Writing tips for May, 2020

Living is tough at the moment, and writing about life is no easier. These days our great challenge is finding ways to refrain from touching our faces, but if you’re healthy and still interested in writing fiction, please let us offer up a few tips.

If you’re looking for a heroine or hero, turn immediately to the healthcare profession, obviously. Where should you begin if you’re creating a fictional healthcare worker for your novel or short story? Perhaps with a description of his scrubs, or gloves, or face masks? If you seek verisimilitude, your nurse might be called on to wear his face mask for up to ten hours per shift, so consider adding dark bruises to the character’s face, preferably along the cheekbones, like the ones shown in photographs of Alessia Bonari, a nurse in Cremona, northern Lombardy.

Track down other recent photos of nurses. There are plenty to choose from. In some, the nurses are shown tying on face masks, or squirting sanitizer, leaning through car windows to administer nasal swabs, or hustling down hallways, offering weary smiles and the occasional gloved thumbs-up. They are shown holding the hands of some patients, dispensing food to others or overseeing the operation of a ventilator, if there is a ventilator available.

If you’re feeling rusty and need a quick writing exercise to get you started with your character preparation, make a list of the verbs you imagine these nurses enact in an eight- or ten-hour shift. Our list stretched on to a third piece of paper.

Where will you place your creation? Setting is important. Perhaps your nurse works at Johns Hopkins in Baltimore or Kings County Hospital in Brooklyn. If you decide to choose the Jinyintan Hospital in in Jiangjunlu Subdistrict, Wuhan, China, research the local differences.The bruises on the face of a nurse named Cao Shan have different patterning thanks to the strap of the mask she was wearing in March. Perhaps your hospital setting is now filled with materials nurses don’t often see. Consider adding objects that even a few weeks ago would have seemed out of place. At Mount Sinai West, Manhattan, your fictional nurse could take a moment from her duties to open a box of twenty hefty ‘strong’ 33-gallon rubbish bags her co-workers have been using to cloak themselves.

At some point you’ll want to describe your healthcare worker. How dry is his hair? How parched are his hands from sanitizer? Perhaps focus on the scab on the bridge of his nose – it might resemble the one on the face of Nicola Sgarbi, who works at the civil hospital of Baggiovara, Modena, Italy. The injury makes him look like a boxer after twelve rounds. Imagine your nurse’s hands, forearms, necks, bloodshot eyes.

Dr Scott Worswick, a clinical associate professor of dermatology at the Keck School of Medicine, University of Southern California, recently gave a reporter some handwashing tips. Worswick has to wash his hands frequently and he finds that soap and water dry out hands more than emollient-enriched foam hand sanitizers. Perhaps your nurse carries around either a small case of Vaseline or Aquaphor ointment on days when his hands are starting to dry.

How does your healthcare worker move? Which shoe insoles has she chosen? Which special socks are good for circulation?When she returns home, does your nurse finally take off her shoes in the garage and stash her clothes beside the car? Has your nurse recently adopted a ‘no pens from work in the house’ rule? Consider the moment when your nurse disinfects her work pass for the fortieth time and looks down at her smiling photo on the card and thinks . . . well, we’ll leave that up to you as you write the scene.

When we started contacting healthcare workers for our own research we were told: ‘Nurses should all be given a mime class at some point because we’re trying to express so much with our eyes.’ Consider the variety of hand gestures they employ.

‘When you’re limited with your communication,’ one nurse wrote to me, ‘you move with economy. You speak with economy. We’re not making a lot of extraneous movement.’ Remember your characters can exhibit contradictions.

‘The challenge,’ I was told by a Canadian nurse, ‘is to be two things at once. You’re open and closed, kind and firm, understanding but resolute, flexible but utterly inflexible when it comes to what you know is right.’

