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Originally published Monday, March 10, 2014 at 5:16 AM

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Q&A: Author and anesthesiologist Carol Cassella

A Q&A with Bainbridge Island author Carol Cassella (“Oxygen,” “Healer,” “Gemini”), who is also a practicing anesthesiologist and a parent of two sets of twins.

Seattle Times book editor

Author appearance

Carol Cassella

The author of “Gemini” will appear at these area locations:

•At 7 p.m. Monday, March 17, at Seattle’s Elliott Bay Book Co. (206-624-6600 or Music, provided by “The Rejections,” begins at 6:30 p.m.

•At 6:30 p.m. Wednesday, March 19, at Liberty Bay Books in Poulsbo (

•She will sign books at noon March 22 at Costco’s Aurora Village location (,

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Lit Life

Here’s the question that invariably pops up when people meet Bainbridge Island author/physician Carol Cassella: How do you manage your life? Cassella is a practicing anesthesiologist. She’s the mother of two (yes, two) sets of twins. And she’s published three critically praised novels — “Oxygen,” “Healer” and now “Gemini” (Simon & Schuster, 341 pp., $25.99), the story of an ICU physician impelled to unearth the story behind a comatose “Jane Doe” in her care.

In California last week on a book tour, Cassella, 57, answered questions about combining writing, medicine and family life.

Q: I think of writing as a right-brain (creative) pursuit, and medicine as a left-brain (logical) occupation. True or false? Are there things about practicing medicine that mirror the writing process?

A: I think that (right-brain left-brain) premise helps us think about the brain in some way that is logical, but the brain crosstalks. The two sides work together all the time.

Medicine is not really science — you’re translating science. To apply it to each individual, you have to pull out their story ... You meet people from all walks of life. That was particularly true when I was an internist (Cassella is certified both as an internist and an anesthesiologist).

Q: You said in a previous interview that you were an English major and came late to writing. Why? What finally prompted you to write, and to keep writing?

A: It was probably my own fear and lack of confidence ... I guess I’m a person that needs a little more of a railroad track. I went to work for a publisher (after college) but in truth I didn’t have the discipline; I didn’t have the courage to dive off that cliff.

I started writing in earnest when my kids were really little. We have these two sets of twins, the second set was not planned, loved but not planned. I needed a job but I decided, I love to write, and the Internet was coming on ... I was writing for a number of startups in the health area. Then I got connected to the Gates Foundation and I started writing for their global health publications. I had to meet deadlines, turn things in.

Then Field’s End (The Bainbridge Island creative writing institute) started, and that really got me going.

Q: OK: How do you manage to write when you’re a practicing anesthesiologist with two sets of twins?

A: I work two days a week in the operating room. My children are older ... I write very slowly, so I work a lot on evenings and weekends. I don’t do as many things as I would like, see friends as much as I’d like. When the kids were little, before smartphones, I would go to the swimming lessons and sit in the bleachers, I would have my laptop and just write.

Q: Reading “Gemini,” I noted that the stark difference between medical care in rural and urban areas is a theme, as it was in “Healer.”

A: It’s not only rural versus urban, but it’s within different tiers of society. If you’re sick and you get admitted to one of the great hospitals, your care will be good regardless of what tier you’re in. But primary care is a different story.

Q: “Gemini” is about an ICU physician who cares for an unconscious “Jane Doe.” Have you been involved in similar cases like Raney’s, a patient who is in a coma, not likely to live but who is still alive thanks to medical technology?

A: I have had that experience, on a couple of levels. Not now, but certainly in training. You would get people airlifted into Harborview with these terrible injuries.

We have advanced to the point where our medical and technical capacity has in some ways exceeded our ethical competence. I think we haven’t caught up. What do we do with this power? Intensive care units only developed in the 1960s; before that, these patients died. Are we benefiting these people by keeping them alive? These are huge things that society has to come to terms with.

It’s very difficult (to care for a comatose person). We were meant to move. If you don’t move constantly you get pressure sores ... there are all sorts of problems that occur if you’re bedridden. Hospital-acquired infections. Every treatment has a downside.

Q: Next book?

A: It’s set in the world of global health ... There’s such a lot going on in the world of global health. The world is discovering that you can go in and fix one problem, but you sometimes leave in your wake a problem that is even bigger. The consequences are worse than what you’ve improved.

Mary Ann Gwinn: 206-464-2357 or Gwinn appears every Tuesday on TVW’s “Well Read,” discussing books with host Terry Tazioli (go to for archived episodes). On Twitter @gwinnma.

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