5 Questions for Columbia Neurologist and Debut Novelist Melodie Winawer

Neurologist and neuroscientist Melodie Winawer, MD, associate professor of neurology at CUMC, has always written, ever since she was a young child. Essays, poetry, short stories, and, at age 15, the beginnings of a novel. When asked in 10th grade to give a one-word description of herself, she said “storyteller.”

Dr. Winawer became a physician, researcher, and an educator instead of pursuing an early career as a fiction writer. At Columbia University Irving Medical Center, she sees patients; searches for epilepsy genes using mouse models, computational genomics, and human studies; and designs neuroscience courses for medical students.

Seven years ago, she sat down to write a novel, “The Scribe of Siena” (Touchstone/Simon & Schuster), which goes on sale May 16. (Dr. Winawer will talk about the book at the Columbia University Barnes & Noble bookstore at 115th and Broadway at 6 p.m. on May 16. Check www.melodiewinawer.com for more details).

“I have about seven novels lined up that I desperately want to write,” she says. “When I started this book, we had just sold our house and were living in my mother’s apartment, with our three young children. We’d put all our belongings in storage and had few chores to worry about. My wife, a violinist, was practicing a difficult Stravinsky piece for hours every night.

“I had just finished reading a bunch of books I really liked and I was desperate for that feeling of being so in the story that you’re lost. But instead of searching for another book to read, I decided to write one. I was in limbo and with more spare time than I was used to. It was a perfect moment to make up a world.”

Q: What’s the book about?

A: It’s historical fiction about medieval Italy—Siena. I invented an answer to an unsolved historical mystery: why Siena fared so badly during, and after, the Plague of the 14th century. No one knows why and there's some academic speculation, even controversy. “The Scribe of Siena” also is to some degree a romance, although really the attraction is between the main character and the past. Her surprising love for the sweetness of medieval existence is what really captivated me.

People ask, “How could you write about medieval Italy? Are you a medieval historian?” I say, ‘No, but I'm a scientist—I know how to do research.” It goes something like this: I come up with a question I don’t know the answer to. Then I look for the answer in easily accessible sources. If I don’t find an answer, I look harder. If I still don’t find the answer, I ask colleagues with special expertise. If not even they know the answer, or even better, if I find disagreement or controversy about the answer, that’s when I know I’ve found my next research project. That happened with “The Scribe of Siena.”

In science, I have to be absolutely systematic and stick to the facts or to experimental results. But if I’m writing fiction—well then, I can make things up. And making things up is incredibly exhilarating.

Clearly, historical fiction benefits from accuracy: building a story on a wealth of rich and deep factual material. I did not discard my scientific method entirely but, whenever there was a gap, I’d invent something, in a way that the factual business of science and medicine doesn’t allow.

Q: You are a full-time researcher and a practicing neurologist. How did you find time to write a novel?

A: Oh my God, I absolutely have no idea. In addition to being a neurologist and a neuroscientist, I run two—about to be three—courses in the medical school, and I have three children. They were 2, 2, and 5 when I started writing this book, and now they're 9, 9, and 12.

The short answer is I wrote on the subway a lot. I have a three-hour total commute. I live very far into Brooklyn and I figured out how to travel at a time when I could get a seat. I have occasionally crouched, when I'm desperate, in a corner with my laptop on my knees. I've done a lot of my writing—grants, papers, and fiction—on trains. I find that I'm sort of divorced from time and I don't know what's going on around me—that can be a good thing. I disappear into whatever I'm writing and then look up and I'm at 168th Street. Or, sometimes, I’ll miss my stop entirely.


Q: Does medicine make an appearance in the book?

A: The protagonist is a neurosurgeon. She has an unusual degree of empathy, which used to help her in her work. She literally feels what her patients feel, and it made her a superb doctor. But that empathy begins to take over in a way that starts to prevent her from doing her job. And then, when she turns that empathy to researching the story of Siena’s decline, it’s through her empathy that she begins to blur the boundaries, not only between herself and another person, but between her own time and the past.

Q: One of your editors said she read your manuscript so fast and learned so much about medieval Italy, but she was amazed to learn so much in so little time. Do you have a similar approach to teaching medical students as you do to teaching in your fiction?

 A: One of the tricks with historical fiction is to teach without teaching, to give detail without making it obvious that you're trying to tell people what you know.

That’s the quality I strive for in education, to have the content come alive.

At the medical school, one of the courses I created is a model Clinical-Pathological Correlation conference—a monthly occurrence in every department in which a very difficult case is presented to a discussant, who goes through all the possibilities and eventually has to try to come up with the right diagnosis. Neuroradiology chimes in to help, and finally neuropathology stands up at the end to give the final answer—it’s always fun and educational, even for seasoned neurologists.

For the students, we recreate one of these conferences. It's been one of the students’ favorite classes every year because they get to see how the science they learn in the classroom informs day-to-day clinical decision making. I think the reason it works is that the students don’t feel like they’re being taught—it’s medicine and neuroscience in real time.

Q: When you started writing this novel, did you think it would ever be published?

A: It's a funny story. I said, "Okay, I'm going to write a novel," and I just started writing. It was like driving in the dark in a snowstorm. I really didn't know what was going to happen. 50 pages in I started to think this might be a thing, and at 100 I said, "Okay, it really is!"

My mother was one of the first people I gave it to. She used to work for a major publisher, and she came to me the morning after reading my draft (we were still living with her at the time).  She put it down and she said, “Your book.” That was my first experience of “Ooh, it's a book?” I kept writing, and then as it got longer and more solid, I started to show it to a few other people.

I had just finished a decent first draft when I ran into my 11th grade English teacher, who’s a poet. He put me in touch with his agent, and I sent her a chapter. She recommended a freelance editor. I worked with her for a year and a half, then started querying agents. Amazingly enough, my first-choice agent picked up the book in less than 18 hours…but then… it took a year to sell the book and multiple submissions. We had a lot of close calls: editors who loved it but committees who couldn’t agree to buy. I went through more rounds of exhausting but exhilarating editing and finally, on our last round of submissions, within three days, Touchstone/Simon and Schuster bought it and we were done, with the publisher and editor of my dreams.

It’s so strange really. I don't liken myself to J.K. Rowling, but I told myself her story a lot. She was rejected many times, and the only reason she got out of the slush pile is that a 9-year-old took it from the editor's bag, read it, and loved it. No one wanted to publish that book, and that's true of a lot of books. And now look!