, which means he has gone through medical school. I loved the book. Obviously, he’d done the time in the wards. Even though it was a totally different field, there was that sympathetic resonance. This was a neat story and a mystery and everything else... He knows the insider’s view because psychiatrists have to do medicine before they become a psychiatrist.

When I finished, I basically phoned his publisher—Bantam. In medicine, you always deal with the top person when you want to do something administratively. So, I asked to speak with the president of the company and got his secretary. The other rule in medicine is: Secretaries make the world go round. I told her, “I am an ER physician and I’ve written a thriller. Because I read Jonathan Kellerman and I like him. I thought you guys might want a similar book but from the ER.”

She told me, “The last person you give it to is the president. He doesn’t even read.” Then she also said, “You have to have an agent. We throw away a hundred unsolicited manuscripts a week.”

I just said, “How do you get an agent.”

She said that you get a list from the Library of Congress and stuff.

I just said, “Look, all I’m wanting is someone to do what I do when I want to read a book: I read the first page. If I’m interested, maybe I’ll go further. If someone does that and then says, ‘Yeah,’ then I’ll do all that stuff with an agent.”

She then said, “It’s in ER?”

I said, “Yeah, it’s ER.”

I think the series, ER, had just come out ‘cause I had to make a decision not to watch it ‘cause I didn’t want to consciously copy. Obviously, I knew there would be some overlapping, but I did not watch it. I’m going to do what I do, and they’re going to do what they do.

Then she said, “Well, send it along and send it in care of me with a letter explaining what you did. I’m not promising anything,”

It went off. I waited three months and didn’t hear anything. I made a phone call; they never heard of me. Nobody remembered anything.

Someone vaguely said to me, “Oh, yeah. We gave that to Kellerman’s editor.” Which was sort of what I was hoping would happen.

So I phoned over there, and they said it was going up the hierarchy of readers. They got me to the person who opened the file and who said, “Actually, you got fairly good reviews. Yes, it’s on it’s way, and the editor is going to read it.”

I said, “Great. When?”

They said, “Another three months.”

So, I waited that time and then when I didn’t hear, I again phoned back. This time, I talked with the editor Mutant by Peter Clement and she said, “I know you’ve been waiting, and you certainly got high recommendations, and I promise you I’ll read it this weekend. I’ll get back to you.”

And she did. She said, “You’re publishable.”

And I thought, “Wow!”

Then, she said, “Unfortunately, I’m the editor for another medical thriller writer, a guy named Michael Palmer.” I’d never heard of him. She said, “That would be conflict of interest.”

I said, “Not only am I disappointed. It sounds like you’re an ethical person, and I appreciate that.”

But she gave me names, and it turns out she was really a very senior, reputable person in New York publishing. When I used her name, people called me back, like in ten minutes. Out of that contact, I got both names of agents and editors. It was from that process that that book got revised, rewritten, and up to par and ready to be presented and was bought by Ballantine.

JF: You’re not alone in some of the unorthodox ways to get published. Granted, it’s out of naivety and not knowing the system.

PC: It was so rough when I realized what I sent them.

JF: You should see what they get. That’s also why people are avoiding the industry snarls and going to Print-On-Demand. There is so much garbage out there and so poorly edited. But these people are selling books... What was the revision process like? As you worked with agents and publishers to get the first book out. Was the story still there? Were there just scenes you had to rework or delete?

PC: There was a lot of cutting. It really depends on the writer. In my case, one person put it: “We have to get the Russian novelist syndrome out of you.” [laughs] They do that with all new writers. I like my Russian novels, but I knew exactly what they meant. It was then learning about pacing, learning about keeping that inner dialogue down to minimum, and action being predominant. Balancing all that was what was unique about my work.

What I like in a book is that you introduce readers to a world that they wouldn’t ordinarily inhabit. My thing was to be inside the head not just of a doctor but of an emergency room physician. Just to see that and learn how really touch-and-go it can be, and how on the outside it might look definite and yet inside you’re confronted with life and death situations with lots of possibilities. It’s all best judgment and nothing is clearly black and white. There’s always that inner drama set against a very big clock. That has its own excitement and defines people and creates a world in which you’re with people who rush to try and rescue what everybody else shrinks from in terms of trauma and violence. These people also leave that and try to go out and be mothers and fathers and lovers and parents, and not be shut down by what they’ve seen and coped with every day.

JF: The glimpse I saw of the ER at the beginning of Mortal Remains Mortal Remains by Peter Clement was accurate. For the few of us who’ve been in the emergency room for various things, it really rings true. I feel like I’m a little mouse in the corner watching everything and getting a real insight into what the doctor is thinking, how you’re trying to keep the patient at ease. The patient may be bleeding like crazy and has to be rushed out some place, but you’re not telegraphing that urgency to the patient.

PC: There’s always that inner dichotomy. It is not as certain as we may appear to be. And there’s the managing of that—well, just managing like in anything that is technical and yet also there’s this high-powered urgency of being life and death. All of us—even in my last shift in EMERG in twenty years—you always have that little tightness in the gut when you walk in to do a shift. That’s what you live on.

JF: And that adrenalin. It’s a wonder that you haven’t had an ulcer before now.

