It helps to be mad

I write when I can and don't when I can't. My career is medicine, writing is a hobby

I write when I can and don't when I can't. My career is medicine, writing is a hobby. With my first book, Scalpel, it was stolen time, late in the evening and weekends. Hours plundered from my family - even Christmas morning, when I lied that I had an ill patient to visit and spent three hours at the PC while everyone else was having drinks. I write about what I know, and research returns me to familiar territory: hospitals, operating theatres, emergency rooms. Even Dublin's City Morgue. "There's no point fantasising about it, my boy," boomed State Pathologist Jack Harbison. "If you want to know what it's like, come on in." So I did. And I saw at first hand a forensic post-mortem. I didn't sleep that night and only fitfully for a week after.

Book Two, Cold Steel, was different. I took time out to work, finishing final drafts late into the evening. My editor ordered major rewrites (and I thought it was wonderful!). I realised something had to give. Either I take this hobby seriously or be a proper doctor and play golf.

I'm now on Book Three, Final Duty. When I write it's hell-for-leather, early morning to late afternoon, drafting, cutting, scrapping, reading, cursing. Lots of coffee and pacing the floor, toying with ideas. There's no time for writer's block or self-indulgent breaks. I work from a large, bright and airy attic where I can lock myself away from the world (and the kids!). Pages are scattered over the floor as the printer churns them out. The good ones I kneel and kiss, the bad I spit on with contempt. Final Duty has a big, ambitious plot and is based in Chicago, that most Irish of US cities. More research included a tour of Cook County Hospital with Dr John Barrett, Head of Trauma. Originally from Cork, he had lost none of his accent. Cook County is the only medical facility I've visited with patients handcuffed to their beds. "Most are young, strong blacks involved in gangland shootings," Barrett told me. "We turn them round and put them on the streets again. The sad thing is they keep coming back." I looked around the ER, wondering would George Clooney suddenly appear. "And when they don't?" Barrett sighed deeply: "They end up in the CME's office." Which is also the main mortuary for Cook County.

Dr Ed Donohue (Irish roots) is Chicago's Chief Medical Examiner and he showed me round his department. "This is our waiting room." A heavy-duty door was pulled open revealing a long, deep chamber, dimly lit by low-watt bulbs. Gulp! There were 247 bodies in tiered rows waiting their turn for post-mortem. I turned away and made my excuses. Patricia Cornwell is welcome to her territory. At the end of a writing day I sit on a sofa my wife lovingly refurbished and go over any completed work. And wonder why I bother. But I know the reason. I'm quite mad.

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Cold Steel by Paul Carson has just been published in a Vintage paperback at £5.99 in the UK