Out of the Isolation Ward

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Talk about multitasking. Joshua Spanogle, 35, is going to Stanford Medical School and writing thrillers at the same time. His gripping debut novel, Isolation Ward (Delacorte), features Dr. Nathaniel McCormick, a young investigator from the Centers for Disease Control, who is desperate to stop a frightening new epidemic in Baltimore before it spreads. Is it terrorism? Is it treachery? Galley Girl caught Spanogle, not surprisingly, in the Stanford library.

Galley Girl: To what degree is Nate, your protagonist, patterned after you?

Joshua Spanogle: There's a good amount of me in Nate. He's pretty brash, more brash than I am.

GG: Which year of medical school are you in now?

JS: I'm actually in my fifth of six years in a four-year program.

GG: Do explain.

JS: At Stanford, most of the students graduate in five years. Most students take a year to do some research, either clinical research or basic science research. So I took a year to do some basic science research and orthopedic surgery. The second year, the reason I'm graduating in six instead of five with most of my classmates, is that I'm writing a second novel. The first one was really kind of crammed in around the corners of my studies and then my lab work. The second one I needed to take this chunk of time to work on it.

GG: You managed to write a novel and go through medical school?

JS: Yes. The rough draft I did in the summer after my first year. I actually received a grant from Stanford to work on the book. I worked on that rough draft after that first summer, and then over classes or between classes, on weekends. I was able to do some writing while I was in the lab, while waiting for experiments and things like that.

GG: Do you have conflict about which path to follow, writing or medicine, or do you assume youíll be able to do both?

JS: I assume I'll be able to do both and I have every intention of doing both. The debate I'm having now is that I have to choose a specialty very soon. I was bound for orthopedic surgery, but being a surgeon and having a writing life ... it seems like it's pretty impossible to do, especially because residency is so rigorous. For five years I wouldn't get any writing done. So I'm looking at different specialties right now.

GG: Like what?

JS: I'm looking at radiology and dermatology. I also think about infectious diseases for obvious reasons.

GG:Your role models as a writer?

JS: Michael Crichton's early stuff especially, like Case of Need, which he wrote while he was in medical school, and then The Andromeda Strain, of course, were big influences. I think anybody who is writing in the genre owes a lot to Robin Cook and especially to Coma. Actually, before I started writing Isolation Ward, I was reading a lot of Chandler and Hammett and tried to bring sort of a noir sense to Isolation Ward. I kind of wanted to craft a noir architecture on to a medical thriller, so they were big influences. In terms of voice, Nelson DeMille, especially a book called The Gold Coast. I think he's a great craftsman and especially in that book it nailed voice.

GG: It sounds like living this kind of dual life suits you. It's not too confusing going from one role to the other?

JS: It's really confusing at times. It does require shifting gears a lot, which has been more or less difficult at times. But that said, they do dovetail very nicely. The intellectual work and the contact with people in medicine is a nice balance to the solitude of writing. Writing gives you a chance to exercise different parts of your brain and also to process what goes on in medicine. Medicine is like a conflagration of personalities and conflicts, both on personal and social scales. So writing is a really nice way, for me at least, to work out some of the issues that I see in medicine.

GG: If you're at a cocktail party and somebody asks you what you do, what would your answer be?

JS: I would say I'm a medical student who writes.