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Jon Franklin’s “Mrs. Kelly’s Monster,” which in 1979 won the inaugural Pulitzer Prize for feature writing, ran 33 years ago but never loses its power to captivate or instruct. Franklin followed a brain surgeon through a tense operation on a woman named Edna Kelly and wrote a tight, timeless narrative that stands as a model of precision reporting and evocative writing.
Whenever I teach this story, students argue about how Franklin reported it: where he was during the surgery, for instance, and how he went about the writing. The speculation was fun but eventually I asked* Franklin to settle the mystery. During our nearly two hours on the phone, he gave the following great answers and graciously agreed to let me reprint the 91-point annotation that he distributed to his students many years ago.
First, a fairly long conversation (contains spoilers!), and then the hybridized annotation.
So, were you in the operating room during the surgery or some sort of viewing gallery? My classes always argue about this – some think you were in the room, others don’t.
Jon Franklin: I was in the O.R. They show viewing galleries on television, but they don’t really have viewing galleries anymore.
How did you know that this was the surgery you wanted to write about? And how many brain surgeries had you observed before this one?
I had done a book earlier on shock trauma, about the first civilian trauma unit in the country. I spent a lot of time there and could walk into an O.R. and know what to touch, what not to touch, and be able to converse with people. So I was very familiar with that stuff. (For Mrs. Kelly’s surgery) I could see what was happening and I thought I had a hell of a story. And then (Dr. Ducker) failed. And I thought, “Well shit, I lost my story.” It wasn’t until four or five hours passed that I thought, “Well, wait a minute, it’s a better story because she died.”
Why?
Because it wasn’t expected.
Yes.
The story is a classic of white knight and maiden, and in this case the white knight failed. But the final thing is, he had to get up after that and go in and work on somebody else.
Some readers expect her to live because they assume the newspaper wouldn’t have run a story about a failed brain surgery. You knew this was an interesting surgery because of the double aneurysm and the tumor, but you couldn’t have known this would happen.
There’s a certain amount of chance to this. Sometimes what you get is wonderful and sometimes it’s not so wonderful. I had told Ducker that I’d like to see him do several (surgeries), and that I wanted to be there for the ones that he didn’t really know how they would turn out. He agreed. Which he regrets to this day, I think.
Really?
Well, the thing people will most remember about him is his failure. I mean we’re friends, but he said to me once, “You know, Jon, people don’t want Not Quite a Miracle – they want a miracle.” As a matter of fact I’m putting that book back into circulation on Kindle and I’m gonna rename it Something Attached to the Soul. The title comes from a quote out of the book; it’s kind of an old bromide among brain surgeons that you don’t want to pull too much on something because it might be something attached to the soul.
You’re putting your books out on Kindle? So you’re into the digital progression?
I’m fundamentally an optimist. The model that’s going to work is going to be Kindle. They give the writer a big cut and they’re gonna be giving them an even bigger cut, so the writer won’t have to sell a million copies in order to make a living. It’s a game changer. Kindle allows you to go directly to your reader. Now, I don’t hate editors – I’ve had one or two that have done me good – I’m just sad that I haven’t had more good ones.
Which of your books are out on Kindle?
Wolf in the Parlor.
And you’re converting the others?
Yeah. A friend of my wife is doing this. Molecules is all but ready to go. Writing for Story is also gonna be on there. At the time I sold it, 30 years ago, nobody was doing (digital) but I kept the electronic rights.
That book’s always been a seller, hasn’t it?
It sells 400 to 500 copies a quarter, though last quarter I think I got a check for a dollar and 74 cents. Maybe the thing is finally gonna die. The only way I got it published was, the publisher really wanted Molecules. I said, “I’ll sell you Molecules but you gotta publish this other one too.”
Had you written Writing for Story on spec?
Yeah, it was my syllabus.
So do you actually own a Kindle?
I bought one about three months ago. That is the future. I love it.
Why?
What’s wonderful about it is that it’s very light. I like to read in bed. My arms get tired, and a year and a half ago I got in an accident and tore off my thumb. Holding a heavy book – I start to get sore very quickly.
You tore off your thumb?
It was a freak thing. I jumped out of a car – my wife was driving – to look at a bus schedule and … I didn’t know there was a curb there. I tripped over the curb and was going to hit a concrete post with my head. I went through a lot of contortions and managed not to hit that thing with my head, but instead my right hand – I’m right-handed – got under me somehow. As I slid along the concrete the thumb got pushed back and pulled off. It starts to hurt after I type a long time.
