Tess Gerritsen published her first novel back in 1987 - a romantic thriller entitled 'Call after Midnight'. There followed a further eight successful novels in that genre, even though some darker strands were starting to appear. Ten years later, in 1997, she published her first medical thriller 'Harvest' which hit the New York Times best-sellers and was closely followed by further medical thrillers 'Life Support', 'Bloodstream' and the near SF tale 'Gravity'.

She burst onto the UK Crime Scene last year with the hardcover release of the visceral and nightmare serial killer tale 'The Surgeon'. The novel is a rare beast, a cautionary peep into the dark recesses of the mind and motivations of a serial killer, and a deep probe into the characterisation of his pursuers. It was launched with enthusiastic words from such diverse talents as Mo Hayder, Stephen King and Tami Hoag.

On the eve of her follow-up, 'The Apprentice', Shots eZine decided to delve underneath the surgical mask to find out exactly who the hell is Tess Gerritsen? And what life is like when your imagination turns over some pretty rancid rocks and reveals the nature of a serious evil.

Thanks Dr Gerritsen for taking time from your hectic schedule to talk to Shots eZine.

The pleasure’s all mine.

Firstly, how's 'The Apprentice' doing in the US? As I guess it's been out for a few weeks now?

It's now in its fourth week on the New York Times bestseller list -- my fastest selling title so far.

You have a pretty hectic tour ongoing promoting the book in the US, can you tell us a little about the touring process? And its contrast to the solitary existence required in creating a novel?

I'm traveling to about twelve cities, and I actually quite enjoy it. I'm rather a solitary person, yet on tour I'm required to show my "public" side, which can be stressful and exhausting for me. Also, I'm not accustomed to putting on makeup each morning, since I'm a jeans-and-sneakers kind of gal. I maintain my sanity while on tour by always reserving at least a little time to myself, and by treating myself to at least one nice meal every day. I'm the daughter of a chef, and one of my greatest pleasures in life is discovering a new restaurant in an unfamiliar city. Book tour certainly offers opportunities to dine in places I'd normally not visit!

Going back in time, you graduated from Stanford and then obtained your M.D. in 1979 from the University of California. Can you tell us about that period? And were you writing during this time?

I have always been a writer, ever since I could put pencil to paper when I was six years old. (My first book was about my dearly departed cat). But when I got to medical school, at the University of California at San Francisco, I had no time to write. My most vivid memories of medical training were of exhaustion. I was so busy cramming in facts that by the end of each day, I'd feel my head was bursting. For comfort, I turned to books - in particular, I recall reading quite a bit of science fiction as well as the Lord of the Rings trilogy during those years. It wasn't until my years of post-graduate training, as a resident in internal medicine, that I began to write again, and only because I went on maternity leave for a few months.

Your first job as a physician was in Honolulu, Hawaii, so why did you leave the mainland USA?

My husband Jacob was from Hawaii, and he wanted very much to return there. So we applied as residents to the University of Hawaii program.

What area of medicine did you practise?

Internal medicine. My job involved the non-surgical care of adults.

I believe you started writing seriously during this period. Could you tell us when you felt that the writing started to take-over your life?

It became an instantaneous passion. As soon as I began writing my first short story, I knew I was a writer. In truth, I've always known I was a writer, and there I was, with a baby at my feet, while I scribbled away, feeling quite driven about completing the story. My husband didn't understand it, and it's taken him years to adjust to the fact I'm so often distracted by people who don't even exist. Add to that the stress and strain of both of us being doctors and young parents - well, you can imagine how chaotic our household was in those early years!

I believe your first short story was published in Honolulu Magazine as a result of a competition. Could you tell us about the story and how you came to write it? And what it meant to you, to win that prize?

At that time, no one believed I was a writer. I had to prove myself, and when I saw the fiction contest advertised in Honolulu, I thought this was one way to show that, yes, I could tell a story. The prize was publication and $500 - it seemed like a lot of money at the time! When I sat down to write my story, strangely enough, I adopted the voice of a young man, looking back at a childhood with his difficult mother. I think I was exploring my conflicts with my own mother, and taking a male point of view seemed to give it a safe enough distance so that I could talk about some painful personal issues - for instance, my mother's repeated suicide attempts. It was only through fiction that I was finally able to deal with my own childhood turmoil. When I got the call that I had won first prize, I felt: at last, I've proved it. I'm a writer.

