I caught up with author Josh Bazell on Thursday and talked to him about his book and his work as a newly minted M.D.

How did you decide to write a novel about a hit man who has become a brilliant doctor?

I was interested in writing a book about the extent to which people can change their own identities. I was focused on that issue at the time because I was doing my medical training, and I was probably curious — and maybe fearful — about how it might change me.

I did want to have somebody turning into a doctor, and I wanted to have them start as far away from that as possible, so having the person be a killer seemed sort of natural. I also felt like I had a take on the Mafia that I thought might be more realistic, and hence different, from what people are used to hearing about the Mafia.

I’ve been interested in the Mafia for a long time and I’ve done a lot of reading about it and met as many people involved with it as I can. I read a lot in a weird sub-genre of Mafiosos who have gone into the witness protection program and then write their memoirs. Usually in these books people say that they’ve come to regret their actions, when for the most part they don’t regret them at all. I mean, they regret having been caught. In a sense, “Beat the Reaper” is sort of a parody of that genre.

In most portrayals of the Mafia (it’s) either an omnipotent conspiracy that can’t be comprehended, or it’s a bunch of lovable goofballs who aren’t doing anything serious to anybody. What I’ve come to understand through researching the book was that the Mafia’s a very simple organization. It’s parasitic; it operates by threatening people who work for a living physical harm, and delivering on that threat. It’s not a whole lot more complicated than that. It’s people who are willing to deny their humanity and making money from that.

I believe you were in some line of work in New York that exposed you to some of these characters?

Josh Bazell. Photo by Tamar Hurwitz

How did you manage to write a novel while at the same time completing medical school?

I should mention I’m still in my residency, I’ve got about two years to go. Residency is not as monolithic as people think it is. One does what they call rotations where one moves around at least every couple of months, often to different hospitals, but always doing something different. Some of these rotations are more onerous than others, and what I did was devote all my free time during my more forgiving rotations to writing — which I was able to do mostly by focusing on only one thing at a time and by treating the writing as a vacation from medicine, and vice versa.

So you wrote during the down time.

Right.

By hand, I presume.

No, I type. Typing was the class I took most seriously in high school. And my handwriting is poor.

Well, you are a doctor.

Yeah, I’ve managed to enter a profession where that’s accepted.

I know you’re a resident at UCSF; do you have other connections to San Francisco, or did you just come here for your residency?

I was born in Berkeley, my father grew up in San Mateo. My parents both went to Berkeley. I have lived here on two separate occasions, both for about a year. UCSF is a great program, and also just a fantastic hospital to do internship in, because it has great staff and great facilities. And there’s also a variety of patient populations because UCSF serves the V.A. hospital and the county hospital, and also is a private hospital.

Talk a little bit about what your job is like as a psychiatry resident.

I’m only two years into my residency, so most of what I’ve done as a resident is medical. You do your intern year, and then the year after that most of what you do is medical service on locked psychiatric wards — things like diabetes care and so forth — as you begin to study psychiatry. The emphasis shifts more to psychiatry over the course of the four years, so I’m in sort of a funny position where I would not call myself particularly highly trained in psychiatry yet. I feel like I haven’t quite gotten to the good stuff.

But at the moment I’m on leave, to promote the book and write the next one.

You got a big book deal, and now it’s been sold as a movie starring a famous Hollywood actor. Is there any part of you that wonders why you’re putting yourself through all the medical training, instead of quitting and being a famous mystery writer?

I was a writer before I went into medicine. I worked as a screenwriter for a few years. I would love it if I could predictably make a living from writing and do medicine on a mostly volunteer basis. But medicine, I mean, it’s just a blast, and I don’t want to stop doing it.

You were a screenwriter?

Yeah, it’s a weird story. When I decided to go to medical school I had a friend whose older brother was a TV movie producer. And he said, “Why don’t you write a screenplay to pay for medical school?” Which, not knowing any better, I thought was reasonable advice. And I wrote a screenplay that immediately got optioned. So I spent a couple years working steadily as a screenwriter. It’s not a story I often tell, because it’s not a good idea — I would never recommend to anybody that they get into screenwriting, really for any reason. Particularly as a fundraising endeavor, it’s moronic. I mean, I got very lucky with it, but I wouldn’t put it out there as a way to pay for medical school. You’re probably better off just taking loans.

