In this interview, Dr. Gustavo Ferrer discusses his path of writing a health book, Graceful Exit, why the book needed to be written, the role of storytelling, his experiences of self-publishing his first book and traditionally publishing this one. Lisa Tener joins us as well to share some of her observations and advice on book writing, storytelling, publishing and first steps.
Olivia Edwards: What initially inspired you to write Graceful Exit?
Dr. Ferrer: My job as a critical care doctor exposed to death and the dying for many years. I’ve seen my patients experience much pain, suffering, and confusion when they don’t know what to do when a loved one gets sick and ends up in the critical care unit. We answer questions like, “Can I get a second opinion?” “What happens when I go to rehab or home?” “What happens when they die, the funeral, etc?”
A Book as a Conversation Starter
Olivia Edwards: In the introduction, you say that your intended audience includes people whose family members are dying, doctors/clinicians, and people who have recently experienced a loss. In what types of situation have you most often witnessed a need for the type of advice in this book?
Dr. Ferrer: For caregivers who are responsible for a loved one. The best time to start this conversation is as soon as a patient is diagnosed with chronic condition diabetes, strokes, and heart problems.
Lisa Tener: And that’s one reason why the book Graceful Exit is so important. A book can be a great conversation starter, whether it’s left out for patients to read in the hospital waiting area or recommended by the doctor as a resource. Reading the book can help family members prepare for the journey early on, which will impact their decisions and the quality of the experience.
Dr. Ferrer: A caring for each other conversation. A conversation where we realize that we are mortal and that someone must be responsible for all the cost involved when caring for others.
Lisa Tener: And I think that’s such a great question for our readers to be thinking about: What conversations do you want to spark in your readers, in your field and in our culture at large?
Writing a Health Book with a Broad Scope
Olivia Edwards: Graceful Exit combines practical advice about legal, medical, and financial matters with deeply spiritual reflections about honoring people’s end-of-life wishes and the nature of life and death. What was it like to write a book with such a broad scope?
Dr. Ferrer: I wrote about the things I see my patients and their family go through on a daily basis. I wanted to cover all the points that inflict pain, suffering, and increased costs that ultimately put significant stress on the caregivers.
Lisa Tener: Olivia, I love that question because it’s an important one. I worked with a doctor on a book on all the decisions seniors face and how to think about them and address them, and he initially got some push back from agents that he was writing beyond his scope of expertise. One of the challenges in writing a book like this is that publishers or agents may push back on writing beyond the expertise for which you received your degree. But good doctors often face questions beyond a narrow practice area and they have an impact on some of the bigger questions of life. So some of your job in a book proposal is to make a case for the expertise you have beyond the specific medical (or other) training. And Gus obviously succeeded in that because he got a book deal with Sounds True!
The Foundations for Writing a Health Book or Other Prescriptive Nonfiction
Olivia Edwards: You have previously published a book, Cough Cures: The Complete Guide to the Best Natural Remedies and Over-the-Counter Drugs for Acute and Chronic Coughs, which was also published in Spanish. Were there any lessons you learned from writing a health book, your first, which you put into practice to write Graceful Exit?
Dr. Ferrer: Yes, absolutely!
I learned how to organize my thoughts with book coach Lisa Tener, and the foundations she taught me are at the heart of Graceful Exit.
Lisa Tener: That’s very kind, Gus. I’m particularly adamant about picturing one person as if you are talking to them when you write. When you do that, the writing is so much more conversational. I think it’s one of the most important rules for good writing. Having said that, sometimes it makes sense to picture a whole audience. I spoke to a professional speaker recently who confessed she can’t write for just one person, but when she pictures a room full of people, the writing flows! So there are always exceptions to the rules!
For our readers, I’d like to elaborate about that process and the foundations we worked on with your first book, Cough Cures. The foundation began with creating your vision statement for the book, getting clear on the audience and focusing on what goes in the book and what’s beyond its scope. We talked about tone and features, as well. And, finally, we worked on structure. Then, the writing began. And that’s helpful to have a sense that you do some work before you start writing.
At the Heart of Good Writing, Storytelling
Olivia Edwards: Graceful Exit is woven together with many beautiful stories of patients and from your own life. Can you talk about how storytelling became part of your author’s craft?
Dr. Ferrer: I love reading, and storytelling has been at the heart of writing, but Lisa taught me how to use stories to make a point. Story—point—story—point.
