For most of my adult life, my day job has involved battling disease. In an average shift at work, I’d fight carcinogens, genetic mutations, blood flow obstructions, and, not least of all, microbial invaders. It’s a bit of a misnomer to call my career a day job, actually; like every ER doctor, I worked days, but also nights, weekends, and holidays, all of it blurring together into a ceaseless stream of injured, sick, and suffering human beings. Being an emergency medicine physician may sound like the job from hell, but in many ways it’s the best job in the world. The ability to ease suffering, even a little, balances the years of grueling training and the hardships of practicing this particular specialty. What could be more gratifying than snatching life from the jaws of death? Every ER doctor knows the fierce joy—and sheer relief—that grips you when you revive a pulseless child or restore consciousness to someone blue and lifeless. We fight pathogens all the time in my job. I thought I understood them. And yet: The world has changed mightily since I first began the process of writing Doctors and Friends. As Kira says in chapter 13, we’ve all morphed into armchair virologists after our collective experience during a real-life pandemic. Maybe we’ve been sick, or we’ve developed longterm symptoms, or we know someone who’s been hospitalized. We know about spike proteins and mRNA, variants, and origin theories. Millions of us have endured the indescribable grief of losing a loved one to a disease that literally steals their breath. To address the elephant in the room, most of the storyline in Doctors and Friends existed before Covid struck. Our understanding of SARS-CoV2—and response to it—was evolving on a daily basis just as I was honing the final portrayal of my nasty little fictional virus. It’s hard enough during normal times to whittle an infinite universe of words into a coherent and interesting story. It’s nearly impossible while getting hammered with hundreds of news stories, scientific articles, and instances of social media outrage on the subject. I spent the majority of 2019 researching, outlining, and writing the first draft. I interviewed more than forty experts in various fields of science and medicine, a process which extended into 2020. (If you have time, please read the author’s note and acknowledgments sections of the book, which detail more of the inspiration behind the story.)
Still, the novel is not always representative of reality. Some of the unrealities in the book stem from what we writers like to call creative license (it’s fiction, y’all!), but some, I must admit, are related to the incompetence of the author. Even so, I might have to get NOT ABOUT COVID tattooed on my forehead in an attempt to ward off the inevitable fallout from people who have strong opinions about what is or is not real when it comes to the nonfictional coronavirus pandemic we’ve endured. Which, of course, is everyone. I loved writing this book, even after getting slapped by the irony of it all. So far, all my novels have featured friendship as a fundamental theme, and I revel in this concept: Your friends are the people you choose to love. There’s no familial obligation or romantic entanglement. It’s a purer form of attraction: You care for these people not because you have to but because of who they are. Friendships, especially those that endure over time, are a blessing beyond measure. I hope readers will enjoy the quirks and complexities of the protagonists of my novels as much as I have. Zadie, Emma, Georgia, Hannah, Kira, Compton, and Vani (and Jonah!) are the inventions of my imagination, but they’re also an amalgamation of many physicians I’ve known. In my own case, the friendships forged during medical school are among the most intense and cherished of my life. I’m curious: If you could create fictional friendships to represent a time period in your life, what kind of personalities and attributes would you give them? As always, I’m so grateful to you for reading my work—especially this novel—and I would love to hear from you.
