Writing for Good Health: An Interview with Gustavo Ferrer and Burke Lennihan

Charlotte:  What inspired you to write Cough Cures?

Dr. Ferrer: The Number One inspiration was my wife Nicole. She always wanted to learn more about which medications to use for our children.

Then, in early 2013, I went for an interview about coughs on Radio Caracol, a Hispanic station with more than 10 million listeners. So many people called in!

I was accompanied by the PR director from Cleveland Clinic, who said it would be great to write a book for the public about coughs.

She mentioned that she knew many physicians who start a book and never finish it. That day I felt I needed to start or I’d never do it.

Charlotte: How did you start?

Dr Ferrer: I talked to one of my colleagues at Cleveland Clinic, Dr. Michael Roizen (co-author with Dr. Oz of the YOU book series).

He said that writing for the public was different from writing for a medical journal, and that you needed a road map. He was right – my medical mind was geared to doctors and how medical journals convey information.

So I searched online and found the Harvard Medical Writers Conference; I read about all the presenters and I really liked Book Coach Lisa Tener’s information. I studied her website and then called her in April of 2013 to sign up for her Bring Your Book to Life course.

Charlotte: What are some of the tips and instructions that helped you most?

Dr. Ferrer: Lisa has a wonderful exercise to help you find your voice and develop your roadmap, using multiple cards with different colors as a way to develop the outline and structure of the book.

The first time I did the exercise, I put the cards on the floor, combined them into about 10 or 14 different ideas, made up titles and subtitles, and gave them to Lisa. Her feedback was that I needed catchy titles to stimulate the brain to better communicate with the general public.

So I turned to Nicole – she has an amazing ability to come up with catchy titles.

Once I had a detailed outline, Lisa encouraged me to then create a file or folder for each chapter and also for research. Lisa was the best at encouraging; she also brought published clients to talk about their experiences and overcoming any writing blocks.

Charlotte: How you keep up your momentum?

Dr. Ferrer: Every week I had a one-on-one call with Lisa, and I had to email her new writing for feedback. Also the weekly group calls helped: when I was ready to give up, I heard others in the group who were going through the same struggles and how they dealt with them.

Lisa created small groups with two or three people who became partners in the training. We could stay in touch with each other during the week for support. Within the first 30 to 60 minutes of each call Lisa would give us an exercise to do in pairs.  We’d discuss Lisa’s specific questions with one another.

I also found that it’s hard to keep up the momentum when you have a full-time job and you’re trying to fit the writing in as well, plus of course my top priorities are God and my family.

I got a good idea from a physician [a graduate of the course], whom Lisa invited to speak to us. This physician found time here and there for writing during his day at the hospital.

I realized I was romanticizing the writing process, as if it were about sitting and having great ideas, but now I jot ideas down on an index cards while I’m walking around the hospital.

Charlotte: Did she give you written feedback?

Dr. Ferrer: Yes, Lisa is an excellent editor. The biggest learning point from her editing was how she cuts out fillers. She forces you to really work on, narrowing down your whole message to one or two powerful sentences. She warned me about distracting readers with fillers; she said you don’t want your readers to lose interest and put the book down.

Charlotte: Any tips she shared that you’d like to pass on to our readers?

Dr. Ferrer: Lisa was the first to tell me that I had to choose how to address my readers. She said she has seen many physicians address more than one audience, or a generic audience. She told me to imagine having a conversation with someone, and to write in the present tense so people feel you are talking to them right now.

Lisa also gave me the idea of opening each paragraph with a story from the patient’s point of view, one that shows the patient’s emotions, like anxiety when walking into the clinic, a story that readers could relate to.

We also spoke to co-author Burke Lennihan about her experience with Cough Cures and her previous book, Your Natural Medicine Cabinet.

Charlotte: Does this book have a specific target audience? Did you want to engage people already familiar with natural remedies and pharmaceuticals or did you want to target people who had no experience with it?

Burke: The target audience question was tricky: we knew that the bulk of readers might well be parents wanting to soothe a child’s cough, but in a way the most important readers would be primary care physicians, pediatricians and others whom we wanted to convince not to prescribe antibiotics for the common cold, cough and other viral illnesses.

We wanted the book to be user-friendly enough for the sleep-deprived mom in the middle of the night, so we summarized the recommendations for natural remedies in just three to five bullet points in a small box at the end of each chapter.

