THE CARDIAC CARTEL |
UP CLOSE AND PERSONAL WITH DAVID MUCCI AUTHOR OF CARDIAC CARTEL Dolphin:I know that Cardiac Cartel is your first novel, but why did you choose this subject to write about. David:I have been a physician for twenty years, specializing in Emergency Medicine. Though the art of medicine has progressed through new technology and medicines, the one aspect that has digressed is that physicians now have to worry more and more about financial considerations. It is a reality that financial constraints now way heavily on physicians' decisions with respect to what type of care a patient will receive. With this as a backdrop one of my associates, who knew I was interested in writing, gave me information on a group of invasive cardiologists throughout the USA who had started a network, "The Cardiovascular Network". They joined hospitals throughout the USA in a network to offer what they felt was and is a higher level of care for patients with cardiac disease. Using this concept of physicians banding together for ulterior purposes, the sinister "Cardiac Cartel" was born on paper, where cardiologists who had pledged the Hippocratic oath would rather kill than expose their secret society. Dolphin:And do you think it could happen in reality? David:Currently in the State of Connecticut there are thirty-eight hospitals, but only five are accredited to perform angioplasty. Eleven major hospitals, including the one I work in, were flatly refused accreditation, this year, to perform this procedure. A few of the official reasons were, lack of skilled invasive cardiologists and technical help, equipment not meeting standards. It is interesting that all of the invasive cardiologists that work in my hospital perform angioplasty at two of the three near-by accredited facilities. But at my hospital they are considered unskilled. Most of the angioplasty technicians work at these other hospitals also. As far as equipment is concerned, our angio suites are state of the art and we informed the state that we would buy any piece of equipment they felt we needed. The situation is similar at the other eleven hospitals that were turned down. The political battle that was waged was down and dirty. The money that the five accredited hospitals would loose if eleven more opened up is mind-boggling. They just could not allow it to happen. The decision appears to be a purely financial, one made with no regard for patient care. When a patient has a heart attack, time is muscle. The longer the patient is in the state of ischemia heart disease (decreased oxygen to the heart) without intervention, the less heart muscle survives. The more muscle damage, the more the patient's disability as a cardiac patient is, and the worse his prognosis is. Though we use clot-dissolving medicine it is now accepted that angioplasty is the best intervention, because the clot dissolving medicine does not always work. Emergency angioplasty is what is required. So as the ER physician I have to diagnose the patient, call in a cardiologist to examine and agree the patient needs angioplasty, then send the patient to one of the three nearby hospitals. If the cardiologist that is present is one of the invasive cardiologists, he jumps in his car and follows the ambulance to the other hospital to perform the angioplasty, because he is "unskilled" to perform it my hospital. Though the nearest hospital is twenty minutes away the lag time is 1-1 ½ hours, which is completely unacceptable from a patient care point of view. It is worse at other hospitals. One is over an hour away by car. By the time the patient arrives, well, why bother. So, most of the time physicians in these situations don't bother. They just treat with the clot dissolving medicine and hope it works, and if it doesn't, only the patient suffers. So you ask, could "The Cardiac Cartel" really happen? I think it may actually exist, but the public doesn't know yet. Dolphin:In writing Cardiac Cartel did you feel you would meet with resistance from the medical community? David:The hospital I work in has been very supportive. Why shouldn't they? They were on the receiving end of being turned down for angioplasty. The book is on sale in a big display in the hospital gift shop, with a big poster outside the shop promoting the book. Only one invasive cardiologist in the hospital has opposed the book and the hospital's accreditation for angioplasty. Could he be a member of a cartel? Could he be very high up in the department of cardiology at one of the accredited hospitals? Dolphin:Where your main characters based on personal acquaintances? David:Legally, I'm supposed to say that all the characters are fiction and any resemblance to anyone living or dead is just a coincidence. In reality, I have met a very versatile bunch of physicians over the twenty years I've been in medicine. I will answer the question with a smile and let my silence speak for itself. Dolphin:When you wrote your last chapter, last word of Cardiac Cartel, how did you feel? David:When I finally knew it was