My Inspiration for In Sickness and in Health by Fiona Sussman

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In Sickness and in Health by Fiona Sussman

By Fiona Sussman

An eerie torchlight procession through the cobbled streets of Stirling, walking alongside the likes of crime-writing greats Denise Mina, Val McDermid, and Stella Duffy, marked the moment I realised I’d been lured to the darker side.

I’ve always been fascinated by the human psyche and the influences (both personal and societal) that impact a person’s behaviour. Each of my novels to date has explored, to a greater or lesser extent, these themes. However, story, more than any genre, has always led the way.

Then in 2017 I found myself unwittingly on a new writing trajectory, genre very much at the forefront of my mind. My novel, The Last Time We Spoke, had won the Ngaio Marsh Award for Best Crime Novel. I was of course delighted, but somewhat perplexed. I’d conceived of it more as a social justice novel . . . I was not a crime writer, was I?

An invitation to attend Bloody Scotland followed, and it was there, over three inspiring days at the crime-writing festival based in Stirling’s historic Old Town, that I discovered the incredible breadth of writing that falls under the banner of crime fiction, from your cosy murder mysteries and police procedurals, all the way through to more literary explorations of crime.

I came back to New Zealand buoyed by the warmth with which the crime-writing community had embraced me and determined to try my hand at a traditional crime novel.  My subconscious was put on alert for a story that would fit the format, and it wasn’t long before I was at my desk writing In Sickness and In Health.

In Sickness and In Health (titled The Doctor’s Wife in New Zealand) is a psychological thriller which sees the gradual and ultimately violent disintegration of a longstanding friendship between four close friends.

Both a whodunit and a whydunit, it affords some insight into the frighteningly deteriorating mind of someone with brain tumours, and the ensuing fallout that occurs within a family.

The story is told from various characters’ perspectives, some of whom are lying, some of whom are lying to themselves. The reader, alongside an unassuming detective duo, Ramesh Bandara and Hilary Stark, are tasked with working out who, if anyone, is telling the truth.

Two of these characters view and engage with the world quite differently from others – Carmen, who has a brain tumour, and Eliot, who is neurodiverse. Their atypical perspectives hopefully add a further element of tension to the narrative.

I deliberately populated the book with unsettlingly ordinary individuals who one might meet on any given day – a journalist, pottery teacher, a doctor, his philanthropic wife – to give the reader a sense of ‘there but for the grace of God go I’. No one is immune from cancer, nor from being the victim of a violent crime.

The book taps into a very personal fear I have of one day losing my mind. Because I have a poor memory, I’m somewhat preoccupied by what constitutes ‘the self’, and how a disease process might alter the very essence of an individual. Someone might lose a limb or have their gallbladder removed, yet essentially remain the same person. However, a disease of the brain might present with no external physical changes, all the while wreaking havoc within.

In Sickness and In Health is the first of my novels to draw overtly on my medical knowledge. I found it very satisfying to finally ‘marry’ my two seemingly disparate professions – namely medicine and writing. Having worked as a family doctor before hanging up my stethoscope to become a fulltime writer, I was familiar with the world my characters would navigate – a refreshing change in terms of the volume of research required. However, I still needed to source some specialist medical, police, and legal knowledge.

In Sickness and In Health draws more on an understanding of human nature my time in medicine afforded me, than any specific experiences. People are often at their most honest when they are sick, illness having stripped away all artifice. As a doctor, it was always a humbling experience, and an absolute privilege, to be invited to journey alongside someone at such a challenging time.

Threading through In Sickness and In Health is a simmering class tension, which speaks to the central role money plays in our society – a recurring theme in all my novels. I’m interested in the power and status money wields, the opportunities it affords or denies, the characters it shapes, the emotions it elicits. In this book the financial disparities between characters are perhaps more nuanced than in other settings, but they never-the-less still exist and go some way to influencing various characters’ behaviour.

Penning my first whodunnit demanded a change in my writing process. I am not usually a planner and often write my way into a story, with just a rough sense of the narrative arc. In Sickness and In Health was different. To ensure all the plotlines and clues added up, I had to do a significant amount of planning before I sat down to write. It was a bit like beginning with a completed puzzle, dismantling it piece by piece while taking note of where each piece belonged, then setting about rebuilding it. Very much reverse engineering! I really enjoyed the process and the challenge of creating a mind game for readers to solve.

Despite my best intentions however, some of my characters took the novel in unexpected directions, something that not infrequently happens when characters start to fill their skin. This meant revising my grand plan on more than one occasion and giving the hard word to some of my more headstrong characters.

And on the subject of headstrong characters, Detective Ramesh Bandara and Hilary Stark have decided that there are more crimes in New Zealand that need solving, and they are currently out in the field doing just that.

(c) Fiona Sussman

About In Sickness and in Health by Fiona Sussman:

In Sickness and in Health by Fiona Sussman

Nothing in Stan Andino’s unremarkable life could prepare him for the day he discovers his wife naked, except for a black apron, bleaching out a stain from the carpet that only she can see. A CT scan one week later explains the seemingly inexplicable; Carmen Andino has a brain tumour.

As Stan and their teenage sons grapple with the diagnosis and frightening personality changes in their wife and mother, Austin Lamb, a close friend and local doctor, does everything possible to assist the family in crisis.

Months later, Austin’s wife’s body is discovered at the bottom of Browns Bay cliffs by Eliot Bard.

But who is lying, and who is telling the truth?

Order your copy online here.

About the author

Former GP Fiona Sussman was born in South Africa and now lives in New Zealand. Her short story A Breath, A Bunk, A Land, A Sky was shortlisted for the 2020 Commonwealth Writers’ Prize. Her debut novel Shifting Colours was published by Allison & Busby in the UK and by Berkley in the US under the title, Another Woman’s Daughter. Her second novel, The Last Time We Spoke (Allison & Busby) was translated into Polish and won the Ngaio Marsh Award for Best Crime Novel in New Zealand. Addressed to Greta (Bateman Books 2020) won the NZ Booklovers Award for Best Fiction. Her new novel, In Sickness and In Health, is a finalist for the Ngaio Marsh Award for Best Crime Novel.

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