Friday, August 31, 2012

Most over-used protagonists in today's novel - part two

I'd like to start this post in an unusual way - with a quote, from a comment, from my previous post:

"Curious what your next over-used protagonist will be! Please make it Kickass Fearless Girl. Because she doesn't exist."

Kiersi, I couldn't agree more.  At first I thought, "hmmm...who is a truly, Kick Ass, FEARLESS girl?  She has to be a teenager.  Teenagers are afraid of nothing, because they have yet to comprehend their own mortalities and the mortalities of those around them - and anyway, they wish most of the people around them dead."

But then I had a quick conversation with a real, live teenager, and quickly remembered the truth: they harbor even more fears than the rest of us.  What if I get a zit on prom night?  What if I get an erection (or my period, as the gender may be...) during gym class?  What if that bully calls me a name and everyone laughs at me?

So I'm back to drawing a blank on the real existence of Kickass Fearless Girl.  Show me someone who is really fearless, and I'll show you a damn good liar.

But there is another protagonist who trumps even Kickass Fearless Girl on my over-used list, and who is even more non-existent: The 22-year-old, Female, Supermodel, Head of [name your department] at [name your world-famous hospital or research institute].

This girl seems to be everywhere in fiction.  I understand that it's almost law in modern literature that the protagonist must be young and beautiful (although I also believe in rebelling against the laws of literature.)  But that said, there's a serious credibility issue with this particular woman.

Let's start with some perspective:

A female scientist friend of mine is 38.  She considers herself fairly successful, as evidenced by the fact that many of her peers on the same pay grade are at least ten years older than she is.  But she's still three levels below the head of the department.  She works out of a cube, not an office, and the business end of a desk in an ocean view corner space is something she will probably never see in her lifetime.

Real Female Scientist spent twenty two years in school before getting her first job.  Surprisingly, that job was NOT Head of Anything, Anywhere.  It was a post-doctoral fellowship that earned her something below the wages of your average plumber.  While attending those twenty two years of school, she also worked two or three jobs at a time.  She spent the income from those jobs on rent, food and books - and not a nickel went to skin care, hair care, or designer clothes.  She pulled all-nighters, made it to class, took the tests, and excelled on them without a second thought as to what her nails were doing at the moment.

So while she might have once been quite a biscuit, Real Female Scientist now wears thick glasses because her eyes have gone bye-bye from peering through microscopes for a couple of decades.  Her forehead is permanently wrinkled with that "deep in thought" look.  She has bags under her eyes.  And her hands, following years of donning, removing, donning, removing, donning, removing and donning latex gloves - while being scrubbed ferociously in between each pair - look like the hands of an old woman.

Real Female Scientist chose decades ago to prioritize her career over her looks, and it shows.  But to the real Head of Cardiology, my friend is still a biscuit.  Because the real Head of Cardiology is a 65 year old man with bad, gray combover, Coke bottle glasses, and absolutely no social graces to speak of.  But he is a genius.  Their story can make for some great fiction.  Or better yet, some great non-fiction.

The young and beautiful Head Scientist is a myth.  Perhaps even more so than Kickass Fearless Girl.  If you want to write a book, or make a movie, about her, that's fine.  We write all kinds of fiction about fictional creatures.  But if you want a realistic Head Scientist for your protagonist, Google Image Search "Nobel Laureate" - and then try not to get distracted by making a drinking game out of the combovers and Coke bottle lenses.

Now, Kickass Middle Aged Woman Who Can Compartmentalize Her Fears And Still Whip Ass On The Bad Guy - she is my hero.

Wednesday, August 22, 2012

Slay the vampire: most over-used protagonists in today's novel - part one

There are books to pick up simply because the protagonist sounds AWESOME!  Cue dragon tattoo.  But there are other books that I instantly lay back down on the bookstore display simply because the main character has already been done, waaaaayyyy too many times, in waaaayyy too many other books.

Number one worst offender?  The vampire. 

Don't get me wrong, I once loved 'em.  As someone who spent her teenage years worshipping at the thrones of Poe and King, I prided myself on an appetite for the macabre.  I secretly wished for fangs and fantasized that wine was really blood (and that I could drink either without gagging).  And I loved the Ann Rice books, especially when they made the first one into a movie starring a barely heard of young actor named Brad Pitt.  

And clearly, I was never alone in this obsession, as anything with a vampire in it seems to sell to teenagers like pimple medicine.  I assume this is, at least in part, the reason why so many authors now want to follow in the Interview with Dracula at Twilight footsteps.

