The books shown on the left are by Charles C. Anderson. Click on the cover to order.

This interview was conducted by
Douglas R. Cobb on August 6, 2012.

I don't often get the privilege of interviewing the same author more than once, but retired doctor and brilliant author of the thriller The Farm and the medical thriller The First To Say No, Charles C. Anderson, has agreed to do a second interview with me. I am honored that he did, and I can honestly say that The First To Say No is another amazing, page-turning thriller from this extremely gifted author. I hope you like reading it as much as I enjoyed interviewing Dr. Anderson.

Douglas R. Cobb: I didn't ask you in the last interview who were some of your literary influences, Charles. It's a question I generally ask in interviews, but I jumped in with questions about your novel The Farm right from the start. So, would you please tell our readers, Charles, which books/authors have influenced you over the years?

Charles C. Anderson: My two favorite authors are Michael Crichton and Michael Palmer, both physician novelists who share my thriller genre. Throughout my career I have benefited from seeking out world-class teachers and soaking up as much knowledge as possible from them. At Emory University Medical School, my faculty advisor was the world's greatest cardiologist at the time, Dr. J. Willis Hurst. Several years after graduation we co-authored a medical article. During my critical care medicine fellowship at George Washington University Medical Center, I was blessed to learn from Dr. Jack E. Zimmerman, one of the founders of the specialty of critical care medicine. During my fellowship I co-authored an article with Dr. Zimmerman that was published in the Journal of the American Medical Association. After a thirty-four career of emergency medicine and critical care medicine, I was hungry to write something besides medical journal articles. Three years ago I noticed an ad in a medical journal directed at would-be physician authors. The director of this four-day symposium on creative writing was Dr. Michael Palmer. A chill went down my spine. I couldn't sign up fast enough. The faculty at this symposium were all physician novelists. I took a week off and drove from Virginia to Cape Cod, hoping to get there early and meet Dr. Palmer. Not only did I get to meet him, I got some one-on-one advice from him and participated in all-day classes by one New York Times bestselling author after another. It was time to get serious about writing my first novel, The Farm. The First To Say No is my second thriller. I retired this year to write full-time.

Douglas R. Cobb: Though The First To Say No is written in the third person, you focus primarily on the POV of the two main female protaganists, Dr. Elita Romanov and Dr. Kate Taylor.

Did you find it at all difficult to write from the POV of women doctors? Have you spoken to some that have perhaps had similar experiences of having been attacked either by patients or in the parking lots of the hospital where they worked?

Charles C. Anderson: Part of the advice I got from Dr. Michael Palmer was to write about my own patients and experiences. Thus, every patient in The First To Say No was a real patient of mine, including the physicians and nurses killed and severely injured. After 38 years in trauma centers and emergency departments, working mostly night shifts (that's where the action is), I have a lot of experience with violent patients. Being six feet, four inches tall and 230 pounds, with a background of military training and athletic competition, I didn't feel as intimidated by the violent patients as a five foot, four inch tall, 125 pound female physician might be. Nevertheless, only a fool would not be frightened by the unpredictability of violent people. In my view it takes tremendous courage for a woman to stand alone as the physician-in-charge of a busy emergency department at night, not to mention the fact that most nurses are also female. I was sympathetic to their plight, because most hospitals do not have any full-time security in the emergency department. That's why I chose female protagonists. And yes, all of my female physician colleagues have been attacked by patients or family members of patients. Emergency department nurses and doctors face potentially violent patients every hour of every day they work.

Douglas R. Cobb: The notorious gang you call the Plagues are the main antagonists of your novel.

Is there really a gang called the Plagues, or did you create that name to be representative of all gangs who"plague" doctors and nurses at hospitals?

Charles C. Anderson: I chose the name as representative of a gang that takes pride in the injuries they inflict on other human beings. These gangs exist in most large cities.

Douglas R. Cobb: The First To Say No: is filled with several dramatic and action-packed moments. One that struck me earlier on is the scene in the park of the Plague named Jack Hopkins, Dr. Taylor, and the HIV positive prostitute and heroin addict, Cassandra Smith.

How does Jack know Dr. Taylor from twenty years ago, and who is Pete Hopkins and how are their fates all entwined?

Charles C. Anderson: Although she does not know it at the beginning of the story, Kate's nemesis, Jack, the muscle of the Plagues, is the son of her own step-father, Pete Hopkins. Pete had repeatedly raped her when she was a child. He had also thrown Kate's mother down the stairs in a drunken rage, leaving her bed-ridden and unable to help her daughter. Pete was a policeman. When she was thirteen, Jack tried to rape her in a fountain in the park. Kate's natural father, who died when she was nine, had taken her to this same park and fountain every day, and she yearned to return to it. Unfortunately, the park was the headquarters of the Plagues. Ultimately, Kate realizes that she must return to that fountain and face Jack in a fight to the death. In the book I try to walk the reader through the events that turn a life saver into a life taker.

Douglas R. Cobb: Dr. William Randall is a love interest in the novel for Dr. Kate Taylor. That is, until he's killed by one of the Plagues. How does his murder strengthen Kate's resolve? Why aren't the police and the hospital administrators more of a help?

