UNNATURAL CAUSES

Doctors and nurses make sinister villains in fiction, don’t you think? Most people, at one time or another, have experienced the sense of powerlessness that goes with having to put themselves in the hands of medical professionals. Although the Internet has been said to empower patients to make decisions about their own health, when something serious comes along, a leap of faith in the medical system is almost always required. It seems to me that when, in crime fiction, we encounter a doctor or nurse with murderous impulses lying beneath the caring façade, it touches on a primal fear of being helpless in the face of danger.

Medical mysteries make a lot of readers squeamish, and writers who revel in descriptions of appalling injuries or disease tend to turn me off too, even though there isn’t much of that sort that I haven’t read about before. Over the past fifteen years or so, since the debut of TV’s CSI, it seems to have become obligatory for crime dramas to display at least one corpse on an autopsy table per episode. Forensic pathologists and medical examiners have become stock characters of crime shows, as well as the stars of several bestselling series of novels, including those of Tess Gerritsen and, of course, Patricia Cornwell (whom many consider the originator of the forensic mystery).

Tess Gerritsen is, like one of her protagonists, Maura Isles, a medical doctor. There are several doctors among EQMM’s contributors, though not all of them write stories that could be classified as “medical mysteries.” Short-story specialist John H. Dirckx, for instance, rarely focuses on the medical aspects of cases for his series cop Cyrus Auburn. Former forensic pathologist Keith McCarthy, on the other hand, does; he’s produced several well-reviewed books featuring fictional pathologist John Eisenmenger. McCarthy’s mysteries intrigue me because his medical knowledge is arcane, and is matched by frighteningly believable characterization. You know more about the human body by the time you finish a McCarthy story or novel than you did going into it, and more about the human psyche, too.

McCarthy’s mysteries are generally classical whodunits, and his doctor is on the side of justice, but medical knowledge lends itself at least as readily to the thriller, and sometimes to the creation of an evil doctor—the best known of all, probably, Thomas Harris’s Dr. Hannibal Lecter.

The protagonist—or antagonist—in a medical thriller isn’t always a doctor, of course; it can as easily be a research scientist, a forensic toxicologist, a forensic anthropologist (as in Kathy Reichs’s books) or an infectious-disease specialist. But having a doctor in the starring role—especially one who sees patients—may humanize a story heavy on technical detail and scientific fact. Besides, a doctor—a good one—is already a kind of detective. As every fan of Sherlock Holmes knows, the model for Arthur Conan Doyle’s Holmes was Dr. Joseph Bell, a professor of surgery at Edinburgh University, and the chief characteristics of Bell that Doyle drew on were related to the doctor’s prodigious powers of observation.

It’s only to be expected that doctors would be good observers, particularly of human behavior, which so often impacts disease. What is surprising, to me at any rate, is that there are not more doctors who write mystery fiction. In our submissions, we must encounter at least ten writing lawyers for every doctor who confronts the blank page. Very often, lawyer crime writers weave corruption in their own profession into their plots; the dishonest or dissembling lawyer is a literary stereotype (one that draws many yawns from editors, by the way). Doctors are much more often portrayed as upright, dependable, compassionate. Yet it isn’t as if real life fails to provide plenty of examples of doctors who engage in crimes related to their profession, ranging from insurance fraud to sexual abuse and even murder. The most recent case that comes to my mind is that of the star M.D. Anderson oncologist convicted, in 2014, of the attempted murder of a colleague.

So why don’t doctors and other medical personnel feature more often in mystery fiction as villains? Is the perversion of a figure we’re sometimes forced to trust with our lives a possibility we simply don’t want to entertain, even in imagination? (Whereas everyone loves to be given a reason to hate lawyers?) Perhaps because it’s only rarely that I encounter an evil doctor or nurse in our submissions, I often remember such stories, especially those that display psychological subtlety. Of the dozens of stories that Edgar Allan Poe Award winner Peter Turnbull has written for EQMM, for example, one that has stayed in my mind for more than seventeen years is May 1998’s “Wee Betty Pope,” about a serial-killer nurse. Nevertheless, if I were asked to choose some favorite medical mysteries from EQMM’s archives, there’d be a number of the good-doctor variety too. They’d include Robin Hathaway’s Dr. Fenimore mysteries (whose central character was based on her doctor husband) and Ellis Peters’s medieval mysteries featuring herbalist Brother Cadfael, a sort of medical man of that time. (FYI, though both authors are deceased, both series have available novel-length entries.)

I’m always interested in hearing what books and series readers visiting this site like. If you have any recommendations for this category of mystery, I hope you’ll jump in.—Janet Hutchings

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3 Responses to UNNATURAL CAUSES

  1. Jon L. Breen says:

    This is a stimulating survey. The villainous doctor that springs first to mind is the evil gynecologist in Mary Higgins Clark’s THE CRADLE WILL FALL. Also, there’s a doctor villain in Robin Cook’s COMA–or at least in Michael Crichton’s movie of it. It’s true that many would credit Patricia Cornwell with originating the forensic mystery. Maybe in its currently trendy form, but what was R. Austin Freeman writing all those years ago? And rereading an early Ellery Queen not long ago, I was surprised at the amount of forensic detail.

  2. A very thought provoking post indeed. Doctors are commonly shown as noble professionals but i find it very intriguing when every once in a while there is a show where the doctor is not your generic honest sincere man. I love how well this post is written. You are a great writer! i am new on wordpress and i was hoping you would give my blog a quick look and tell me what you think about it? an honest opinion from you would be incredibly helpful. thankyouuxx

  3. Thanks for pointing out those examples, Jon. I had not thought of R. Austin Freeman, but you are right, of course!

    And thanks for your comments, thestressedmess. Unfortunately, I am not able to comment on things unrelated to EQMM, but good luck with your blog!

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