But that said, the vampire has become the default protagonist.  If I see one more, I really might bite into someone's jugular.  I must assume that agents and publishers are getting weary of this trend as well.  Are they?

Evidently not.  The bookstores have entire tables dedicated to them.  The movie theaters are alive with them.  My Twitter feed is crawling with them.  Enough, already!

The vampire has become a zombie - dead, decaying, and yet, impossible to turn one's back on or get rid of.  Would someone please write a novel about a beautiful, young Sasquatch, and the human who wants to have his squatchlets?  Now that would be original. 

Wednesday, August 8, 2012

The heroine of the FDA: a Stranger than Fiction true thriller

This blog is about fiction, but I am a firm believer in authenticity.  A thriller that incorporates slices of truth can enthrall me, as I race through the plot while marveling at or wondering about the non-fictional elements.  If the story is good enough, it can drive me to research the non-fiction laced within.  And I hope to motivate my readers to do the same.  The below is the first in my "Stranger than Fiction" series - a collection of true stories that, like a good thriller, can have us on the edge of our seats.  This is the story of thalidomide, and the one brave woman who narrowly averted a national epidemic in the United States.

In 1953, German pharmaceutical company Chemie Grünenthal first synthesized the drug that was to be termed thalidomide.  They were searching for antibiotics, but thalidomide showed no antibiotic activity.  However, it appeared to be safe.  Extremely high doses did not kill lab animals nor show any obvious side effects.  They began to consider it as a sedative, although no sedative or tranquilizing effects were observed.

In 1955, Grünenthal began distributing free samples of thalidomide to doctors in Switzerland and West Germany.  They recommended it for the prevention of seizures.  Although no anti-seizure activity was found, some patients reported experiencing a deep sleep or a noticeable sense of calm.  Grünenthal began to advertise thalidomide as a perfectly safe, powerful hypnotic drug.

An employee of Chemie Grünenthal brought home samples of the new drug for his pregnant wife, ten months before thalidomide was approved for market in Germany.  On Christmas Day in 1956, their child was born without ears.

Chemie Grünenthal began selling the drug over the counter in Germany in October 1957, under the brand name Contergan.  By 1960, the drug was being sold in 46 countries under at least 37 names, without any additional independent testing.  There had never been any teratogenicity tests (tests on pregnant females); yet, thalidomide became the drug of choice worldwide for morning sickness.

The United States was the exception.

In September, 1960, Richardson-Merrell applied for Food and Drug Administration (FDA) approval to sell thalidomide in the United States under the brand name Kevadon.  The approval was not expected to be controversial, and the case was given to the agency's newest reviewer, Frances Oldham Kelsey, who had joined the FDA just one month prior.

At the time, the prevailing US law was the 1938 Federal Food, Drug, and Cosmetic Act, which required proof of safety be sent to the FDA before a medication could be approved for sale in the United States.  The law did not require demonstration of efficacy.  It also allowed "investigational" or "experimental" use of a drug while approval for its sale was being sought, allowing a medication to be widely distributed prior to approval.  The law gave the FDA 60 days to review a drug application.  If the FDA reviewer told a drug company that its application for a medication was incomplete, it was considered withdrawn and the company would have to submit more data when it resubmitted the application.  With each resubmission, the 60 days started anew.

Francis Kelsey had studied the effects of another drug on pregnancy, and was unconvinced that thalidomide was safe for pregnant women, their fetuses, or children.  In addition to the lack of teratogenicity data, Kelsey wanted to know about the drug's mechanism of action – its effects on human metabolism, its chemistry and pharmacology and its stability.   None of this data had been provided by Richardson-Merrell.  Kelsey rejected the application and requested additional data.

Richardson-Merrell resubmitted the application with no further data.  Richardson-Merrell employees began a campaign of harassing Francis Kelsey, rather than providing the data she requested, even complaining to her superiors that she was being unreasonable in her requests for additional data.  Kelsey continued to reject their proposals.  In total, she rejected the application six times.

Then the birth defects began.  As women worldwide who had been taking thalidomide for morning sickness began giving birth, it became clear that thalidomide was a horrible, horrible teratogen.  Children were born with abnormally short limbs, toes sprouting from the hips, flipper-like arms, eye and ear defects, or malformed internal organs.  Chemie Grünenthal encouraged doctors to withhold reporting of the abnormalities, as they continued to vehemently insist that they could not have been caused by the drug.

