Several of my fellow bloggers have mentioned some of the difficulties of writing. Can I preface what I am going to say with the observation that writing is difficult, but I think there are many other jobs that are more difficult and perhaps less rewarding. I’m not talking about financial rewards here, but rather the realisation that, despite all the predictions to the contrary, books still really matter to people.

I would like to be able to tell you that writing Dissection was a breeze, but that wouldn’t be true. I would like to pretend that I knocked it off at night, after a full day in the clinic, and that it was finished in a year. But that’s not true either and, since it seems I’m in the mood to make a full confession, I can also tell you that there were several times when I was close to giving up on it and returning to full-time general practice instead. So what’s my point here? I guess it’s this: that for reasons of bravado or for living up to some ‘creative’ stereotype, I’d like to say that writing a novel was easy and the words and ideas just flowed naturally, but the reality is that it was slow and hard and often demoralising. (I think the subject matter of my novel didn’t help in this regard: those of you who have read it will know it’s fairly heavy stuff). But that’s the end of the bad news. The good news is that, through this sometimes grinding process, I learnt something valuable: you need to trust your instincts but, more importantly, you need to persist. It’s blindingly self-evident really, but as a first-time novelist with no claim to fame, you are the only person on the planet who is really going to care (and I’m talking here about that deep personal level to do with self-identity and life goals) whether your novel ever gets finished, let alone published. Of course you can be blessed, like I was, with a supportive mentor, great colleagues and a wonderful spouse but even they are unlikely to be shattered if you set your unfinished novel aside for a year or two. So, as Carolyn Landon has already pointed out, persistence is key. Rework until you’re satisfied. If you really can’t face it, then put it away for a while but come back to it with renewed energy and determination. Keep going until you know it’s finished. As I said, it seems self-evident, but it’s all a bit like childbirth: people can tell you it’s going to be painful and exhausting and totally worthwhile in the end, but you can’t really understand until you’ve actually done it.

I’ve already alluded to the subject matter of Dissection. I’ve been asked a few times if the novel is autobiographical. It’s not, though I have brought to it my experience of being a GP. I need to quickly add that I’ve filtered out all the positives (and there are many) and only included the negatives – the worries and insecurities and frustrations. So please don’t think all GPs feel as embattled as Anna McBride does!

While writing Dissection, I thought a bit about the connections between medicine and writing. They may not seem immediately apparent but I do think they exist. Arnold Zable has already talked about the need for writers to be attentive listeners. GPs also do a good deal of listening to their patients. You might think that listening to a patient talk about their sore foot is not really the stuff of great literature. But there’s another kind of listening that occurs at the level of the psyche and tells you something more than the words the patients says – that, I think, is something writers do as well.

Listening also ties in with observation, a skill that both writers and doctors value. Doctors closely observe body language, mannerisms and physical characteristics to aid with diagnosis. Writers do it to flesh out characters, to make them real.

There’s also a sense of responsibility that comes with both writing and doctoring, though you’d have to say that, perhaps with the exception of the fatwah against Salman Rushdie, the consequences are usually greater for doctors if something goes wrong or offends in some way. Nevertheless, as a writer, I think there’s a responsibility to readers to make the book as good and as truthful (and I don’t mean factual here) as you can.