For those thinking of writing a health book or other nonfiction, today Janice Harper interviews Dr. Beverly Zavaleta, a physician and a breast cancer survivor, who is the author of Braving Chemo: What to Expect, How to Prepare, and How to Get Through It. Can you tell us Dr. Zavaleta, what prompted you to want to turn your training and experience into a book?
This book was really inspired by a friend of mine whose sister had breast cancer. She was diagnosed shortly after I was and her sister and my friend and I
shared many texts and emails about our experience. They relied on me to decode a lot of the information from their doctor and how things were going and help out with a lot of the symptom management and side effects. So after that experience, I had a big stack of emails and notes, and my friend urged me to turn it all into a book.
Janice Harper: Had you had any writing experience before you set out in writing a health book, other than university?
Dr. Zavaleta: I have had a little bit of creative writing experience, just keeping some notebooks, jotting down what I like to call bad poetry, writing down, maybe stories and things. I had done some writing in medical school, that was based on my experiences and patient experiences or impressions of things as I was going through medical school. Then I had done a little bit of writing, submitted some opinion pieces in college to the college newspaper. So a little bit here and there.
Envisioning Your Health Book
Janice Harper: How did you envision the book when you first started out?
Dr. Zavaleta: Braving Chemo started as a quick handbook, something you could stick in your pocket, your glove box of your car or your purse and have with you just to refer to as you’re going to your chemotherapy appointments. I thought of it as maybe a hundred pages, almost like a collection of handouts. When I was a primary care doctor, I had about 30 different handouts that I had created on different health topics. And I thought of this as a collection of handouts about the most important chemotherapy information topics.
Janice Harper: Did the final book match your expectations of what you envisioned or how did it change?
Dr. Zavaleta: The final book is actually a lot longer than I expected. It’s still not long by any means, it’s about 200 pages of content and then 40 pages of references. I ended up fleshing it out a lot more and putting some more narrative into it, which I think is for the better. Certainly a hundred pages of just bullet point lists would be pretty boring. So I think it ended up being a little more of a story than when I first started writing it.
Using a Book Coach or Editor
Janice Harper: You have degrees from Harvard, University of Michigan; you’re very self-directed, accomplished, but what led you to seek out a book coach and editor in the process of writing a health book?
Dr. Zavaleta: Well, a couple of things. First of all, I had written the first draft in 2016 in the months after my first surgery. And then I spent about six months revising it myself. I sent it out to some beta readers in my local environment, some other cancer survivors, some friends of ours who have English degrees and have also published books. And then I got to a point where I had been going over and over it so much in my own mind that the words almost lost meaning.
So I put it away for a while and then as I was getting serious about writing and publishing, I kept reading the advice to work with an editor. I came across Lisa Tener’s site and I reached out basically to find somebody to help because I felt like I was in a rut of some sort. I just didn’t know quite what that was. It seemed like that would be the best choice, to get help. Which is basically good medical advice too. If you need medical help, you go to a doctor. Lisa and I spoke, and she recommended you for coaching. It turned out to be an excellent match, given your background in science writing and publishing.
Janice Harper: And what worked in that process?
Dr. Zavaleta: One of the things that I needed to do was to increase the readability of the book. In other words, like I said a collection of to do lists isn’t going to be very readable. I needed to make it a little bit more accessible and perhaps more interesting to people than just a list of things to do and not to do. That insight was something that you really helped me with. So, getting specific insights like that were very helpful to me.
I also felt like each session was able to focus on a section of text and then give me essentially homework. In other words, this is the section I’m working on, the goal is to get it from where it is to where it needs to be. But then where it needs to be there was actually a defined place. In other words, it needs to be fleshed out in this manner. I want it to look like this.
Another example of that was how to link the different sections together. That also has to do with changing it from a collection of handouts, and making it into a book. So one of the other aspects that I learned was having the last few sentences of one section do a segue into the topic of the next one. Once I heard that, I was like, “Well, that seems obvious.” And then when I was reading other nonfiction books, I could see it. I became aware of it and I could see it happening. I mean, I never knew that the author was doing that, but of course they were.
Finding the Time for Writing a Health Book
Janice Harper: One thing that I found really amazing with working with you was you are a full-time physician. You are a mother of young children and you managed to not only find time to write a book, but you did it quickly. How did you manage your time?
Dr. Zavaleta: Not perfectly, let me tell you. Well, first of all, I will say that I had a very much worked-over draft. It wasn’t even a first draft, I mean, it was like a 12th draft or more. So it wasn’t that I took just an idea and got it finished. So for sure that was part of it. I think also because of my work schedule, I had weeks when I didn’t do any work on the book at all and then I would have a week where I had to do all of that homework, so to speak, that was assigned during the coaching session. So for me having it batched like that, was very helpful because it helped me stick to a schedule.