1 0 . 1 7 T H - C E N T U RY P L A G U E Yersinia Pestis • 1600 3 million 9. COVID-19* Coronavirus • 2019–Present 4 million+ 8 . A N TO N I N E P L A G U E Possibly Smallpox/Variola Major or Measles/Rubeola 165–180 A.D. 5–10 million 7. C O C O L I Z T L I Unknown Hemorrhagic Fever, Possibly Salmonella Enterica 1500s 2–15 million 6. THE THIRD PLAGUE Yersinia Pestis • 1855 12–15 million 5 . H I V/A I D S Human Immunodeficiency Virus 1981–Present 25–35 million+ 4. PLAGUE OF JUSTINIAN Yersinia Pestis • 541–542 20–50 million 3. INFLUENZA H N , aka Spanish Flu • 1918 25–100 million
¹ ¹
2 . T H E B L A C K D E AT H Bubonic Plague/Yersinia Pestis mid-1300s 75–200 million 1 . S M A L L P OX Variola Major • ended 1975 500 million
Are these numbers accurate? Almost certainly not. It is, of course, insanely difficult to estimate the death toll for diseases now, let alone in the times before formal epidemiology existed. Diseases overlap in place and in time. In the long history of our battle with our microbial enemies, we’ve managed to erase only one infectious disease from the face of the earth: smallpox. For this reason, I grouped together the various outbreaks of smallpox into the top spot on the list. Thanks to vaccines, we no longer suffer from one of the greatest scourges ever known to humanity. Despite all the mortality guesswork, we know a lot about the pandemics of the past, present . . . and future. In terms of population loss, consider a disease like the Black Death. Even with a vigorously debated death toll, the many outbreaks of bubonic plague killed massive numbers of people in a swift and gruesome manner. Imagine, for example, waking up in fourteenth-century Europe with swollen lymph nodes and a fever. You’re achy; everything hurts. It takes only an instant for you to process a shattering realization; you will likely die today. In this heart-wrenching era, more than half of European children perished before they reached adulthood. Up to 60 percent—60 percent!—of the continent’s population disappeared, victims of an unseen and dreadful foe. Or picture yourself in the 1600s, when up to 90 percent of Native American civilization was wiped out by smallpox brought over by Europeans. Or think of the super-flu of 1918, which killed millions of young adults in the prime of their lives; or the helpless and horrified population of Rome in 189 A.D., when thousands of people a day were dying of a mysterious, drawn-out, disgusting illness; or even the various outbreaks of cholera in the 1800s and 1900s—a waterborne (and preventable!) disease that still affects us today. Infectious diseases will one day target us again on a colossal scale. It’s coming: another super-bug, perhaps one resistant to our medications. We are, as a whole, better equipped than we were in the past, but if it happens again on the scale of the Black Death, we will be just as brutalized as our ancestors were. Thanks to scientists and doctors and public health experts, however, we will stand a chance. Covid-19 was a wake-up call that we can do better: We must be prepared for the next big one.
*Even today, with all our scientific advantages, analysis of excess deaths indicates the overall mortality for Covid-19 is likely to be higher than official reports suggest…and deaths are rising at the time of this writing.
DR. KIRA MARCHAND Infectious Disease • Atlanta, Georgia D R . C A N D E E C O M P T O N -W I N F I E L D Emergency Medicine • New York City, New York DR. HANNAH GEIER Obstetrics and Gynecology • San Diego, California (also in The Queen of Hearts) DR. GEORGIA BROWN Urology • San Diego, California (also in The Antidote for Everything and The Queen of Hearts) D R . VA N I D A R S H A N A Internal Medicine • Berea, Kentucky DR. ZADIE ANSON Pediatric Cardiology • Charlotte, North Carolina (also in The Queen of Hearts) DR. EMMA COLLEY Trauma Surgery • Charlotte, North Carolina (also in The Queen of Hearts) DR. JONAH TSUKADA Family Medicine • San Diego, California (also in The Antidote for Everything)
Kimmery’s Quizzes W H AT K I N D O F D O C T O R W O U L D YO U B E ?
1 . Which of these things would you be willing to forgo for your career? A . Sleep
5 . Select one statement: A . I’m the reason your mom told you to wear clean underwear B . Vaccines cause adults
B . Sanity C . Hygiene
C . Hours of calm punctuated by moments of terror
D. All of the above
D. I’m at your cervix
2 . Can you hand le the sight of blood ? A . Yes, I enjoy blood. The more, the better B . Yes, when necessary C . Yes, if it’s in a hermetically sealed test tube D. I barf at the sight of blood 3 . Okay, but what about intestines?