Charles C. Anderson: Every human being, including doctors, has a breaking point, a point where they do things that they would not normally do. Kate confirmed that the local police were paid by the Plagues to look the other way. No one was going to help her except her friend Elita and her mother. As you may have noticed I am not a fan of hospital administrators. In short, most do not want the public to know how dangerous the emergency department really is; so they oppose the presence of armed security guards, metal detectors, and bulletproof glass. The truth is that over 60 per cent of all assaults in the workplace in America occur in healthcare, with the emergency department being the most dangerous place of all. Nurses are assaulted far more often than policemen. The first rule of managing potentially violent patients is to show enough force, all the time, to prevent misbehavior. But hospital administrators think that armed security will scare patients away, and they don't want the added expense of security measures.

Douglas R. Cobb: Charles, could you please tell our readers who your character of Jake Forest is, and what does Dr. Taylor do for him that Dr. Baker wouldn't do? Also, what does he ask Dr. Taylor to buy for her, and why?

Charles C. Anderson: Jake Forest was also a patient of mine (another name). He had been put on a mechanical ventilator more than once due to a progressive lung disorder. He didn't want to die in a hospital and he didn't want to go back to the intensive care unit. He asked Kate to give him enough sleeping pills to end his own life on his own terms when the time came. Jake had been a special forces sniper in Viet Nam. Like many professional snipers, Jake preferred precision hand-made rounds turned on a lathe and casings loaded with different types and amounts of powder than were available in off-the-shelf ammo. Such rounds were highly efficient and untraceable. Jake wanted Dr. Kate Taylor to take his order for this specialized ammunition to an old buddy of his who produced the ammunition in his basement. In such a transaction, there is no receipt, no paper trail, and the two parties never meet. Jake and I had the same goal: to confuse everybody as to the identity of the real sniper in the park.

Douglas R. Cobb: Who is Margaret, and in what ways does she assist Dr. Kate Taylor in ridding the park of the Plagues?

Charles C. Anderson: Margaret is Kate's mother, the same who was thrown down the stairs by her second husband. She is a remarkable woman who sacrifices herself to help her daughter and her community systematically kill the Plagues. She has many talents, but her greatest aspiration is to see her daughter happily married and free from fear of Jack Hopkins and the Plagues.

Douglas R. Cobb: What finally causes Detective Dave Whitt to take an interest in the deaths of Plague members at Parkview Hospital?

Charles C. Anderson: Margaret had come up with an elegant way of poisoning Plagues, and her daughter had added a gimmick to confuse the police as to the source of the poison. An elderly woman who ran a homeless shelter called Detective Whitt to say that somebody was killing off her "clients," who were mysteriously turning yellow before dying.

Douglas R. Cobb: What finally gets the community to work together to rid the park and their town of the Plagues?

Charles C. Anderson: Kate is willing to sacrifice her own life in order to improve the lives of everyone in her community and protect those who work in the local hospital from the Plagues, who prey on the female staff members with impunity. Such courage inspires her neighbors and friends to take risks of their own. The more hopeless her situation becomes, the more sympathetic her neighbors are to her cause and methods. This is true for readers as well. Normally, one would not cheer for a doctor who kills people.

Douglas R. Cobb: Though you don't come right out and state your own POV in The First To Say No, in a way, it's relatively implicit in the title itself and the actions of the doctors and their community to try to take back their town from the Plagues. I have read in your blog about your concerns that the woes of the medical profession are a fairly accurate and direct reflection, a microcosm, of the road America, itself, is traveling on.

I'm guessing that you, personally, don't advocate a violent solution to the problems the medical profession and America are facing, but the action and violent acts of revenge in your novel make for a pulse-pounding, exciting read.

What are some things that we can do as individuals and together, as communites, to help turn the direction of violence around, and to get on a better path into the future?

Charles C. Anderson: Vigilante killings are frowned upon by almost everyone, including myself. They are born of desperation and a lack of alternatives. We should remember that this was how our American West was governed for several decades at the close of the 19th century. Also, few people recognize that the comic book heroes we cherish the most (Superman, Batman, Spider Man, and Batwoman) are all vigilantes. Each of them metes out justice apart from the law. We have a tendency to overlook this fact because they have superpowers.

It is my fear that a financial collapse is impending in our country due to our crippling debt and government ineptitude. I believe that emergency departments concentrate those people most likely to be violent, and that it should be a national priority to secure our emergency departments in order to protect the caregivers and the sick and injured from the potentially violent people who make up a significant part of our patient population. As more and more people lose their jobs and government benefits, the number of desperate people will rise dramatically, resulting in more violence. Mentally ill patients do not have good coping skills, and thus are the first to start shooting. I think we can see this happening already. I can't change human nature or the disastrous path our politicians are taking us. My mission is to call attention to our insecure emergency departments, which are generally unprepared for disasters, and to point out that emergency departments will be the epicenter of violence at a time when many people will have nowhere else to go for acute illness and injury. Currently, hospital corporations are in denial regarding the vulnerability of their own staff. Only about 5 percent of our hospitals have armed security around the clock. In most cases, these 5 per cent only hired security after a tragic loss of life. In order to draw attention to this national weakness as well as its causes I write a weekly blog.

Douglas R. Cobb: Thanks for agreeing to do this interview with me, Dr. Charles C. Anderson! If you're a fan of medical thrillers, I highly recommend Anderson's excellent novel, The First To Say No--check it out! Also, if you haven't yet read his powerful and page-turning thriller, The Farm, about ex-Navy Seal Dr. Anderson, you should--you will be gripped from the very first page, and want to read it until late into the night!

Read Our Review of The Farm #1

Read Our Review of The Farm #2