Your first ten years as a writer was in the Romantic thriller genre, like Tami Hoag. Can you tell us about that period?

I wrote nine romantic suspense novels for Harlequin and Harper. It's a genre I've always enjoyed reading, and it seemed natural to write it as well. Romance is very much "comfort fiction", and while I was working as a physician, I needed that comfort. I feel it gave me the grounding I needed to be a better writer, whatever the genre. Romances emphasize character and relationships and conflict - the very core of what makes any good novel - and writing them gave me the chance to develop my own voice. Also, I learned quite a bit about the publishing industry during those years, and picked up a readership that followed me when I moved into mainstream suspense.

Who inspired you to take up writing? And who would you cite as influential writers for you?

My first influences, as a reader, were in science fiction. Isaac Asimov and Ray Bradbury taught me that fiction can move beyond our everyday world, and that the imagination knows no bounds. J.R.R. Tolkien taught me that a good writer can pull us into worlds so vivid and enthralling we never want to escape. And later, romantic suspense author Victoria Holt taught me that a love story can heighten the excitement of a mystery.

When did it become clear to you that the writing would overtake your medical career?

After I sold my second book. Mind you, I was not making much money yet (it's almost impossible to live only on the income of a Harlequin author) but after that second book, I realized that I could make a go of it. That if I just applied myself and wrote faster, I could combine a career and still be home with the children. They were my first priority.

Did you have any apprehension in putting down your medical bag, and picking up the word-processor full-time?

Oh, yes. It took me a year of agonizing before I finally made the decision to quit. I thought: if I walk away from being a doctor, I might never be able to come back. Medical advances move on so quickly, and skills become rusty after a very short time. But by then, I had two toddlers in the house, and a promising writing career, and so I finally made the break. I remember waking up that next morning and feeling so completely happy. And free.

Were your colleagues in medicine aware of your literary aspirations?

They did notice that every so often I'd suddenly start scribbling notes, when a particularly clever sentence would occur to me. But I didn't really talk about it all that much. I think the fact I was writing romance might have not have gone over too well with my male colleagues.

What about your husband Jacob? What were his feelings with regard to your literary career - I've noticed a special thank you acknowledgement in your books to him?

My husband Jacob has gone through a major evolution during our marriage. At first, he did not understand what on earth I was thinking. He had married a physician, and suddenly, he found himself with a writer! He resented the hours late at night when I ignored him, because I was too busy pounding away on my electric typewriter. He felt I could be contributing a lot more to the household income as a doctor. He thought I had my head in the clouds. There were some serious conflicts back then, in which I felt my dreams were being squelched, and he felt I was being irresponsible. But just as our marriage reached a crisis stage, he suddenly came to the conclusion that our being together was all that mattered to him, and that he would try to respect my drive to write. We've been married twenty five years now, and we've both evolved. We couldn't be closer.

You wrote an original screenplay, 'Adrift', that was filmed and aired in 1993 as a CBS movie of the week. How did this come about? And any plans to return to screen-writing?

For a while, I flirted with the idea of becoming a screenwriter. I've actually written three scripts, and managed to sell the one that became "Adrift". The whole process was not a particularly pleasant experience, as I discovered that screenwriting is in many ways a committee project. Everyone involved wants to make a change here, a change there, until the writer feels his creation is no longer his. I decided, after that, to simply write books, where I could be the master of my own universe.

How did you feel when 'Harvest' vaulted into the NY Times Best-seller Charts?

As though I'd walked into a fantasy. After all those years of writing romances, to suddenly find myself a "big" author was astonishing. It was also a bit frightening. I didn't know if I could maintain the quality in my next books. I didn't know if I could justify all the hoopla, or would simply vanish from sight after "Harvest".

You live in Maine in New England. This area has always seemed to have been an interesting back-drop for horror/crime writers such as Stephen King, Michael Kimball and John Connolly, as well as Boston featuring heavily in work by Dennis Lehane and Robert B. Parker. Have you any thoughts on why this is so?

