When did you first start writing?

Around the age of 14yrs I wrote an article entitled ‘An evening at the Abbey Theatre’ and it appeared in my college magazine. Sometime later the same editor refused to publish my account of an inter-school football match (we lost and I said we deserved to) so I suppose this was my first rejection.
When I returned to Ireland in 1984 to develop my own medical practice I became a regular contributor to medical journals, women’s magazines and newspapers. After that came health books, children’s books and finally Scalpel in 1997.

How do you manage to work as a doctor and write novels?

With difficulty! At the beginning, particularly with Scalpel, it was by stealing time from the family. I’d hide in the attic until late at night, through the weekend and holidays, hammering away at the PC keyboard. Later I took time out to write and now have managed to clear as much as I need.

Where do you get your ideas?

Often from the most innocent of conversation snippets, newspaper reports or personal experience. For example, Scalpel was based on an encounter I had with a mentally unstable doctor while working in Australia in the late 70’s. In the book the villain Dean Lynch is a heroin addicted, HIV infected, woman-hating gynaecologist and while you don’t meet too many misfits like that occasionally a medical monster does surface
(e.g., Harold Shipman, the GP serial killer).
The plot for Final Duty came from a conversation I had with a group of colleagues about the collapse of a pharmaceutical company. Its biggest selling product was withdrawn after side-effect scares and we wondered out loud how far a medical multi-national would go to protect its image? Murder was the agreed conclusion. (Doctors can be very cynical at times).

When you’re writing do you type all day or treat it as a 9 to 5 job?

I’m not overly disciplined and easily distracted. I write for as long as I’m enjoying it and stop when I’m fed up. Like any occupation or hobby, if you feel it’s no longer fun it’s time for a break.

How long does it take to write a novel?

This depends on work and family commitments but usually twelve months.


Do you know the ending when you start a book?

Yes I do. And I also know the beginning. It’s the huge gap in between that is difficult to create.

Do you find writing a solitary occupation compared to the routine of a doctor?

Absolutely. I miss the daily contact with patients (though not always their complaints) and the chance to chat and gossip. In particular I’m having withdrawal symptoms from not interacting with my very young patients. Dealing with children is always a joy and now that my own kids are in their teens I’m getting broody again.

How does the world of writing compare to life as a doctor?

Very different in the obvious ways (solitary vs. sociable; thinking on your backside vs. thinking on your feet; taking time out when you want vs. not enough time to do everything needed), yet similar in one important aspect: many of the writers I’ve met are slightly mad and so too are many of the doctors I’ve worked with. Not mad as in mentally deranged or psychiatrically disturbed but mad as in odd personality. A long time ago while I was in university a fellow student quit the medical course after only two years. The dean of the faculty took him aside and congratulated this decision. “You need to be slightly mad to become a doctor,” he explained. “And since you’re obviously quite sane this may not have been the best career choice for you anyway.” Medicine is a tough life requiring considerable mental stamina to survive without cracking. It’s a profession with a high attrition rate: alcoholism and other addictions; suicide; marital breakdown; psychiatric problems. By contrast writing does not create as much pressure. Still, you do need a tough hide to put your work in the marketplace and then occasionally suffer the very public embarrassment of a bad review.

How do you handle bad reviews?

I don’t read them.


You often describe quite violent scenes in your novels. Have you experienced anything like this?

Unfortunately, yes. While working abroad I was confronted by a mentally deranged patient hell bent on killing me. Only the timely intervention of local police saved me from being burned to death. On another occasion I was challenged by a terrorist in Belfast whose body language suggested malicious intent unless I cooperated with his medical needs. I didn’t, not because I was particularly brave but because I was leaving the city that night.

In the acknowledgements to Final Duty you mention a visit to a medical department in Chicago that ‘scared the hell out of me’. What happened?

