How Medical Phenomena Can Be Used in Crime Fiction

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Various medical phenomena have shocked, surprised and fascinated us since the dawn of time. From the terrifyingly named Alien Hand Syndrome to alleged accounts of spontaneous human combustion, we are insatiable for stories which slip outside our realm of understanding. We are driven—be it through empathy, morbid curiosity, fear or intellectual interest—to ponder the meaning of our existence, and wonder: what does this mean? why does this happen? how can we feel safe, when our field of knowledge is incomplete?

In If I Die Before I Wake, the protagonist suffers a fall which leaves him in a coma, suffering from locked-in syndrome. However, the realization quickly dawns that this was not an accident but attempted murder. How can he find the perpetrator and potentially save his life, when he cannot communicate with the outside world?

It’s an interesting premise. Here’s another: in The Silent Patient, a woman with apparently no motive kills her husband and has never spoken since. Can her new therapist unlock the puzzle of her elective mutism and find the truth?

Interesting, right? Crime fiction invites readers to peer into the mind of criminals and turn a mirror to their own darker instincts and desires, and there are countless other examples of medical riddles being used in this genre, from amnesia – explored in S.J. Watson’s unforgettable Before I Go to Sleep—to Munchausen’s by proxy in Gillian Flynn’s incisive thriller, Sharp Objects.

Done well, they can draw attention to a condition or disorder, raising awareness as well as providing an interesting and engaging story. Done badly, they can damage your reputation as a writer, offend sufferers of the condition and spread misinformation.

So, think about why this particular medical phenomenon interests you. Why do you want to tell this story? The disorder or condition should not be there as a convenient device or deux ex machina to solve plot or character issues. Neither should it be the sole focus of the story, but it will almost certainly shape the individual’s perceptions of life. How do friends and family see this person? How does their condition change the way they see themselves? How do people relate to them? Is someone secretly jealous of the attention they receive?

I was inspired to write My Name Was Eden after being diagnosed with Vanishing Twin Syndrome: one of my twins had literally vanished in the womb and become absorbed by its sibling. The surviving twin – my son – was born, and as he grew, so did my curiosity about what happened to the other. There were more questions than answers, however: upon researching the condition, I was surprised to discover that little had been documented about Vanishing Twin Syndrome, despite it happening in approximately 1 in 5 twin pregnancies. Stranger still, there were stories of the surviving twin absorbing the vanished twin’s DNA, others where they reported feeling “different”, and I thought this raised some interesting questions – not only about genetics, but also about personality, the formation of identity and the debate surrounding nature and nurture. My Name Was Eden is a story about vanishing twin syndrome, yes, but beyond that, it’s about the conflicting forces which act upon a family and how these can drive a person (or people) to commit acts of crime. In short, it is not the medical phenomenon that pushes the story forward, it’s the characters and their responses to change.

When writing about medical phenomena, research is essential, but if there is limited information available, read articles, blog posts, forums. Be sensitive. If possible, talk to sufferers of the condition or their relatives/caregivers and find out how it impacts them on a day-to-day basis. This is key to understanding the condition from a personal perspective. Where do they live? How much support do they receive? Can they afford the treatment they require?

Consider the time period that your crime fiction is set in. Early medical treatments such as bloodletting and lobotomy were once accepted medical procedures, and while it’s true that we now have a much greater understanding of the human body and have come a long way in terms of scientific advancements, there is still much that continues to confound and defy medical expectations. Take Stone Man Syndrome, a genetic condition whereby muscle and connective tissue regenerate as bone in response to damage, gradually forming a second skeleton. Or Walking Corpse Syndrome: a mental disorder whereby a person believes they are missing body parts, or even that they have lost their soul or died.

Luckily, our job as fiction writers is not to cure, but to explore. Could my experience of Vanishing Twin Syndrome have been triggered by anxiety or stress? Possibly. Or maybe it was caused by something unknown to medical science at this time. Paradoxically, without modern technology to enable earlier and more sophisticated scanning, I would not have known about the vanished twin at all. It begs the question: what else can’t we see?

Sometimes, we’d just kill for answers.

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