We also address how to navigate choosing the most appropriate over the counter medication for cough and cold symptoms in a sea of countless choices.

We took a very respectful tone towards physicians, very sympathetic towards busy doctors and the need for evidence-based recommendations. We wanted the book to take a collegial and collaborative stance, so we have more than 200 research studies referenced in the appendices – tucked safely in the back so as not to overwhelm the average reader yet easily located for the health care professional.

We even included research studies on the cost-effectiveness of the natural approach, aimed at public health officials and insurance company executives.

As for targeting those new to natural remedies versus the experienced holistic moms: the book has something for everyone; It provides enough information on herbs and homeopathics for people new to these areas yet there’s a treasure trove of information for even the experienced home herbalist.

Parents committed to the natural approach will appreciate the fact that finally, here is a book they can give to their PCP or pediatrician, one that will create respect for their approach.

Charlotte: Did you have to do any research before writing this book? If you did have to do additional research, what did this research process look like?

Burke: We both did a ton of research. Our goal was that every single natural product or therapy recommended in the book (we also included acupressure, breathing exercises, meditation etc.) would be supported by at least three research studies available on PubMed. I used PubMed, Google Scholar and also consulted expert colleagues.

Dr. Ferrer provided extensive studies on conventional medicine. We are in the process of posting all our research on the book’s website so that we can keep updating it.

Charlotte: What are some of the steps you took to get Cough Cures published? How did you choose this method of publishing? What do you think worked well with this method of publishing as opposed to other methods? What do you think didn’t work as well?

Burke: Having self-published my first book successfully, I felt from the beginning that we would do best to self-publish for several reasons:

• Once we signed with a publishing company, we would lose control over the editorial content. Several of my holistic health care colleagues have had bad experiences with a publisher forcing changes in their manuscript which they did not agree with. In my field of homeopathy, there are legal niceties around exactly how certain things have to be worded. An editor unfamiliar with the field could easily have changed wording in such a way as to create confusion, make it incorrect or even create problems for us.
• Dr. Ferrer already had extensive connections via hospital chains, clinics and pharmacies both in the US and in Latin America where we knew we could do bulk sales (in fact, Lisa Tener had encouraged him to get confirmation from hospitals, medical practices and bookstores that they would buy in bulk or offer the book in their stores before the book was even finished); why hand over a percentage of the profit to a publishing company?
• Publishers now expect authors to do all their own publicity. The main advantage to having a well-known publisher would be access to retail bookstores; but my experience with Your Natural Medicine Cabinet was that people would be buying online anyway. (My experience was that I got the book into Barnes and Noble, did about 15 instore book signings, on most of which I lost money due to travel expenses etc., and there was no residual benefit in terms of the store staff recommending my book. I got a lot of returns which were too scuffed to be reusable.)

We are just at the beginning stages of promoting our self-published book so I can’t tell you yet about sales success via Amazon and other retail outlets. I can say that doing it ourselves made for incredible flexibility and speed in putting together a book that included lots of tables and illustrations. I did the typography and layout myself, using the professional design for my previous book, so corrections could be done immediately.

Charlotte: Why did you decide to publish a book about acute and chronic cough remedies in April?

Burke: Good question! Dr. Ferrer was eager to have the Spanish translation ready for South America, where the cough season starts in June. He was advised by experts in the Latin American book trade that a book HAS to be published first in the US, in order to be taken seriously there; and it has to become a bestseller in order to really gain respect.

We got the book out in April, did a big Kindle giveaway in May, and made it to #1 in 3 Amazon categories within the first month of the book release. Dr. Ferrer has been really focusing on the Spanish version, and we will start promoting the American edition as soon as cough season starts here.

Charlotte: Can you tell me about the Spanish translation process? Why did you decide to publish a Spanish language version as well? Did you know you wanted to publish a Spanish version when you began writing the English version?

Burke: Dr. Ferrer has a friend, another Hispanic physician who has translated other medical books for the Latin American book trade, and he volunteered to do the translation; Dr. Ferrer of course has been very busy checking and completing it.

He knew from the beginning that the Spanish version would be, if anything, more important than the English version. He keeps talking about how the huge Hispanic community here in the US is not well served by the health care establishment and they tend to turn instead to disreputable internet and infomercial herb scammers.

