• Removed for their Safety Does Not Mean they're safe: Foster Care for Writers with Nikki Grey


    Today, we are talking about writing characters correctly and specifically characters who are involved with Social Services as foster children. 

    There are many reasons why a child might be placed in foster care such as:
    • Physical abuse
    • Sexual abuse
    • Neglect (including such things as food, safe/clean environment, emotional support)
    • Medical neglect
    • Incarceration of the parent/guardian
    • Abandonment
    • Voluntary placement because of parent/guardian illness.
    • Placement because of parental/guardian death

    There are  also non-parental/guardian involved reasons for placing a child within the system  
    • Juvenile delinquency
    • Truancy
    • Runaways
    • Length of stay in U.S. foster care
      Length of stay in U.S. foster care (Photo credit: Wikipedia)

    To help us with this subject, I welcome Nikki Grey.

    Robby Barthelmess, photographer

    Nikki Grey was born in Southern California, but grew up in Northern Nevada. At 12 years old, she entered the Nevada foster care system, and spent the next six years living in different foster homes. After a great deal of self-advocacy (including realizing the power of writing after she wrote the Nevada governor’s office when she felt her case was being mishandled by social workers), the then 17-year-old moved in with one of her high school teachers, who later adopted her as an adult.

    Nikki grew up wanting to become a lawyer and advocated for herself during court hearings about her living situation in foster care. Later, after working in two law offices, Nikki decided she wanted a different career. In hopes of going into public relations, Nikki chose journalism as her major at the University of Nevada, Reno. She is now a freelance writer.

    In Nikki's case, she became part of the foster care system when her mother was dying from cancer, her extended family was unable or unwilling to care for her, and she experienced abuse and neglect.

    Thank you so much for your willingness to share your story so that we writers can write our characters correctly in our storylines, Nikki.

    From your experience, can you walk us through the child's perspective? How does one learn they are going into care? Who interacts with them? And who has ongoing contact with the children once they are placed?

    Nikki - 
    In my case, and many cases, the child doesn't know what is going on or what foster care is or where they are going.

    A social worker came to my house and told me to pack a bag full of clothes but not to take anything valuable. I was doing laundry so she had me fill a garbage bag with dirty clothes.

    She drove my brother and me to an emergency shelter group home, where she said we'd only be for a few weeks (which is why she wouldn't let me take more than a few outfits).

    Once I arrived, I had to "inventory" all of my clothes by writing my initials on the tags so if they were stolen by another child they could be identified. That was upsetting. My brother was placed in a foster home before I was. I stayed in the emergency shelter for six months before a placement, in a different town, was found for me.

    Once placed, I had a social worker who was supposed to visit once a month. This didn't always happen but happened more for me because I was moved around a lot. I was allowed to speak to my mother on the phone.

    She had colon cancer so when I was removed from my father's home I couldn't live with her.

    Fiona - 
    What were the things surprised you about being a foster child?

    Nikki - 
    I felt like I was being punished, like I was in jail (when, in fact, my dad was the one in jail).

    I was surprised at how many rules I had to follow and how many of the group home workers and foster families were unkind to me. I thought, why are they doing this if they don't like kids?

    I was also surprised that many of the homes I ended up in didn't seem any better than the one I left. I was abused and neglected in foster care, too.

    And the worst was always assumed of me; I must be a bad kid, because my parents were bad or other foster kids were.

    I was surprised by the horrible stories I heard of former foster kids who lived in the groups homes I did. How they were prostitutes or pregnant; why did my foster parents tell me these things?

    And I had no privacy.

    Fiona - 
    Can you tell me about some of the new rules you were expected to follow?

    Nikki - 
    I couldn't stay the night at a friend's house. I had to do chores, but often not just to clean up for myself or foster siblings. I had to clean up after my foster parents.

    I had one foster father insist I clean my room for his "military room inspection". He'd look for dust with a white glove on and if he didn't find anything he'd lift a piece of furniture, like a dresser that was too heavy for me to lift, find dust and fail me. So then I'd be grounded.

    I was grounded a lot and then had to do chores on the ranch I lived in, like clean up horse poop.

    There is more, but I don't know that I need to go into all the specifics.

    Fiona - 
    Were you offered counseling? Did you have a trusted adult at this point to help you deal with your mother's impending death?

    Nikki - 
    I actually had to go to counseling (although I wanted to, it wasn't optional). So, I did have a counselor help me deal with my mom's death.

    I didn't have a trusted adult, per se, until I moved in with my foster mother (my teacher), aside from my grandmother, but she couldn't care for us so that's not exactly the same.

    I had a few teachers and coaches say nice things to me, which I held on to.

    At the time I didn't see it this way, but I was very fortunate to have been moved into a small town, because people noticed me there. I think in a city or larger area, foster kids may "slip through the cracks" with no one noticing because there are so many people and so many things going on.

    Fiona -
    If you could give one fairy god-mother swish of the wand to every foster child what would you gift them?

    Nikki - 
    A family, but I don't think that's what you're asking. I'd give them the ability to believe that being in foster care is temporary and that, although the bad that has happened to them in their life so far likely wasn't their fault, when they become adults they are in control of their lives, for the most part, and can make good decisions that will make their lives better.

    Fiona - 
    When you read books or watch TV and movies which include a plotline that has foster children what kinds of mistakes do you think writers who do not have a personal experience with foster care make.

    Nikki - 
    Foster children have long been misrepresented in the media by shows like Law and Order. I mean, how many plot lines where the former foster kid is the criminal can you run? Other shows, while entertaining, depict foster children as deviants. In The Secret Life of the American Teenager foster youth Ricky Underwood, who was sexually abused by his father prior to entering foster care, manifests his self-loathing by sleeping around with girls, treating them badly, and ultimately becoming a teenage father after a one-night-stand.
    (I'd like to add that The Secret Life character does end up becoming a good dad in the end.)

    Although there are many negative statistics that show what tends to happen to foster kids when they grow up, not all foster children turn out to be criminals. And constantly receiving messages that imply that’s all we are going to amount to isn’t doing anyone any favors.

    With that being said, Law and Order is a really great show! And I liked The Secret Life of The American Teenager, too.

    I'm just saying it would be nice to see other outcomes represented more frequently. The Fosters on ABC is better at making the characters more multi-dimensional.

    Fiona - 
    What do you wish that I asked about foster kids?

    Nikki - 

    A few things off the top of my head, that I would like to add.

