Royal Pains: First, Do No Harm by D. P. Lyle

by John T. Cullen

Royal Pains jumps from the small screen to the page as disgraced and blackballed ER physician Dr. Hank Lawson finds himself exiled to a concierge practice in the Hamptons. There, he confronts money, power, and a dangerously incompetent medical practitioner. He finds many patients from both sides of the track in need of his own brand of clever, personal, and compassionate medical care. Dr. Hank Lawson (played in the series by Mark Feuerstein in the TV series) is a disgraced New York City emergency room doctor exiled to the Hamptons, after being wrongly accused in a patient’s death.

Award-winning author Dr. D. P. Lyle, M.D. is a medical doctor, forensics expert, and practicing cardiologist whose medical thrillers are backed up by years of training and work experience.

D. P. Lyle, thanks for talking to us today. How does Lawson’s character develop over the span of your novel? How do you build upon his existing black eye?  In what ways is Lawson ‘clever, personal, and compassionate?’ Do you develop several parallel threads, one on the ritzy side of the tracks, the other on the poor side?

The most important aspect of dealing with Hank, Evan, Jill, and Divya is that they are not my characters. I can’t manipulate them or develop them in any significant way. They are locked in by the TV series and by the creators of that show. Therefore none of them really evolves over the timeframe of the two books that I am writing. They interact as they do on the TV series and these stories bring situations that stress them into play. Particularly Hank, since it is really his story.

I like Hank a lot. I like all these characters. I have a lot in common with Hank and therefore can feel what he feels. He is a guy who in many cases fights the machine. He doesn’t care for bureaucracies and thinks that taking care of sick folks is what’s really important. He doesn’t care whether they are rich or poor or whether they can pay or not he simply has to solve the problem and make the patient better. I like that about him.

The Hamptons, on Long Island, are just a few miles from Great Gatsby territory (North Shore, vs. Southeast), and every bit as ritzy, particularly as a resort area for the wealthy of New York City. Do you know the area? Maybe we all know it as a part of our culture. Have you explored the area? What have you learned? Any surprises?

Interestingly, I have never visited the Hamptons. But I’ve been to many places where rich folks live and they’re pretty much the same everywhere. They’re just like the rest of us only they have more stuff. Mostly. Like every other stratum of society some can be jerks and some can be wonderful people. Hank meets both types but most of the characters that he interfaces with her pretty decent people who just happen to have a medical problem that he can solve.

There is no question that the Hamptons environment is an important part of the stories. After all, Hank lives in a mansion–albeit the guesthouse–but a mansion nonetheless. He sees the upper crust of society but he also sees the poor. I think he would be just as happy in a small apartment working in an emergency room as he is doing concierge medicine. In fact, he would probably be happier. After all he came to this completely by accident after an unfortunate incident took place in the emergency room he ran. But Hank is resilient if nothing else so he makes the best of the situation and does the best job he can.

I looked up concierge medicine, since few lay persons will understand the term. Apparently, it refers to a kind of retainer or boutique practice, in which the client pays a hefty annual fee and receives specialized attention.

Basically that’s exactly what it is. These physicians step away from traditional medicine and become practitioners in a very unique environment. They are on call to the wealthy at all times. They make house calls. They likely do as much coddling as they do actual medicine. At least in real life. What makes Hank unique, I think, is that he doesn’t see himself as a concierge physician but rather simply as a physician. That’s why he is perfectly willing to take care of anyone regardless of their ability to pay.

Sounds like you have cornered all the right dramatic angles (money, power, and a dangerously incompetent medical practitioner) to create a suspenseful story arc. Tell us about how you structured the story arc.

Royal Pains: First, Do No Harm is a fairly linear story. It begins with Hank going about his normal business but is soon confronted with several patients with bizarre behaviors and significant medical problems. In order to solve this mystery he must uncover the cause of these illnesses and in so doing uncovers a profit scheme that is extremely dangerous.

Does Lawson have a love interest? Is there a romantic arc in the overall story arc? The Hamptons must be filled with rich, attractive people doing all sorts of wild and crazy things, or so one imagines. Is truth stranger than fiction? Did you crib any true stories, or make it all up?

Hank’s Main love interest is Jill Casey, his on-again, off-again girlfriend and the administrator of Hamptons Heritage Hospital. In the TV series he also had a fling with another concierge position but that character is not included in these stories. So his main love interest remains Jill and sometimes they are dating and sometimes they are merely friends. It goes back and forth. This story is completely made up but it is at least partially built on some medical situations that I have seen in the past. But these are not based on any true Hamptons stories.

Is your portrayal fairly loyal to the TV character, or have you refashioned him according to your experience and tastes? How does that work? Are you working out the kinks for creating a novel series based on the TV series? Have you built a bible detailing all the character and locale facts?

I’ve attempted to remain very true to the characters since as I said above they are not my characters. I don’t think changing them greatly would be appropriate nor would it be accepted by the creators of the show. So the characters and their actions remain very true to the TV series and don’t step too far away from those relationships.