Hang on, I’m stuck on your thumb – you really tore it off?
It was actually kind of neat. I could see inside my hand. Those pictures you see, of the ropes and pulleys down inside the human hand? It really is like that.
Gross! There’s a line in “Mrs. Kelly’s Monster” that kind of makes me sick every time I read it.
Which one is it?
“Dead ahead the field is crossed by many huge, distended, ropelike veins.”
It’s usually the blood dripping on the floor that gets people.
What happened to the thumb?
They sewed it back on. It was just dangling there. I put it back where it belonged and put pressure on it, to stop the bleeding.
Your wife must’ve been freaking out.
It helped that I wasn’t. By the time the ambulance got there and offered me morphine I said, “I don’t need it, I’m still in shock.” A few minutes later I changed my mind.
So back to the reporting. Did you review videotape of the surgery afterward or do all your reporting in the moment, in the O.R.?
All of it ended up in my notebook that day. I don’t even think I had to call (Ducker) back and ask him anything. When I finished the final draft I realized my heart was beating real fast. I was very innocent of that kind of power. John Steinbeck once said, “I’ve held fire in my hands.” I always thought that was sort of pure – I mean, you know, writer bullshit. But it wasn’t.
How do you mean?
That story scared me so much. It was either so good or so bad, and I couldn’t tell which. I called Ducker and read him everything, every word. I’d never done that before and I haven’t done it since. I’ll never forget it: I’m done and there’s this long silence and he says, “Well Jon, that’s pretty much the way it was.”
How long did the writing take?
The answer is either four days or 20 years. Because what you do is, you use everything you know. That’s one of the reasons why there are very few good young writers. Unlike with poetry, which favors young artists, or science, which favors younger people, writing is just the opposite. I was 35 before I could do that. And writing is something you’ll never get too old to do. You could certainly get too senile.
But literally four days then?
Three days maybe, not counting the day in surgery and the time with Mrs. Kelly and her husband.
Did you start writing that night?
I don’t remember whether I started writing that night or thinking it through. I used to do things quite a bit differently than I do now, because now I can be more efficient. I try not to put anything on paper until I’ve crystalized the story. But in that case, the story – I mean it was just there, you know? Somebody, I forget who, recorded people’s heartbeats as they read various things, and they said (readers’) heartbeats matched the story as they read Mrs. Kelly. You can do that in music too, control heartbeats.
Why do you think the story scared you so much?
I’m trying to think how to phrase this answer. When you’re really doing it, when you’re what I like to call in contact, which means you’re living in the story just like the reader’s going to, it’s very frightening. Because it takes an awful lot of chutzpah. I’m as insecure as everybody else. And the paper had never run anything like this before. And they didn’t actually want to run this but they knew damn good and well they had to.
What do you mean?
Well, they buried it. It was on the bottom of the feature page.
No way.
They also – because there had been an edict about no long stories, they insisted on cutting it in half and running one part on one day and the second part on the other day. I was resisting all this, but it was their paper, not mine.
I’ve never heard that it ran as a two-parter.
I cut it for them and gave them the lede for the second part. And then the editor came back and said, “Jon, you’re not gonna like this but since we don’t find out what happens till the second day, we can’t do that to the reader; we have to tell them on the first day that she dies.”
Oh my God.
So I hit the roof. At that point, out of desperation, I think, I got one of my finest moments of insight and said, Okay, what we’ll do is I’ll write a precede saying she dies. I’m a writer, which means that by definition I’m a sneaky sonofabitch. I know how to make rhythms and I also know how to break them. I wrote that precede so that the mind simply could not absorb it.
Couldn’t absorb the fact that she died?
Yes.
Do you have that copy? I’d love to see that.
A lot of people have wanted to see that. You can probably find it at the Pratt Library. It’s one of the best pieces of writing I ever did. I used totally unemotional words – it was flat. And the interesting thing was that I could get away with it, because the editor – and this illustrates what’s wrong with journalism – to the editor this was fine.
And what happened?
The thing was published on the first day and that night the switchboard was totally jammed with “What happened to Mrs. Kelly?”
How many story drafts did you do?