The Value of Accountability in Writing a Health Book
Janice Harper: I think you also needed some accountability, knowing you’re going to be talking with someone and need something to turn in.
Dr. Zavaleta: Yeah, absolutely accountability. That I had to turn in those pages and I had to have them in three or four days before the coaching session. That accountability was absolutely key to being able to get it done. And I think also flexibility was important too, because if it was just too much, then you and I could email and negotiate and come up with, “Okay, if I can’t get that much done, I’m going to get this other part done.” Because there were a couple of chapters that were just … they were extremely important chapters and they turned out to be much more monstrous than I had realized. So then that ended up taking two weeks instead of one week, or what have you.
Editing Your Book
Janice Harper: How did the editing help you? Did the editing help focus your words without taking away from your voice?
Dr. Zavaleta: Yes. And actually, I became a much better user of the software because I learned to use the editing functions in Word. Just the color highlight features and the note features on the side, because then I could read your suggestions and take it or leave it. I also found it really helpful because if you read something I had written and interpreted it one way and then reworked it, I remember thinking, “Oh, that’s not what I meant at all.” And then I would have to go back and rewrite it. So it actually was very helpful to me as a physician and you as a non-physician.
It was a good check to make sure that my words were coming across the way that I meant them. I also found that what was helpful about editing was to standardize my voice throughout the book. Obviously not every chapter has the same tone. So some chapters might be a little more upbeat and encouraging. Other chapters might be more comforting and concerned. Other chapters might be a little more like, “Yeah, get with the program.” I mean, there’s a different tone, but at the same time I think voice is a different thing than tone.
I felt having your feedback on word selection and maybe the timing of the sentences, somehow helped me. It pointed me in enough of a direction that I could tell when my own voice became more standardized throughout the book. That for this book, I mean, who knows if I wrote something else, I might have a slightly different voice. But the voice of Doctor Zavaleta, the doctor/cancer survivor, that voice that is coming out in this book, became more standardized throughout the editing process.
Janice Harper: You make a good point about tone, because dealing with such a serious topic as cancer as with many books, you don’t want your tone to be the same throughout. Sometimes your tone needs to be serious and other times you need to pull back and lighten up for the reader or it’s going to be too much for the reader to absorb. You need that back and forth levity, and not too much levity, not too much pulling back, because you’ve got to get back to, “This is a serious topic.” You do want to achieve that balance.
Advice for Those Writing a Health Book or Other Nonfiction
Janice Harper: Do you have any advice for writers just starting out to write their first book?
Dr. Zavaleta: I would say you’ve got to write something. Don’t overthink it and this I say wholeheartedly as a chronic over-thinker. I like to overthink things, but one thing as I mentioned at the beginning of our talk, I had been writing bits and pieces of things for years and years. I learned that what helped me write was just to have little notebooks everywhere. One on my nightstand, when I was in medical school I had one stashed in my backpack.
Now with all the devices, I use the memo or note-taking function on my phone. So if I’m in the grocery line and I feel inspired, I just open up a new note and I scribble something, scribble it into my phone. It is sort of a nightmare because I have probably thousands of these little mind bites written down but the point is that gets you material. So instead of saying, “Oh my gosh. Oh no, I must wait for some magical period of time to come along when I’m going to sit down and fill up an entire notebook or fill up 500 pages in my word processor.” When is that time going to come?
Most of us aren’t going to have that time and then if you do, you’re going to sit there and you’re not going to be inspired. So I just realized that I was just going to start essentially making little sticky notes full of whatever. And then the irony was, this book was literally made out of messages, little emails, little texts. That is what made this book. So that would be my advice.
Why Choose Independent Publishing?
Janice Harper: Whatever works, whatever works. Now you have a topic that would have been quite saleable to a traditional publisher. You’re writing a health book on how to get through chemotherapy, what you need to know, what to expect. You’re a physician and a survivor yourself and there aren’t a lot of competitive titles for that. Yet you chose to go with independent publishing. Why was that?
Dr. Zavaleta: I think there are two reasons. First, I did do a little bit of shopping of the title to agents. In retrospect, I probably shopped it out too early because that was when it was much shorter. It was before I worked with you. So the book was not as good as it is now, by any stretch. And I got a little bit frustrated. I only queried 15 agents, which I realize now is not very many. Oftentimes you do have to query 50 agents, a hundred agents. And so then I was lost in the wilderness for two and a half years. I think some of it was just frustration and being naive to what the publishing process is.
And the second reason is, once I did start working with you and I really got into knowing more about the publishing process, and I also got closer to finishing the book, I saw that independent publishing was more in my reach and I could just get it done. I guess I didn’t want to wait and independent publishing was right there. It was an option.
