Preparation for every one of my books begins with a simple, one sentence (two at the absolute most), “What if” question. For example, creating The Patient began with the question: What if the most ruthless terrorist in the world had a brain tumor and needed surgery? For Extreme Measures, the question was: What if there was a drug (like the one described in Wade Davis’s wonderful book, The Serpent and the Rainbow) that can make you look dead to a trained physician even though you aren’t. For The Sisterhood, I asked: What if there was a secret society of nurses dedicated to mercy killing? The “What if?” is the absolute beginning of each of my books. I work hard at crafting it, and then submit it to my agent or editor for scrutiny. The reward for that initial meticulousness is that I get to start on the long and harrowing road to a 400 page novel with clarity. I also have a brisk, tight way of describing my book to the publisher, an interviewer, or anyone else who asks.
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