Paging Doctor KickassInterview by Rob Hart
How good is Josh Bazell's debut novel, Beat the Reaper?
Last year I took my girlfriend to see Equus. During intermission, I pulled the book out of my bag to see how much I could read before the show started again. That's the measure of a great book - one where you spend your day looking for moments to get in a few more pages.
Beat the Reaper is the story of Peter Brown, a.k.a. Pietro Brwna, a reformed Mafia hitman looking for a little redemption through a medical residency in a Manhattan hospital. When a dying mobster threatens to out him, Brown finds the old adage true: just when you think you’re out, they pull you back in.
Bazell writes a narrative that barrels forward, barely pausing in the form of footnotes to flesh things out, like explanations of complicated medical terms, most of them with Brwna’s trademark sarcasm. In lesser hands they would have been a major roadblock, but Bazell makes them serve the story, rather than distract.
The star of the show truly is Brwna, a cynical, funny and charismatic narrator who can tell you how the bones of your elbow work before he shatters them.
And that ending. Faced with an impossible situation, Brwna resorts to a solution - part MacGuyver, part Patrick Batemen - that left me squirming on the subway as I read it. Literally. People were staring at me.
Bazell has a BA in English literature and writing from Brown University and an MD from Columbia. He’s currently a resident at the University of California, San Francisco. He’s also working on his next book, while New Regency is working on turning Beat the Reaper into a movie with Leonardo DiCaprio in Brwna's scrubs.
Rob Hart: Writing a book is a long, difficult, involved process. So is going to med school. Somehow you managed to do both at the same time. How did you strike a balance between the two?
Josh Bazell: I did my best to treat them like vacations from each other. I would urge anyone working while writing to try to appreciate the opportunities for procrastination that a straight job can offer.
RH: Was there anything in particular that inspired you to write Beat the Reaper?
JB: I think I was worried that medicine would suck my personality out or in some other way make me a different person, so I wanted to write a book about someone actively seeking to use medicine to do that to himself and, for the most part, failing. It’s a lot of fun writing about someone trying to contain a personality that can’t be contained.
RH: Can you tell us about your writing environment? Are there any rituals you adhere to? Do you have a set process for writing and editing?
JB: Obviously writing four or six hours a day like clockwork, in the same place, is the way to do it, but I’ve been writing since I was nine and professionally since I was twenty-four, and I’ve never been able to do that. I travel a lot and I tend to treat projects like campaigns, with a lot of ramping up, relatively brief periods of flurry, then some stunned but hyped-up recuperation time. I don’t recommend it. I’ve gotten used to it, though, and I like it.
RH: In a lot of fiction today, guys like Tony Soprano are presented to audiences as anti-heroes when they spend most of their time doing pretty terrible things. Obviously we feel for Pietro, but the mafiosos in your book have little to no redeeming qualities. Was this an intentional commentary on the mystique of organized crime?
JB: Yeah. Real-life mobsters are parasites who use their willingness to commit violence out of greed and laziness to take money from people who work for a living. They seemed like pretty ripe targets.
RH: You get a couple of good digs in about the current state of the health care industry, with the unhealthy relationships between pharmaceutical companies and insurance companies. What are your thoughts on the current health care debate?
JB: Right now it looks like a disaster. Pharmaceutical and insurance companies leech money from the system and ration healthcare on the basis of profit, and look like they’ll continue to do so. Every doctor who cares more about patients than income knows that the only thing that can save healthcare in the U.S. is to redesign the system around a single payer or at least government option model. So does every member of Congress who cares more about constituents than income, but it turns out there aren’t too many. Despite it being illegal in this country to pay a past or present member of Congress to influence policy, or for a past or present member of Congress to accept such a payment, the healthcare industry used loopholes to give $95 million to members of Congress in 2008, and members of Congress used loopholes to take it. Until our government represents people instead of corporations, and until people learn to vote their own interests instead of their diversionary (mostly hate-based and advertising-fueled) emotions, we’re screwed.
RH: Why footnotes? They're a tough lift - either they enrich the story or drag it down. I think you pulled it off really well. Why did you decide to use them in the first place, and did you meet any resistance from your publisher in getting them through to the final product?
JB: The footnotes were fun and originally designed to give the book some verisimilitude, like it was an actual autobiography. It also adds a kind of cool mid-way tense, in that it seems like the character is commenting later on what he wrote before. That said, I wanted the footnotes to be primarily just for entertainment value so that readers could skip them or, if my editor hated them, I could just take them out and move any information that really needed to be conveyed into the main text. But my editor, Reagan Arthur, liked them from the start, so they stayed in.
RH: You really put Pietro through the paces, but that last scene in the freezer is just intense. I've never had such a physical reaction to something in a book, and I mean that in the best possible way. Without giving it away, where did you even get the idea that was possible?
JB: Thanks. It’s actually a common procedure for transplant purposes. Regarding the self-directed aspect of it, there were also a couple of relatively recent cases that were inspirational, like the hiker who got to safety by cutting off his own arm in 2003, or the woman who gave herself a Cesarean section, with both baby and mother surviving, in 2000.
RH: Last I had read, Beat the Reaper was optioned as a movie with Leonardo DiCaprio in the lead. Do you want to be involved in the process, or do you want pass the book along to the studio and see what happens? Can you tell us what your experience has been like, dealing with Hollywood?
JB: The experience has been cool, but I’m not very involved. I’m happy to be working on the next book, and I imagine they’re happy to not have some rube drawling around during the development process, knocking over word processors with my cowboy boots or whatever. I don’t actually wear cowboy boots.
RH: Are there are writers you're currently reading, and any books you would recommend out of your own personal library as must-reads?
JB: I don’t make a book recommendations because people’s preferences tend to be so personal, but if you love Palahniuk you would definitely do well to check out The Pugilist at Rest by Thom Jones and Jesus’ Son by Denis Johnson.
RH: Any advice you would give to an aspiring writer? Any lessons you learned from having the first book published?
JB: Write the book you’d want to read right now. It’s the only reliable guideline. And be good to yourself in the tough times, because you won’t need to when it’s going well.
RH: Karen Long, the book editor of The Plain Dealer, wrote in her review of your book: "Bazell's story is closest in tone to Chuck Palahniuk's work. Both authors write smart, savage, macho stories about men with double lives, tales that speak directly to smart, disaffected 17-year-old boys." Any thoughts on that comparison?
JB: Despite the implication that smart, disaffected 16- or 18-year-old boys are going to have to look elsewhere, it’s an ego-pump. I love Palahniuk in about a million ways, including minor ones like having the page numbers count down instead of up in Survivor. And once when I brought my Boston terrier, Lottie, to Powell’s, a woman who worked there said Palahniuk has two of them. So there’s that, too.
RH: You're working on your second book - can you tell us about that? How has the process differed from the first?
JB: I’m really loving writing right now. The second book is, as promised, an ordeal in some ways – it’s hard to recapture the bat-shit freedom of not thinking anyone’s going to read your work. But for whatever reason, I’m feeling particularly unrestrained at the moment. That feeling is one of the things I love about Palahniuk’s work, and when it’s happening it’s hard not to be in a good mood.