The main character in your book, the hit man who has become a doctor, seems to be very cynical about human nature, and he’s around a lot of people almost all of whom are pretty cynical too. And the ones who aren’t, like the drug rep who breaks down and cried because somebody died, the main character says something like “Well, she’ll toughen up eventually.” I guess a cynical attitude is natural for a hit man, but it is also something you run across in the medical profession?

The practice of medicine does, absolutely, contain forces that are oppositional to patient care. I’m thinking of the heavy involvement of corporations that don’t have patient care as their primary motives, such as insurance companies and pharmaceutical companies. And I suspect a lot of doctors have to deal with the conflict of working in a profession that’s designed to improve quality of life even if their own quality of life suffers somewhat. I think for most people, it’s well worth that bargain. I think most doctors I know are far less cynical than people in the book;

One of the things about your main character is that, while he is a hit man and kills a lot of people and is very good at it, he also has this moral attitude toward it, where he’ll only kill people who he considers are evil. He also doesn’t want to kill women and children. Why did you decide to imbue the character with that kind of moral stance?

Because I wanted to like him, and I wanted readers to, at least potentially, like him. It’s such a hard sell to make people care about a killer. And it’s important to note that his crimes are not quite at the level of his guilt. He’s done some very heinous things, and he’s a desperate character, but the things he’s done are not entirely his own fault. And the extent to which he feels guilty about them is only partially justified. The book is about changing yourself — and in the case of Pietro, changing yourself into somebody that’s hard to change yourself into, (someone whom) you don’t have a natural affinity for. And there had to be a reason why he would want to do that. Somebody without a moral compass would be unlikely to work so hard at something that didn’t come naturally to him.

He feels tremendously guilty, and feels like he had to do something that is not only beneficial to others but is punitive to himself. He seeks out something that’s the opposite of his instinctive skills as a killer.

What did you have to learn about and research that you didn’t already know when you began to write the book?

A lot of the Mafia stuff. A lot of the political stuff. Some of the stuff about the transitory nature of the perception of the Holocaust, particularly in Poland in the late 90s. And the extent to which the understanding of the Holocaust remains in motion all the time.

How about the martial arts stuff? Had you already studied that?

Yeah, that’s something I have a very long history with. I started out in judo, then did tai kwan do for a long time, then did kempo. But I’ve been completely out of practice since I went to medical school — which is years now. That, and the medical stuff was (something I knew about). I tried to make sure everything was accurate in terms of statistics and so forth. Which is not to say that everything in the book is accurate; some things are changed for plot reasons , or else to keep readers from learning how to kill people.

Anything else you want readers to know about the book?

Just that it’s my first book, and it makes me immensely happy anytime I hear of anybody reading it — like any individual. I still get a huge kick out of the idea that anyone would spend their time reading it.

Among the several radical changes:

• Bryant Street is totally out of luck. No more service in the Mission District or South of Market. That means that if you wanted to take a bus to or from the Hall of Justice — like if your car was towed and you wanted to get it back — you have to catch a bus on Folsom and then walk two blocks.

• The 22-Fillmore will no longer climb Potrero Hill, but go all the way down 16th St. to Third St and turn around in the biotech district. If you want to go to Potrero Hill, you’d have to transfer to the 33.
• The 7-Haight would be no more. The 6-Parnassus would take over the route and go all the way down Haight St — meaning no more service to Masonic and Frederick and Clayton. That neighborhood is just fucked. Also, buses would no longer go on Page St. inbound; Haight St. would be two-way all the way.

Those are just a few of the changes, and there are many small ones. To find out, you have to browse the Flickr set.

For more on Muni’s proposals, which could be implemented by July 2009, see the Muni TEP page. I think TEP stands for Transportation Elimination Project.