    • I think it's important that people realize that prior to entering foster care, these children have had difficult lives, most likely, and the things that have happened to them have shaped their worldview, how they act, how they speak, how they treat people. 
    • They often didn't have great role models showing them how to live. Even then, they probably love their families, even if those families abused them. It's all they've ever known. And then they are taken from that, thrown into a new world, with little guidance and few, if any, people who take the time to understand them, help them cope and grow. They then are sometimes treated badly and again and again moved around, causing problems in their schooling.
    • Foster kids can tell if people are judging them or looking down on them. And they may be too proud to admit it, but this can be humiliating. They just want to be like everyone else.
    • Foster care is scary sometimes. You don't know what's going to happen; you have little to no control over any of it; and you're lonely. It can be very, very lonely.
    • These kids need people who are patient and loving and understanding. Not judgement. But they also need people who are firm and provide (appropriate) discipline. The saddest thing for me to see is foster kids who end up just like their parents. It doesn't have to be that way.

    Fiona - 
    Why are the children moved around so frequently?

    Nikki - 
    Not all children are moved around frequently, but some are. There are so many reasons. Sometimes if foster kids get into trouble, they get kicked out (which is sad, because kids misbehave and most of the time, their biological parents won't kick them out for that). Sometimes the foster parents aren't equipped to deal with a certain child's needs or didn't realize what they were getting into. Sometimes the kids are abused in the homes. Or they don't get along with their foster families. Or because they don't qualify for that level of care anymore. There are levels in the foster care system and those levels constitute different types of care and different funding, it's kind of complicated.

    Or foster parents might just not want you anymore; that happens, too.

    Fiona - 
    Can you ask to be moved?

    Nikki - 
    You can ask, but there aren't many foster homes so your wants might not be listened to unless you're being abused, then they'll remove you, but foster kids don't always tell their social workers what's going on.

    I was moved from town to town because there weren't homes available near my school often.

    Some kids lose credits and have difficulty advancing grades or graduating because they have to switch schools frequently. Fortunately, this didn't happen to me.

    Fiona - 
    Can you talk a little about your writing and if/how you think your foster care experience influenced you?

    Nikki - 
    I'm a full-time freelance writer.

    I have been published in national print and online media outlets. My articles have appeared in New Hair Trends, American Survival Guide, Geek Out and other Engaged Media magazines. I used to be a features reporter at a newspaper and, recently, I started publishing personal essays about my life. I hope to do that more in the future.

    I write fiction, too, and I just sent my newest manuscript (with a protagonist who is in foster care) to my agent.

    I think having experienced a lot with my family and foster care helps me have empathy. I've seen a lot in life for my age and that helps me as a writer.

    I care very much about people and their struggles. I hope to use my writing to inspire and help people, including foster kids!

    Fiona - 
    Thanks, Nikki.

    If you want to stay in touch with Nikki Grey you can contact her through her WEBSITE and on Twitter

    Thank you, ThrillerWriters, for stopping by. Remember, if you
    like my blog, you'll love my books. Why not try one today?
                Fiona Quinn's Newsletter Link, Sign up HERE

    Happy plotting.


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  • Every Day Carry for Police: Information for Writers

    We're going to take a quick look at the typical tools available to officers as they confront their days.

    Politiekoppel met VLNR: Portofoon, transportbo...
     (Photo credit: Wikipedia)

    Duty Belt


    • Weight - upward of 30 lbs. (think one-year-old baby) many of the belts are made of leather, though modern uniforms often use nylon to be lighter and washable (think body fluids). 
    • Gravity - with all of that weight, the belt wants to slip down. "Belt keepers" circle the duty belt sometimes referred to as a Sam Browne, to hold it snugly to the officer's dress belt. These are snapped into place.

    Advantage - 

    • Having equipment at the handy.

    Typical EDC (every day carry)

    • Pepper Spray - TW blog article
    • Semi-automatic pistol in a security holster - TW blog article
    • Magazines (clips) - TW blog article
    • Phone - TW related article
    • Flashlight
    • Mini-flashlight (typical preparedness saying "One is none and Two is one.")
    • Asp -  TW blog article
    • Portable radio
    • Taser - TW blog article
    • Handcuffs TW blog article
    • Handcuff keys
    • Zip ties - TW blog article
    • Glove pouch (latex)
    • Bullet resistant vest (required by some jurisdictions adds about 5 lbs to the already 10-15 lb duty belt)
    • By individual discretion - back up gun (police personal gun often in an ankle holster)
    • By individual discretion knife/utility tool such as a Swiss Army knife or Leatherman.
    • By individual discretion a kubotan - TW blog article

    The Patrol Vehicle

    • Mode of transportation
    • Mobile office
    • Equipment storage

    Modifications might include:
    • Push bumpers TW related blog article
    • Rifle mounts
    • Prisoner partitions
    • Specialized locking systems
    • Wiring systems which support the add ons
    • Hidden lighting systems
    • Bar lights
    • Weapons lockboxes
    • Camera equipment
    • Sirens
    • Radio equipment
    • Computer terminals (called MDT for Mobile Data Terminal)
    • For officer safety, the light that usually comes on when opening the door is often disconnected.

    In the Trunk of the Patrol Vehicle:
    • Fire extinguishers
    • First Aid Kit
    • Shotgun TW blog article
    • Gas mask/protective suit
    • AEDs or Automatic External Defibrillator (at around 1200$ these are slow to getting in each vehicle)TW blog article
    • Traffic cones
    • Flares
    • Floatation devices
    • Rechargeable flashlight
    • Snow chains

    Other Equipment might include:
    • Radar 
    • Alco-Sensor (for initial analysis of blood alcohol levels)
    • Tint meter
    • Ballistic shield
    • Pepperball gun - this shoots round pellets (like paintball pellets) filled with a powder form of pepper spray. Shot at the feet the powder will spray up to disperse a crowd; hit in the chest of an aggressor or suicidal person it gives the officers time to take non-lethal action.

    Thank you, ThrillWriters, for stopping by. Remember, if you like my blog you'll love my books.  Why not try one today?

                Fiona Quinn's Newsletter Link, Sign up HERE

    Happy plotting.


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  • Looking for Zebras - What a Doctor Thinks When Your Unconscious Heroine Shows Up in Emergency: Info for Writers with Dr. Carlon

    Plains Zebras (Equus quagga), more specificall...
     (Photo credit: Wikipedia)
    Your plot is moving right along. You have a stud muffin of a hero, built like a dancer from Magic Mike. He's a good guy too, and every single one of your readers is swooning for him. But now he's in a panic. The love of his life (shhh, it doesn't really matter that he met her last night - just go with me on this) has passed out. He spots a doctor's office, screeches into the parking lot, lifts the unconscious woman  -- who drapes gracefully from his arms (and somehow did not pee on herself) -- and races through the doors.

    What happens next?

    To answer this question, Dr. Michele Carlon is visiting us.

    Dr. Carlon attended college at the University of Pittsburgh at Johnstown and graduated summa cum laude with a Bachelor's of Science degree in Biology. She attended Robert Wood Johnson Medical School (formerly known as Rutger's Medical School) in the Camden Program where she graduated with honors and was elected to the Alpha Omega Alpha Honor Society. She attended a three-year residency in Internal Medicine (medicine for adults) at Michael Reese Hospital and Medical Center in Chicago.