I wrote this on a computer. When you write on a computer, you write something that I call a road map, which is a sequence of events, how you’re gonna tell the story. Then you go back and expand that. Then you go back and polish it. In theory you can do it in those three steps. I damn near did that with Mrs. Kelly. But Mrs. Kelly was a special story, for me. I do experiments with stories, or I did when I was on the paper: Will this work, will that work? I did it very quickly. I don’t usually do things that quickly. I mean the current book took me almost 20 years, but that was for a lot of other reasons, and there were a couple of other books in there that were stillborn. I’m slow.
And nobody likes it when we’re slow.
This kind of work is slow. I’ve never been able to support myself solely with my writing. As a personality, I’m an inventor. I try to invent things when I’m writing – forms and things like that. I can’t help myself, but it’s not a good thing, because I can’t do production. I got out of the newspaper business right at my peak because it became very clear to me that I could spend the rest of my life writing Mrs. Kelly’s Monsters. That, in fact, was what they wanted me to do. And I mean I like to write stories like that now and then. If I could’ve been happy just doing what I knew how to do, then my life would’ve been a lot different. But then I’d have had to have been in newspapers for the last 25 years, while they were going down the tubes.
It’s hard to have an entrepreneurial mind and follow formats.
I can’t write when I’m bored. I cannot do it.
Mrs. Kelly is 3,539 words long, but it reads short.
What makes it read fast like that – of course you’ve got pacing on your side, although the pacing was not an obvious thing. The idea is to say things just before they pop into the reader’s mind. You get your reader going 100 miles an hour, and how fast it reads is what governs, not how long. For a while when I was teaching, I got a beautiful film off YouTube – it was some sort of a contest about how many dominos can you line up and knock over. He’s on a pool table and three or four other pool tables, and they’re all full of dominos. We used to watch them all get knocked over, and there’s ways he gets them from one table to another – it’s a very harmonic kind of thing. That’s the way things have to read. And also, setting up the dominos is a very tedious task– it’s very nit-picking and you don’t go fast and it’s not capital-S fun. Knocking them over is fun. Now what the writer does is, he sets them up. And almost everyone who wants to be a writer, including myself, wanted to be a writer because they were a reader and they thought, Oh wow that’ll be fun. And it is fun in some ways, but it’s not like reading at all. You’re writing a program that will play in the reader’s brain.
What do most students and writers want to know about this story?
What they’re basically interested in is how to do it. Often we’ll get into: Hey, I didn’t have to be there, I reconstructed things that worked just as well. Tom Wolfe convinced me you could do that.
What was reconstructed? For instance, you have an early morning scene where Ducker’s wife hands him his lunch. Were you there for that?
That’s the one thing that I didn’t see.
Well, that and Mr. Kelly telling his wife goodbye.
Yes. I confirmed that with the family later, and probably with Ducker.
So about the breakfast, you asked him – or his wife – what he ate?
I wanted to end the piece with the food, the universal. So I called his wife and asked her what she fixed him, which is when I learned about the coffee thing. So then I had the magic bookends, which are always wonderful when you can get them. She told me later that she always fixed him a nice lunch and why did I have to watch him on the only day when she was in a big hurry and fixed him a peanut butter sandwich.
So you put everything down, you were saying.
I put everything down. I put down the times because when you’re doing a drama it’s this happened and the next thing happened. I didn’t expect to use the time (element) the way I did. There’s another story that I did, called “A Death in the Family,” which is another story that I had no idea what I had until I was on my way home. You go in and you just observe. You teach yourself – see, I think you can teach vision. I have yet to find anybody who will agree with me on this, and I don’t know that I’ve ever actually taught anybody this, but there are techniques for getting outside of yourself and turning yourself into a kind of recorder. [ed note: Here we got into a conversation about Freud and brain development.]
About that time I got interested in going to shrinks. I started going to a Freudian shrink. I was thinking, The brain’s a tool and I want to know how to use it better. As a matter of fact I think the second Pulitzer came as a direct result of seeing the shrink.
How so?
It helped me recognize how my mind worked and what part of my mind was mine and what part was universal. Jung was right – at some level our brains are all alike and at some level they’re all different. The part that’s interesting is how they’re all alike. That tells you what story is.
How do you mean?
Story is what you feel. Story is emotional. It’s not your eyes you see with; it’s your mind.
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“Mrs. Kelly’s Monster”
by Jon Franklin
Baltimore Evening Sun
December 1978
My questions are in blue.
Franklin’s responses are in red.
The green bits are Franklin’s annotation, reprinted with his permission.
