More critically, though, in the last four years this question has become quite personal because several close friends and family members have become gravely ill or died. Being at someone’s bedside as a family member, rather than as a doctor, has had a profound effect on my thoughts about end-of-life care.
As our technological ability to extend the end of life increases, do you think understanding the implications of that ability is as challenging for doctors as it often is for individuals and families?
Absolutely. We are approaching the question from different angles—doctors who are deeply invested in saving lives and becoming skilled in the tools that accomplish that, and families who are mired in grief, remorse, and longing as they struggle with end-of-life decisions. Only fifty years ago, less even, death happened more naturally. There was nothing we could do but console. Now we sometimes have to make very hard decisions, and the outcome of those choices isn’t always predictable. Will they lead to a few more days or months of good quality life, or a very uncomfortable, even more tragic death? These conversations are extremely difficult for doctors to initiate. They take time, and need to happen early and frequently, and there is little leeway in the fast-paced healthcare system to support that.
It’s critical for doctors to remember, though, that we must not only be shepherds of good health and long life, we must also be shepherds of good deaths. Death is not a failure—it is the natural and inevitable transition we all make at the end of our lives, just as we made the natural transition through birth into the beginning of life.
What sort of research did you do for the novel? Do you research as you write, or beforehand?
The research for Gemini was extensive and broad—maybe that’s why my acknowledgments run two and a half pages! But I love that part of writing. Before I begin a novel, I have to know that the topic interests me enough to hold my attention and curiosity for the two or three years it takes to finish it. I spoke to neuroscientists, geneticists, intensivists, medical ethics specialists, forensic specialists, law enforcement officers, lawyers, and protective guardians. Then there’s the Internet, which can become a drowning ocean of valuable facts. I usually do several months of research in advance, which gives me the nuts and bolts of the mystery twists, then I augment that with focused research questions as plot points or dialogue need tweaking. I’m sure I still miss some details, but it is really important to me that my novels are grounded in solid science. While I want my novels to be entertaining, I also enjoy translating the fascinating world of medical science into words that anyone can understand and appreciate.
Your books always contain intriguing medical quirks or situations. Have you always been interested in these unusual details? Do you find yourself collecting them, making note of them for future books?
The best part about medicine is the mystery—the challenge of taking a collection of symptoms and physical findings apart and tracing them back to the root problem—hopefully one we can fix. There are so many more mysteries in medicine than confirmed facts that it never gets boring, particularly when they involve all the social and emotional layers that affect our health and wellbeing.
I’ve been a fiction writer and reader since I was very young (though I didn’t fully dive in until my forties), so I tend to walk through the world looking for ideas. If some new and startling fact intrigues or puzzles me, I figure it will intrigue and puzzle readers, too, so I write it down or make a voice memo for later reference. Now if only I could live long enough to use them all. . . . Ah, but that dilemma goes right to the heart of this novel, doesn’t it?
Would you describe where and how you like to write? In the mornings or evenings? With music or without? How do you transition from parent or doctor mode to writing mode?
Here is my ideal writing life: Every single morning I get up and put on my soft baggy sweat pants and fleece, make a huge latte, sit in front of the fireplace by the windows and let my imagination spin out on the keyboard for two or three hours before I tackle the less creative tasks of my life, such as email or those dirty dishes. Here’s the reality: I leave for the hospital at six and come home too tired to do anything but eat and go to bed, or (on the days I’m not in the operating room) I get pinged with critical meetings or messages about children, the business side of being a novelist, or the business side of medicine, and I’m lucky to get an hour or two somewhere in the day to create a bit of fiction. To compensate I often spend two or three days locked in a room where I do nothing but write.
Unfortunately I need total silence to write, though I love music and find it very inspiring. I usually try to take a break and go for a long walk or run with music, and I always come home with fresh ideas. Movement and exercise are important for generating creative work. It can be difficult to transition from parenting or doctoring to the quieter, inner world from which my stories arise. But that’s a problem all of us face, isn’t it? I’m so often asked how I balance the different roles in my life, but truthfully I don’t know many people—especially women—who aren’t constantly juggling all the obligations in their lives.
If there’s one thing you’d like readers to take away from Gemini, what would it be? What do you look for in fiction?
A good book needs to linger much longer than the time it takes to read it. I want readers to come away from all my novels with more questions than answers—questions that spark conversations and richer internal thought about issues we all face. In Gemini, I’m hoping to spark a conversation about what, for each of us, constitutes a good and meaningful death. Those answers will be different for everyone, but they are key to another question I’m raising in these pages: What constitutes a meaningful life? How do we approach love and art and work, and our own definition of family, so that our lives are as rich and fulfilling as they can possibly be and we fully appreciate each of the finite days we are granted on this earth?
About the Author
Carol Cassella, MD, is a practicing anesthesiologist, novelist, and speaker. She majored in English Literature at Duke University and attended Baylor College of Medicine. She is the bestselling author of the novels Oxygen and Healer, both published by Simon & Schuster. Carol lives on Bainbridge Island, Washington, with her husband and two sets of twins. Visit the author at CarolCassella.com.
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This book is a work of fiction. Any references to historical events, real people, or real places are used fictitiously. Other names, characters, places, and events are products of the author’s imagination, and any resemblance to actual events or places or persons, living or dead, is entirely coincidental.
Copyright © 2014 by Carol Wiley Cassella
“Days,” from The Complete Poems of Philip Larkin by Philip Larkin, edited by Archie Burnett. Copyright © 2012 by The Estate of Philip Larkin. Reprinted by permission of Farrar, Straus and Giroux, LLC.
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First Simon & Schuster hardcover edition March 2014
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Author photo © Susan Doupe
Library of Congress Cataloging-in-Publication Data
Cassella, Carol Wiley.
Gemini / Carol Wiley Cassella
p. cm.
1. Single women––Fiction. 2. ––Fiction.
3. ––Fiction.
PS3603.A8684 O99 2008
813'.622 2007037542
ISBN 978-1-4516-2793-0
ISBN 978-1-4516-2795-4 (ebook)
Contents
* * *
Epigraph
Part One
Chapter 1: Charlotte
Chapter 2: Raney
Chapter 3: Charlotte
Chapter 4: Raney
Chapter 5: Charlotte
Chapter 6: Raney
Chapter 7: Charlotte
Chapter 8: Raney
Chapter 9: Charlotte
Chapter 10: Raney
Part Two
Chapter 11: Raney
Chapter 12: Eric
Chapter 13: Raney
Chapter 14: Charlotte
Chapter 15: Raney
Chapter 16: Charlotte
Chapter 17: Raney
Chapter 18: Charlotte
Chapter 19: Raney
Chapter 20: Charlotte
Chapter 21: Raney
Chapter 22: Charlotte
Acknowledgments
Charity Suggestion for Book Clubs
Reading Group Guide
About the Author
Gemini: A Novel Page 37