E . Yes, I am a doctor! F.
If you fib, you get paddled
G . No, you don’t need a Z-Pak H . Drama with the trauma mama I.
I’m the last person who will ever see you naked
J.
No, there is not an herbal cure
6 . Okay, now select a phrase: A . Womb to tomb B . Bugs and drugs
A . Yes, I dig them
C . Sad and mad
B . Hell to the no
D. Treat and street
4 . What’s your response when someone overshares? A . Keen analysis of their inner psyche B . A focus on extracting the relevant info C . I pretend I’m being paged
E . Guts and butts F.
Stones and groans
7. You’re on a roll ! Now select one word: A . Hedge B . Vampire C . Hammer D. Steroids E . Gas
RESULTS Anesthesia: 1-d; 2-b; 3-b; 4-b; 5-c; 7-e Card iology: 1-d; 2-b; 3-b; 4-b; 5-f Colorectal Surgery: 1-d; 2-a; 3-a; 4-b; 6-e; 7-e Dermatology: 2-c; 3-b; 4-b; 5-e; 7-d Emergency Med icine: 1-d; 2-a; 3-a; 4-b; 5-a, c, f, g, h; 6-d Famil y Med icine: 1-d; 2-b; 3-b; 4-a,b; 5-b, d, g; 6-a
Forensic Pathology: 1-d; 2-a; 3-a; 4-c; 5-a, i General Surgery: 1-d; 2-a; 3-a; 4-b Gastroenterology: 1-d; 2-b; 3-a; 4-b; 6-e; 7-e Hematology: 1-d; 2-a; 3-b; 4-b; 7-b Infectious Disease: 1-d; 2-c; 3-b; 4-b; 5-b; 6-b Internal Med icine: 1-d; 2-c; 3-b; 4-a,b; 5-g Obstetrics-Gynecology: 1-d; 2-b; 4-b; 5-d Oncology: 1-d; 2-b; 3-b; 4-b; 5-j
Orthoped ic Surgery: 1-d; 2-b; 3-b; 4-c; 7-c Rad iology: 2-d; 3-b; 4-c; 5-e; 7-a, b Ped iatrics: 1-d; 2-b; 3-b; 4-a; 5-b Physical Med icine & Rehabilitation: 1-d; 2-a; 3-b; 4-b; 5-e Plastic Surgery: 1-d; 2-b; 3-a; 4-b Psychiatry: 2-d; 3-b; 4-a; 5-e; 6-c Trauma Surgery: 1-d; 2-a; 3-a; 4-b; 5-a, h Urology: 1-d; 2-b; 4-b; 6-f
D O YO U H AV E T H E P E R S O N A L I T Y O F A W R I T E R ?
1 . You have written the world ’s best novel. It’s humorous, it’s poignant, it’s compelling and brilliant, d isplaying a level of literary talent previousl y unknown to humankind. You know this is true because three of your friends said so. Excited l y, you send a letter to a literary agent, who reads your description of the masterpiece and responds with the following email: “Not for me, thanks.” Do you: A . Reply with an impassioned ten-page rebuttal B . Real ize you are a talentless fraud and weep bitterly as you delete your entire manuscript C . Go onl ine and trash the agent as an uncultured vulgarian who wouldn’t recognize l iterary genius if it bit him in the ass D. All of the above
2 . You survived the epic failure of your first literary effort and have moved on to another manuscript. This one starts out pretty well but is soon derailed by a gargantuan plot problem. Do you: A . Blame your muse/spouse/children/day job for their endless attempts to sabotage your creative process B . Gnash your teeth, rend your clothes, and weep bitterly at the death of your dream C . Console yourself by going onl ine and posting a scathing review of Jonathan Franzen’s latest book D. All of the above
3 . You face a looming dead line but you’ve come down with a crushing case of writer’s block. Try as you might, you cannot conjure up anything coherent for the almost-due portion of your latest manuscript. Do you: A . Tell your agent there will be an unavoidable delay because you have contracted Ebola B . Go dark: unplug your computer, turn off your phone, lock yourself in your bedroom, and instruct Alexa to play the Irish Funeral Dirge station on repeat C . Obsessively stalk #5amwritersclub on Twitter in hopes that someone is suffering a more catastrophic blockage than yours D. Self-plagiarize a few chapters from a hideous unpubl ished manuscript you composed in college and hope for the best
4 . Let’s tal k fashion. Which of these best describes your look: A . All-black clothing, nose ring, tattoo of Anaïs Nin on your bicep B . Sweater set, reading glasses, trousers C . Boyfriend ’s sweatpants from 1997 + t-shirt reading I’m Plotting Against You D. What is fashion?
