AWW: Every Menzies Mental Health book features a range of patients who are grappling with mental health challenges. How do you pick the cases that you’re going to include in each book?
Anne: I’ll tell you what happened yesterday. I was telling these stories and Graeme’s saying, ‘Why didn’t you tell me this one before? We could have put that in!’ So, there are always stories that don’t come to mind but in the first book we picked [distressed new mother] Sian because we wanted something that showed it is medication responsive, but medication alone isn’t enough. So, you’re treating the biological part, but it had psychological ramifications.
In this book, a friend of mine has been on my case to put in a dowry abuse case. That swayed us towards that. We were originally going to follow our spinal injury woman a lot more. In fact, we re-wrote it. She was a much bigger part of it, but our first readers just said this is so grim. So, we pulled back on her. We felt in the Ishani case, even though the burns are pretty grim, we could highlight the mother coming to the rescue.
Graeme: One of the really interesting things for us was people saying, ‘We don’t want this grim physical stuff on the page; people facing death or disability from, say, a car accident.’ And yet in the first two books we had people facing death and disability with mental health. Schizophrenia is terribly disabling. And that didn’t bother people the way that the physical stuff did. It just shows how people see mental health as something you can get over or choose not to have. Whereas, ‘Oh my God, someone’s had a car accident, and they might never walk again.’ That’s really tragic.”
I was interested to hear in some interviews you gave about the earlier books that some publishers were concerned that readers would find mental health discussions too grim. Yet the books have been a huge commercial success. Why do you think they’ve resonated with readers so much?
Anne: Because mental health issues are just so common. We really thought Australia in particular was ready for this. Here, mental health has really featured quite upfront. Sometimes in really bad ways, like the original Bondi shopping centre tragedy where the man had schizophrenia. So, there’s been a lot about it. Certainly, at our talks that we give, we have people coming up to us saying, this has effected my family in some shape or form.
Graeme: Let me put it to you, that I don’t know if you have anyone in your close family or friends who has a spinal injury, but I guarantee you know somebody who’s got a mental health problem.
When promoting The Glass House, the first book in the series, you visited 400 bookshops. Were there any stories, or moments, when people came up to you and expressed that a particular part of the book helped them? Were people seeing their experiences reflected for the very first time?
Anne: Because it’s an episodic thing, Graeme makes me do ‘the cards’. He writes the cards while I’m saying, ‘These are the cases I remember personally.’ I will never forget a relatively young man who was refusing dialysis because he really felt that his life was not worth living with it. I really wanted to include that experience. We basically had a list of cases and then we juggled them around, so they weren’t too heavy all at once.
Graeme: I said only two patients are allowed to die and we would literally line up and say: here are our 10 cases or so. Light, heavy, light, heavy. Let’s have our alcoholic headmistress on either side of people wanting to die and so on, to just try and break that up a little.
The episodic style is unusual, but it seems to reflect what it is like in a hospital. There’s always a new patient and a new story.
Anne: Yes, that is what we were trying to get across. It’s interesting because we juggled it around a little bit because real life is pretty frenetic. Nevertheless, you do hold in your head the 10 patients that you’re looking after. There might be one or two that you only see once that don’t get stuck in your head, but you do hold this case load in your mind. It’s about getting it across so it’s not too much for the reader.
There are some really heavy topics in this one. Is there anything that’s a no-go zone?
Graeme: I have to say, you don’t normally kill children in books. We kicked off that first chapter and we thought: We’re going to hit people right between the eyes. This is a hospital. Some really ugly shit happens in hospitals and lets just orientate people and then we’ll back off from that. We’re not going to build up to it. We’re just going to say right up front: This is the environment you’re in, and it’s life and death and not in that fantasy way where the dog gets to live, and the kid gets to live. Some horrible stuff happens and from then on we can ease back and relieve the reader. I don’t think we’ve ever consciously said: We can’t touch that.
Has the mechanics of how you write the books changed since you published the first one?
Anne: Not really. Graeme writes more of the chapters now from scratch. Particularly the family-related ones because that doesn’t require the psych input.
Graeme: At the beginning Anne wrote basically everything. We planned together but she knew how it happened, so we might write: Sian is admitted to the ward, but Anne knows how it all words. Then we go back and edit back and forth. Now I’m able to write a lot more just because I’m more comfortable in that space and then Anne will go back and correct me when I get it wrong.
I know you have a lot of experts contributing. How many drafts would you say you do?
Anne: Not as many as we did the first time around. The first time around nearly killed me!
Graeme: I’m going to correct Anne. We did more drafts of this book than of any. It was a real tough one and we made some really substantial changes as we went through. We did about 20 full end-to-end passes. That’s all the way from getting that rough first draft down to making sure the proofreader has got the commas in the right place.
AWW: As I was reading I was thinking of that term we’re hearing a bit, particularly in reference to the award-winning medical drama The Pitt, and that is competency porn; the idea that people are seeking comfort from people doing their jobs effectively and efficiently. Do you get the sense that readers are craving comfort and reassurance at the moment?
Graeme: I think it’s not just at the moment. I think readers have always looked for that. We take a big risk when we kill a child in the first chapter. Some beta readers said: Whoa. I had to put it down and pick it up again.
For me, I like to draw the threads together at the end and I also want to redeem characters. David, for example, [anorexia patient] Chloe’s father, who’s probably the nastiest character in the series, the last time we see him, I just want us to feel something of where he’s coming from and why he might be the way he is. We don’t have to forgive him. But we’ve got to understand that the world and his life made him the guy he is. So, I’m a great one for wanting to redeem characters and not just put “bad” people on the page and I think that helps a little.
Anne: I was just thinking about David and how I’m happy to dislike him. I like crime so I don’t mind having baddies. That’s not quite true, because as a psychiatrist I always have to see the other point of view.
Graeme: I let Anne have a baddy in this book. There is a baddy…
Anne: I think you do need some of that to be entertaining. It’s always a balance of how much you’re doing that.
Are we going to be seeing more of Dr Hannah Wright?
Graeme: We would like to see how this third book goes, because there’s normally a bit of a drop off as a series goes along. You don’t want to just write another book that sells fewer. On the other hand, we think this book will appeal to a broader market because it’s set in a general hospital. We’re hoping it will attract a whole bunch of new readers. You don’t have to have read the first two books. And if that happens, I think we’re going to see Hannah in child and adolescent psychiatry.
Anne: We’ve already got a vague outline but we’re not writing at the moment, so it won’t come out next year. We’ve taken a year off. We’re about to have another grandchild. We’re just taking a year out and waiting to see how this book goes but later in this year if it looks like Hachette wants to go ahead, we’ll start knuckling down.
This interview has been edited for length and clarity.
Read the book review here.
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