Many, many writers live here, and we simply write about the places we know. Also, the weather is conducive to writing (as there's not much else to do when the snow is flying!). I find that my most creative months are the cold ones. New England has such a long tradition of literature, particularly dark literature, and I suspect it's because of the long nights and long winters. I would find it hard to think of dark plots if I was sitting on a beach in sunny California.

Stephen and Tabitha King are big followers of your work from as early as your Techno-thriller period, and, as you reside in the same state, have you ever met or corresponded with them?

I've met them both. In fact, I was a guest musician with King's band, the Rock-Bottom Remainders, when they played in Bangor. I've always been a big admirer of their writing (Tabby writes as well), even more so after I met them. I believe that Stephen King is the smartest man I know, with a brain that moves at light-speed.

Your Techno-thrillers were very well received in terms of critical acclaim as well as being commercially successful. Can you tell us about this period in your writing career?

My first really "technical" thriller was "Gravity", about the International Space Station. It was the first time I had to do massive amounts of research outside my own area of expertise, and I suspect that my enthusiasm for the topic is what made that book stand out as one of my best. And yet, I was terrified while writing that book, because I didn't know if I could pull it off. When it came out, to critical praise, I think I gained a great deal of confidence. I also picked up a number of male readers, which I'd never had before. So this period in my career, tackling new and unfamiliar topics, spreading my wings, is one of continued challenges and growth. I always want to be growing. And I always want to be able to indulge my curiosity in whatever topic catches my attention.

How do your editor, agent and publishers feel about you genre-hopping both in the US and overseas?

I've had the good luck to have had a terrific agent and terrific editors every step of the way. Almost every project I've wanted to write has been greeted with enthusiasm. I think they understand that I love to do new and different projects, and that I'm not one to stick to one theme for book after book.

What are your thoughts about genre classifications?

They're useful primarily for booksellers. They need to know where to shelve them, how to market them. Writers simply want to write the books that interest them, without worrying about which genre it might fit into.

So how come you decided to write an out-and-out crime novel like 'The Surgeon'?

It was a reader who suggested it to me. At a booksigning for "Gravity", she told me she had no interest in the space program, and wanted me to write about her favorite topic: "Serial killers and twisted sex." Taken aback, I asked her what she did for a living. She told me she was a third grade teacher. I thought, if third-grade teachers are hungry for serial killer books, then these books must have some kind of universal appeal. I began to think of ways to turn the tried-and-true serial killer book into something with a medical twist, something that I was uniquely qualified to write. That's when it occurred to me: wouldn't it be creepy if the killer was choosing his victims because of something to do with their blood tests - that's how "The Surgeon" came about.

Where did the thought process come from? Were you toying with venturing into the crime genre?

Not at all. I had a number of medical thriller ideas floating around in my head. But when the plot of "The Surgeon" suddenly came to life, that was the book I knew I had to write.

Were you nervous producing such a visceral work? And what attracts you to the dark side of the human condition?

Yes, I was nervous. In all my books prior to this, I've never really dealt with the nature of pure evil. I was always dealing with villains who had believable motives - greed, jealousy, etc. Not cruelty for its own sake. Suddenly I was writing about a killer – The Surgeon - who tormented women for enjoyment. It made me a little queasy. The only way I could approach it was by wearing the thinking cap of the police and forensic scientists who try to solve the crime. I never show acts of violence on the page - what I show are the police walking in afterwards, looking at the crime scene, and trying to reconstruct it. I assume the role of scientist, and that's just enough of a buffer for me to be able to stomach what happens.

British female crime writers who write visceral or psychologically disturbing work such as Mo Hayder, Val McDermid, Denis Mina, Ruth Rendell - to name just a few - seem more accepted than perhaps their US counterparts do - even Patricia Highsmith left the US and came to Europe. Do you have any thoughts on this point?

I do think there's a certain amount of sexism involved here in the U.S. Men may write brutally violent fiction, but critics seem to accept that as men simply being noir, while women who write realistically about violence are criticized for being "over the top." Meaning, I suspect, that it's "over the top" for nice ladies. But I am a physician. I've stood in operating rooms and watched patients bleed to death. When I write about blood, it's what I know, what I've experienced, and I try to be as unflinchingly realistic as I can be. It's honest fiction, but it's also brutal at times.

