"Success isn’t a book sale." Interview with medical thriller author Tom Combs


In this interview with Tom Combs author of Nerve Damage and Hard to Breathe, we chat about what it takes to write a book you can be proud of, how to find an editor, and one measure of success that’s more important than a book sale.


Lori Puma: Your latest book Hard to Breathe is the second book in a series. Was writing a series the plan from the beginning?

Tom Combs: Yes, very much so. So that when I’m writing book one, I’m laying the groundwork, foreshadowing, establishing plot and character, in anticipation of where I’m going in book two and book three and beyond.

I wrote Hard to Breathe so it can be a stand alone, but i think the better overall experience is if you read book one, Nerve Damage, first.  I’m currently working on my third book in the series.

LP: How did you get the idea to start this series?

TC: I’ve always been a rabid reader of fiction. I grew up in Minnesota and I was one of those kids who’d be hiking across the lake at 20 below to get to the library and turn in my seven books at take out my next seven.

Ten years ago I lost my job. I’d been working at a Level One Trauma Centers for about twenty years. Had a great job at a great hospital working with great doctors and nurses. It was an inner-city, high trauma, very intense kind of place. I had an aneurysm in my brain that bled. I took a run at dying. I was ten days in the neuro-intensive care unit and I don’t remember much of that. I was messed up for a while. I couldn’t read for a couple of months. Well, I could read, but as soon as I read it, it was gone. So I read the same book for about nine months.

About a year and a half after my bleed, I was doing well enough that I started taking writing classes. We have a great resource here in the Twin Cities called the Loft Literary Center.  In one of my first classes, I wrote a scene. And in some ways, that scene served as the seed from which my character, the emergency medicine physician, and the whole drama and excitement and high stakes suspense action grew out of.

I ended up taking over 30 courses, conferences and seminars.

LP: How did you go from taking writing classes to having your first published book?

TC: It’s a long process. Nerve Damage took over five years.

LP: Oh, wow. Tell me more about that.

TC: Well, it’s an evolution. You develop skills and in part you learn to write by writing.

I was doing ongoing upper-level study of writing craft and I was also getting feedback. I had the support of other authors that I met and became friends with. For example, Vince Flynn, William Kent Krueger. And two gentleman, Michael Sears and Stanley Trollip, who write under the name Michael Stanley. They’re South African and they write a really fun detective mystery series.  I became friends with Michael Sears in part through some Loft events. At early points, he read my drafts of the book and also provided editorial suggestions throughout.

The other thing that was hugely significant was that I retained a top-level editor.

LP: How did you find your editor?

TC: I had started following a writing blog called The Kill Zone. That’s a blog that has like eight or nine published authors in the mystery, suspense and thriller genre. There’s some excellent people there including James Scott Bell, a leader in teaching writing craft.

A guest blogger who appeared a couple of times and her content on writing craft was excellent. She had been the editor for one of the other author’s bestselling books. I was seeking an editor because common sense and everything I’d learned all along the way supported the wisdom of working with a top-notch editor. That to create a professional book, a top quality book, a quality editor is a huge resource.

So I had been on the lookout.  I contacted her, her name is Jodie Renner. She specializes in suspense, mystery, and thrillers. She had more than enough clients, so I had to submit writing to her, to see if she would be interested in working with me.  I went through the submission process. She enjoyed my work and was excited to work with me. She returned my sample with her editorial suggestions and I was likewise enthused. That started a great collaboration. Jodie edited both my first and second books and is now involved with the third.

I’m afraid she’s going to retire pretty soon.  I may have to find another editor. It’s going to be a challenge to find somebody as good as she is.

So there were a lot of years of work, study, and good fortune involved in the transition from ‘I’m going to write a book’ to completing a book that I could feel proud of.

LP: Can you talk about what you’ve tried in terms of promoting your book or what you’re thinking about doing for your next book?

TC: I have been learning along the way. I am independently published by choice as I did not pursue a traditional publishing contract (another large topic). I do wish I had access to the distribution network that the big publishers control.

I’m totally committed to producing completely professional, high quality, no corners cut work. And that’s where the importance of a top-notch editor, learning, study, feedback, criticism, and reviews. When you talk about getting books into more readers’ hands number one, two, and three on the list is write a kickass book.

LP: Hahahahaha. Yes.

TC: I have the opportunity to do some face-to-face sales. My wife is an artist and she has a studio in a building with two hundred studios in it. Twice a year they have events  events where the studios are open and thousands of people come to visit. I set up a small table and I meet a lot of great folks and sell a lot of books. One of the things that that face-to-face experience has brought home to me is that I don’t want to sell my book to somebody who is not going to enjoy it.

Success isn’t a book sale. Success is an appreciative reader. Based on the feedback I’ve received my readers are very appreciative but, like every author, I want more of them.

I’m trying to develop further in marketing, but I’ve mostly focused on step one that I mentioned earlier.

LP: Write a great book?

TC: Yes - write a kickass book.

I’m thrilled and honored that I have hundreds of five star reviews. And I very honestly get emails regularly from people that say that they love my books and can’t wait for the next one. I do book club events. I’ve got an event coming up on August 2nd where I’m the featured author and it’s been sold out for a month, and that’s all exciting. I’m thrilled when anybody communicates that they love my book. That just really hits a joy spot like nothing else.

LP: One of the things that caught my eye was that you had a review from The Journal of Emergency Medicine. I was curious if you did a lot of outreach among the medical world for your first book and if you were planning on continuing that for the series.

TC: That was nice. I was fortunate to get that review. The Journal of Emergency Medicine is a prestigious journal in my specialty – emergency medicine. And actually, Nerve Damage was only the second work of fiction ever reviewed in that journal. It was an honor and great exposure (They loved it!). It certainly established the credibility of the medical content and characters in my stories.

LP: What are you currently working on?

TC: My third book. The twin premises are, one, people in the hospital are dying that shouldn’t die.

And two - and this is fiction and fact - in the Twin Cities, an incredible upswell of narcotic overdoses and deaths are occurring. My protagonist ER doctor Drake Cody finds himself in the middle of these tragic developments.

Part of what drives my writing and what I hope gives a leg up on that step one – writing a kickass book – is the authentic drama of the setting of emergency medicine. Patients and their loved ones plus all those trying to help (EMS, nurses, hospital workers, etc) face incredible pressure and blast furnace emotions. That world is a part of my stories and it is unbelievably intense.

Most everyone has experiences with the emergency department or critical care medicine. The stakes are the highest and emotions off the charts.

It’s tremendous soil for creating compelling fiction.


LP: Where can people find you and your books?

TC: You can pick up a copy of Nerve Damage or Hard to Breathe on the web at  https://goo.gl/XTSLQ7.

Join my mailing list at tom-combs.com. Or follow me on Facebook.



This interview has been edited for clarity and length.