    Dr. Carlon likes to take time with her patients and finds that her favorite part of being a physician is getting to know her patients well. She likes the diversity of patients and ailments in an Internal Medicine practice. And Michele is also my friend and go to gal.

    Michele, here comes hunky dude.

    Michele -
    Ohh laalaaa

    He rushes through the doors, "Help! PLEASE! I need a doctor!"

    Can you please tell us about the concept of the zebra.

    Michele -
    Okay, a zebra is a diagnosis that is not common. So in the normal world, when you hear the sounds of hoof beats, you think horses, not zebras.

    Doctors are taught to think about common things commonly.
    I have a propensity to attract zebras.

    So, for example when someone comes in with a cough, they usually have a cold. I tend to see weird stuff, like histoplasmosis. 
    I think broadly about all of the diagnoses possible and that includes “zebras.” I also attract zebras because my reputation is that I listen.

    Fiona - 
    And histoplasmosis is?

    Michele - 
    Okay. Histo is a fungus.
    It's in the midwest, and you can get it from spelunking, or camping,
    or being near a river. It causes infections in the lungs, liver, spleen and looks like little grains of sand on an -xray. 

    H istoplasmosis  causes coughing, weight loss fever and can be mistaken for cancer or TB.

    Fiona - 
    So let me pick apart what you just said. You tend to think of zebras and you also tend to attract zebras. 

    Do you think that maybe the other doctors are seeing through horse colored glasses so the heroine comes in with some horrible lung fungus from spelunking and the doctor says, "You have a cold and you'll feel better in a few days..."

    Michele -

    That's exactly it. I tend to take a lot of time, asking probing questions, taking an excellent history. You can make a diagnosis often just with a good history. One should have a good idea of what the diagnosis is before you lay a stethoscope on the patient.

    I had a patient, young woman who came to me with bloody diarrhea. She had been patted on the head and told she had irritable bowel syndrome.

    She didn't.

    IBS doesn't cause bloody diarrhea. Also, IBS doesn't ever wake you up at night. She had ulcerative proctitis. I sent her to GI , who diagnosed it with a colonoscopy. She had been in tears before because she was sick and no one would do anything.

    Fiona -
    In the case of our draped heroine, Stud Muffin is strong, but he's starting to form little beads of sweat on his lip. He needs to put her down somewhere. Can you walk us step by step through the process of seeing the unconscious woman and finding some horrible life threatening disease that will bring them closer together as they fight the good fight to keep her alive.

    Pick a romantic disease please.

    Michele - 
    Hmmm. let me think.
    Ohhh-something she got when they went somewhere together on a honeymoon. Not New Jersey?

    Maybe loa loa?

    Fiona - 
    Loa loa! LOL Isn't that eye worm?

    Michele - 

    Yeah - that's not romantic. How about malaria?

    Fiona -
    Malaria is good.

    Michele - 
    Okay. Malaria .

    So she is febrile, spiking temps to 104. Mr. Hunk has a thermometer. He's checking it, and she has periodic fevers.
    She has shaking chills and then after a couple of days she's okay.

    She goes about her daily activities until the next episode.

    Fiona - 
    Tell me the story from your POV - You see the hunk. You think Yowza! You gesture him into the exam room, and he lays her on the table. Take me through each step.

    Michele -

    Okay, I’ve managed to shake our heroine awake so she can answer questions.

    The first thing we usually ask is what brings a person in today. I obviously see that it’s Mr. Hunk and smile at him.

    She says, “Doc, I’m having these horrible fevers and shaking chills.”

    I immediately start thinking about the causes of fevers and chills. I stay quiet though and let her keep talking until she’s done. The studies show it only takes 3 minutes for a person to “tell their story” to the end. Doctors often interrupt patients within 30 seconds.

    You ask about chronology of the symptoms.
    * Acute illnesses are less than 6 weeks long.
    * Subacute are 6 weeks to 3 months
    * Chronic are over 3 months.

    I take the “Review of Systems,” which is a litany of questions starting with the head and going down to see if other symptoms are occurring—like sore throat, runny nose, cough, chest pain, nausea, vomiting, diarrhea, abdominal pain, urinary symptoms, rashes, sores, numbness, tingling, etc.

    Once we’ve done that I can start narrowing down things.
    * If it’s acute, it’s likely common things
    * If it’s subacute or chronic, one starts to think of more unusual 

       conditions. TB, fungus, cancers, autoimmune diseases, etc.

    Fiona - 
    So how long has little Miss Stoicism been running hot then cold

    Michele -

    Malaria causes people to get quite sick and they often will show up in the ER (now called the “ED” for Emergency Department).

    The key bit of history in this case is the travel history.

    Once I’ve established that she is a nun in Mother Teresa’s clinic and Mr. Hunk is her brother, I start to flirt with the brother.

    Oh. I also know I need to look for zebras. India is rife with tropical diseases, and I need to examine Mr. Hunk since he was her bodyguard. We step into my office, and I ask him to disrobe…
    Oh, wait, that’s not right. Got side tracked there.

    (I was just kidding; I know they're really not related and are deeply in love.)

    Fiona - 
    Okay - just to throw a monkey wrench in here.
    Lets say she hadn't travelled but she is presenting with some weird issues - why/when would a doctor ask for genetic heritage?

    Michele - 

    Family history is important in this case.
    There are diseases more common in some groups, like FMF (Familial Mediterranean Fever) or Sickle cell disease.

    FMF patients are often written off as drug seekers because they have mysterious abdominal pain for which no cause can be found

    Sickle cell disease occurs most often in African Americans in the US.

    Fiona - 
    I saw a movie once about a girl who had FMF. The mother tried everything to get her a proper diagnosis. The girl had had multiple exploratory surgeries, etc. Finally, the child was taken into social services custody and the mother charged with abuse via Munchausen by proxy. Turned out a doctor asked the mom the right questions (at the prison) - yes, the child was conceived during an affair; the biological father (NOT her husband) was from the Mediterranean. Diagnosis given, mother released, child saved, divorce pending. I always thought that was a good plot twist.

    Michele - 
    Breast cancer - 

    I had a woman once who had an aggressive case of breast cancer and had a  family history of prostate and ovarian and breast cancer. She had an Irish surname. On a hunch, I asked her whether she was of Ashkenazi Jewish heritage. She looked at me like I was nuts.

    Two weeks later, after she’d asked her family, she found out that her family HAD been Jews and during WWII had changed their names and became Catholic to avoid the Nazis. That was interesting. It wasn’t that uncommon a survival strategy, but often, later generations have no idea that they’re Jewish.

    She was BRCA positive.

    Fiona -
    Very cool. So you've asked if the patient has travelled - no. 

    You got her family heritage, and she's 100% English and everyone lives to be 105 in her family. 

    You're stymied by what you are seeing - now you turn to pets?

