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Nurse leader now writes medical mysteries

RNL Editors |

Pamela Triolo, media award recipient, plots new career.


She had published extensively in professional nursing literature, but when Pamela Klauer Triolo, PhD, RN, FAAN, decided to fulfill her longtime dream of writing fiction, she had to start all over again.

 Now the author of two medical mystery books, Death Without Cause (2013) andThe Impostor: A Medical Mystery  (2014), Triolo shares her publishing journey in a Reflections on Nursing Leadership Q & A. She is the recipient of the 2015 Nursing Media Award – Print from the Honor Society of Nursing, Sigma Theta Tau International (STTI).
RNL: What sparked your interest in writing these novels?
Triolo_Head_SFWPamela Triolo: Writing mystery novels has been my dream for decades. Good writers must be prolific readers as we learn from other writers—everything from characterization to plot to writing action or romance. As a child, I loved reading mysteries, starting out with Nancy Drew books. I have read technical mystery thrillers by Tom Clancy and other authors, suspense novels by Robert Ludlum and Catherine Coulter, historical mysteries by Dan Brown and Steve Berry, plus the classics: Agatha Christie, Sir Arthur Conan Doyle, Edgar Allan Poe, and Alfred Hitchcock.
RNL: What preparations did you make before starting to write?
Triolo: I studied mystery writing with best-selling author Max Allan Collins at the University of Iowa International Writers Workshop many years ago. I joined writers’ organizations, Sisters in Crime, International Thriller Writers, and Romance Writers of America and went to many conferences to network, practice, study, and get feedback. In addition, I studied books, articles, and blogs about pace, plot construction, character development, and other topics. 
Your ability to write develops as you write, re-write, and acquire constructive and tough feedback not only from readers, but also from experts in your genre. 
RNL: You once described your writing journey as “humbling, exhilarating, and great fun.” Tell us more about that.
Triolo: You have the false impression that because you are published in the professional world of healthcare, you can write fiction. In professional publishing, the rules of engagement are clear—peers review your manuscript, and a network of colleagues will read your work. In fiction, you are starting all over. No one has a clue who you are—there is a heavy artistic component, and you are one in a million fiction writers wanting to be published.
In writing fiction, one of the first rules is “show don’t tell.” The reader must see, feel, and smell the scene. In technical writing, we can load up on all kinds of details. In fiction, dialogue and action explain and illustrate the point and scene. Dialogue must be realistic and create greater insight into the characters and issues. Good authors spend a lot of time reading their work aloud.
Another challenge is being clear on the point of view. Which character’s head is the reader in now—and how does the writer compose using the “voice” and personality of that character? What does the writer want this character to illustrate?
"Hooking" the reader can also be challenging. How many books have you started and never finished? Every scene should have purpose and entice the reader to turn the page. In addition, you must build tension and create scenes and characters that generate conflict, angst, and interest for the reader.
The fiction writer also must discover new ways to describe people—their feelings, eyes, body style, hair color—without exposition. 
Writing credible fiction requires a great deal of research: At what temperature will body tissue freeze in a morgue refrigerator? How will chilling a blood sample affect results?
You must be very willing to critically, or "ferociously," edit your work and engage editors to make recommendations. Both of my books have had professional editors. I’ve had very smart alpha and beta readers give me feedback, and I’ve revised each book at least 75 times.
RNL: The main character in these two books is a Latina nurse. Why did you decide on a Hispanic nurse?
Triolo: When I first came to Houston as chief nursing executive for the Methodist Hospital System, we had nurses from all over the world but very few Hispanic nurses. Since our population is very diverse and includes people from many cultures, especially Hispanic, I wanted to create a role model to show young women and men that perhaps they could be a nurse—if they have intelligence and the right aptitude, love working in teams, are willing to study and work hard, and have compassion and a commitment to serve.
RNL: Improving the image of nursing in the media has been one of your career goals. How has publication of these books accomplished that aim?
Triolo_death_SFWTriolo: We launched the first book, Death Without Cause, during Nurses Week of 2013. That Sunday, "60 Minutes" featured a story about a nurse serial killer that drew a lot of attention. Most news stories are about the dark side of nursing. I wanted to shine a light on the other side of the coin—the greater number of nurses who are exceptional practitioners.
The books portray the challenges and rewards of contemporary nursing and provide a dynamic window into healthcare that cannot be visualized by participating in a shadow program, hearing a speaker, or reading one article about nursing. The books are currently in the Klein High School system in the Outstanding Students of America health sciences interest area, with the aim of inspiring the right students to pursue a healthcare career.
RNL: Reviews of your books have noted that you present a realistic representation of professional nursing. What are some of the topics you explore through your characters? 
Triolo: You have to think yin and yang when writing books like these. What are the values you want to portray in your role models? What are the challenges in the situations they face and the people they meet? Finally, what should the layperson learn?
Triolo_Imposter_SFWTopics addressed in the books include workplace bullying, new-graduate angst, and psychopathology in the form of sociopaths, killers, and toxic healthcare leaders. The second book, The Imposter: A Medical Mystery, has a heavy emphasis on end-of-life care and how people must be prepared to write their destinies through living wills. The books also explore the concepts of teamwork, hard work, study, friendships, and love.
RNL: Whom do you consider to be the primary audience for your books?
Triolo: The general public. The challenge was to write in such a way that my professional colleagues would favorably critique the “faction” of fiction based in fact, and the public would understand what was written and not be lost in the terminology of healthcare.
RNL: What’s next?
Triolo: Right now, I am ghostwriting a family history set in Europe in the years surrounding WWII. It’s a historical fiction about challenges the family faced when immigrating to the United States. With immigration being one of the hottest international topics of our times, constructing the story along the historical timeline of U.S. immigration has been very interesting.
I have plans to write my third novel. Life is busy and fulfilling.

Editor’s note:
In The Imposter: A Medical Mystery, one of the nurse leaders develops breast cancer. Triolo described her personal breast cancer journey in a 2003 Reflections on Nursing Leadership article. Fourteen years after her diagnosis, she remains cancer-free.
Triolo retired from traditional nursing in 2009 after serving in numerous leadership positions, including corporate chief nursing executive and associate dean for the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania, USA. In addition to writing and marketing her medical mystery novels, she keeps busy consulting, giving presentations, ghostwriting, and writing chapters on leadership and organizational performance improvement.
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