PC: If you’re that, you don’t last. There’s a certain breed that thrives on it, and they’re the ones that are there over time to become veterans. They, too, can burn out—and do. When I left EMERG, I was nowhere near that. I really left too soon. I was at my peak. But I don’t think it was too soon at all.

JF: What is your writing day like?

PC: It’s very mundane. I get up and usually I’m sitting down by 8:30, somewhere between 8 and 9. That’s partly me, too. Medicine is something that requires discipline and structure, and yet it also imposes it. That also becomes what I must do in order to feel that I’ve spent a productive and useful day at work. I need that structure. Just as it is required, I require it. I’ll work—the first big rush—until about 2. Then I take a break, then go back to writing or little odds and ends or revising. Sometimes, when it’s just one of those days when nothing’s working, I’ll just then get it down and wind up at 5 or 6 so there’s something there the next day.

There’s little tricks, too. Sometimes you like to leave off where you know where you’re going to go, but you just don’t do that because you can dive in much easier and you get going the next day.

JF: So, you sort of leave yourself your own little cliffhangers.

PC: Not even that. It’s just, “OK, now I know where I’m going.” But sometimes that’s the point, and I’ll quit. I dive in on that the next day.

JF: That’s a good trick. At least you aren’t just sitting there trying to figure out where you’re going next.

PC: Sometimes a good night’s sleep sorts that out. You wake up and you go back to the place that you thought you had no idea what you would do next. And, it’s there. It’s not always like that, but if I have something clear cut and it’s near time, I’ll quit before, rather than write it. I use that as a springboard for the next day. Sometimes, you reach and you have no ideas and then it’s time to quit.

JF: Do you outline or do you just let it flow?

PC: I outline, then change it all. [laughs] The best parts are the stuff that’s just serendipity. Mark Roper was not in the outline. My story was about Earl Garnet and about a hand coming out of the past and just grabbing him by the throat.

When I sat down, I had the opening scene where they had to find the body. I thought I’d have to introduce a character. And that’s another thing, I don’t like just having spirit characters. You have to say something about them. And then if you’re going to go to the trouble of introducing them at all, why not make use of them.

I knew I had to have a country physician. I can’t say that I didn’t outline Mark Roper; that’s not true. I did outline that there was the country physician. But, it wasn’t to the extent that he became a main character. Critical Condition by Peter Clement When I sat down and said, “OK, who’s going to discover the body?” I thought, “Let’s say they’re looking for something else. They couldn’t obviously be looking for her.” Who would be doing that?

Then I remembered that my father-in-law was an old-time doctor, and he also served a while as the coroner. Why not just lock them together and make him a young guy, make him a different generation, and that he’s fresh? And that you would have to have that for him to have the relationship he had with the murder victim. If he were the coroner and he were the guy who found the body, it would be so much more efficient... That just grew.

In writing the character, I just said, “This guy is a neat character.” The outline was vague. There would be a doctor and he would work together with Earl Garnet. It was still going to be an Earl Garnet story. It changed radically when he played such a prominent role. And then, there was the possibility of comparing country with urban, which I appreciate so personally, and it became just such a stage to play with that. It changed a lot.

And then the Lucilla Connor character that came in–her involvement—that evolved as the story went, that extra connection that she had. Why was she there? Was she just a resident and they happen to click or does she have her own agenda? That was actually suggested by the conversation with editors, tossing ideas back and forth.

First, I thought, “Nah, it’s too big a cliche.” Then, I thought, “Well, there could be a way to make it work.” This came from experience with residents and why people come back to residency after being out a while. If there was a way that it wasn’t such an odd coincidence, then that’s what I worked out, and it certainly added a dimension to it.

That’s the fun stuff, and it always is the best stuff. There’s no way I could have outlined that at the outline stage. And it just grew. You know when that’s happening, you’re on to something... And, the bottom line is not the income. It’s being read. That justifies the doing of it.

JF: Tell me about your latest book.

PC: The Inquisitor by Peter Clement For the few of us who’ve been in the emergency room for various reasons, The Inquisitor was accurate. That one is more a really inside, pressure-cooker, hospital-based story, yet I think an interesting one. It’s about that zone between life and death.

Again, it came from total serendipity. You talk about planning. I had some ideas. Then, I ran into one of the hospital chaplains in the corridor, a rollicking, joking guy. And he said, “When are you going to make one about a priest?”

We kibbutzed for awhile. Then I was out in the parking lot, and I thought, “Holy, sh--!” and it just hit me. The whole idea, the whole book just hit me. It just kind of came down on me like a ton of bricks. Again, where Mortal Remains allowed me to get out of the hospital and into the woods, this one just clamps down the lid and lets it fester. But again, beyond all the planning and looking for a story. Bang, out of the blue!

Also, the priest happens to be a priest from the Greek Orthodox church. It’s different. So, that was an interesting experience. Outlines all went out the window.

JF: Peter Clement will always surprise his readers.

 


Bibliography

Lethal Practice (1997)   [Dr. Earl Garnet]
Death Rounds (1999)   [Dr. Earl Garnet]
The Procedure (2001)   [Dr. Earl Garnet]
Mutant (2001)   [Dr. Richard Steele]
Critical Condition (2002)   [Dr. Richard Steele]
Mortal Remains (2003)   [Dr. Earl Garnet]
The Inquisitor (2004)   [Dr. Earl Garnet]

 


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Critical Condition

 


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