In the cold hours of a winter You must set the mood early in the story. Dr. Ducker also rose to a warm house and a bright future, but those facts are not relevant to the story being told. morning Dr. Thomas Barbee Ducker, chief brain surgeon at the University of Maryland Hospital, rises It is no accident that the first verb in this story is an action verb. The use of present tense tends to make the story more immediate, but it increases the pressure on the writer, who must supply an endless stream of detail to make the immediate nature of the story seem real. Because of the increased technical problems with present tense, the technique must never be used lightly. Also, present tense is usually unsuitable for long pieces. before dawn. This provides sense of time. Sense of place is implied here: It’s in Dr. Ducker’s house, in Baltimore. His wife serves him waffles Be specific with symbolism. Also note how the food imagery here dovetails with the food imagery in the ending. Food is a life process. In the morning the food is warm, and served lovingly. In the end, the food is dry, cold and packed in an anonymous paper bag. but no coffee. Coffee makes his hands shake. Straight news technique requires the writer to sum up the story in the first paragraph. Feature style often requires that it be implied. The implication here is that it is very important that Dr. Ducker’s hands don’t shake.
In downtown Baltimore, Place transition on the 12th floor Be specific…but only when it doesn’t interfere with the story you’re telling. You need a good literary reason for the inclusion of each fact. In this case, it was rhythm of University Hospital, Edna Kelly’s husband tells her goodbye. This implies danger, building on the implications of the “shaking hands” line above For 57 years Mrs. Kelly shared her skull Note the perception that Mrs. Kelly is her brain. Such a unity, once established, must be carried out throughout the piece with the monster: This perception was Mrs. Kelly’s, not the author’s nor the surgeon’s. Your subject will do much of your head work for you, if you’ll be observant No more. Today she is frightened but determined. It is 6:30 a.m. Pacing. Pacing must begin before the need for it becomes apparent. This story picks up a definite beat later. It begins here, with the stipulation of an exact time. To make it an odd number, such as 6:32, would have been enameling the lily, and would have lost the effect when the story shifts to specific time later, as the pace increases
“I’m not afraid to die,” she said Flashback to material gleaned in an early interview as this day approached. This sentence marks the transition from the opening, or lead, into the complication “I’ve lost part of my eyesight. I’ve gone through all the hemorrhages. A couple of years ago I lost my sense of smell, my taste. I started having seizures. I smell a strange odor and then I start strangling. It started affecting my legs, and I’m partially paralyzed. How much time did you spend with Mrs. Kelly before the surgery? I like that you don’t quote her on the day of the surgery. The idea was not to capture her words. As time went on in the story I used fewer and fewer quotes. There’s nothing magic about quotes. Dialogue is a whole different matter. I spent maybe 40 minutes with them Ever? Uh huh. I used a tape recorder on that. I didn’t take a tape recorder into the O.R. Why? Well, I’d had some bad experiences with them. I use them today. They’re a lot more reliable than they used to be. Sounds like you’ve got some horror stories. Yeah I’ve got one that’ll make you cry.
“Three years ago a doctor told me all I had to look forward to was blindness, paralysis and a remote chance of death. Now I have aneurysms; this monster is causing that. I’m scared And we’re back to present tense to death … but there isn’t a day that goes by that I’m not in pain, and I’m tired of it. I can’t bear the pain. I wouldn’t want to live like this much longer.” The reader must clearly understand the motivations of your characters. In this case, Mrs. Kelly has decided to go for broke because the disease had made her life not worth living
As Dr. Ducker leaves for work, Mrs. Ducker hands him a paper bag containing a peanut butter sandwich, a banana and two fig newtons. Foreshadowing is the magic of the dramatic feature writer. In this part of the story, the lunch helps get Dr. Ducker out of the house and shifts the reader’s attention toward his work. (The information does double duty, another hallmark of good dramatic writing.)
Downtown, in Mrs. Kelly’s brain, a sedative takes effect.
