Michael Blumlein's Blog

Getting the Research Right: Author Michael Blumlein on the Medical Sources Behind Longer

By Michael Blumlein
Originally posted on Tor.com
May 14th, 2019

I’ve been reading SF and Fantasy for as long as I remember, starting with Harold and The Purple Crayon, and later, The Phantom Tollbooth, and many many more. I’ve been writing it not quite as long, but almost.

Longer is my homage. I put every SF trope I could think of into it, or nearly every one, including space travel, which I’ve never written about before, and wouldn’t know the science of if it bit me. It was a steep curve to climb, but I climbed it, with plenty of help. Help is crucial for a writer, particularly when you’re writing about science. The majority of Longer concerns the biological sciences, which are right in my wheelhouse. But even then, maybe most especially then, I wanted to get things right. I always want to get things right.

Here are some of the ways I go about it:

Like every writer I know, I have a ton of books in my house: new ones, not so new ones, and old favorites. Like every doctor I know, I have my share of medical books. Very few are new. Most are references and memorabilia from my medical school days: big, fat, old, treasured volumes. I refer to them from time to time. For my first (possibly most hated and loved) story, “Tissue Ablation and Variant Regeneration: A Case Report”, I had Grant’s Atlas of Anatomy open the entire time. I preferred Grant’s to Gray’s, the other anatomy staple, for its minimum of text and maximum of fine ink drawings, each of which took up an entire page and was color-coded. With little explanatory text, I had to figure things out for myself. This took considerable, often-painstaking effort, but what I learned stuck with me. I had a similar experience with a terse, short-on-the-hand-holding book on the electrocardiogram. Hugely difficult, richly rewarding. Reading these books, grasping them, was like being branded indelibly with knowledge.

I still have these two books, along with two others geared more to daily clinical practice—one on Paediatrics, one on the Ears, Nose and Throat—written by Brits, who at the time were the very best clinicians. I have a short, green, leatherbound monograph on syphilis, given to me by a wise, bright-eyed, elderly teacher of mine on the day I first saw the telltale spirochetes under the microscope, the day I made my first diagnosis of the disease. The inscription from him reads: “To Mike Blumlein J.C., On This Day of the Spirochaete, 10 Sept 1973 (Admission Day)”

I have outdated texts on physiology, pathology, pharmacology, endocrinology, microbiology, and virtually every organ of the body. And many, if not most, medical specialities. I never refer to them any more. They just take up space and gather dust. I should get rid of all of them.

Sometimes I ask myself, is it me, or do all book lovers, and writers especially, and more especially still, that subset of writers who are doctors, have a weakness for keeping things? Are we all victims of sentiment? Do we fear letting go? Is hoarding our millennial brand of voodoo, our hedge against mortality, our magic spell to stave off death?

Nowadays, of course, doctors don’t need books. We can get everything, or nearly everything, online. I use PubMed, the open source, free of charge repository of more than 7000 journals, most of them reliable. PubMed is a treasure trove of information. But bad actors—so-called predatory journals—can sneak through. Personally, I never trust a fact or assertion, particularly an important one, without double and sometimes triple-checking it.

In fiction writing, all facts are important, at least as much as they are in medicine. Use the wrong one, your reader may lose faith in you. Use the wrong one in medicine, a lightning bolt will strike you down. Checking facts is time-consuming but critical. Often the checking leads to surprising new facts and avenues of inquiry, much as searching for a book in a crowded bookstore or library often leads to new authors and books, what some call serendipity and what I call the spillover effect. It’s part of the fun of research.

For all the latest medical stuff, I use online sources such as PubMed, Science, The Proceedings of the National Academy of Science, and others. In Longer one of the characters, a surgeon with a rich, maple syrup complexion, has his sense of touch enhanced. His skin changes as a result. To understand the physical scope of this change, I dove six or seven journals deep into the dermatology, neuroscience, and sensory organ literature. (The emotional scope was another matter.)

I subscribe to Nature, which publishes original, typically hot-off-the-press, medical research. If you’re a writer, any given article might not fit your particular need at the time you read it. It probably won’t. But if you’re like me, it’s bound to tickle your imagination.

I subscribe to the New England Journal of Medicine. When I started my subscription forty years ago, it seemed hopelessly out-of-step and conservative to me, particularly its opinion pieces and articles on politics and policy. Now, with the country’s rightward shift, these articles (which address issues of public health, law, and medical ethics, among others) seem more relevant and useful.

The NEJM also publishes clinical research, much of it having to do with drugs. Since most of this research is funded by the companies making the drugs in question, the results must be read with more than the normal critical eye. Bias—rarely intentional, likely unconscious—is endemic to this world.

Speaking of reading with a critical eye, there’s a relatively new kid on the block: pre-print servers, such as bioRxiv. Most scientific papers take months, if not a year or more, to go through the lengthy process of peer review, revision and publication. Pre-print servers will publish your paper as soon as it’s written. The upside: knowledge gets disseminated rapidly. The downside: the knowledge may be hopelessly flawed. These places require no peer review and precious little quality control at all.

For clinical questions, including all things regarding the diagnosis and treatment of disease, I use Up-to-Date. Nothing beats it, in my opinion. It’s thorough and fairly technical. True to its name, it’s updated regularly. It’s a pricey service, but indispensable to a general practitioner, who sees everything under the sun, and can use the occasional refresher from an expert. For those of you who can’t get enough of all the ways the human body misbehaves and rights itself, those of you as enamored as I am with our beautiful selves, I recommend it.

Michael Blumlein is the author of four novels and three story collections, including the award-winning The Brains of Rats. He has twice been a finalist for the World Fantasy Award and twice for the Bram Stoker. His story “Fidelity: A Primer” was short-listed for the Tiptree. He has written for both stage and film, including the award-winning independent film Decodings (included in the Biennial Exhibition of the Whitney Museum of American Art, and winner of the Special Jury Award of the SF International Film Festival). His novel X,Y was made into a feature-length movie. Until his recent retirement Dr. Blumlein taught and practiced medicine at the University of California in San Francisco. You can find out more about him at www.michaelblumlein.com. He is author of Thoreau’s Microscope with PM Press.

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