SF doctor’s book released; film to star DiCaprio; interview

A year ago I blogged about Josh Bazell, a doctor at UCSF who had just gotten a million dollar book deal. Well, the book, Beat the Reaper, has just been released, and Leonardo DiCaprio has just been signed to star in a film of the comic thriller. I’ll let that E! Online article give the one-line summary of the book: it’s “a comic suspense tale about a former hit man hiding out as a Manhattan emergency room doctor whose cover is blown after a mobster recognizes him.” The main character is also a martial arts expert who kills people with his hands, as well as with — not to give away the ending — a particularly unique weapon.

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

Josh Bazell. Photo by Tamar Hurwitz

I worked for the office of the Chief Medical Examiner while I was in medical school, so yeah, I had some exposure to the world of violent crime, and to the banality of the people who tend to get involved in it.

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.


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.

2 Comments so far

  1. barneywilbur on January 10th, 2009 @ 6:50 pm

    Interesting interview! I read the book (impossible to put down) and enjoyed it immensely. I can’t wait for Bazell’s second book…

  2. dissertation on October 16th, 2010 @ 4:39 am

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