First Page Critique: Reluctant

By Elaine Viets

Here’s another first page from the prolific pens of our TKZ readers. I’ll make my comments after you read it.

Galilee Medical Center, Nahariya, Israel
11 November 1982

The child lay limp and pale on the gurney like a cast-off doll. Blinking hard, I terminated the unrelenting replay of a past tragic failure.

Block it out doctor! But the brutal images of another little girl clutching a Raggedy-Ann doll mocked me, and refused to give way. The little one I tried to save. The one I was forced to leave, to die, alone.

No Moshe. Not now. Save this one!

“Okay Dr. Sabin, we’re ready to go,” said Lydia, giving her a few more breaths with the ambu-bag. The self-recrimination momentarily halted, I slid the laryngoscope blade into her mouth, and gently lifted.

“Suction please.”

I cleared the tiny girl’s pharynx of bloody sputum. She smelled of smoke, dust, and something……what, urine? I was just about to pass the endotracheal tube, when the emergency-room doors burst open. Two medics exploded into the room, pushing another gurney, violently jolting the stretcher under my patient, nearly causing me to lose visual of her vocal cords.

“What the hell?” I blurted, but quickly slipped the slender tube into her trachea and removed the laryngoscope blade before glaring up at the offender. Instantly, the acrid, sharp stench of burned flesh and violence hit my nostrils.

“Burn patient doc,” grunted an IDF medic.

“Hannah!” I shouted to another nurse, “Grab the burn kit. I’ll be right there!” Commanding shouts rang out from beyond the double doors, followed by the high-pitched whine, and whop, whop, whop of an approaching helicopter.

“Huh?” I gasped, taping the ET tube to my patient’s face.

“We’re expecting more casualties, some sort of bombing.” Lydia said, as she attached the ambu-bag to the little girl’s airway. I squeezed the bag delivering a few quick breaths. A blush of pink replaced the dusky, ashen hue of the girls face, as oxygen-enriched air filled her lungs.

The doors crashed open again, and a barrage of wounded IDF soldiers cascaded through.

“You! Doctor!” barked a stocky, red-faced IDF captain, one hand holding a blood-drenched trauma pad against his neck. “Get your hands off that Palestinian dog and treat my men now!”

With that, the captain grabbed the end of the girl’s gurney and gave it a fierce yank, launching the stretcher into the back wall, and ripping the airway right out of her trachea.

Elaine Viets’ critique:
I assume, since the date is written European style, that the author is not an American. The story feels authentic and starts off with a bang. However, it quickly loses its impact when the second sentence trips over Dr. Moshe Sabin’s memories as he tries to save the life of the little girl on the stretcher. That sentence (Blinking hard, I terminated the unrelenting replay of a past tragic failure) is hard to read.

Rather than loading the action-packed beginning with extra information, why not wait until the little girl is breathing? That would be a good time to add the back story about the doctor’s previous failure.

The story is also slowed by medical jargon. Since many of us watch hospital dramas, we have a pretty good idea what an ambu bag is and we may even know where an endotracheal tube goes, but the phrase “lose visual of her vocal cords” should be in plain English.
Why not say: “nearly causing me to lose sight of her vocal cords”?

A laryngoscope is a fearsome-looking contraption. It would be a good idea to briefly describe it and the difficulties and dangers of using it – especially the blade.
What is an IDF medic? Tell us what those letters stand for.

Suppose the author began this way:
The child lay limp and pale on the gurney like a cast-off doll.

“Okay, Dr. Sabin, we’re ready to go,” said Lydia, giving the child a few more breaths with the ambu-bag.

“Suction please.”

I cleared the tiny girl’s pharynx of bloody sputum. She smelled of smoke, dust, and something . . .what, urine?

I was just about to pass the endotracheal tube (AUTHOR, TELL US WHERE ARE YOU PASSING THIS TUBE), when the emergency room doors burst open. Two medics exploded into the room, pushing another gurney, violently jolting my patient’s stretcher, nearly causing me to lose sight of her vocal cords.

“What the hell?” I blurted, but quickly slipped the slender tube into her trachea and removed the laryngoscope blade before glaring up at the offender. Instantly, the acrid, sharp stench of burned flesh and violence hit my nostrils.

“Burn patient doc,” grunted an IDF medic.

“Hannah!” I shouted to another nurse, “Grab the burn kit. I’ll be right there!”

Commanding shouts rang out from beyond the double doors, followed by the high-pitched whine, and whop, whop, whop of an approaching helicopter.

“Huh?” I gasped, taping the ET tube to my patient’s face.