    Michele - 

    When taking a history, a lot of doctors forget to take a history for pets, occupations, and travel. With the Ebola virus, and now with measles, we see how important the travel history part is, but many forget about pets and jobs.

    Pets can carry all kinds of fun diseases.

    Let's start with birds.

    Birds can cause psittacosis and avian hypersensitivity pneumonitis amongst other things.

    Avian hypersensitivity pneumonitis is caused by an allergy to the bird. You can test for the specific bird’s avian antigens. It’s done in very specialized labs.

    You have to know they have a bird. They get severely SOB, develop respiratory failure, and interstitial changes on their Chest x-ray. They can die from it.

    I diagnosed that over the phone once. I heard a parrot over the phone whilst talking with the patient’s daughter.

    Fiona - 
    SOB? I know some severe SOBs but didn't know it was part of a disease profile, is it contagious?

    Michele - 
    Oops. Sorry SHORT OF BREATH (SOB)
    Yeah, I had a patient see that I wrote SOB and got really insulted.

    Okay, Dogs!
    Dogs eat their own and other dog’s poop and have ticks and fleas. Ticks carry lyme disease amongst other things. Dogs also get leptospirosis and worms, along with other lovely diseases.

    There is a canine vaccine for leptospirosis now!

    Dogs AND cats have a bacteria called Pasteurella multocida in their mouths. When a dog or cat bites and punctures the skin, it can cause a rapidly spreading cellulitis (skin and subcutaneous tissues infection) that can cause septic shock and death. Our doc needs to do a skin check for rashes, puncture wounds and bites.

    There’s cat scratch fever too, which is bacterial infection that you can get from petting an infected cat and rubbing your eyes as well as from cat scratches.

    Mice and Rats:
    Rats carry fleas. Fleas carry Bubonic plague!

    Mice carry Hantavirus. The feces become aerosolized into dust which is inhaled by the victim and causes respiratory failure and sometimes death.

    A physician takes a structured approach to physical examination:
    The doc will:
    * Check Vitals: Blood pressure, pulse, respiratory rate, temperature.
    * Check general appearance like: skin coloring-jaundice, paleness, 
       redness, blue discoloration of nails and lips; puncture wounds or
       rashes; muscle wasting, obesity, etc.
    * Look in the eyes, ears, nose and throat for signs of illness
    * Feel for swollen glands in the neck, underarms and groin
    * Listen to the lungs for sounds consistent with fluid or infections 
       or solid masses.
    * Listen to the heart for murmurs. Heart valves can get infected and    when blood flows across heart valves that are damaged, it is 
       turbulent and makes a noise called a murmur. Maybe she is an 
       Intravenous drug user and has Subacute bacterial endocarditis.
    * Examine the abdomen for distension, bowel sounds, organ 
       enlargement or masses.
    * Do a genital exam: looking for chancres (syphilis), abscesses
       (boils), vaginal or penile discharge (Sexually transmitted 
       infections or STI’s), a Chandelier sign (when you move the 
       uteran cervix-the pain with pelvic inflammatory disease is so bad
        the woman screams and jumps towards the ceiling).
    * Rectal exam: looking for black or bloody stool or for worms, for 
       abscesses or masses
    * Looks at the joints and muscles for swelling, redness, and fluid. 
       Joint infections can cause swelling, redness, heat and pain in a 
       joint and STIs can cause joint infections as well as can regular 
       run of the mill skin bacteria.
    * Neurologic signs and symptoms: Level of consciousness, 
       delirium, dementia, weakness, numbness, temperature sensation,

    Whew! So that’s the approach.

    Fiona -
    So say she has a pet rat named Algernon and she developed the Bubonic plague. Now what? Do you put her in quarantine?

    If Hunky and damselle are not married, can they stay in the same hospital room if they want to? Can they hold hands and make doe-eyes at each other? OR are you, the Dastardly Dr. Carlon going to separate these young lovers so they are pining away and in agony on opposite sides of the hall?

    Michele -
    If they have Pneumonic plague, they will be on “Droplet precautions” which means people have to wear masks and eye protection when they enter the room.

    They won’t be well enough to MOVE their eyes much less MAKE DOE eyes! They’ll be on life support most likely.

    If they have Bubonic plague, they’ll need IV antibiotics. They’ll be sick, febrile, (feverish) and won’t be in the mood, although they won’t be on isolation.

    Malaria-no isolation. They can hold hands and dream of their future together between episodes of parasites swimming around in their bloodstream making them sick.

    Oh—if they have Falciparum malaria, they might die. That one is nasty, so let’s call the chaplain and marry our two star-crossed lovers before they succumb.

    Fiona - 
    A scenario from MISSING LYNX and questions:

    A man comes off the plane we don't know from where. Last leg Dallas DC he deplaned and passed out. Just before he does, Lynx asks if it's a recurrence of malaria. He says yes. An ambulance rushes him to the E.D. He gets to hospital all but dead, and they don't know where he had flown in from,  but this is not simply malaria. 

    What precautions does the hospital take to safeguard themselves and other patients while waiting for a diagnosis? And how fast can pathology work stuff up if it's STAT!!!

    Michele - 

    If he’s alive, he’d be put in reverse isolation and with any possibility of Ebola, he would be put in level 4 isolation.

    Unfortunately, there is no “stat” with cultures. They take days to months depending on what they’re looking for. They can do stains for different bacteria, like AFB for TB, gram stain for bacteria, special stains for other less common bacteria, parasites, etc. Pathology results, where the pathologist stains tissues and looks at them under the microscope usually takes at least a week to come back.

    They would likely interview family, friends, and acquaintances, and get his travel history. Check his flight records.

    Fiona - 
    Is there a lottery system for the lucky nurse who gets to go in there?

    Michele -
    Short straw?

    No, it's standard of care....unless it's Ebola, and they actually have a volunteer system. My husband volunteered. He does critical care.

    Fiona - 
    Great guy! I wouldn't kiss him for a while though

    Michele -
    I told him he wasn't coming home.

    Sleep in the hospital until you're cleared.

    Fiona - 

    "I have a tent set up for your outside, honey."

    Michele - 

    Fiona - 
    Traditional question on ThrillWriting - your favorite scar or harrowing story?

    Michele - 

    I was a first year medical student.

    While skiing in Vermont under bad conditions, someone cut me off. I fell but my bindings didn’t release. I hurt my knee badly and was brought off the mountain by ski patrol in one of those baskets. I was strapped in and unable to move. I prayed that the guy wouldn’t lose control leaving me to careen down the mountain and unable to get my hands out to stop the basket…

    In the ED at the bottom of the mountain, the Doc found out we were medical students and decided to teach us ALL ABOUT TORN LIGAMENTS. He did a Clinical Correlation –a method of teaching students at the level they are. We had just finished the anatomy of the leg. He took a piece of gauze and tore it slightly side to side to demonstrate what a torn ligament was like. I had a VERY vivid imagination and almost passed out.