Do you feel that perhaps a woman is better placed to write visceral material featuring the horrors of rape/torture, than perhaps a man would be? And what are your thoughts on writing material that features such depravity and evil?

I don't believe that either men or women have a superior claim on any particular topic, unless it's something that they can't possibly have experienced (like the pain of childbirth.) We all bring our own unique and valuable perspectives. As for writing material that features such evil, I chose to do it because I do not understand evil. I have lived a happy and un-traumatized life. I have never brushed up (to my knowledge) against evil on a personal level. I wanted to explore this new landscape, perhaps so that I could understand it better. And the only way I could wrap my mind around it was to take on the perspective of a lion, or a wolf, hunting for prey. Completely amoral, without any sense of it being right or wrong to kill that prey. It reduces evil not to some supernatural, horrifying force, but rather to a simple matter of inborn nature. It is the nature of The Surgeon to kill.

Do you ever feel that there is any line that you wouldn't cross as a writer? Or do you feel that it's a writer’s job to push out the boundaries within their chosen genre, even if it means delving into the darkness?

I won't cross over into what I see as sexual or violent exploitation. I may try to understand my villain's fantasies, but I won't allow him to indulge in his acts on the page. My focus is on the work of law enforcement - on what the police see and think and do.

Are you at all apprehensive in meeting your fans considering the dark emotions that your books reveal? As writers such as Thomas Harris remain forever reclusive.

While I've certainly met a few odd fans during my book tours, I have never met anyone who actually frightened me. Perhaps it's because I'm not easily frightened, or perhaps it's because the readers who enjoy this sort of fiction are actually quite mild-mannered. I enjoy meeting readers, even when they tell me all the reasons they didn't like the latest book!

What are you like as a person when you are in full-flow writing, say 'The Surgeon' or 'The Apprentice' and deep into the minds of both antagonist and protagonist? I saw you had put some nice words (in the acknowledgements of 'The Apprentice') about how difficult it is for your husband to put up with being married to a writer.

I'm very difficult! I'm distracted, uncommunicative, and don't like having my train of thought interrupted. My husband knows to be quiet at those times, because he understands that there's a whole host of people talking in my head, and I have to listen to them.

Do you allow anyone to read a 'work-in-progress' for reaction? Or do you wait until you're at the final draft stage? And then who are your trusted advisors?

I don't allow anyone to see the work in progress. Only when I deem it finished do I allow my husband to read it. And then it goes straight to my agent.

Your plots in both 'The Surgeon' and 'The Apprentice' are very intricate, but also very character-driven. Can you tell us your thoughts on character and plot? And the process you employ in writing a novel?

Each book is different. For "Gravity", plot took precedence. The premise was driven by the theme "Titanic in space," and the main "character" of that book, so to speak, was the International Space Station. With "The Surgeon", it was character that took precedence - the characters of the villain and of Catherine Cordell, the traumatized yet coolly self-contained surgeon. The interplay between them, the battle of wits, the game of terror, was all driven by the sorts of people they were, and how they reacted to each other.

So how long does it take to carve out one of your novels? And what are your thoughts on re-drafting?

It takes me about a year from start to final polish, but that's only because it's all the time I'm allowed. My publisher wants a book every year, so I have to work within that time-frame. I can usually finish a first draft in about seven months, and then I take several months for revisions. Sometimes it will take three or four re-writes before I'm satisfied. I've learned that my first drafts are always very rough, so I try not to get too panic-stricken when I read them and think: "This is terrible." I have confidence that I can fix whatever needs fixing.

When you finished 'The Surgeon' did you feel that the story had run its course? Or did you feel that the strands left required following up?

At first, I thought that I was done with those characters. I even started work on a totally different project. But I never stopped thinking about the villain. I'd almost hear his voice whispering, "Don't you want to know what I'm up to? Don't you want to know what I'm planning next?" He almost demanded another book. That's when I set aside my other project and started work on a sequel – "The Apprentice".

Was it difficult to re-enter the world of the serial killer with 'The Apprentice'?

Not at all. I felt he had never really left me. That I was just taking up where I'd left off, the way you take up a conversation with an old friend.

I read that the trigger for 'The Apprentice' was a vacation in Italy. Would you care to elaborate?