“We’re expecting more casualties, some sort of bombing,” Lydia said, as she attached the ambu-bag to the little girl’s airway. I squeezed the bag delivering a few quick breaths. A blush of pink replaced the dusky, ashen hue of the girls face, as oxygen-enriched air filled her lungs.

Blinking hard, I tried to terminate the unrelenting replay of a past tragic failure.

Block it out doctor! But the brutal images of another little girl clutching a Raggedy-Ann doll mocked me, and refused to give way. The little one I’d tried to save. The one I was forced to leave, to die, alone.

No Moshe. Not now. Save this one!

The doors crashed open again, and a barrage of wounded IDF soldiers cascaded through.
“You! Doctor!” barked a stocky, red-faced IDF captain, one hand holding a blood-drenched trauma pad against his neck. “Get your hands off that Palestinian dog and treat my men now!”

With that, the captain grabbed the end of the girl’s gurney and gave it a fierce yank, launching the stretcher into the back wall, and ripping the airway right out of her trachea.

 

Anonymous Author, the last three paragraphs are outstanding. Congratulations on an intriguing first page. I’d really like to read this novel.
What do you think, TKZ readers?

Win Backstab, the first e-book in my Francesca Vierling newspaper series. The police say the deaths of the St. Louis columnist two friends were accidental, but Francesca is searching the city for their killer — before he finds her. Click Contests at www.elaineviets.com

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About Elaine Viets

Elaine Viets has written 30 mysteries in four series, including 15 Dead-End Job mysteries. BRAIN STORM, her first Angela Richman, Death Investigator mystery, is published as a trade paperback, e-book, and audio book. www.elaineviets.com

33 thoughts on “First Page Critique: Reluctant

  1. Starts with high stakes, action, intrigue and multiple levels of conflict with an interesting protagonist and setting.
    Excellent suggestions Elaine and I’m with you – i want to read more.
    Note to author – I’m a retired US emergency doc and author of a medical suspense-thriller series. If you want to contact me I’d be happy to share what little I know. tcombsauthor@gmail.com
    Love the set-up here and wishing you all the best.

    • Thanks for taking the time to invest in the first page of my WIP! Yes, I am American. The time stamp is formatted mostly from habit, working for private U.S. Aeromedical Services and hospitals. Also, this story includes military and clandestine services from at least three countries. But, since I am writing this for primarily US and Israeli readers, I would change the format if it is recommended. Regarding Dr. Sabin’s memories, I do concur with your assessment (and others’) that it does interrupt the action of the scene, and I will make changes. Regarding the medical terms, this will be a big learning curve for me as they have been part of my vocabulary for a long time. I will have to be conscious of their usage. I need to pursue non-medical beta readers to keep me honest!

      • opps, the first comment was for Elaine.

        To Tom:
        Thank you for your kind offer! I will absolutely be emailing you with questions. Please feel free to tell me “that’s enough!”, if I become a pest.

      • You can do it, Kimberly. Your idea of non-medical beta readers is excellent. They can tell you when they don’t understand something.

      • Elaine –
        I’d be t happy to gift book(s) to you if interested (print or kindle)
        Please send info/address per my email if interested.
        Thanks!

  2. Like Elaine said, I loved the last three paragraphs, immediately hooked me. Until then, I was stumbling through, not really over the medical jargon but because there didn’t seem to be any emergency going on. My suggestion would be to focus on the situation instead of the doctor’s back memories. One of the big things I’d want to know right off is that he’s treating a Palestinian. That will immediately spell danger for anyone who knows anything about Israel. Also, are they in Palestinian territory or inside an Israeli city, or one of those half and half settlements? Is doctor Israeli or European? All these bits of info will raise the already high stakes.

    • Dr. Sabin is an Israeli physician treating a critically wounded Syrian girl, from a bombing earlier that morning at the Israeli Defense Headquarters in Tyre, Lebanon (of which he still knows nothing about). The hospital is located in Nahariya, Israel which is located about 6 miles south of the Israel/Lebanon border.

  3. AZAli, the dateline does say: Galilee Medical Center, Nahariya, Israel, but I agree the author needs to focus on the emergency and let us know if THIS little girl is dying instead of bringing up the girl who didn’t make it. And I like the Palestinian revelation at the end.

    • Sure, but the populace of Galelei could be anything. The Israeli/Palestinian ratio shifts so fast plus what is legal and what is not. I would like to know whether this doctor is being completely illegal and smuggling patients in, or half illegal by, or just doing his job and trying not to think about who he is saving.