Lisa Tener: One of the basic lessons in storytelling is to begin in a moment in space and time. If I ask a writer to tell a story and they begin with generalizations about their experience, that’s not really storytelling. Storytelling isn’t about naming some feelings you had (frustration, fear, overwhelm) but about illustrating an experience in a particular moment in time, by the actions, small movements and dialogue that takes place, as well as by sharing some of your sensory experience (what you saw, felt, sensed, heard, tasted or smelled). Of course, you don’t want to just make a list of sensations. Choose one or two specific, unique, even quirky details that bring the story to life for your reader. The more specific and quirky the better!
And, Gus, you do that so well. For example, early on in the book, you give the example of runaways—family members who disappear when they hear that a loved one is critically ill. Rather than just explain the phenomenon, you start with a specific patient and the runaway daughter who left for Mexico and couldn’t be tracked down. Those specific details, like Mexico add a little spice to the story and make it concrete, rather than generic and vague.
How to Stay Inspired, Even When the Writing Gets Hard Emotionally
Olivia Edwards: Many of the stories moved me to tears. Did you find the process of writing cathartic, draining, uplifting, or some other emotion?
Dr. Ferrer: It has been inspiring. Pulling information from notes, memories and the faces that are engraved in my mind was at times emotionally draining, but the lessons they taught me has left me feeling uplifted and inspired.
Lisa Tener: Writing about emotionally difficult experiences can be draining and I often suggest that writers have a plan ahead of time for how they’ll take care of themselves after the writing. For instance, you might plan to walk in nature, play catch the Frisbee with your dog, or get together with a good, supportive friend after the writing is done. That way, you’re not stuck in a draining experience with nothing to pull you out. I imagine that your spiritual practices, such as prayer, were also helpful, Gus, when the writing process got intense.
Olivia Edwards: Speaking of the spiritual, Graceful Exit highlights the importance of connecting with spirituality in times of loss. How does your own religious faith influence your thoughts about death, approach to your job as a doctor, and the advice you give in this book?
Dr. Ferrer: My faith is one of the components that drove me to write this book. “There is a season for all things”…says the Scriptures, and we are commanded to be responsible and to help one another. The moment I internalized my faith and recognized my mortality and acknowledged my destiny, talking about planning death become natural and necessary.
Publishing Two Health Books and Choosing a Publishing Path
Olivia Edwards: You’ve experienced both self-publishing with Cough Cures and traditional publishing with Graceful Exit. For someone trying to decide which publishing route to choose, what advice would you have? What are some of the benefits of each?
Dr. Ferrer: Excellent question. All depends on where you want to go with your writing career. If you are planning to continue to grow as a writer, traditional publishing will help you develop your writing career. People respect traditional publishing more than self-publishing. Now, if you want to improve your professional career and use the book to advance your career self-publishing is the way to go. In both cases, you need great editors, wonderful cover designers and a large team of people willing to help you.
Lisa Tener: Gus, your last point about hiring excellent editors, cover designers and an experienced team is critical. The low bar to entry is what gave self-publishing a bad rap in the past. That has been changing as many self-published books equal traditionally published books in quality.
Gus’s first book, Cough Cures, is a case in point of a high quality product—well written, beautifully designed—that is making a difference in readers’ lives every day. I might add that by self publishing, you do have the book faster, you have ultimate control and you can make changes and updates whenever you want. For example, Gus was able to quickly create a Spanish language version of Cough Cures and have an immediate impact.
And yet many times I do suggest traditional publishing to authors, for a whole variety of reasons. Cachet is one. The experienced editing, design and sales team is another. So, it’s not one size fits all.
Olivia Edwards: Are there any questions I didn’t ask that you wish I had asked?
Dr. Ferrer: I just want to highlight that it is a marathon commitment. You need help and support from friends and family. In my case, my wife, Nicole, is my hero. She has been at the center of all things, organizing my time, reading, editing, encouraging and above all my number one cheerleader.
Gustavo Ferrer, MD FCCP, is an experienced pulmonologist trained both in Cuba and the US, founder of the Cleveland Clinic Florida Cough Clinic, Interstitial Lung Disease and president of Intensive Care Experts. An authority on respiratory ailments with more than 20 years of experience. He is author of two books, Graceful Exit: How to Advocate Effectively, Take Care of Yourself, and Be Present for the Death of a Loved One and Cough Cures, which is also available in Spanish.
Dr. Ferrer has received several prestigious awards, including: being listed among the Best Doctors in the US by U.S. News & World Report, Most Compassionate Doctor, Patients’ Choice Award, and multiple teaching awards. He has been featured in USA Today, NBC News, CNN en Español, Huffington Post, Health Times, Doctors Channel, Doctors Show Sirius XM, Miami Herald, Fox News, Telemundo and many more.