Taking a cursory review of the Draft Mitigated Negative Declaration (who knows what that means?) the structure looks kind of cool and modern. Built into the slope of the hill to minimize impact to the observer. The document states that the new building will meet the UC Regents minimum LEED rating, I’m not sure what that min is but it’s exciting the building will keep an eye towards LEED cert.

If you are interested in participating in the public comment please contact:

UCSF Campus Planning
3333 California Street, Suite 11
San Francisco, CA 94143-0286
Attention: Michelle Schaefer, Environmental Coordinator
phone: (415) 476-2911
email: EIR@planning.ucsf.edu

One Cole Valley Neighborhood NIMBY is angry, and getting no where with the folks ensconced in historic McLaren Lodge, he’s been reaching out to Board of Supes Prez Aaron Peskin at City Hall. In fact in a recent open letter, he claims that Peskin, is “Our Only Hope”, giving the nerdy Telegraph Hill dweller a rep more akin to the one Princess Leia heaved on Obie Wan Kenobi.

Perhaps such Sci-Fi dramatics are warranted when you spend hour upon unpaid hour voluntarily analyzing the topsy turvy alternate universe of the 2005-2006 Park & Rec expenditures, something the city doesn’t seem to have time to do. It’s a wacky world where one guy can turn a park patrol gig into a 6 figure feast & make more than 70% of his pay via overttime, and yer average staff gardener or debris truck drivers can literally rake in over $80,000 a year, yet basic services like public restrooms languish.

With the recent California Supreme Court decision that declares gov’ts must release public employee salary information…who knows, maybe something will finally come of this long running ten year fiasco.

After all, it was in a city employee audit in 1996 that this comment was made:
” By providing a culture of unfettered acceptance and opportunity for individuals to increase their salaries substantially over base levels, the City may be inadvertently encouraging its employees to overwork themselves and to manipulate the work scheduling system to achieve personal economic advantage.”

Huh? like G.W Bush said of the effects of Katrina, who could have ever imagined or foreseen such a thing occuring?

Not the folks in charge in McLaren Lodge anyhow… hmmm, maybe the guy in charge of the still fk’d up stables can get a job running FEMA?

The full letter to Peskin about SF tax dollars at work in the parks after the jump…

The citizen responsible for the analysis, a retired dentist who also spends a fair amount of time complaining about any and all noise emanating from Golden Gate Park, has been making some noise of his own. He’s been doing some research via the “Sunshine Ordinance” and found out some interesting things about Park & Rec’s budget, namely overtime pay. His main query in a recent open letter to Aaron Peskin concerns overtime pay for park patrol officers. The lead Park & Rec security officer for example apparently earns overtime pay well over 100% over his base salary, far exceeding anyone else in the department, and has therefore become one of the highest paid officials in the Park & Rec department. Originally slated to pull about $57,700 a year, this officer has managed to ride OT into the playoffs, and reaped a champs salary of over $134,000 per annum. That’s more than any of the park dept’s top landscape architects, managing project directors and also over twice what another head patrol officer with similar duties made including all his overt time.

According to Martin Macintyre, the SF Park & Rec’s

Head Patrol Officer who received $77,050 in overtime pay averaged approximately 33 hours a week in overtime, which, when added to his 40 hours of regular time, amounted to an average work week of 73 hours (assuming no vacation, a 12 hour work day and a six day work week, every week of the year). This seems beyond belief and demands a full investigation.

This overtime was and continues to be approved by Mr. Kern, Director for RPD Operations and by CA law has to be justified in writing. Where is the justification? WIll RPD release it?

Dear President Peskin,

I did an analysis of the overtime pay of the Rec and Park Dept. employees for 2005-2006. I know you have been given my report and promised to get the updated salary information and to hold hearings but I have to know when will you hold hearings. The Mayor can’t help, the Controller can’t help, RPD won’t help, the City Attorney won’t help, and the courts are out of the reach of normal citizens.

This was published on PROSF.ORG and sent to Supervisors on the Board. It shows that the supervising Park Patrol Officer had overtime pay of 134% of his base salary and way above any other employee and and other Park Patrol officer. He was the 4th highest paid employee in RPD. I quote from my report:

The Head Patrol Officer who received $77,050 in overtime pay averaged approximately 33 hours a week in overtime, which, when added to his 40 hours of regular time, amounted to an average work week of 73 hours (assuming no vacation, a 12 hour work days and a six day work week, every week of the year). This seems beyond belief and demands a full investigation.