    I hadn’t developed the emotional wall that all physicians develop, separating the grosser aspects of what we do, from our emotions.

    Anyway, I ended up having extensive knee surgery and have a 12 inch long scar along my knee, and haven’t skied since.
    Fiona - 
    How can people stay in touch with you, Michele?

    Michele - 
    My blog is: www.doctordivagetshealthy.blogspot.com

    Fiona - 
    How is your writing going?

    Michele - 
    I was published in The Chicago Muse with a short story called, "The Round Faced Boy" and am working on two novels at the moment, and hope to find time to finish them. One on bed bugs spreading psychosis from a Level 4 CDC research lab. One on superpowers developed in postmenopausal women with their hot flashes.

    Fiona - 
    Oh FABULOUS! Last question - as a doctor what's your pet peeve that writers get wrong in their plotlines?

    Michele - 
    When they describe procedures wrong. I bought a trilogy recently, and ended up not reading past the first half of the first book because the details on the medical procedures like central lines, and iv insertions were all wrong.

    Fiona - 
    What would you suggest to writers so they can get details like that correct? I just wrote a medical section into my novella MINE, and I have some background from my graduate work, but I had a nurse working with me to get the details precise.

    Michele - 
    That is a terrific approach. Nurses see everything in the hospital. They actually help with all of the procedures, and do the majority of the work in the hospital. If you have a friend who is a nurse, or even better a Nurse Practitioner who is hospital based, they are worth their weight in gold. You want to ask someone for sure because procedures change quickly. What was standard of care last year, may be out of date this year. So you can date your book AND you have to make sure that if you are writing 2000 storyline that you aren't using 2015 interventions. 

    Also medical textbooks aren't enough. If you take a description right from a textbook, it stands out. I've seen some authors do that and they use the terms incorrectly and it's ---ugh

    Fiona - 
    Thank you so much, Michele, for your time and expertise.

    And thank you ThrillWriters for stopping by. Remember, if you like my blog you'll love my books.  Why not try one today?

    Fiona Quinn's Newsletter Link, Sign up HERE

    Happy plotting.

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  • Rational and Irrational Behavior in Your Characters: Info for Writers with Dr. Vivian Lawry

    Dr. Vivian Lawry
    A big welcome to Dr. Vivian Lawry. Vivian holds a BA, MS, and PhD in psychology and was a professor of psychology prior to her retirement.

    Today, Vivian,  we are going to wrestle with a complex part of the human psyche. In our plots, we try to make the story conform to what a rational person would do, but the truth is that given the right circumstances, motivation, and perception, anyone is capable of anything. Would you help us to understand this concept?

    Vivian - 
    Circumstances refers to options and constraints.

    Motivation refers to what drives the person.
    Perception is what the person thinks is going on. 

    All of these offer writers lots of room for making anything happen—believably.

    Fiona - 
    Can you describe the famous Zimbardo prison experiment to give context?

    Vivian - 
    The Zimbardo prison experiment is classic! Here's a quick and dirty overview that hits the highpoints:

    The basic question was whether ordinary people would/could be as cruel as Nazi concentration camp guards, or whether the Nazis were truly aberrant. 

    So they advertised in newspapers around Palo Alto, CA, for people to participate in a paid psychological study. Volunteers were screened with all the psychological tests they could think of to make sure they were healthy, stable personalities. Then they were RANDOMLY assigned to be either prisoners or guards. The guards were issued uniforms and reflecting sunglasses. 

    The prisoners--all men-- were picked up from their homes by real police cars, sirens blasting, handcuffed, and taken to the "jail", which had been created in the basement of a campus building. They were stripped of their street clothes and issued night-shirt type garments, flip-flops for shoes, and stockings on their heads to simulate a shaved head. The prisoners were given no directions (as far as I recall). 

    The guards--also all men--were told to maintain order. 

    In a matter of days the prisoners were depressed, plotting a break-out, weeping, and compliant with the guards. The guards, for no apparent reason, had become controlling and abusive. They told the prisoners to stand in line and count-off repeatedly, or do push-ups till they collapsed. One guard made them do push-ups while pressing his foot on their backs. The experimenters terminated the experiment early. And I should mention that everyone involved got counseling and so forth after. But the strength of this work is demonstrating the incredible power of circumstances in shaping behavior. These two groups of people differed only in which circumstance they were randomly assigned to.

    Fiona - 
    I know the researches were astonished by the outcomes. Do you have information about how the students felt following the experiment and if there were lasting effects?

    Vivian - 
    As I recall, not all of the participants were students—not that that's important. All were distressed and were given group and individual counseling. I haven't heard of long-term negative effects. But it definitely shook the foundations of certainty about what ordinary people would do when thrown into extraordinary circumstances. 

    You don't know how you will behave till you are there. Within each group there were variations: some guards were noticeably nicer than others, though they didn't stop the abuse. Some prisoners had sleep disorders and some became aggressive themselves.  And the whole thing  caused a huge upheaval and contributed to the dialogue that led to the creation  of ethical standards for research in psychology. 

    Fiona - 

    Reasonable man theory refers to a test whereby a hypothetical person is used as a legal standard, especially to determine if someone acted with negligence. This hypothetical person referred to as the reasonable/prudent man exercises average care, skill, and judgment in conduct that society requires of its members for the protection of their own and of others' interests. This serves as a comparative standard for determining liability. For example, the decision whether an accused is guilty of a given offense might involve the application of an objective test in which the conduct of the accused is compared to that of a reasonable person under similar circumstances. http://definitions.uslegal.com/r/reasonable-man-theory/
    The above "reasonable man" definition is often used as a court standard. Now imagine if you will an unreasonable circumstance - an out of the ordinary event - a man standing in your room, and you have to chose to shoot or not. According to science, unreasonable circumstances lead to unreasonable outcomes. Can you talk about the ability to think/process/and react reasonably under high stress circumstances? When is "reasonable" unreasonable to ask of our characters?

    Vivian - 
    High stress increases the likelihood of the dominant action. If a behavior is well-learned, as in the case of a professional athlete or musician, the stress of a command performance at Madison Square Garden or Carnegie Hall would actually improve performance. For the less skilled athlete or musician, it would increase the likelihood of mistakes. In the sort of situation you are describing, people when frightened tend toward either fight or flight. Whichever is the dominant pattern for your character should predict the outcome.

    Fiona -
    That is a very interesting point. What are some other ways that we could predict the outcome even if it were out of character. I will give you an example I recently read...

    The mother, in a John Gilstrap book, was kidnapped with her son. The son wanted to be proactive. The mom wanted to conform to whatever the kidnappers wanted them to do - she thought safety came from docility. She was docile by character.

    What might spur someone to act "other than"?

    and by that I mean other than their nature would predict

    Vivian - 
    This goes to the point of what is the best perceived alternative. If the son can make the case that active is better, Mom would go along. Or if she does something as told and then she or her son is punished anyway, she might see the light. She might see or hear something that says the kidnappers/guards/whoever can't be trusted to reward docility, that could do it, too.