Chicago has the highest homicide rate in the US so the emergency rooms and mortuaries are busy. I was given a tour of the emergency room at Cook County hospital (the unit on which the TV series ER is based) with John Barrett MD, Director of Trauma Services. (Barrett is an Irish doctor who grew up in county Cork and emigrated to the US). The emergency department was fascinating in that almost every medical crisis could be dealt with immediately. Heart attacks, asthma attacks, knife attacks, gunshot wounds, motor accident injuries etc were stabilised at the ER before being transferred to the main hospital. In the wards many of the patients were handcuffed or ankle chained to the beds in which they lay while police officers interrogated them. According to Barrett a lot of his work comes from gang wars and drive-by shootings.

However when the best efforts of the trauma team fail, or when the patient succumbs before receiving medical attention, he or she ends up in the Medical Examiner’s office, i.e. the Cook County morgue. I was shown around this facility by Dr Ed Donoghue (the CMO) one rather gloomy October morning in 1998. At one stage Donoghue stopped by a strange looking door held closed by an old-fashioned fridge handle. “This,” he announced grandly, “is our waiting room.” He dragged open the door and poked his left hand round the corner into a darkened room to flick on the lights. “Have a look.” GASP! Inside 144 bodies rested in tiered rows, floor to ceiling with only narrow gaps to allow attendants move about. They lay as they had been discovered; often blood stained, many with mangled limbs, some with ECG leads still attached to their bare chests. I stared open-mouthed and aghast, finally spotting a row of plain pine coffins propped against a wall at the back. “For the unclaimed,” Donoghue explained. “Eventually they are buried in a paupers’ plot outside the city.” One hundred and forty-four bodies stacked in neat rows is not an easy sight, even for a doctor and I was relieved when the fridge handle clicked shut again. “That’s a pretty packed waiting room,” I remarked, my head still reeling. “How do you decide which corpse is next for autopsy?” Donoghue didn’t have to think. “Homicide comes first. We can’t keep the cops waiting.”
And that’s the scary story that didn’t reach the pages of Final Duty.

These are additional Q & A’s that have been posed through the CONTACT PAUL link

What sort of books do you read?

Thrillers mainly. I read for escapism and entertainment, anything to relieve the pressures of medicine. My favourites are Grisham, the earlier novels of Patricia Cornwell and Michael Connolly, all US writers.

Which of the five thrillers are you most pleased with?

Scalpel, because it was my first attempt at this genre and its success surprised me. However my favourite book is Betrayal because I didn’t know what was going to happen from opening line to the last sentence until I’d written it. I delighted myself with the narrative. Also, I got to write some racy scenes for a change!

Do you have any regrets in life?

I wish I hadn’t wasted as much time in my teens and early twenties carousing. A little would have gone a long way but I did enough for an army.

Do any memories haunt you?

Whaooh, steady up there. That’s going deeper than I’d like but yes, some memories do trouble. Every doctor has at least one ghost but few of us talk about this (for obvious reasons). One or two faces do haunt me. As a writer, not really. However research has taken me into strange and scary places and some images linger which I’d prefer to have forgotten.

You’re a doctor and a novelist. You are much sought after on both medical and writing lecture circuits. Is there anything else you’d like to have been?

Taller.

Of your writing to date what has given you most satisfaction?

One of my Norbett Bear MD tales is included in a German anthology of READ ALOUD BOOKS for children (Das Tiergeschichten Vorlese Buch, published by Thienemann). In German it’s called Hilfe fur einen Drachen and in English this is Help for a Dragon. It is also beautifully illustrated in colour. So Paul Carson’s Norbett Bear sits alongside characters created by (among others) Hans Christian Andersen, the Brothers Grimm, Ursula Wolfel and Michael Bond (creator of Paddington Bear). This gives me more satisfaction than all the other books put together.

Has anything surprised you in your writing career?

Lots of things but one especially: I wasn’t expecting the amount of jealousy and begrudgery. It’s bad enough in medicine but equally as bitchy with writers. Disappointing, really.

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