My travels in Italy weren't so much a trigger as a confirmation that the killer was still very much on my mind. And on my husband's mind as well! We'd passed a billboard advertising the Torture Museum in San Gimignano. My husband looked at me and said, "You know who wants to go there, don't you?" I knew immediately who he was talking about. It's as if the Surgeon was sitting beside us, talking to us both. When a character is that vivid, it's hard not to write about him.

There is a conspiracy at the heart of 'The Apprentice' (which is not revealed until the climax) so are you a 'grassy-knoll' type of person?

Not really. Most of the time I think conspiracies are nothing more than the fabrications of paranoid minds.

You use the paranoia of what Thomas Harris called 'The Damp Floor of the Internet' to good effect in 'The Apprentice' without going all 'Blue Nowhere'. Could you tell us what your thoughts are on this media? And what you use it for?

I use the internet for communication as well as research. I use it to hunt down obscure medical journal articles. I've also found it a great place to search out obscure topics. Some of the details on human sacrifice in "The Surgeon" (the Aztec method of heart extraction, for instance) are results of online searches. I try, wherever possible, to back up internet nuggets with printed sources. The internet has made techno-thriller writing much easier than it ever was before.

What books do you read and which writers to you in the Crime genre give you a buzz? And what are you reading on tour?

Historical fiction! Whether mysteries or not. One book that stands out as a favorite is "The Dress Lodger" by Shari Holman. While on tour, I read Fidelis Morgan's "The Rival Queens", another historical novel. I was very sorry when the Fremont Jones series (by Dianne Day) was recently discontinued. Even though I write contemporary thrillers, I don't particularly care to read many of them!

You use quite an array of professional detail in the technical/procedural side of your books but ensure that your work doesn't become a textbook on forensics which seems to be a trend with some writers. What are your thoughts on this point, in a genre that sometimes veers toward the C.S.I. approach?

I do enjoy the technical aspects of homicide investigation, and use forensic detail when it's vital to the plot. But I try to stick with forensic details that inspire some sort of emotion - horror, dismay, disgust - and not just details for their own sake. For instance, in "The Apprentice", I spend quite a bit of time on the autopsy of a woman's corpse found several days after her death. The point of that scene isn't just to show the autopsy. The point is to reveal a rather shocking finding: that there's fresh semen inside her, which reveals a vital aspect of her killer's practices. A great deal of attention is paid to the collection of the swabs, etc., - a procedure which might otherwise be boring. But that revelation of motile sperm makes the routine suddenly turn horrifying.

I liked the way you had Detective Thomas Moore as this clean-cut, almost 'Jack Crawford' character (with a dead wife in tow), and then you subverted it with him falling in love with Catherine, and a divide with his partner Jane Rizzoli. Would you care to talk about subverting convention?

I'm not aware of doing anything for a literary reason. I made Thomas Moore the way he was because that's simply the way he was. A good, decent man who tries to stick to the straight and narrow, and is that much more disturbed when he can't stick to it. I like decent men, and he fulfilled my image of the sort of man I could admire and fall in love with.

Jane Rizzoli is an interestingly flawed character, and starts (in my opinion) as a 'chip-on-the-shoulder'/driven-loser, but manages to redeem herself in 'The Surgeon' and even more so in 'The Apprentice' - transforming into a hero of sorts. Would you care to talk about the genesis of her character? And her development? And will we ever see her again?

I started off disliking Rizzoli quite a bit! But as "The Surgeon" progressed, I found more and more of myself starting to appear in her. In particular, her sense of being the outsider. I'm of Asian descent, and I was the only Chinese girl in my elementary school. I remember vividly how much I wanted to be accepted, how much I wanted to be like everyone else. And I remember how angry it made me to be called names because of my race. In a way, I poured out my own frustrations and hurts into Jane Rizzoli, and what resulted was a woman who is more than just smart and aggressive - she's also hurt and vulnerable. By the end of the book, I came to care about her, and I wanted her to have some sort of happy ending. She finally got one, in "The Apprentice".

You will be seeing more of her in the next book, but she pulls back to a secondary role. The medical examiner I introduced in "The Apprentice", Dr. Maura Isles, will take center stage.

