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Featured Interviews

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What would you like our readers to know about yourself?

Tom Combs is an as an award-winning now retired emergency physician whose 25 years working in level one Trauma center ERs provided the foundation for his best-selling medical suspense-thriller series. 

A Minnesota kid from a big family, Tom was a bit of a goof-off in high school and characterized the “major” for his early college years as “misdirected studies”. Maturation happened, he met his wife and settled down with he dream of becoming a physician. 

He worked his way through college doing jobs using jackhammers, chainsaws, and heavy machinery. A biochemistry degree, work as a research assistant in pharmacology and a job as a technical writer led up to his dream-come-true acceptance to medical school. 

Tom discovered the relatively new specialty of Emergency Medicine as an intern and his career path was clear. His tools became the stethoscope, scalpel and other instruments of the emergency medicine specialist. Specialty training included 3 years as a flight physician for helicopter rescue. Following 25 years working in metropolitan level one trauma center ERs the opportunity for him to indulge his passion for writing presented. His current tools of choice are the keyboard and a fertile imagination.

Tell us about your experience as an ER physician; what a fascinating topic.

Working in emergency medicine in a big city, level I trauma hospital is intense. The challenges are continuous and time-pressured. One never knows what’s going to arrive via ambulance, rescue helicopter, or personal transport (occasionally a gunshot victim dumped out the door of a moving car at the ER entrance). 

No matter what desperate illness or injury presents it is the emergency physician’s responsibility to make the immediate and appropriate response. It is a daunting challenge.

It is both exciting and sobering to know that at any moment if something terrible happens to anyone in your community that they will be raced to you to do what can be done. Emergency medicine is shift work and round-the-clock. It is commonplace that within the first five minutes of being at work challenges as desperate as a crashing newborn, several multiple trauma victims, a person dying of respiratory distress or any of too numerous to list life or death problems can arrive.

Due to the skills and teamwork among medics, emergency nurses, physicians and many others there are oftentimes dramatic successes – lives are saved and suffering relieved. 

Unfortunately there are also the distressingly frequent deaths, tragic accidents and illnesses, where the damage can not reversed. The terrible burden that patients and their loved ones experience is shared by the emergency team. It is part of every shift.

The ER is the ultimate safety-net for our communities. In my early exposure as a medical student I learned of the very large number of people who live a life totally unlike anything I had been exposed to. Poverty, mental health issues, substance abuse, and criminal activity was much more frequent/commonplace than I recognized based in my fortunate upbringing. The ER exposes caregivers to aspects of our world that are completely unlike what most people have any familiarity with. 

At times in my years it was rare that I could get through a shift without a gunshot victim arriving by ambulance. 

When patients have profound mental health crises the ER is where they are taken for help. When an individual is too violent or out of control for police to manage they are brought to the emergency room. People in the community who are suffering or without any support and who are in crisis are brought to the emergency room. 

Most everyone in the United States has experience with emergency rooms and oftentimes the events involved are among the most powerful in their or loved ones’ lives. I spent twenty-five years working with others to make outcomes the best possible. It involved being exposed to emotions that were blast-furnace intense.

As a emergency physician was my good fortune to work with the very special people. Police, fire/rescue, emergency medical services, medics, emergency nurses, and many more - these are people who respond when illness, trauma or tragedy strike. Oftentimes we are able to help and those times make it all worthwhile. That is what drives these special people who are out there 24/7/365 for us all. I was honored to be a part of those efforts.

Successful fiction writings involves characters that readers care about, high stakes, and trigger emotional engagement. My emergency medicine experience immersed me in real life drama and emotion of the greatest intensity. The people I have worked with and the patient’s, families and loved ones who I have met in the high-stakes world of the ER inspire me. 

I was fortunate to have teamed with such amazing people and to have been a part of so many people’s lives. The opportunity to have helped is among my life’s greatest satisfactions. It is easy to understand how dramatic interventions that saved lives are rewarding but I also learned that being kind and helping a mentally ill, substance-abusing homeless person who has nothing could be similarly meaningful. 

In my writing I attempt to create stories involving characters readers care about in fast-paced engaging stories. My ER experience allows me an authentic and special perspective that informs my writing and that readers seem to enjoy.

How did you go from being a successful ER physician to becoming a writer?

I had an experience on the other side of critical care medicine. An aneurysm (abnormal blood vessel) in my brain burst causing a subarachnoid hemorrhage (more than 50% fatality rate). I was treated in the Stabilization Room of the ER I worked at. I then spent ten days in the neuro-trauma ICU that I do not recall. 