Mrs. Kelly was Flashbacks provide supportive, background and character information born with a tangled knot of abnormal blood vessels in the back of her brain. The malformation began small, but in time the vessels ballooned inside the confines of the skull, crowding the healthy brain tissue. This story becomes a portrait of the tumor and the surgeon; how much did you intend to anthropomorphize the growth? Anthropomorphizing things—we do it. It’s a human trait. It’s not necessarily a super idea, but we believe in agencies. If there’s a lightning bolt, somebody must have thrown it, which is where you get Thor. When a tree falls, the tree god knocked it down. It’s very deep in our mind. I don’t think you can really write without some of that, but when you get into a life-and-death situation—I mean I’ve been in an operating room and heard people say things like, “I can’t get to this sonofabitch.” You know? Or, “Look at this bastard.” The fact is, we take life personally. You might as well not deny it. And when you deny it, I think we get a skewed picture of what the world was like. And in that respect journalism is guilty as charged—the definition of news is what happens in front of the reporter. Some people have a hard time embracing narrative. Man, it’s a high-tension business. Everybody stands around and they don’t look like they’re fighting tigers, but they’re fighting tigers. You’re constantly having to make decisions based on too little information and understanding, and when you have to do that you have to come up with rules of thumb. And since you depend on these rules of thumb to survive, over the years they metamorphose into the stations of the cross. And that’s why newspapers are gonna die, even without the Internet.
Finally, in 1942, the malformation announced its presence This personifies the malformation. Personification of objects is a tricky, tricky business and should be done only with the greatest care—and only with the principal forces in the story. It would not do, for instance, to personify the peanut-butter sandwich when one of the abnormal arteries, stretched beyond capacity, burst. Mrs. Kelly grabbed her head and collapsed. The story does not say how Mrs. Kelly felt. Rather it implies and shows it. Action (grabbing one’s head and falling) tells much more than attempts to describe her feelings. The first rule of feature writing is ‘Show, don’t tell.’ After that the agony never stopped.
Mrs. Kelly, at the time of her first intracranial bleed, was carrying her second child. Despite the pain, she raised her children and cared for her husband. She is never said, specifically, to be courageous. Rather, by her actions, she is shown to be The malformation continued to grow.
She began Today I would hesitate to use “began.” I would say, instead, “She called it ‘the monster.’ Words like begin, began, commenced and started are usually unnecessary and tend to give the sentence in which they reside a distant and passive cast calling it “the monster.”
Now, at 7:15 Fifteen minutes past the hour is more specific than thirty minutes past. A minor point, but the tempo is building a.m. in operating room eleven, a technician checks the brain surgery microscope and the circulating nurse lays out bandages and instruments. Always use action. If you want to tell the reader that the operating room is ready, then show the crew getting it ready Mrs. Kelly lies still on a stainless steel table.
A small sensor has been threaded through her veins and now hangs in the antechamber of her heart. The anesthesiologist connects the sensor to a 7-foot-high bank of electronic instruments. Oscilloscope waveforms begin This word is unnecessary to build and break. Dials swing. Lights flash. With each heartbeat a loudspeaker produces an audible popping sound. The steady pop, pop, popping The value of sound as a pacing and descriptive device is widely overlooked. Clocks tick. Babies cry in the background. Pencils tap restively on tables. Rain clatters on a tin roof. Notice these things, and use them isn’t loud, but it dominates the operating room.
Dr. Ducker enters the O.R. and pauses before the X-ray films that hang on a lighted panel. He carried those brain images to Europe, Canada and Florida in search of advice, and he knows them by heart. This serves to emphasize the danger/jf Still, he studies them again, eyes focused By using the eyes, what’s going on in the brain can be illustrated on the two fragile aneurysms that swell above the major arteries. Either may burst on contact.
The one directly behind Mrs. Kelly’s eyes is the most likely to burst, but also the easiest to reach. If you’re taking your reader into unfamiliar territory, it’s necessary to step back periodically and tell the reader, in brief and nontechnical terms, what’s going on. Otherwise, certain readers will become disoriented and quit reading That’s first.
The surgeon-in-training who will assist Dr. Ducker places Mrs. Kelly’s head in a clamp and shaves her hair. Dr. Ducker checks to make certain the three steel pins of the vice have pierced the skin and press directly against Mrs. Kelly’s skull. “We can’t have a millimeter The word “millimeter” is rather unfamiliar to the reader. It is necessary to run it through the reader’s mind once, in a relatively slow-paced situation, so that it will seem more familiar later when it’s used under more dramatic tension. The rule is never to use an unfamiliar word for the first time in a fast-paced part of your story, because it’ll slow the narrative down. (It is, incidentally, not relevant here exactly how large a millimeter is. It is sufficient that the reader know it’s small.) slip,” he says.