Marketing is something that every author does, regardless, so I have a great deal of autonomy in doing that. Right now, I have giveaways that I do every month. I’m working with a lot of book sponsors that donate books to oncology centers and clinics and patient organizations. I’m not sure that I would have as much autonomy if I had sold my publishing rights to a larger imprint, then I would not have as much autonomy to do this type of charity work. Maybe I would, I’m not sure, but that is one of the freedoms that it gives me, is to do this type of book donations and book sponsorships.
Book Marketing Advice
Janice Harper: And you’ve done quite a bit in that regard. What has been the most effective and the least effective? Any tips on marketing a health book?
Dr. Zavaleta: Everything is topsy turvy obviously because of the pandemic. We started out in early 2020 doing in-person book signings and I was visiting cancer centers. I was starting to do locally some in-person talks and outreach to patients and families, which is wonderful. But then when all of the in-person activities shut down, everything became virtual. So social media became more important as it has for just about everything.
In that realm, Facebook has maintained great importance and that has to do with the demographics of who is a Facebook user and who has cancer. Not to undermine or undercut Instagram or Twitter or any of the other platforms. A lot of authors are on Twitter and actually I am very active on Twitter as part of my physician group. But the patients tend to be more active on Facebook. A lot of the patient support groups are on Facebook. Promoting my blog posts on Facebook is something that I’ve found to be very successful to draw people to my website, where they can read my blogs, get information for free and then if they’re interested, they can find out more information and find the book.
Get Help with Publishing
Janice Harper: Your book is already in the top 10 for a number of categories in cancer on Amazon rankings. It’s quite popular. Have you had to handle all this publishing yourself or did you have help to get where you are with it?
Dr. Zavaleta: For the actual publishing, I hired a graphic designer to do the interior and exterior, all of that was pre-published. And then I also hired a book marketer. The book marketer and their team do help me with the scheduling of my social media content. We work together to figure out what type of posting we want to do.
I write my own text 90% of the time. My book marketer knows me pretty well, so we work together to work the texts. But then they help me with scheduling it all in. There’s a lot of tools you can use. There’s Hootsuite and I think they have some other fancy software that they use to get it all scheduled in, so that you don’t live your life, just sitting there posting things. But I have to spend money in order to have the marketing be automated like that on social media.
And then there’s something else, Janice. I’ve done a lot of interviews on different cancer podcasts, and that’s been really fun. And it’s educational for the audience of the podcast. I mean, there’s a million podcasts out there, but I think if people are interested in marketing their book, whatever it is, if they can participate in interviews and podcasts that are related to the topics of their book, it does help. Number one, it’s useful to the audience, to hear what you have to say. And then two, it gets your name out there and puts you in connection with other people that are also interested in your topic, so I would suggest doing that.
Janice Harper: And your book is being translated in Spanish.
Dr. Zavaleta: Yes, that’s almost completed. We have the first rough draft in Spanish completed, and I’m going through it now to do the final edits.
How Writing Changes Lives
Janice Harper: You wrote a health book that helps lives, that changes lives because it will help people get through chemotherapy and ease that experience as they’re going through cancer treatment. Did writing a health book or having your book out change your own life in any way?
Dr. Zavaleta: I do think that it did. I didn’t realize it until probably close to the end, but I do think that it helped me gain some perspective into how having cancer can change a person and helped me reflect on that. Especially in the sense of analyzing a little bit how bad things and good things can occur at the same time.
I think that writing the hardest chapters which were about some of the emotional fallout from cancer and chemotherapy, and writing some of the more personal chapters, really did give me that perspective on having a very difficult, challenging, or sad experience. But then also at the same time, maybe experiencing good things and joy and that weird paradox of those two things going together.
Janice Harper: It’s funny how sometimes living it is one thing, but then writing about that experience, is transformative in a different way. Well, one last question. Do you have plans for another book?
Dr. Zavaleta: The second book will be the Spanish edition, which is called Afrontando la Quimio, that’ll be hopefully out in the next few months. But as far as a completely different book, I’ve had requests for writing one about radiation. So we’ll see about that. And I think in a few years, I’ll do a second edition of this because there will be updates they need to have, because there’s a lot of science in this book. So whatever’s outdated, I’ll need to update.
Janice Harper: Well, thank you so much, Dr. Zavaleta.
About Beverly A. Zavaleta, MD
Beverly A. Zavaleta, MD is a board-certified family physician, cancer survivor and long-time advocate of patient education. Dr. Zavaleta received her medical degree from Harvard Medical School and practices as a hospitalist physician in South Texas. In addition to publishing Braving Chemo in 2019, her health-related articles have appeared in the Brownsville Herald and online at KevinMD. For more chemotherapy tips and Braving Chemo updates, sign up at Beverly A. Zavaleta, MD – Braving Chemo or follow her on Twitter and Instagram at @BZavaletaMD.
And again for our readers, Dr. Beverly Zavaleta’s book is Braving Chemo: What to Expect, How to Prepare and How to Get Through It, available on Amazon.