I’ve always liked to read and write since high school. Contrary to my science background my favorite subjects in high school were US government and English literature. When medical school started I didn’t want to lose this part of me so I read government, psychology, philosophy, and religious nonfiction books. Over the next four years I filled up a large bookcase. I probably bought about 50 books. I read about one per month. Student loans well spent.
In residency as I learned more and more about anesthesiology. Surprisingly one thing I didn’t find was a “central dogma”. I couldn’t find a textbook for why anesthesiologists think the way they do. As I learned more about anesthesia, cognitive psychology, and behavioral economics I realized many of the things I learned in residency were also described in psychology and economics books. My interest grew. Perhaps the two were part of the same fundamental process?
I had one last hurdle: I had no knowledge of publishing. Luckily for my one of the cardiac anesthesiology attendings at my program (Kavah Navab) showed me a company called Scribe Media. Scribe was different from traditional publishing companies.
Traditional publishing involves an author sending a book proposal to a publishing company who then pays the author an advance to write the book. The author functions as a screenwriter in that he or she sells the manuscript to the publishing company then the publishing company does the editing, cover design, and distribution. The author may not own the legal rights to the book or make the final decisions about the back end publishing tasks.
Typically, publishing companies will only publish books with large pre-existing audiences because they earn most of their money through book sales. However, authors usually write books for non-monetary reasons. An important idea may or may not be popular. Typically authors have soul in the game and publishers have only financial skin in the game. That means the writer and publisher may have different, even opposite, goals. For a publisher it may be more profitable to change the content of a book at the expense of the author’s purpose for writing the book. This model did not fit my values.
In Scribe’s publishing model the author provides the initial capital instead of being paid an advance. In exchange the author owns 100% of the book at the end and receives 100% of the profits from book sales. In my arrangement Scribe is accountable to me instead of book sales. They get paid the same whether I sell 10 or 10 million copies. Instead of me focusing on writing a book for personal reasons while they try to maximize book sales we are both focused on creating the highest quality book possible.
More information is available at http://www.scribemedia.com
Now I didn’t need a million connections to write a book…Scribe had all the resources I needed! As long as I could pay them and write the manuscript perhaps I could actually pull this off! But interest IS very different from execution. What I mean is everyone has good ideas. Very few people have the guts to actually do the scut work day after day to make their idea a reality. “Idea people” are a dime a dozen. Those willing to put in the work are rare. Did I want to take on such a big financial risk and not finish the book?
Then COVID happened. Suddenly elective cases were shut down. I had nothing to do for about a month. Then I saw similarities between COVID-19, anesthesiology, and my book collection. Now in my 4th year of residency my collection had doubled in size. My mind was overflowing with ideas. So I started writing.
I spent about a month on the positioning. Positioning is the business plan for a book. It describes who the author is, his motivation for writing a book, the target audience, and why the book is different from other books on the market. After a few calls with Scribe I decided to take the plunge. In September 2020, without any savings, I signed a contract committing $12,000 for the initial writing process. Bravery and foolishness are only separated by the result.
After that I committed myself 100% to the book. I wrote day and night; in the morning and in the evening. Some days I woke up at 3am to write before going to the operating room. Other nights I stayed up until 2am writing then went to OR at 6am. On my days off I woke up early and wrote nonstop. When I ran out of the money I created a Kickstarter which raised about $3500. I tried not to think about bankruptcy because I was literally bankrupt all the time. Luckily Scribe was flexible with my payments. I paid them whatever I could give.
I finished the initial manuscript in November 2020. After I saw the initial feedback from Scribe I realized I needed to delete half of the manuscript then re-write it. November 2020 to January 2021 were miserable. I edited and re-wrote chapters nonstop. For perspective my book will be about 50,000 words and I have about 500,000 total words of writing. In January my life felt like me bashing my head against a wall every day. I was numb. I felt like I was half dead. But I kept writing.
I also realized I needed more editing so I committed an additional $5000 for line-by-line editing. I was in this whether I liked it or not. Either go all in or go home. And there was no going back home. Then I needed $1000 more for a graphic designer because my home-made graphics were literally garbage. Then I had to pay for author pictures. Then I made an LLC to protect the book from legal and financial perspective. Now I needed to pay an accountant. The price kept growing! But I kept up my payments. My bank account was overdrawn multiple times to pay my rent. By January 2021 I had paid off $12,000.
In February 2021, after three months design I saw my finished cover! A week later I submitted my manuscript for proofreading. I literally danced around my apartment. The last 5 months felt like I was running a marathon without a finish line. For the first time I could rest. Now Scribe will do most of the back-end publishing work. I will function more as a CEO, approving changes and managing finances, marketing, and distribution. I still don’t know whether writing a book was brave or foolish. Only time will tell
Despite the physical and psychological suffering I already have an outline for my next book. Once the manuscript is locked for Vigilance i’m going to start my background research. Now that I have all this experience I would be foolish not to write another book.