    Fiona - 
    In this vein, can you talk about Stockholm Syndrome?

    Vivian - 

    I'm not an expert on Stockholm Syndrome, but here goes: there is a lot of evidence from a lot of sources that victims tend to identify with their abusers. For example, children who are abused are more likely to grow up to be abusive themselves. 

    In a somewhat related vein, there is evidence that when a powerful or popular figure espouses a point of view/attitude/action, others do the same. (The whole basis of political endorsements or celebrities in commercials.) With Stockholm Syndrome, you have a person who is under complete control of some other person or group, everything from food, being allowed to sleep, physical abuse or the threat of it. It doesn't get much more powerful than that. Under such circumstances, people start to doubt themselves and their view of reality. The younger the person is--the less formed his/her sense of self—or the more unstable the personality, the more likely that person is to accept the reality as given by the authority figure. 

    Often victims of abuse have low self-esteem and come to believe that they deserve whatever happens to them. 

    Fiona - 

    Here at ThrillWriting, it is traditional to ask you for a story. Can you tell us how you got your favorite scar?

    Vivian - 
    I was a young child, 5-6 years old. My younger sister and I were staying a couple of days with our young aunt and uncle, who had no children. They spoiled us a bit. She took us to the big department store in town and bought matching red Jensen bathing suits for my sister and me. We were going to the pool as soon as the dishes were done. 

    I was handing a bowl to my aunt to put in the cupboard. I thought she had it, and I let go. It broke on the edge of the sink and a chunk cut the artery in my right wrist. My aunt nearly panicked, pushed her thumb into the geyser, and ran out to the driveway, yelling until the neighbor came out and took us to the emergency room. I remember everything being very bright and white, except for my sister's red bathing suit as she clung to my aunt's skirt—and, of course, the blood. 

    I cried so at not being able to go swimming that we went anyway, my aunt carrying me around the pool while I held my white bandaged wrist aloft like the Statue of Liberty. I now have a scar on my right wrist about half an inch long, with three small scars crossing it perpendicularly. In college, I was sometimes asked whether I'd tried to commit suicide—which might have been a much more interesting story!

    Fiona - 
    Last question - How can we apply what we learned today to our character development (for good or bad) and our plotlines?

    Vivian - 
    I think the most basic tip is to take the reader inside the character's head/heart, to see the world as s/he sees it. 

    Behavior is believable when it flows from the character's perceptions. In my recently published collection of short stories, DIFFERENT DRUMMER, one story involves a man who feeds parts of his body to his cat. I invite you to decide whether his behavior was believable, in context. 

    Thank you so much for your insights, Vivian. ThrillWriters, if you want to stay in touch with Vivian you an reach her on her 
    website, and you can follow her on Facebook.

    And thank you for stopping by. If you like my blog, you'll love my books! Why not give one a try?

    Fiona Quinn's Newsletter Link, Sign up HERE

    Happy plotting.

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  • The End - Hospice Information for Writers with Lara Nance


    Today, we are visiting with Lara Nance. Lara has been
    a nurse practitioner for 10 years in a variety of settings. She mostly works with geriatrics and also works with a hospice company. She's  had a lot of experience with death and dying and was certified as a trainer for the palliative care program for nursing homes, as well as being a fellow writer.

    Lara,  c an you give us a tutorial on hospice? Under what circumstances does someone come under hospice care?

    Lara -
    Hospice was originally developed by Medicare specifically for cancer patients so they could be in the home setting in the end stages of the disease and have a more comfortable, dignified death.

    Then over the past years, it has expanded to cover any type of illness where a person's life expectancy is likely to be six months or less.

    Medicare funds the program. It's a plus for them financially because it is less costly for patients to stay in their homes and receive care than to be in expensive hospital or nursing home settings.

    It's better for the patient because they can be more comfortable in a home setting as institutional settings can be very stressful with the level of activity and noise.

    Hospice provides medicines that are for the comfort of the patient, equipment for comfort, such as hospital beds, and in home care with aides and nurses providing bathing, etc and medical care for issues not related to the person's primary diagnosis.

    They will provide what is called a "Comfort kit" that contains liquid morphine for respiratory distress and pain, Ativan for anxiety, a drug like haldol for agitation, and atropine drops for increased secretions. The family is trained to administer these drugs appropriately as needed.

    Hospice also provides a social worker to help the patient and family deal with issues of dying. They also provide a chaplain for spiritual needs.

    My role as Nurse Practitioner is to visit patients every 60 days to see what their current status is and help determine if they continue to remain in the program.

    It's possible for a patient to be discharged from hospice if they improve and their 6 month life expectancy changes. I've seen this happen, so a person doesn't necessarily die in hospice. Sometimes the extra care they receive improves their condition and allows them extend their lives. This is usually for the non-cancer illnesses.

    All in all, hospice provides extra hands on patient care and support for the patient and family that will allow them to stay in a more comfortable setting in the end of their days.

    Fiona -
    Just recently, my father-in-law died from cancer. We are very grateful that he is no longer in pain. The doctors had been suggesting that he be in hospice for months prior to his passing. But my mother-in-law put it off until the very last few days. 
    I imagine that for her, deciding to enter into the hospice process was like giving up. Do you see resistance to the process in either patients or their families? 

    Lara -
    Oh yes, that is the most frequent objection we see. Because of the old use of hospice strictly for cancer patients the life expectancy could be pretty accurately predicted. So when a cancer patient was given the 6 month time frame, it was usually a death sentence.

    Now, with all sorts of illnesses, the predictability of end of life is less precise. Usually when I take time and explain all this to the family, it helps. I tell them that it actually means more care for the patient. They can change their minds at any time if they don't want to stay in hospice. Also, I let them know that there have been times when patients come out of hospice. Once they understand the whole concept, they are more accepting.

    There are also time when the family accepts but they don't want the patient to know. We can deal with that and just provide the care without mentioning the word "hospice" in front of the patient.

    I've also heard people say that they heard hospice uses the medicines, like the morphine to kill people, or to make them die sooner. So I have to explain the proper uses of morphine in more detail.

    Usually, when a healthcare provider takes the time to explain, the objections can be dealt with. When hospice is mentioned but not explained, it can be a problem. I try to start these conversations with families and patients before it is imminent. People need to make end of life decisions before they are at the end. And they need to make their wishes known.

    Fiona -  

    As you are engaged in reading/viewing plotlines that include the process of death and dying -- when it is not a trauma-induced death but an illness -- what issues do you see in the writers getting the scene right. Granted, I just asked a very difficult question because I'm asking about generalities in a very personal moment.

