Category news

Feb 20 2020

Resources for writers

Book Covers SFOver my almost two decades of writing and (occasionally) publishing, I’ve learned some stuff. Lots of stuff, actually. Some of what I learned (such as a great place to buy a box for a manuscript) is out of date. However, there are some resources that budding writers should utilize that are still quite relevant, so here goes—

While a novel (or a short story or screen play) is still in the drafting stage, consider getting editorial help. Informally, there are many writer’s groups which offer support and critiques. If you live close enough, consider that as a first source of assistance and career development. I was once privileged to judge a short fiction contest held by the Northeast Georgia Writer’s Group, and all of the entries were quite worthy. The group is active, with contests and guest speakers. Many libraries sponsor such groups. There’s a great list of writer’s groups in Georgia at ReadersUnbound.com.

Depending on genre, there just may be a writer’s conference waiting for you. Such conferences usually feature guest speakers, workshops, and opportunities to meet with literary agents, who are the typical conduits between writers and publishers. I was fortunate to attend a few in nearby Athens (at the UGA campus) which was sponsored by the Mystery Writers of America, but there are a number of conferences, either general or targeting specific types of writing.

When the work is more or less complete, if there is no conventional publisher in the picture paying for it, an author seeking to self-publish or polish a manuscript for possible submission should really consider a paid editor. The Writer’s Digest magazine folks have an entire “store” devoted to such services. When I was working on my first novel, a publisher recommended that I go through a course with Writer’s Digest, and the experience taught me quite a lot about the value of editorial assistance.

Whether self-publishing a novel or developing a website and/or a social media publicity campaign, hiring a professional graphic artist is really important. For a web only publication, such as Kindle Direct, I might try the do it yourself method, but even then, it is good to use a site such as Canva.com. However, if there is any serious money going into the project, such as self-publishing in print or multiple platforms, then a cover artist is very helpful. Both The Gift Horse and the second edition of Trinity on Tylos have covers designed by an independent artist. There’s a list of cover artists over at The Creative Penn. By the way, I’d steer clear of Fiver. I tried that, and got nothing, not even a refund for my initial payment.

Once a book is in print or available as an eBook, most writers will want to help with marketing. This can be rather daunting for many writers. The publisher of The Gift Horse (Booklocker) has a companion site, Writer’s Weekly, which has some links to paying markets for shorter works, as well as articles about writing and marketing.

There are a lot of companies that offer “services” to authors. Be very careful to choose wisely, or money that should have been spent on editing and cover design will be frittered away on something else. While some of these resources have costs, others are cheap or even free. Regardless of how much money you spend, for a novelist the two most important resources are editing and cover design—in that order.

 

Feb 8 2020

Snow in the South

In celebration of a rare snowfall in Georgia, here’s a picture and a poem:

IMG_1559

The Snow Storm

Ralph Waldo Emerson – 1803-1882

Announced by all the trumpets of the sky,
Arrives the snow, and, driving o’er the fields,
Seems nowhere to alight: the whited air
Hides hills and woods, the river, and the heaven,
And veils the farmhouse at the garden’s end.
The sled and traveler stopped, the courier’s feet
Delayed, all friends shut out, the housemates sit
Around the radiant fireplace, enclosed
In a tumultuous privacy of storm.

Come see the north wind’s masonry.
Out of an unseen quarry evermore
Furnished with tile, the fierce artificer
Curves his white bastions with projected roof
Round every windward stake, or tree, or door.
Speeding, the myriad-handed, his wild work
So fanciful, so savage, nought cares he
For number or proportion. Mockingly,
On coop or kennel he hangs Parian wreaths;
A swan-like form invests the hidden thorn;
Fills up the farmer’s lane from wall to wall,
Maugre the farmer’s sighs; and, at the gate,
A tapering turret overtops the work.
And when his hours are numbered, and the world
Is all his own, retiring, as he were not,
Leaves, when the sun appears, astonished Art
To mimic in slow structures, stone by stone,
Built in an age, the mad wind’s night-work,
The frolic architecture of the snow.

Jan 18 2020

Why do writers need editors?

editing-apps-800x600Before you say, “Duh!” please remember that some people have lots of self-confidence. Others can crawl off into a mental state and ignore the world around them, which can be considered a skill in the writing biz, but conformity is comforting to readers. Other writers seem to think that the rules don’t apply to them, like ee cummings. A few insist on ignoring the red and green squiggles that the word processor uses to offer help in eliminating common mistakes. Writers suffer from any of those problems, or have other idiosyncrasies that make editing necessary. Yes, I considered dealing with editors to be something of a pain, because I am self confident and not afraid to break a few rules.

However, I have learned quite a lot from writing teachers and editors. Friends and family will offer a few tips, but if those friends really like you, brutal honesty is off the table. Sometimes the distance combined with authority that goes along with having an editor is transformative. My first novel was a hot mess when it finally got a full length reading at the micro press that ultimately put it through line editing. My second novel was better, but still needed a lot of work in the editorial phase, beginning at conceptual, then line by line, and finally, proofreading. At that time, WCP did not pay proofreaders, instead relying upon volunteers, which was a bad business decision. My work suffered from that lack, as a few errors made it into the printed work, and sales were less than optimal.