5 . When describing your writing process, do you say things like “My characters drive the car. They d ictate their own actions; I cannot control them any more than I could reverse the flow of the mighty river or crumble the mountain into fine ash. They simpl y channel me, like a literary med ium, to bring them to life”? A . Yes
6 . Humiliating incident at your day job: you accidentall y cc’ed your clinic administrator on an email mocking his mustache. He retaliated by assigning you to a weekl y meeting taking place Friday evenings at 7:00 pm. Do you write him into your latest novel as a repellent, foulbreathed man-beast with a teeny-tiny . . . shoe size? A . Of course
RESULTS Based on the fact that you read this entire thing, I have determined your personality type is: Writer. Congratulations! You are now free to return to the voices in your head.
1.
If you could take a vacation anywhere with your closest friends, where would you want to travel together?
2 . The novel explores the concept of friendship as a fundamental human relationship, portraying a group of women who’ve been close for most of their adult l ives. Have you experienced this kind of long-term friendship in your own l ife? In what ways did the characters lean on one another as they were fighting to survive this pandemic? 3.
Doctors and Friends immerses the reader in some of the dayto-day responsibil ities of physician special ists in emergency medicine, obstetrics-gynecology, and infectious disease. Which of the medical specialties was most fascinating to read about?
4 . Kimmery Martin has stated that the scenes from Compton’s perspective felt the most natural to write because of her own background as an ER doctor. Have you ever read a novel in which one of the main characters shared your career or field of study? 5 . The main characters in the book are all female. Did you enjoy the portrayal of the supporting male characters? If you were able to select between Wally, Jonah, Declan, and Dr. Mike Zhou as a real-l ife friend, which one would you pick and why? 6 . Each of Kimmery Martin’s novels has been a spin-off of the previous one, focusing on different protagonists but set in the same fictional universe. Dr. Georgia Brown was in a minor character in The Queen of Hearts and the protagonist of The Antidote for Everything, but she is also a pivotal character in Doctors and Friends. If you read Antidote, did prior knowledge of her character change your reaction to her fate in this book? If you haven’t read the previous novels, are you curious about her backstory? 7.
Hannah—an ob-gyn who is described as the most nurturing of the group of friends—struggles with infertil ity. Toward the end of the pandemic, she is finally pregnant but leaves the safety of her home to go into the hospital to take care of Georgia—a decision that costs her dearly. Meanwhile, Compton and her colleagues risk death on a daily basis in the emergency department. If you were a doctor in this scenario, would you put your own l ife at risk to care for others?
8 . The characters face many difficult losses over the course of the book. Which hit you the hardest? 9 . Did you have a favorite character? What about their story resonated most with you? 1 0 . Kira’s choice—the most difficult one a mother could face—defines the pandemic for her. What would you have done in her situation? 1 1 . According to the author, in the original “more medically plausible” draft of Doctors and Friends, Kira’s choice resulted in a fatal outcome. What’s your opinion of the outcome for Kira’s children and career in the novel ? Would different consequences have negatively or positively affected your experience of the book?