Mrs. Kelly, except for a six-inch crescent of scalp, is draped Here, you’ll note, she’s draped. Later, the image is “shrouded.” with green sheets. A rubber-gloved palm goes out and Doris Schwabland, the scrub nurse, lays a scalpel in it. Hemostats snap over the arteries of the scalp. Blood spatters onto Dr. Ducker’s sterile paper booties. Gore, like sex, is sometimes more effective when it occurs off camera
It is 8:25 a.m. The heartbeat goes pop, pop, pop, 70 beats a minute, steady.
Today Dr. Ducker intends to remove the two aneurysms, which comprise the most immediate threat to Mrs. Kelly’s life. Later, he will move directly on the monster. This is another orientation paragraph. Note that it is used also as a pacing device, to keep the action from getting too fast here. We want the action to build
It’s a risky operation, designed to take him to the hazardous frontiers of neurosurgery. Several experts told him he shouldn’t do it at all, that he should let Mrs. Kelly die. But the consensus was that he had no choice. The choice was Mrs. Kelly’s.
“There’s one chance out of three that we’ll end up with a hell of a mess or a dead patient,” Dr. Ducker says. Says to whom? The reporter, of course. But imagine how awful it’d sound to say, “said to this reporter.” Keep yourself out of the copy and let your subject talk directly through you to the reader. Remember, as a feature writer who puts himself into the action, you are a surrogate for your reader, and your existence on the scene is totally unimportant “I reviewed it in my own heart and with other people, and I thought about the patient. You weigh what happens if you do it against what happens if you don’t do it. I convinced myself it should be done.”
Mrs. Kelly said yes. Now Dr. Ducker pulls back Mrs. Kelly’s scalp to reveal the dull ivory of living bone. The chatter of the half-inch drill fills the room, drowning the rhythmic pop, pop, pop Pacing devices must be heavily foreshadowed. The pops are going to be critical later, so they have to be firmly embedded in the front of the story of the heart monitor. It is 9 o’clock when Dr. Ducker hands the two-by-four-inch triangle of skull to the scrub nurse.
The tough, rubbery covering of the brain is cut free, revealing the soft gray convolutions of the forebrain.
“There it is,” says the circulating nurse in a hushed voice. “That’s what keeps you working.” Greek choruses are very useful. Watch for the opportunity to use them
It is 9:20. The times are getting more specific
Eventually Dr. Ducker steps back, holding his gloved hands high to avoid contamination. While others move the microscope into place over the glistening brain the neurosurgeon communes The difference between the right word and the almost-right word, Mark Twain said, is the difference between lightning and the lightning bug once more with the X-ray films. The heart beats strong, 70 beats a minute, 70 beats a minute. Repetition can add dramatic tension and emphasize building tensions in the story. Most professional writers understand that events and ideas must be foreshadowed, but few apply the principle to gimmicks, like repetition, as well “We’re going to have a hard time today,” the surgeon says to the X-rays. Actually, of course, he doesn’t expect the x-rays to hear him. The words are directed to the occupants of the operating room—or to the readers, in the persona of a reporter, who is standing beside him. Here is another example of physical action (his voice is aimed at the x-rays) being used to keep the story concrete while implying moods and tensions
Dr. Ducker presses his face against the microscope. His hands go out for an electrified, tweezer-like instrument. The assistant moves in close, taking his position above the secondary eyepieces. This is the pause before the battle. A romantic novel uses the same technique when the writer describes the knights settling into their stirrups just before the heroic charge. Some things never change
Dr. Ducker’s view is shared by a video camera. Across the room a color television crackles, Sounds, like smells, are extremely effective in putting the reader into your story. The senses of hearing and smell are ancient, and are most closely connected to the emotional brain than is the sense of sight. That’s a good anatomical fact for a professional writer to know displaying a highly magnified landscape This is the hardest-won word in the piece. I wanted something that implied a bigness. The word “landscape” is commonly applied to continents and planets, and so carries an aura of great spaces. Few people realize how big a drop of water becomes under a microscope, and how the viewer can actually get lost and disoriented in it. Getting disoriented and lost is one of the most important dangers in neurosurgery of the brain. The polished tips of the tweezers move into view.
It is Dr. Ducker’s intent Anytime you start talking about something that happens in the subject’s head, you almost automatically slow the narrative and move into background discussion. So, when you do that, make sure you’re doing it at a place you can afford to slow down. Also, this does double duty as another orientation paragraph to place tiny, spring-loaded alligator clips across the base of each aneurysm. But first he must navigate “Navigate” is something you do over a landscape or seascape. See the footnote on landscape, above a tortured path from his incision, above Mrs. Kelly’s right eye, to the deeply buried Circle of Willis.