What happens to your nurse under pressure? Some primary examples of nurse frustration have appeared in the past weeks on YouTube. In one, a nurse from Long Island speaks straight to cameras and begs for more equipment while a mask dangles from her neck. In another, the voice of Dawn Bilbrough, a critical-care nurse from York, breaks as she implores shoppers to stop panic-buying. ‘I had a little cry in there,’ she says, while sitting in her car after leaving a shop, as she adjusts the camera on her phone. Notice what looks to be an empty shopping bag in the back. Examine the faces in these videos. Try to capture the way a frontline worker leans into her phone to enunciate her warning.

‘When you’re with a person, touching them helps you remember they’re human,’ I was told by a nurse on Vancouver Island. ‘You do a swab, or take blood, and you can see them, you can see a person’s skin and their mouth and their eyes, so I think nurses are less interested in the abstractions politicians come up with like, “We should get the economy going and let a few people die.” These people aren’t numbers to us. We are actually holding them in our arms.’

If you are interested in exploring your nurse character’s sense of humour, keep it dark. Dark survival humour is a must. Some jokes can’t be repeated or taken out of context. ‘It’s a sensibility,’ I was told.

Many writers out there would now like to create the next Contagion, the next Outbreak. What are the attributes of healthcare workers who deal specifically with infectious diseases? I was told by a retired pediatric infectious-disease specialist who worked in Brooklyn: ‘Many are in the field because they simply get caught in it. My mentor used to say, “You learn medicine with the epidemic of your time.”’

Should a fictional infectious-disease specialist be harried or calm? ‘They are studious, calm and patient,’ he said, ‘for it takes time to assist the healing.’ They must give sound advice and enforce its implementation. They must focus on both statistics and emotions.

‘The process involves the weighing of data,’ he said, ‘best practices and outcomes. Emotions are mostly suppressed, especially in the care of adults.

The HIV epidemic changed a lot of this, mostly because doctors in the field were required to go to the clinic and see patients individually and provide direct care. Seeing patients in the clinic one to one helps you to acknowledge them, their names, their problems and concerns—the emotions. Even if you do not sympathize with the lifestyle of a drug addict you end up providing comfort and advice.’

What about the inner monologue of the infectious-disease expert? What do they think of in the morning? ‘You wake up listing in your head the tasks of the day and how to complete them,’ he said. Make sure your character dresses normally, especially when dealing with children. ‘You do not want to scare the kids with gowns.’ Your specialist will need to have respect for viruses ‘and all of the monsters of the microscopic world.’ And when the crisis hits? How does he act? ‘Calm. Without consideration for personal injury, born out of a sense of invincibility.’

If you want to include a scene in your piece of writing about a healthcare worker coming home from her shift, think about the moments when she looks at the empty streets of the world and imagines life returning to the restaurants and pet shops. Imagine her imagining people blithely walking down the street, like their real-life counterparts do; consider including a moment when your character expresses an exhausted thanks at the end of a shift for the beauty and resilience of the world.

For those of you working at home, try to incorporate at least some of these writing tips. If you are writing other characters—perhaps you’re creating a banker or a lobbyist or a politician— compare and contrast their experience with your new nurse. Compare their working hours, exposure and access to hand sanitizer. Are your characters equal?

The theme of this issue of Five Dials is not illness. We chose ‘love’ long before the coronavirus arrived, and no one needs to be told at this moment how important it is to love from a distance, love through our screens, even via a crackling old landline. Love those in your own quarantine as well as the neighbour you can see through a window. Perfect outlandish mime gestures that can relay ‘love’ through a pane of glass.

Inside the issue you’ll find a reminder of the French capacity for love, a short story about love for a dying parent and some advice on how effectively to love someone close – perhaps in the same quarantine as you. There’s an extract from Nikita Lalwani’s new novel about a small restaurant in London, exactly the sort of business we’ll need to eat at, preferably four courses, when we’re allowed back through the doors. The issue features some timely art from our good friend Stanley Donwood. We may be nothing but an occasional free literary magazine, but we do love you.