  4. “I terminated the unrelenting replay of a past tragic failure.” is an odd wording. But given that English or American English may not be the author’s main language, I’ll let it slide.

    What I can’t let slide is the IDF Captain acting in a way that would lead to his intimidate court martial and possible arrest. Even given a timeline putting this story in the middle of the Israel-Lebanon war. The author no where makes this a military hospital or the Israeli injured soldiers. Then and now, Israel has treated Palestinian civilian casualties.

    Perhaps that is where the story is going, perhaps not. I can’t tell from 400 words.

    Intermixing Middle East politics into a murder mystery is quite an undertaking. And could lead to a very thick book.

    • I don’t want to argue politics here, but the IDF officer spoke absolutely true to me. Who would a doctor report to in a war torn environment? What do you think happens to people who complain to the government about the government?

      • I think we can all cite examples of officialdom who did not perform “by the book.” The fact that this was your own experience will make the novel more immediate.

    • So, I’ve literally been grinning for the last 30 min since I read your comment! “What I can’t let slide is the IDF Captain acting in a way that would lead to his intimidate court martial and possible arrest.” Israel could certainly use more of this kind of support! IMO you are completely correct regarding the IDF code of conduct, and the historical relationship IDF soldiers have with human beings of all races, especially children. Although Galilee Medical Center was not a military hospital, they, along with the hospital in Haifa, received casualties from the bombing of the IDF Headquarters in Tyre, Lebanon on 11 September 1982. Later in the first chapter, a little backstory reveals Dr. Sabin’s soft spot for Palestinian children, along with his immediate (wound driven) revenge against the captain. Later still in Act 1, the captain and Dr. Sabin must put aside their differences and become allies working towards something bigger than the original conflict in the region.

  5. Thanks for sharing your work with us, brave writer. I agree with Elaine. Great critique. Here are a few additional comments:

    Too Many Character Introductions on First Page

    A lot of names are thrown around on the first page, and it can be overwhelming. Here’s a list of names I saw (and had to try to keep track of):

    child holding rag doll
    the new patient that looked like a cast-off doll
    IDF medic
    stocky red-faced IDF captain
    Dr. Sabin
    Lydia
    Hannah
    two medics who “exploded into the room” (an aside: is exploded the right word?)
    barrage of wounded IDF soldiers

    I understand that you want to convey an atmosphere of confusion, but I think you can still do that without causing as much reader confusion.

    A few additional comments that may echo what has already been said (but sometimes it helps to hear things in a different way):

    I like the first sentence, but the second sentence is clunky. Get to the action before giving the doctor’s inner thoughts. Introduce the doctor by showing his/her (would be nice to know if the doctor is male or female) actions first. Be careful about overdoing the medical jargon on the first page.

    Nice job. Keep going!

    • Thank you. I will have to work on cutting down on the cast for the first page.

      Dr. Sabin is a man, I may need to add a beard comment.

  6. Joanna said, “I like the first sentence, but the second sentence is clunky. Get to the action before giving the doctor’s inner thoughts. Introduce the doctor by showing his/her (would be nice to know if the doctor is male or female) actions first. Be careful about overdoing the medical jargon on the first page.”
    I agree, except that the doctor’s first name is Moshe, which I believe is a man’s name.
    Do keep going, Author. You have quite a story to tell.

    • I wasn’t sure that “Moshe” was referring to the doctor, but it’s the Hebrew word for Moses. So, that would definitely be masculine. I think slipping in a comment about a beard would be great.

      Again, keep going, Kimberly. Good stuff here.

      • Thanks Joanne. I’ve actually added a characteristic to him regarding his beard. You guys are so awesome!

  7. Don’t have much to add to the comments other than glad the writer showed up and is taking this excellent critique in stride and with a great positive attitude. It will serve you well on your journey, writer.

    • Agreed, Kristy. Too many good writers could be so much better, except they have trouble taking criticism. We’re both old newshounds and used to being barked at.

    • Thanks Kristy. I can’t imagine why anyone wouldn’t take you guys up on your excellent instruction and writing advise! This experience has been so encouraging.

      • Well, the thing with criticism, Kimberly, is you have to take it all in and then decide (this is the hard part) what works for you. It’s a fine balance figuring out what is truly helpful and what goes against your writer grain. But that comes with experience. Sometimes, it can be overwhelming. Good luck!

        • And learning when to take criticism is a hard lesson. For my first book, my editor suggested that I cut a section I loved because it slowed the pace. I refused. Then I read that novel as a book on tape and realized my editor was right — the scene had nothing to do with the book.
          Good luck, Kimberly. You’re off to a good start.

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