I was lucky. Survivor’s of brain bleeds are frequently left with significant stroke damage. My residual issues were not moverment or coordination but aspects of memory and concentration. I could not read for the first few months and had other issues with concentratioon and multi-tasking. With time and work I improved dramatically though I was unable to continue as an emergency physician(memory and multi-tasking essential). I was able to regain full reading skills and began studies in creative writing. 

I enrolled at the Loft Literary Center in Minneapolis and completed over thirty writing courses, conferences and seminars over the next six years. In that time I began Nerve Damage (book one of my series), wrote extensively and secured a top-notch editor.

Was the transition from ER physician to writer a difficult one?

Yes and no. 

In some ways initially my writing was therapy as well as passion. I missed the satisfaction of helping patients and the special comradery of being part of the ER team. Because of my past I had I was able to make emergency medicine part of my writing. Now I remain engaged with the world of medicine and am also lucky enough to create stories that readers enjoy.

How has your experience as an ER physician helped with your writing?

The real-world, human drama that was part of my life for so long fuels my writing. The stakes were high and the emotional aspects intense. I interacted everyday with people who were facing crises. Disease, trauma, mental illness, behavioral emergencies, crime (both victims and criminals) and the worst of what occurs in society visits the ER. The patients and families show incredible courage and too often face heart-breaking loss – that is what I was a part of. Additionally my work teamed me with police, fire/rescue, medics, emergency nurses, physicians of every specialty, and more. The people who are there to help others when things are at their worst are inspiring. 

The victims of illness, trauma and crime and those dedicated to helping them people my books. The people and experiences of my ER career are a rich source for my writing.

How hard is it to put medical terms into a language people can understand?

I work very hard to make my work accessible to those who have no medical or science background yet compelling for nurse-readers and others who are medical experts. I use authentic language (can’t have dialog such as “hey nurse give me that sharp cutting thing” 😊) but always include context or parallel description that makes it totally clear to the reader what is involved. 

Additionally of benefit is that my excellent editor is not familiar with medical matters and does not have a science background – she provides a foolproof screen.

What’s your favorite thing to do when you're not writing?

Lots of passions – reading!, family fun, fishing, hiking (did Alaska solo mountain trek last summer and hope to repeat this year), swimming, basketball, movies, photography, music, more

Introduce us to Drake Cody. Is this series protagonist fashioned after you?

Drake Cody is a young emergency physician and medical researcher. His past is one that no physician is allowed to have. 

He’s married to Rachelle and they have two young children. He is dedicated to his family, his patients, his medical research and feels responsible for any who are abused by persons in power. His fundamental makeup is that of a protector. 

His past includes terrible hardship and loss. His passion to protect others and capacity for violence has cost him greatly. He has difficulty controlling his passions and his work in the ER frequently places him in the middle of major conflicts with powerful individuals and institutions. He is incapable of ignoring injustice or those being victimized.

He finds the life-or-death challenges of the ER both gratifying and terrifying. He is immensely skilled and respected in the hospital yet his make-up and troubled history drive him relentlessly. He is constantly battling to meet his responsibilities as a physician, a husband and father, a medical researcher, and more. He is both driven and haunted by personal loss and what he has been forced to do in the past.

He revels in the ER “saves”, helping others, and those times Rachelle and the kids are happy and secure. When he sees anyone victimized his anger and capacity for violence are sometimes beyond his control. He fears what he is capable of but also, fundamentally, is at a base level gratified to deliver primal justice .

Is Drake fashioned after me? I have to say in some ways yes, though he is much better than I. His professional self, approach to patient care and appreciation of his coworkers is something I share.

I suspect, as for many authors, there are number of my characters that are in some respects “me”. 

An amusing and potentially troublesome situation arises when people I know or have worked with believe that other characters in my series represent individuals they and I know. Virtually all of the characters in my stories have been inspired by patients, coworkers, or acquaintances, but none of them “are” anyone I’ve known. I often take a unique feature or trait of an individual I know or have interacted with and create a hybrid character incorporating that. If the unique feature is recognizable to others and the hybrid fictional character is a jerk, murderer or otherwise evil, it can be awkward.

You currently have three novels: Wrongful Deaths, Hard to Breathe, and Nerve Damage.  Can you tell us a little about number four?

The new story will include more headlines reflecting content. 

I’ve been very interested in Ebola epidemic from 2014 to the present. I’ve spoken several times on the radio regarding this threat both in the earlier West African outbreak and the immensely dangerous outbreak that is now raging in the Democratic Republic of Congo. The issue of terrorism and, as always, the overwhelming power of greed, corruption and ugliness in the “business” of modern medicine will play a part. Additionally romance, redemption, and the influence of the media will be key. First and foremost it is a story of characters facing critical challenges and desperate circumstances. 