Publishers seldom take on a fiction manuscript that isn’t complete, which leaves out the project development phase. Once the novel is finished, most writers will attempt to put it into the hands of either an agent or a publisher. Problems with style or continuity may crop up at this stage, but if the work is compelling, those can be addressed. What most people consider editing is copy or line editing, which is a line by line examination of grammar, spelling, mechanics, and style. Any “big changes” in the manuscript probably occur at this stage. The back and forth over details can be annoying or even funny, but most problems in the work are solved at this phase. Once, an editor challenged me on a detail where I described a man wearing a glen plaid suit. I thought it descriptive, but she thought it was a weird description that no reader would understand. Ultimately, the description remained, but that is the kind of thing that comes up in line edits.

Before printing comes proofreading, when any style or content changes have been addressed—so what’s left is a last look at spelling, capital letters, and adjustments to make the page layout work. I remember the copy editor at Whiskey Creek Press had to substantially change one sentence to avoid a page with a single word on it, and I was okay with her changes.

A good editor makes printed work better—by questioning, suggesting changes, and insisting on being absolutely correct. Real editing makes the author’s work shine, without the distractions of mistakes or inconsistencies. Nowadays, many people think that word processors have made editors obsolete. Unfortunately, that is simply wrong, and writing is suffering mightily. Errors abound, and the solution is a great editor who reads and corrects. Technology is advancing, but it cannot replace editorial expertise.

Dec 2 2019

The book of the year?

The price we pay book cover
Lots of books are published each year, and I can only read a few of them. But, when a really important general interest book comes along, I often put it on the top of my “to be read” pile. In September, Dr. Marty Makary, a surgeon associated with Johns Hopkins, released a book entitled The Price We Pay: What Book American Healthcare—And How to Fix It. Since most people in America eventually get sick or have an accident, and only a few of us are fifty rich, this is the ultimate general interest book.

In Part I, entitled “Gold Rush” Makary doesn’t have to travel far—he visits “health fairs” at local churches, where salespeople disguised as medical professionals do screening tests and scare participants, mostly those on Medicare, into unnecessary and rather expensive procedures, such as placing stents into leg veins. In the second chapter, he discusses the lack of transparency in hospital pricing, as well as the astronomical rise in common procedures. For instance, a medical center in New Jersey offers joint replacement surgery for $135,400.00, which rose a mere 76.8% in a single year. BTW, Medicare only pays 13K for that procedure. For his third chapter, Makary travels to Carlsbad, NM, where the medical center seems to have overcharged and then sued almost everyone in town. Back in Virginia, Makary visits the courthouse to learn more about similar shenanigans at Mary Washington Hospital in Fredericksburg. Sadly, this hospital is supposed to be a “not for profit” hospital, and thus receives favored tax status, too. Also in this section, Makary provides an analysis of the proliferation of for profit helicopter ambulance services, which charge somewhere between $40K and $60K for a ride that I could make in an hour in my Toyota.

In the second portion of the book, Makary delves into some medical practices that can be improved by focusing on individual physicians. One OB doctor in Florida had a reasonable rate of C-sections, until figuring in Fridays, when the rate rose 80%. Why? The good doctor didn’t want to be bothered on the weekend, so moms who were in labor on Friday got the surgery. This section of the book also discusses the opioid crisis, and Makary admits that he had to learn to write fewer prescriptions for pain pills, after learning about the misuse of all those pills.

Part III of the book is about “Redesigning Healthcare” and it does offer several solutions to problems, but one chapter in this section explains how drug prices are affected by middle men (pharmacy benefits managers) who don’t supply anything other than a big bill for their services. Here’s an example: A pharmacy is paid $34.94 for 90 40mg doses of Zocor, but the employer is charged $442.85–and the PBM gets over $400 on that one transaction. Another chapter discusses problems in health insurance, which less and less helpful except in catastrophic circumstances, and there is even a chapter on “wellness” and how those well meaning programs are far too costly, especially as they often mean an invasion of privacy, or worse, over-treatment for minor issues.

Makary doesn’t make the mistake of only discussing problems without discussing solutions. Several positive programs are mentioned throughout the text, including websites such as ImprovingWisely.com, and the last chapter is a bit of a call to arms. In short, legislators and employers need to be educated on these matters, and healthcare consumers should do everything possible to demand transparent pricing for upcoming procedures.

The Price We Pay is a very important book. This should be the topic of your next book club, a gift for your friends and/or family, or even a holiday gift for your doctor or your legislator. Please buy this book, read it, and pass it on. Knowledge is power, and as this text has lots of information for Americans, this may well be the most important book you will read this year.

Oct 18 2019

How much for a flu shot?