    Lara - 
    I just watched a movie called, The Judge. It's an awesome movie. But the end was all wrong. The Judge, Robert Duvall is dying of colon cancer. He and his son, Robert Downy Jr. are in a boat fishing. First of all, he is not thin or wasted, which would be expected at end of life for this sort of patient. Duvall is acting as if he feels fine and is actively fishing. His son turns to cast his line, and when he looks back, his father is slumped over dead.

    A person with a terminal illness typically goes through a sequence of events. They reduce their intake of nourishment over a period of time and lose weight, then they will usually go through a few days of not eating or drinking at all. During this time, they may not be aware and may appear to be sleeping or dozing. They may have periods of anxiety or agitation. They may have a build up of secretions that cause labored and noisy breathing. Pain issues may increase, and there may be periods of apnea, where their breathing stops for a few seconds.

    Using the morphine, atropine and ativan help slow the heart rate to normal, ease respiratory efforts and clears secretions. This makes the patient comfortable. They may move in and out of alertness until they finally die.

    In the case of the movie, to have a sudden silent death like that made it unbelievable for me. Even with a massive heart attack or stroke, there would at least be a peep from the guy before he died! Anyway, that's one example. A majority of the deaths I see from terminal illnesses in hospice follow a specific pattern as mentioned above.

    Also, at end of life, the hands and feet of a patient become cold and may have purple mottling as the heart pumps less and less to the extremities. That's one of the ways we can predict time of death.

    Fiona - 

    It is a tradition on ThrillWriting to ask our guests to tell us a story about how they got their favorite scar and if somehow you have survived without a scar up to this point then a harrowing story.

    Lara -
    Well, I only have one scar, and it's not a very thrilling story. LOL. 

    It happened when I was a teenager. My cat had gotten into a closet that had a lot of folding chairs in it. The chairs shifted when she was crawling on them and one fell on her and she let out a blood curdling howl. I ran to the closet and opened it then tried to lift off the chair. I guess she was in shock and afraid because she attacked me and bit my hand, clamping down just below my thumb. Caused a pretty good gash, and I had to go to the hospital. She was okay, though.

    Fiona - 
    When you are not helping people with their end of life comfort, you are writing. Can you tell us a little bit about what you write and your newest book, A Coma with Dragons

    Lara -  
    Yes, my other full time job...LOL. I love writing and hope to do it full time soon. I have over a dozen books and short stories published in a variety of genres from mystery to paranormal romance, to steampunk adventures.

    My latest book, A Coma With Dragons , is a fantasy with romantic elements. I call it, When Sleeping Beauty meets Game of Thrones.

    In two of my books have a nurse practitioner as the heroine and I'm able to throw in some of my real life experiences there. They are: Memories of Murder and Dealers of Light.

    Fiona - 
    My last question - What is it like to be a hospice nurse, how does one cope with death being the work day - every day? 

    Lara -
    Nurses tend to help each other with these issues. We are a giving and nurturing bunch and seems to be in our DNA to be able to cope with the death and dying.

    The issue that hits me the hardest is not the folks at end of life in their 80's and 90's that have had a good life. It's the people like my ALS patients who are in their 40's and 50's who can no longer move except for blinking an eyelid. They have spouses that are caring for them in their homes and seem completely hopeless and filled with despair. I have a hard time after visiting them.

    You just try to do the best you can for the patients while they're here and make life better for them. That's all you can do.

    For me, writing helps take me away from the harsh realities of my profession. I think other nurses have similar outlets as well. 

    If anyone has any questions about nursing stuff they can e-mail me through my website:  www.laranance.com.  Happy to answer!

    Fiona - 
    Thank you so much for sharing this information with us Lara. 

    And thanks you all for stopping by.
    If you like my blog, you'll love my books! Give one a try.

    Fiona Quinn's Newsletter Link, Sign up HERE

    Happy plotting.

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  • Society and Survivors: Information for Writers with Rachel Thompson

    TRIGGER WARNING - for those of you who might be triggered by abuse survival stories, please be cautious about reading this article.

    Today we welcome Rachel Thompson. 

    Many of you will know her as  the author of the award-winning Broken Pieces , the newly released Broken Places , as well as two additional humor books, A Walk In The Snark and Mancode: Exposed .  She  is published and represented by Booktrope

    Rachel owns BadRedhead Media , creating effective social media and book marketing campaigns for authors. Her articles appear regularly in The Huffington Post , The San Francisco Book Review (BadRedhead Says…), 12Most.com, bitrebels.com, BookPromotion.com, and Self-Publishers Monthly

    Rachel is the creator and founder of #MondayBlogs and  #SexAbuseChat and an advocate for sexual abuse survivors. She hates walks in the rain, running out of coffee, and coconut. She lives in California with her family.

    Luckily, today Rachel is all caffeinated up and ready to help us write it right.

    Rachel, you have a new initiative concerning survivor stigmas. Can you tell us what prompted your initiative and a little bit about where it's going?

    Rachel -
    Well, I can't take credit. The nonprofit organization is called Stigma Fighters, and it was created by the amazing Sarah Fader.

    Sarah and I connected prior to last year's BlogHer '14 in San Jose. She asked if she could share her story on my blog.

    Sarah suffers from panic disorder, anxiety, and a few other things, and wanted to share with others, especially women, that they're not alone, that it's okay to tell our stories, and not feel bad about it. She started her organization and helped spread the word via her platform and writing for Psychololy Today and Huff Post.

    Her initiative has grown dramatically. She bravely connected with sports stars, actors, musicians, even senators.

    I'm on her board now, and she's creating a college speaking tour, which I'll be joining, as well.

    Fiona - 
    How would you define stigma? And are you focused solely on crime survivors?

    Rachel - 
    Well, stigma can have many definitions, for both survivors and their families/friends. I am a survivor myself. The biggest burden we carry is shame, so it makes it difficult (if not impossible, for many) to discuss what happened to them. And because 1 in 3 women and 1 in 6 men are sexually abused before the age of 18, many of these survivors carry the extra burden of dealing with an intimate type of shame (myself included). The result of that shame manifests itself in any number of mental disorders: anxiety, flashbacks, depression, many of which are manageable (to a degree). Some have it much worse: suicide, bipolar, addiction. OCD can be especially difficult

    Discussing these behaviors in public makes us feel like freaks or crazy. That's the stigma I personally wanted to help break when I wrote Broken Pieces. That it's OKAY to discuss what happened and also the after effects

    As for only survivors of crime, not necessarily for me -- I'm open to talking with any kind of trauma survivor. The advocacy work I do however: #SexAbuseChat is pretty obvious -- it's for sexabuse survivors but also their families or anyone who wants to help survivors in a supportive way. That's why I didn't start the chat until I connected with a certified therapist (Bobbi Parish) who is herself an incest survivor.

    I'm not an expert or psychologist; my goal isn't to create therapy for people -- simply a group support community.

    Sarah's Stigma Fighters works well with my vision also, because it's about support.

    Fiona -
    Shame has various ramifications in survivor mentality. I think it is critical for writers to understand that a crime is not over, a victim is always trying to prevent that experience from happening again. 