finished, (after the 35th re-write) I threw my arms in the air and yelled, "It is done." The inner sense of fulfillment was tremendous. For over ten years I have been working on writing a story that could be published. Dolphin:Was reading an important part of your childhood? David:My childhood was one of passionate adventure. I sailed, started a band, biked across the country, and traveled throughout Europe by rail. I remember the times when I would passionately read, but those times were dispersed amoungst my other passions. Dolphin:What type of books do you like to read? Favorite authors? David:I love Clive Cussler, Micheal Creighton, Tom Clancy. All my life I have loved ancient world literature. I also have a complete first edition collection of Mark Twains books from the Hartford Publishing company. That was the company he published through when he lived in Hartford Connecticut. Dolphin:Do you have any special rituals or routines that you use when you write? (Good luck charms, habits, etc..) David:Because I am an Emergency Room physician my schedule is a rotating one, days, evenings, nights. Therefore it has been impossible to develop any sort of routine. I just write when I can. Dolphin:Are you a computer, typewriter or pen and paper writer? David:I write long hand with pen and paper then I transcribe it onto the computer. I find that with the sheet of paper in front of me I feel I have a more complete feel for the entire scene. My eyes can roam without having to scroll up and down. Dolphin:How much outlining do you? Or, do you just write what pops into your head? David:I roughly outline the entire plot, though the details of each scene come to me while I write. But the plot is laid out before I start anything. Dolphin:Did you experience writer's block and how did you overcome it. David:I live with writers block, I am writers block. I overcome it by not trying to force it. I put it down and walk away. Then inevitably in a few hours or a day or two the resolution comes to me. Mostly it's when I'm in the shower. Why wife says I'm a water person, because I come up with some of my best ideas while the water is rolling off my shoulders. Dolphin:Could you tell us something about how you began writing and how you broke into print? David:I became interested in writing while I was in medical school. I was in the first graduating class of St Georges University School of Medicine, Grenada. While a student we went through a revolution where the government was over thrown and the Cubans took over. This led many years later to President Reagan attacking and liberating the island, and the hostage American students. I was long graduated by then. But while there I wrote a story in what little free time I had called "Bloody Monday", about the initial take over by the Cubans. Needless to say, it went nowhere, but it started me on the road to where I am today. Dolphin:Have you always been interested in writing? David:My life has been filled with all sorts of passions, and interests. Writing has become my most passionate interest over the last 10 years. Dolphin:What, in your opinion, is the biggest mistake that you see writers make? David:For beginning writers, which still includes me, the biggest pitfall is getting caught up in too many little details and not moving the action and scene along. For established writers, sometimes they get lazy and fall back on their laurels and stop trying. Their earlier books are great but years later they just pump out the books, and they sell because they have a name. Dolphin:The Internet has become an all important tool for first time writers. David:Yes it levels the playing field. It gives full exposure to all, good writers and bad writers. It lets the public choose and takes the decision out of the hands of the overworked agents and publishing editors. Dolphin:Do you feel the access and promotion time you have to spend online is beneficial? David::The benefit of online promotion time is still too soon to determine. I've gotten quite a bit of public awareness, but have not seen sales jump dramatically yet due to online promotion. Dolphin::How have you been received in online book clubs? David:Several online book clubs have expressed interest. I'm looking forward to working with them to promote my book and discuss the art of writing.. Dolphin:Do you appreciate establishing a repoire with your readers? Do you gain insight from those who respond to you? David:Establishing a repoire with you readers is critical for growing as an author. Feedback from readers is an important tool an author can use to improve their writing techniques. Dolphin:If you could pass one thing on to your readers about your book, what is the one thing you want them to know about why you wrote it and what it means to you? David:I want the reader to understand that "The Cardiac Cartel" is simply a fun book to read. I have no delusions that it will win any awards. If the reader finishes it and says to himself or herself that they enjoyed it, and it was fun to read, that is reward enough. |