I thought Detective Kosak was a bit of an asshole initially at the start of 'The Apprentice', but he became funny, and then there was a turn/twist that really made me think about him (as a person) but you were careful when it came to ladling out the pathos. At the end of the novel his character to me seemed like a metaphor for the impotence of some men when facing a greater force? Would you care to comment on this point? Or am I totally off-base?

Like the character of Thomas Moore, Korsak was just who he was - I did not plan out his role, but simply let him walk onstage and act the way he wanted to act. If it seems as though my characters get away from me, then it's true - they sometimes do! I saw him immediately as a basically decent but uncouth guy with a real sadness at his core, a man who knows he'll never achieve everything he dreamed, who sees his life as one big disappointment. A man with regrets, who now has to face the terror of his own mortality. A very lonely man who has done the best he can. I felt very sorry for him. At the same time, he was a hilarious character, but those wise-cracks were a cover-up for his sense of inferiority.

The opening of 'The Apprentice' features the dismembered body of an illegal immigrant being found after falling from an aircraft. It is only at the conclusion, that I thought that this too was a metaphor in the story. Without giving away the ending of the book, would you care to comment?

Ah yes - that was, indeed, a metaphor, one I didn't recognize until later in the book. I opened the story with "Airplane Man" because I thought it was a riveting way to throw Rizzoli straight into the action, to show her on the job. But as the book progressed, I began to see "Airplane Man" as a symbol of futility. He represented all the dreams we'll never see fulfilled. By the end of the book, his role in the story seemed almost poetic - a role that only developed later. It's an example of how we, as writers, sometimes don't recognize the reasons why we've written something until long after we've put the words to paper.

I guess for our generation, people will always recall where they were, and what they were doing when the planes crashed on September 11th. So where were you on that awful day? And what are your thoughts now a year on?

I was on book tour for "The Surgeon". I woke up that morning in Seattle and turned on CNN, and saw the twin towers burning. My first reaction was: "I want to go home. I want to be close to my family." Then they shut down all the airports, and I was stranded in Seattle, at the other end of the country from Maine. I spent six surreal days far from home, wandering in a daze, questioning my role as a novelist. It felt like the most irrelevant of professions, in a time when the world was coming down around us.

Now, a year later, I have come to realize that writers are absolutely vital to society. Readers have told me that reading "The Surgeon" was the only thing that gave them any relief and comfort after 9/11. Imagine that - taking comfort from a serial killer book. But yes, there is comfort in reading a mystery in which good can defeat evil, in which justice prevails, unlike the real world.

With 'The Apprentice' coming to the UK soon, are you planning to tour here? And if so will you feature tour dates at www.tessgerritsen.com?

I believe I'll be coming to the UK in February on book tour. I will certainly feature my tour dates on my website.

Are you going to remain in the Crime genre? Or are you contemplating yet another genre-change? Maybe a children’s book?? So what's really next for Tess Gerritsen?

I can only see ahead to the next book, which I'm now in the progress of writing. For now, I'm still intrigued by forensic medicine, and that will be the focus of my next novels.

Your hobbies are reported as gardening and playing the fiddle, could you tell us about them?

I have a large garden with many winter-hardy roses. Come June, the place is bursting with blossoms and lovely scents. I also am a fiddler, and have my own band, "Ballywick". We play Irish music at various restaurants around town. I often think that if I ever retire from writing, I'll just spend the rest of my years fiddling away.

Finally, can you give any advice to other writers who juggle writing in their spare time as well as holding down responsible jobs and families?

I would tell them to be patient, but persistent. You won't be able to write as quickly, because other people need you, but in every day there's at least a few spare moments in which you can write a sentence, a paragraph, maybe even a page. Very young children simply need attention, and for a few years, it may not be possible to devote much time to your writing. But kindergarten comes around sooner than you expect, and then you'll have a bit more time to work. Real writers find the time.

Dr Gerritsen it has been a pleasure having the opportunity to discuss your work, and from all our readers at Shots eZine, a big thank you, and we wish you great success on the UK launch of 'The Apprentice' as it is one gripping and dark ride!

Thank you and all the Shots readers for their support!

This interview was recorded mid-September 2002 Ó SHOTS Magazine