Charlotte: Burke, Lisa tells me that your first full-length self-published book, Your Natural Medicine Cabinet won three prestigious national awards – two Ben Franklin awards and the Silver Nautilus Award. What advice do you have for authors writing and self-publishing a health book to make it that kind of extraordinary quality and to achieve that kind of recognition?

Burke: I had a huge amount of information to convey and I edited it down so that each of about 100 home-care-type conditions got just one page in the book. That meant, no extraneous words. I put in my best tips gleaned from 30+ years in the field plus unique things I learned from clients and customers. I tried to keep the interest level high, the energy level high, like a volleyball team tapping the volleyball to keep it in the air.

I have a gut sense of when the energy is sagging, when it feels like I’m just padding a section. I wanted every page to be absolutely packed with information, conveyed in words that sparkle.

When it felt like the bottom was falling out of a passage energy-wise, I would put it down, go for a walk or a bike ride, and mull it over. When I came back, I would tighten it up so the through-line of energy would be maintained. It’s like what Dr. Ferrer describes about Lisa’s editing: cutting out all the filler.

I had top quality graphic design help: Alan Barnett in New York did the typography and Nita Ybarra in San Francisco did the cover design; I paid several thousand dollars for each and it was totally worth it in terms of my book being taken seriously.

It’s so obvious when a book is self-published, right from the cover design. I used to work in book design after I graduated from Harvard (I actually learned typography there while writing for the Crimson) and a publishing professional can spot a book cover designed on a CreateSpace template from a mile away. Bottom line: do not use standard templates for the cover or the interior!

Charlotte: What are some things that you learned from writing and publishing your first book that helped with the writing and publishing process of your second book?

Burke: I learned not to be afraid to make scientific writing funny or sparkling with unique ways I use words. Dr. Ferrer has some of his own unique expressions since he’s a native Spanish speaker; another editor might have “fixed” them but I advocated for keeping them in, for keeping Dr. Ferrer’s own voice.

I also learned about the limitations of retail sales, which has influenced our strategy for selling Cough Cures.

Charlotte: Can you tell us about your experience with foreign rights while writing and publishing your first book, Your Natural Medicine Cabinet?

Burke: I had a great experience with foreign rights for Your Natural Medicine Cabinet, and I highly recommend it to authors whose books would be of interest to people in other countries. It’s like free money!

I especially recommend my foreign rights agent, Nigel Yorwerth of Yorwerth Associates. He goes to the Frankfurt Book Fair and the London Book Fair every year to represent books in natural healing, self-help and spirituality. He has a longstanding relationship with publishers in other countries who specialize in those areas and who trust his taste. I would pay him $150 to cover his expenses and to represent me; he would get contracts with publishers in other countries that would pay me several thousand dollars to print my book, and they would cover the cost of translation. It’s been a thrill to see my book in print in Chinese, Russian, Polish and other languages.

Charlotte: What are some of the positive results or responses you have received since writing and publishing Cough Cures?

Burke: The most gratifying response has been from physicians’ organizations and hospital chains that are interested in bulk copies. It means our book will have an impact on health care on the national level – exactly what we were hoping for.

One of the largest hospital chains in the country will be ordering the book in bulk, as well as a large chain of nursing homes. Dr. Ferrer has been invited to prepare continuing medical education courses that will include the book.

He has been invited to give major keynote addresses for the National Hispanic Medical Association, including one at which the book will be provided to all the attendees. It is being bought in bulk by other organizations trying to educate physicians about natural healing.

Charlotte: What can our readers find on your websites?

Burke: We’re posting blogs and videos related to the book.

Gustavo Ferrer, MD was trained in Pulmonary Medicine in both Cuba and the U.S. He worked with the United Nations University in South America and had his fellowship training from George Washington University. He later founded the Chronic Cough Center at Cleveland Clinic Florida. As part of the National Hispanic Medical Association, Dr. Ferrer went to a White House briefing to discuss the Affordable Care Act. He is continually striving to improve health care worldwide.

Burke Lennihan, RN, CCH (Certified Classical Homeopath) is a Harvard alumna with more than 30 years of experience in holistic health care. Currently at the Lydian Center for Innovative Healthcare in Cambridge, Mass., she teaches heart-center meditation at Harvard University’s Center for Wellness and lectures on natural healing at Lesley University and Massachusetts College of Pharmacy.