    One of the ways that you express your self-protection is not wanting to present anything but perfection for fear of judgement - judgement meaning that maybe you deserved what happened to you because of your imperfections. 

    Can you talk about instances in literature that you have seen a writer portray this well? How does this show up in your writing?

    Rachel - 
    Well, gosh. So many instances. One of my favorite books is John Irving's THE WORLD ACCORDING TO GARP. He strived for have the perfect family when clearly, it wasn't going to happen, given his start and all the craziness of his mother. But I loved the story because of the imperfection and ultimately, it was about love.

    Another favorite is THE TIME-TRAVELER'S WIFE -- Henry worked so very hard to have a life with Clare -- to discover why he traveled and to beat it -- but he couldn't outrun his flawed DNA. Even perfect love wasn't enough. But they tried and their story is compelling. I reread that book a lot, actually.

    As for my own writing and for my life, I've always felt that what happened to me is an event (or events) that don't define me. I'm not a victim and I don't ever refer to myself or others as victims, but as survivors, because we're still here. We survived.

    We may be flawed, or changed, but who isn't? Everyone has experiences of some sort that helps to shape who they become. Not to minimize those experiences (because minimization drives me insane). What happened to us is horrific, and we need to recognize and deal with that. But we also have to progress from it as well.

    What I love about the survivor community is that we are fiercely protective and supportive of each other -- I wouldn't have that if I hadn't survived what I did, and so I'm grateful. Which is ironic, in a way.

    Fiona - 
    In reading books and watching films/tv what mistakes/stereotypes do you find authors leaning on and how would you prefer they portray victim/survivors?

    Rachel - 
    It's frustrating to see so many 'fairy tales' that still exist -- the man saving the woman from her fate. Though I do see more and more that woman are making their own decisions. For example, like many, I got sucked into watching Showtime's THE AFFAIR this year. I really enjoyed the acting and writing. It was evocative.

    But it also kind of pissed me off that the female was in a position of having to depend on men for her fate, going from one guy to another to live. Why not have her go it alone? I know that wouldn't be as interesting -- sex sells -- and maybe that's the bottom line in movies and TV. It's not about independent women, it's about sex.

    Gilmore Girls seemed to be the exception, to an extent. I enjoyed watching that show w/ my 15yo daughter (we Netflix binged watched it)

    I'm not opposed in any way to love stories -- we live for love, right? But when it shows women as victims or having no fate or future without a man, I get ticked.

    Sadly, that is reflective of reality, given domestic abuse stats and sexual abuse stats. Most victims (and I use that term here in a legal sense only) of sexual and domestic abuse ARE women, and most perpetrators are men (look at RAINN.org for stats)

    Strong women with strong storylines are often seen in Shonda Rimes shows -- I like her a lot

    Fiona - 
    Earlier you said, "it's okay to tell our stories and not feel bad about it." Can you talk about ways that society (and here we can see this extrapolated out to include how our survivor-heroines are treated in their plotlines) prevents survivors from expressing their distress. I'm thinking for example if someone has a medical diagnosis they receive support but if it's not a broken leg - if it's broken courage or depression...

    Rachel - 
    Lots of minimization, for sure. I experienced that in my own life. "Well, her abuse wasn't as bad as some of the others, so it doesn't count," or, "she'll be fine."

    I told myself, well, if that's what my parents are saying, then it must be true. But you can only suppress that for so long. I had the whole 'good girl' thing going on, but inside I was dying. Partying, doing things I shouldn't have been, and later, depression, panic, anxiety.
    Even now, flashbacks and nightmares.

    To this day, my family still doesn't really believe that it was "that bad" because it wasn't "rape" -- JUST inappropriate fondling and touching and showing me things like that makes it okay in some way because there wasn't penetration. Which is totally fucked up.
    And not at all uncommon, sadly.

    A friend shared a story of domestic abuse on his wall the other day -- it was fairly graphic, about how his father used to beat him and his mother, and his two sisters were very young (less than age 2) so they wouldn't remember). One of his sisters showed up on his wall and yelled at him IN ALL CAPS to take it down, that this wasn't the father she remembered, and how dare he do that to HER.

    It's very sad that people want to shut us down (though my folks have been super supportive and for that I'm grateful) because they are uncomfortable with the truth.

    In my case, I was 11 -- more than old enough to remember. I even testified in 2 trials. So plenty of documentation.

    Depression is similar -- more publicized now of course -- but people have a hard time with intangibles. If they can't see it, they don't understand how to deal with it, which of course, doesn't mean it doesn't exist. It's about respect more than anything, and learning.

    Fiona - 
    A writer has a unique means of teaching the public about things that are outside of a person's experience. I for example have never had someone close to me die. I only know what to do, say, how to act at funerals because I have read about it. If an author was writing a helpful response from the survivor characters support system, what elements would be most useful to include - yes, our job is to entertain - but getting something like this "right" in literature might just make a difference in someone's life.

    Rachel -
    Well, that's what I hope my books do -- give insight into a survivor's mind, body and soul. In fact, that's how I set up Broken Places.

    Some people will never be open, and that's just a fact. A friend wrote about writing through her depression in the most beautiful, organic way and shared it on Stigma Fighters -- a women tweeted 'how boring and narcissistic' -- I mean... There will just always be ignorance.

    And to be honest, that is some of the feedback I receive in 1-star reviews: that it's boring, that everyone has bad experiences, that I should have never said anything. And that's okay -- we as writers put ourselves out there and not everyone will understand or accept our POV.

    I didn't really understand grief until my ex- committed suicide. I had lost my grandmothers, and I missed them, but they were old and in so much pain. It was a blessing for them, really.

    Some things people have to learn themselves. Just like writing or marketing a book -- you can read how to write, but until you write, you don't know.

    Fiona -
    A traditional ThrillWriting question is, would you please share your favorite scar story?

    Rachel - 
    I gave birth to my second child, my son, in 2005. He was supposed to be almost 11 lbs, and I'm not a big person (about 5'3"), so they said, no way, your hips won't accommodate that boy. He was also breech. I had a C-section, and he was almost 9 lbs. Still a big boy! He's 9 now and a big kid, full of life and a big heart, too. Loves his mama. However, I think this quote sums up me and my writing the best:

    Stay in touch with Rachel: Web site:   rachelintheoc.com
    BadRedhead Media Site:  badredheadmedia.com
    Twitter:   @RachelintheOC Twitter (Business):   @BadRedheadMedia
    Facebook:   https://www.facebook.com/AuthorRachelThompson Facebook Broken Pieces Fan Page:   https://www.facebook.com/BrokenPiecesByRachelThompson

    Thank you so much for sharing your experiences, Rachel, and the very best of luck with Stigma Fighters.

    As always, thank you so much for stopping by. If you like my blog, you'll love my books! Give one a try today.
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