Oh yes, I have extensive notes that I have taken on the shows. I’ve watched every episode that has aired so far and have made notes and in some cases outlined the stories. This was all done so that I could understand the characters, the types of intrigues they become involved in, and how they interact with one another. This was essential before beginning the novel.

Were you able to use all the TV characters? Did you create any new ones? Did you have fun?

Except for the four main characters and of course Boris who owns Shadow Pond where Hank and Evan live, all the other characters are made up by me. The stories are mine though they had to be cleared with the creators prior to the writing but in this book none of the other characters from the TV shows were used.

What brought you, Dr. D. P. Lyle, to writing? What were your early reading interests? What movies have you most enjoyed? Anything else cultural or artistic we should know?

I grew up in the South where you must be able to tell stories, otherwise they won’t feed you. If you can’t spin a yarn you’re not worth much. Everybody in the South is that way. The simplest tale of what happened yesterday becomes a multipart story with multiple characters, setting, dialogue, and subplots. That’s just the way it is. I always said that when I retired I would write some of the stories that I’ve been thinking about for years. But approximately 15 years ago I decided, “If not now, when?” So since I have no intention of retiring from cardiology anytime soon I took some classes at UCI–the University of California at Irvine. I also joined a couple of critique groups and began writing.

I read constantly and my favorite authors are James Lee Burke and Elmore Leonard. I read everything by them as soon as it comes out. I also enjoy Tess Gerritsen, Michael Palmer, Robert Crais, Harlan Coben, Sandra Brown, Lee Child, and the great T. Jefferson Parker. There are many others but these are some of my favorites.

As for movies, I tend to like psychological thrillers and in fact thrillers of all types. I thought the “Dragon Tattoo” trilogy of movies was outstanding–the Swedish versions with subtitles. I of course like all the Hannibal Lecter movies. My favorite movie of all time?  Inherit the Wind. It’s a little different than a thriller but it’s historically significant, wonderfully written, and incredibly well acted. I mean Spencer Tracy. What else do you need to say?

What intrigues and excites you about writing? Do you feel writing is an alternative career, an escape from the demanding rigors of medicine, or both? Many medical doctors have been successful authors, many of great poetry or fiction. What is the connection? Is it the analytical aspect? The puzzle or problem solving as in diagnosis?

Where else can you sit in a dark room and kill three or four people before breakfast? They needed killing. I swear. I love writing. I love sitting down at the computer and trying to spin a story. I find that first drafts, the heavy lifting, are not my favorite part, but rewriting and editing I really enjoy. It’s the time that you really create the story. I write every day or at least work on something related to writing every day.

Actually, I think that being a professional in a scientific career often interferes with storytelling. Physicians, myself included, tend to think and act linearly. Scientifically. Stick to the facts. It’s a necessary part of the profession. But when it comes to fiction, all of that structure must be cleared out of the way so the story can be told. The story is the bottom line, the science is simply the background of the story. We physicians often think too scientifically and this can get in the way of creativity as far as storytelling is concerned. That said, I know many physicians who are incredibly talented in other creative fields. Writing, music, art, you name it.

Thanks again for taking time to interview with us today. Best of luck in all your future writing, and of course in your brilliant medical career.–JTC

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D. P. Lyle is an award-winning author of medical suspense thrillers as well as nonfiction books in which he offers his expertise at forensic science. Dr. D. P. Lyle, M.D. is a medical doctor. He is a practicing cardiologist in Orange County, California.

He won the 2005 Macavity Award for Best Non-Fiction for his how-to book Forensics for Dummies. He has also authored the nonfiction books Murder & Mayhem, Forensics & Fiction, and Howdunnit: Forensics.

In June 2011, he has two new novels appearing: Hot Lights, Cold Steel (Medallion Press) a Dub Walker medical thriller; and Royal Pains: First, Do No Harm (Penguin Putnam, TV series tie-in).

He has been nominated for the 2011 Edgar Award, the 2011 IBPA Benjamin Franklin Award, and the 2011 Anthony Award. In 2005, his nonfiction book Forensics for Dummies was nominated for the Edgar Award for Best Fact Crime.

His earlier Dub Walker thriller is Stress Fracture. He has also written two Samantha Cody thrillers, Devil’s Playground and Double Blind. He wrote an essay, ‘The Mysterious Island by Jules Verne,’ published in Thrillers: 100 Must Reads (2010). A DVD, Forensic Science For Writers, was released as part of the Killer Fiction Workshop Series (2006).

As a lecturer and consultant, he has worked with many novelists, and with the writers of popular television shows such as Law & Order, CSI: Miami, Diagnosis Murder, Monk, Judging Amy, Peacemakers, Cold Case, House, Medium, Women’s Murder Club, 1-800-Missing, The Glades, and Pretty Little Liars.