On November 18, 1961, the German paper Welt am Sonntag published a letter by German pediatrician Widukind Lenz.  Lenz described more than 150 infants with thalidomide-induced malformations.  The data showed that 50 percent of the mothers with deformed children had taken thalidomide during the first trimester of pregnancy.  Grünenthal finally withdrew thalidomide from the market.

Worldwide, an estimated 8,000 to 12,000 infants were born with deformities caused by thalidomide, and of those only about 5,000 survived beyond childhood.  Due entirely to the intelligence and will of Francis Kelsey, the medication never received approval for sale in the United States.  Nonetheless, 2.5 million tablets had been given to more than 1,200 American doctors during Richardson-Merrell's "investigation" and nearly 20,000 patients received thalidomide, including several hundred pregnant women.  Seventeen American children were born with thalidomide-related deformities.

The actions of Francis Kelsey led to a major change in U.S. law for drug approval.  Prior to the thalidomide scandal, US drug companies only had to show their new products were safe.  Afterward, they would have to show that new drugs were safe and effective.  To this day, informed consent is now required of patients participating in clinical trials, and adverse drug reactions were required to be reported to the FDA.

But thalidomide has been revived.
In 1964, Israeli physician Jacob Sheskin was trying to help a critically ill French patient with erythema nodosum leprosum (ENL), a painful complication of leprosy.  Sheskin searched his small hospital for anything to help his patient sleep.  He administered two tablets of thalidomide, and the patient slept for hours, and was able to get out of bed without aid upon awakening.  Dr. Sheskin's drug of last resort revolutionized the care of leprosy, and led to the closing of most leprosy hospitals.  

Thalidomide has potent anti-inflammatory effects that may help ENL patients. In July 1998, the FDA approved the application of Celgene to distribute thalidomide under the brand name Thalomid for treatment of ENL.  

The very mechanism of action that led to the wave of thalidomide-induced birth defects is also responsible for its efficacy in treating cancer.  Thalidomide inhibits the growth of new blood vessels (angiogenesis).  Angiogenesis is a critical process for cancer growth, and also, for the development of a fetus.  Pharmion Corporation, who licensed the rights to market Thalidomide in Europe, Australia and various other territories from Celgene, received approval for its use against multiple myeloma in Australia and New Zealand in 2003.  Thalomid, in conjunction with dexamethasone, is now standard-of-care therapy for multiple myeloma.

Now that its anti-angiogenic and anti-inflammatory effects are understood, thalidomide is under investigation for prostate cancer, glioblastoma, lymphoma, arachnoiditis, Behçet's disease, and Crohn's disease as well as several AIDS-related conditions.  It is approved to treat leprosy and multiple myeloma.

It carries a black box warning and is not for use in pregnant women or in children.

Saturday, August 4, 2012

Subverting authority: don't let those pesky police ruin a good book

One of the first challenges a thrill writer faces is protagonist credibility in reacting to the initial conflict.  John Q. Doe just found a body, or a head, or an eerie note scrawled in the handwriting of a serial killer.  Why doesn't he just turn it over to the police and walk away?  The answer: because that would make for a very short, very boring book.  But that's not a good enough reason.

We need to find a way to deal with authority in nearly every mystery or thriller we write.  If the protagonist is not actually the policeman, FBI agent, or other authority figure on the case, then he has two choices when the conflict ensues: involve the authorities, or have a damn good reason not to.  Because if he simply ignores the fact that law enforcement exists for the purpose of solving crimes, the reader won't buy it.

Here are a few techniques for neutralizing authority - or better yet, using them to up the stakes.

1) Make the protagonist a suspect.  A technique that instantly adds a new subplot, this is also a great way to incorporate Option Number Two. 

2) Corrupt the police department.  No smart protagonist turns to an authority figure who is stupid or incompetent, and especially not to one who has his own agenda.

3) Create a conflict that only the protagonist has the expertise to solve.  The Loch, by Steve Alten, is a great example of this.  Who better to scientifically determine the existence of the Loch Ness Monster than a marine biologist.  Which leads us to...

4) Create a villain who is not human, or a conflict that is not a crime.  Cujo.  The Birds.  Anything with a vampire in it.  In today's world of obsession with the supernatural, the sky is the limit.  

5) Put the action in the middle of nowhere.  Start with a shipwreck, or an avalanche, or anything that isolates the characters.  This can also create a ticking time bomb: the ship is sinking.  They are running out of food.   

What are some of your techniques for neutralizing the authority figure?