Mostly, I write about books, or maybe films. No doubt, I will do that again soon, but recently I have been experiencing various forms of health care, and my latest such visit was for the annual flu shot, so I’ll write a bit about that. For some years, I opted out of having this injection, but after hubby lost a week of work and felt terrible for even longer, I went back to getting the shot. After all, the couple of times I had influenza it was no fun at all.

Current United States policy (via the Affordable Care Act) requires that insurance cover the flu shot as a preventative measure, without any co-pay from the patient. So, my doctor’s office has made a business decision to “stick it” to the insurance company—pun intended. See the attached screen shot of the EOB for this procedure:

Flu Shot

Now, thinking that $248 is a bit steep for this, I just looked at GoodRx (a nifty site if you have never used it) and it tells me that the estimated cost for the shot is $32 at Walmart.

GoodRx

Now, going to my doctor’s office was convenient and fast, but I’ve had flu shots at the grocery store or at a mini clinic, and neither of those were inconvenient. Bottom line, the doctor’s office knows that they can charge whatever for preventive procedures, and my insurance has to pay for it, so they are taking advantage of this. Kudos to Walmart for making this injection available for regular folks. If you don’t have insurance, or if you want to keep it real, just go to the GoodRx site and put in your zip code. The site automatically offers several locations and price points. BTW, the average when I looked was $32.

As for Piedmont Athens Primary Care, they’ve made me think, yet again, that when insurance premiums go up again, and they will, their approach to business is one reason for those hefty increases.

 

Aug 10 2019

Overdignosed— a brief review and commentary

OverdiagLike many people in the USA, I am concerned about the state of our health care. Don’t get me wrong, I’m grateful to live in a country that has lots of great medical facilities and practitioners. But, I’ve watched people go through some pretty difficult situations, too, so I read Over-diagnosed: Making People Sick in the Pursuit of Healthcare in hopes that I’d learn more about what sometimes goes wrong with our healthcare system. This book offers some first hand insights from three physician authors, and I learned a great deal from it.

Many of the chapters have a “case study” to frame the discussion. One of the most memorable is the story of an older gentleman with a borderline diagnosis of diabetes. In the interest of keeping those blood sugar numbers in the optimal range, the principal author (Dr. H. Gilbert Welch) prescribed medication. Unfortunately, the gentleman’s blood sugar dropped, causing him to lose control of his car, resulting in an accident that broke his neck. The gentleman survived, but he had to wear a halo brace for many weeks while his neck healed. When it was all over, the doctor and patient agreed that the best practice in his case would be to forgo the diabetes medication. This anecdote is a great way to illustrate how over diagnosis can make people sick!

Each chapter explains how modern testing, coupled with ever changing standards for “normal,” have resulted in more and more people being diagnosed with something. The approach is cautionary, explaining that many times a diagnosis might be correct, but if the condition is unlikely to cause the patient any reduction in quality of life, or end the patient’s life early, then it is far better to not treat the disease. However, once diagnosed, both the patient and most physicians will be reluctant to “watchfully wait.” Indeed, the principal author states in the introduction that he does not have routine checkups, even though he works in healthcare and could easily do so. Instead, he waits for something to go wrong. As the old saying goes, “If it ain’t broke, don’t fix it.”

The mammogram is probably the first test that my doctor wants me to have done, but our author states that for most women, they do more harm (due to radiation) than good. Aggressive cancers can develop in the one to two year interval between tests, but slow growing cancers can result in over-reaction by doctors and patients. Also, many women go through the “false positive” situation, which might mean more testing, including a breast biopsy. I’ve known several women who had that done, only to find out that the mammogram was incorrect (or incorrectly interpreted.)

Another interesting story is a conversation between the author and a pharmaceutical rep. The latter was touting the benefits of a drug for women with bone density issues. After a friendly discussion, the drug company rep admitted that the greatest risk for these women is mostly hip fractures, which can lead to all sorts of problems, including premature death. The author states that helping women prevent falls, though physical therapy and other practical measures, would be much more useful. And the testing phase of the drug was eventually discontinued due to subjects developing bone cancer.

The author is firm in his stance that patients are often over-tested and over-diagnosed. He believes that many doctors do this out of an interest in finding answers for their patients, and not merely in making more money. He is also firm that the threat of a law suit can be a driver for hyper testing and the end result of over-diagnosis. I’m all for people having the right to seek redress in the case of gross malpractice, but doctors who have been the defendant in a case, win or lose, will often err on the side of caution and order tests that probably aren’t needed and will refer cases that are only marginal. The costs of this mind set are not negligible, as tests can costs hundreds or even thousands, and that doesn’t include the costs of treating a condition that might not need any treatment. Nor does it address the mental stress of having a chronic “condition.”

Common sense is sorely lacking these days. Certainly many aspects of modern America are getting totally weird, so I guess it is not unusual that medicine is affected. I am grateful to Dr. Welch and his fellow authors for this very cogent discussion of the problem of over diagnosis. I am seriously contemplating what to say at my next doctor visit, when I will face that computerized list of items that modern medicine says I need, but just might result in me joining the long list of those who are “over-diagnosed.”