This overtime was and continues to be approved by Mr. Kern, Director for RPD Operations and by CA law has to be justified in writing. Where is the justification? WIll RPD release it?

Nothing was done about this. RPD has refused to release the overtime records of their employees. They say only the Controller can do it and the Controller says they need permission from RPD. There is no excuse for RPD and no excuse for the BOS not doing something about this and no excuse for other citizens who read PROSF.ORG for not following up. The Controller said they are doing an overtime study but where is it and how can we tell if they have done the job properly without having the raw data? RPD is rife with corruption, pure and simple. The overtime is just a symptom, the tip of the iceberg. The RPD Audit by the BOS budget analyst didn’t uncover it so, even they must share responsibility for this failure in our governmental process.

You are the only hope. If you get the salary data as promised, that includes the overtime for all RPD employees for 2005-2006 and 2006-2007 and analyze it, you will be on the side of the citizens and good government. I would like to think that you aren’t like the rest of them. If you do, it won’t take long to find the obvious.

DO THE MATH and then DO THE RIGHT THING.

Sincerely,

Martin MacIntyre
San Francisco Citizen, Resident, and Voter.

(From Ephemera.)

It’s tasty! The core of the menu is a collection of open-faced sandwiches ($8), served with greens. Choices include goat cheese and pesto; smoked salmon and crême fraiche; and hummus, avocado, and tomato. I had ham, Gruyère, and béchamel, and enjoyed it quite a bit. The salad’s generous loading of vinaigrette complemented the creamy cheese nicely, and the coffee (all organic, $1.30 small, $1.60 large) with which I washed it down was strong and smooth, in the best French tradition.

I flirted with posting this in our Best Bars series, but I decided it wasn’t barlike enough. Nonetheless, with thirteen beers on tap ($4.50/20 oz., $3.50/16 oz. during happy hour: 4-7pm Monday-Friday) and a dozen wines, the alcohol selection is quite good if you aren’t looking for spirits. I had a glass of sangria ($3.75) last night which was quite refreshing.

I don’t live close enough to Café du Soleil to become a true habitué, I think, but I’ll definitely be found here a few times this summer. I’ve got a PowerBook, a bunch of reading, and an appetite, and all three of these are good things to bring here.

It’s just that I have this innate sense of justice. And when I see the jerks of the world getting away with their jerkiness, it burns me up inside.

Here’s the story. Last Thursday night, as I was taking the pups on their last walk of the evening, there was the unmistakable sound of a moving car hitting a still one. A car alarm blared out and the dogs and I turned to see a purple Scion speed down Carl Street and off into the night. No note, no nothing. A hit and run. Bastard.

My car was similarly hit on Carl Street a few years ago and it cost $7,000 to fix. Insurance covered it, but my rates went up for a year. Probably some drunk idiot stumbling out of one of the bars and driving when they shouldn’t. Same thing happened to this poor car – it had been sideswiped from front to back. I made a mental note to keep an eye out for purple Scions.

Then, this morning, I saw the same purple Scion. I knew it was the same car because it had a dent and a broken taillight right where it hit the other car.

My mind raced. I could leave an angry note! No, better, I could etch a few choice words on the side of the car with my keys! No, better! I could go to the store, buy yellow spraypaint, and write HIT AND RUN on the side of the car. But I did none of those things. Instead, I took a photo.

Later in the day, I called the police and reported the license plate number and what I’d seen. Then I took the photo, added personal note to the people involved, made a poster, and put it up in several places on my street with enough tape to make it a huge challenge to remove.

Yeah, I’m a neighborhood busybody. But it could be worse. I could be a bastard who smashes into parked cars and flees the scene.

I know, I could be fighting global poverty or working on a cure for cancer or something. But those are problems too immense to think about. If I can bring a tiny bit of justice to my little corner of Cole Valley, that’s enough for me.