Which novel was your favorite to write and why? 

I think it’s important to always recognize that an engaged reader is the goal. I try and create books that will provide readers an experience as pleasurable as a great read provides me.

I believe it is critical to read extensively, study craft and learn from others. Approach writing professionally. Work with a top-notch editor. 

The single best writing lesson I’ve learned is that the reader experience is created by the words on the page. It does not matter what is in the author’s heart or mind if the words on the page do not deliver. Writing must reveal characters readers care about and stimulate powerful emotion, excitement, curiosity and the satisfaction of a solid ending. For me being an author is about allowing the reader to create their own unique and compelling reading experience. I try to write books that I would love to read.

What do you think are the biggest lessons you’ve learned along your career as a writer and what could you share with those contemplating this career?

Reader validation determine success for me. 

The reviews, emails and other communications wherein readers share that they love my books provide me the greatest thrill and satisfaction. I’ve been fortunate and received over 80% five-star reviews but I very desperately want more readers. As an independently published author access to the major distribution system is blocked. I’m appreciative to TopShelf and their dynamic operation in helping me get more exposure. Every author wants more readers.

Who designs your book covers? Do you have creative input? Can you describe the creative process a little?

I’ve developed the lay-out, discovered most images and have worked with two different graphic artists to execute (Travis Miles, Wyatt/EKO film). For the most recent cover worked with a young Minneapolis photographer/graphic artist in collaboration with my more experienced artisan. My wife is an oil painter and I love to support artists of all types. Opportunity and discovery is as challenging for them as it is for authors.

Do you have an editor, or do you edit and proofread your own work? Can you summarize your editing and proofreading process?

Jodie Renner has been my excellent editor. We developed a very solid pattern of edit and exchange. She is retiring and I will miss her. I am hopeful I can find an editor who can match her skills and commitment.

Your work is high-quality and likely could have been picked up by a traditional publisher. What ultimately lead to you choosing to self-publish?

As I shared in my answer to an earlier question I started writing after surviving a near-death experience. The traditional publishing path involves significant application effort and agent pursuit before a book can get in a publisher’s hands. Additionally I learned from writing colleagues and blogs that it is not uncommon for a book to take two years before release if and when accepted by a publisher. It was also communicated that many traditional publishers no longer are able to provide significant editing, marketing support, or sizable contracts.

I’m impatient by nature and was very eager to get a top-quality book in readers’ hands. I did not skip any steps in study, preparation or editing - my books are professional in all respects but I did not pursue agents or a traditional publishing contract.

There are major trade-offs. At this point in my career I view the primary distribution networks that the traditional publishers control with envy. I’ve created books that readers identify they greatly enjoy but it is a major challenge increasing readership as an independent author. Being responsible for publishing involves learning new skills and investing time. Effective marketing is a challenge and I am thankful to have teamed up with TopShelf as an excellent resource. 

Traditional or independent publishing? it is a tough call and dependent on each individual’s inclination. 

Has self-publishing been a positive or negative experience?

It’s been hugely gratifying to have released three books and have tens of thousands of readers. I’d like to think that if I had pursued a traditional contract I would’ve been published but that can’t be known for sure. 

Traditional publishing has pros and cons. Deadlines, some lack of autonomy, and the long time involved in production and book release are negatives. Conversely greater exposure, potentially more marketing, less of my writing time taken up by the business of publishing and the potential for a greater readership (especially print books) look very appealing to me at this time.

I’ve met a lot of great people and have had wonderful reader support. That being said I suspect I’m like a lot of other authors where oftentimes the grass looks greener on the other side of the fence.

Whether traditional or independently published the thing I desire most is a large number of readers who genuinely enjoy my work. That is more important than money, prestige or anything else. I truly value every satisfied reader and that is what drives me to continue.

How important would you say marketing is for self-published authors? Do you have any tips for others who have gone this route and are struggling?

That marketing and discovery are hugely important as is self-evident. My philosophical joke-line is “if an author writes a book and no one reads it, does a tree fall in the forest?” 

Tips I would offer are try not to let marketing and the business of publishing rob you of too much writing time and energy. The quality of the books you create is what is overwhelmingly most important.

My second tip is to hook up with the great folks at TopShelf magazine! 😊

How do you interact your readers and do you enjoy getting feedback?

I do a number of speaking events such as library fundraisers, and upcoming event with the Minnesota Medical Association, and a 100 member local book club/philanthropic organization. I never turn down a local book club as those gatherings are great fun and become a better writer. I also include contact information in each of my books and have received a large number of communications that have been particularly enjoyable. As I’ve stated it’s all about the reader experience for me and when I receive reports of someone’s appreciation of my work it makes me a very happy fellow.