kathy o brien

"The difference between the almost right
word and the right word is really a large
matter -- it's the difference between the
lightning bug and the lightning.

- Mark Twain


10 minutes with…Leonard Goldberg, M.D.
by Trish Beall, California Physician

For 12 years, Leonard Goldberg, M.D. – who is board-certified in internal medicine, hematology, and rheumatology – was a full-time UCLA professor of medicine and research immunologist. For the past 15 years, he has been a rheumatology clinical professor at UCLA, has maintained private practices in Los Angeles and Bakersfield, primarily consulting in rheumatology and immunology, and has extended his expertise into the realm of forensic medicine, frequently serving as an expert witness. He has testified at criminal trials, but more often is involved in medical malpractice cases, testifying for defendants in 60-to-70 percent of the cases. California Physician found that Dr. Goldberg revealed his South Carolina roots in his speech and relaxed, gentlemanly manner, as he discussed his latest novel and what goes into writing medical thrillers.

California Physician: Was it hard to get your first novel, Transplant, published?
Leonard Goldberg, M.D.:
It was not really difficult. As with my later books, it took approximately eight months to write. One of the more difficult things to do in writing is to get an agent, particularly a good one. I found my agent through an issue of Los Angeles Magazine that listed four or five up-and-coming local agents, and I contacted the first one. She said she never reviewed books from newcomers who were not referred to her. Otherwise, she charged $100 to tell an author whether or not their novel was any good. I had no referral, and my response was, “Fine. But if you take me on, I want my check back.” She read the novel, and within two days my check was back. She sent it to several publishers, it was accepted rather quickly, and we’ve been together more than 15 years now.

CP: When do you write and where do you get your ideas?
: I usually write for two or three hours in the early morning and sometimes at night. Because I get my best ideas late at night, I keep paper and pencil by my bedside. Most of my initial ideas are sparked by the newspaper. I’ll see something that clicks, and suddenly a story begins to form. Usually I resist it at first, but if it sticks with me, and percolates, I know I have a story. Then, after I’ve thought about it for two months, sorting out the good stuff from the bad, I’m ready to write.

CP: Without giving away too much about Deadly Care, we can say that it involves patients in an HMO. Did you  have an ulterior motive regarding educating readers about managed care?
Obviously, this is a work of fiction, but the reality is that HMOs and managed care have been presented to the American public as a cure-all. [They promise] they will give us a system in which they will reduce the cost but increase the quality. Of course, that’s absolute nonsense. If you want to reduce costs then you have to somehow eliminate or ration services. One of my “ulterior motives” is to simply present the other side, namely that these are people who have decided to cut costs and eliminate services.

CP: There are good and evil doctors in Deadly Care. Do you write with a certain intent about what you want readers to think of the medical profession?
Not really. Medicine is like all professions: We have good and bad. Most of us are good people, and we do fairly good jobs in our profession. However, there are exceptions, and you read about them all the time in the newspaper. A doctor can commit an awful deed – switching embryos, hiring a hit man to kill a lover, whatever – and we can’t turn away and say it didn’t happen, because it did. But it does not represent the medical community by a long shot.

CP: You act as an expert witness in many trials, but in Deadly Care, you deride physicians who frequently do that. Is that a jab at yourself?
It’s a little bit of a jab, but it is also true that there are some physicians who are professional witnesses. That’s all they do. They are on the stand four times a week, testifying and testifying. The vast majority of those who do that are not really experts, if you look carefully at their credentials. Other people who testify – the ones who are genuine experts in their fields – don’t spend their lives in the witness box. But yeah, it was a jab at the so-called professional expert witness.

CP: Do your friends and colleagues see themselves in your books?
Some do. Some feature of one character may resemble them, but I don’t draw my characters from real people.
            The major character in Deadly Care is a female forensic pathologist. I picked her because medicine has always been more of a man’s profession, and women physicians sometimes have a tough go of it. Particularly when they are young and pretty, they are not always taken as seriously as they should be. I wanted to create a character who was very pretty and bright, and show how her life in medicine was altered by the way people looked at her superficially. People like the underdog.

CP: Deadly Care, with its conspiracy centered around a hospital, new medical technology, and mysterious patient deaths, has a feel similar to Robin Cook’s Coma. Is there a formula to medical thrillers, and do you follow it?
I don’t. As a rule, if you follow formula when writing, you eventually bore readers, because they know what is going to happen. The first real medical thriller was Coma. Before then you couldn’t think of a physician as being evil; we were demigods who did no wrong. Dr. Cook’s next few novels followed the same pattern, and I felt they weren’t as believable.
            One of the first things you have to do when you begin a novel is employ “suspension of disbelief.” From the start, readers must believe that this is truly happening. If it’s too outrageous, you have lost them.

CP: Do you get fan mail from doctors and patients?
A lot of fan mail comes in from physicians, medical students, nurses, and medical technicians. I answer a few letters, but there are too many to answer them all.
            Most people say they like the novel and the ideas. Occasionally I get letters in which readers wonder about the preciseness of the medical phenomena I describe. In Transplant, I included a patient with an abnormal chromosome. A University of Texas researcher asked that if the problem was with that chromosome, why didn’t the patient have this or that abnormality. It was a good point, and I replied that it wasn’t the whole chromosome that was damaged, just part of it. Many readers pay close attention to detail, and if something strikes them as off-base they want to know if they are right.

CP: How are sales for Deadly Care?
It’s doing exceptionally well. The book came out in April, and it’s already in its third printing. Foreign publishers also seem to be fond of this book, which is now being translated into a half dozen languages.

CP: Are movie deals in your future?
Most of my novels have been optioned, but have not become movies. Deadly Care looks promising, because it’s now under option to Warner Bros. It would be a big kick to see something I have created on the screen.

CP: Would you ever give up medicine?
No. I enjoy it too much, and I think I am quite good at what I do. In an interview with the Russian writer Chekhov – not that I am comparing myself to Chekhov, but as you know he was a writer and a physician – a journalist asked, “You do so well in writing, why do you practice medicine. Why bother yourself with two professions?”
            Chekhov’s response was memorable: “Medicine is my wife, and writing is my mistress. When I get tired of one, I turn to the other.” It’s good to have different disciplines, occupations, or professions going on because it keeps you more interested and never lets you get in a rut. If you do feel yourself getting in a rut, then change. The change is temporary and you can always go back to what you left.