The journey will be immense. Under magnification, the landscape of the mind Now, the perception of “landscape” fully established, we can make the story’s most important metaphysical leap, from the brain to the mind. When I wrote this piece I was beginning an unusually technical series on the brain, focusing on the brain-mind connection. I decided to do this story as the lead piece because I thought it would embed that point firmly in the reader’s brain/mind/jf expands to the size of a room. Dr. Ducker’s tiny, blunt-tipped instrument As the instrument and its movement become the focus of the reader’s attention, it becomes a surrogate for Dr. Ducker. Thus the instruments get a very specific personification travels in millimeter leaps.
His strategy is to push between the forebrain, where conscious thought occurs, and the thumb-like projection of the brain, called the temporal lobe, that extends beneath the temples. More orientation. Note the regularity of orientation paragraphs, and how they fall off as the pace picks up
Carefully, Dr. Ducker pulls these two structures apart to form a deep channel. The journey begins at the bottom of this crevasse. This paragraph should have read, “…Dr. Ducker pulls these two structures apart to form a deep crevasse. [annotation-group][annotate color="green"]The journey begins at the bottom. The time is 9:36 a.m.” [annotation-group][annotate color="green"]Some heat-of-the-moment awkwardness is, sigh, unavoidable in the newspaper feature writing business The time is 9:36 a.m.
The grey convolutions of the brain, wet with secretions, sparkle beneath the powerful operating theater spotlights. The microscopic landscape heaves and subsides in time to the pop, pop, pop of the heart monitor.
Gently, gently, the blunt probe teases apart the minute structures of gray matter, spreading a tiny tunnel, millimeter Never use an awkward word for the first time in a poetic passage. It takes the reader’s brain longer to process it the first time, and that will throw off the rhythm you’re trying so hard to establish. Foreshadow! by gentle millimeter, into the glistening gray. Count the number of “m” sounds in this paragraph. Then count the number of “g” sounds. That is a very, very tricky gimmick and can be used only with care. Very much of it, and an otherwise elegant piece turns saccharine
We’re having trouble just getting in,” Dr. Ducker tells the operating room team. Here, action is used to foreshadow
As the neurosurgeon works, he refers to Mrs. Kelly’s monster as “the A.V.M.,” or arterio-venous malformation. Shift here to background Normally, he says, This attribution is unnecessary and slows down the flow arteries force high-pressure blood into muscle or organ tissue. After the living cells suck out the oxygen and nourishment the blood drains into low-pressure veins, which carry it back to the heart and lungs.
But in the back of Mrs. Kelly’s brain one set of arteries pumps directly into veins, bypassing the tissue. The unnatural junction was not designed for such a rapid flow of blood and in 57 years it slowly swelled to the size of a fist. Periodically it leaked drops of blood and torrents of agony. Parallel construction tugs compellingly at the mind. It makes things seem related that aren’t, and makes for slick stream-of-consciousness transitions. The concepts “drops of blood” and “torrents of agony” come from separate universes, or do they? This piece was written specifically to make the reader ask that question/jf Now the structures of the brain are welded together by scar tissue and, to make his tunnel, Dr. Ducker must tease them apart again. [annotation-group][annotate color="green"]This statement brings us back to story action But the brain is delicate.
The screen of the television monitor fills with red.
Dr. Ducker responds quickly, snatching the broken end of the tiny artery with the tweezers. There is an electrical bzzzzzt A good feature writer learns to observe noises and, when possible, bring them to his reader. Sometimes this can be tricky. I’ve got an hour invested in “ka-Glup, ka-Glup, ka-Glup,” used to describe a heart-sounds amplifier in a recent book as he burns the bleeder closed. Progress stops while the blood is suctioned out.
“It’s nothing to worry about,” he says. “It’s not much, but when you’re looking at one square centimeter, two ounces is a damned lake.” Driving home the idea, again, that the microscope magnifies everything, including the problems
Carefully, gently, Dr. Ducker continues to make his way into the brain. Far down the tiny tunnel the white trunk of the optic nerve can be seen. It is 9:54.
Slowly, using the optic nerve as a guidepost, Dr. Ducker probes deeper and deeper into the gray. The heart monitor continues to pop, pop, pop, 70 beats a minute, 70 beats a minute.
The neurosurgeon guides the tweezers directly to the pulsing carotid artery, one of the three main blood channels into the brain. The carotid twists and dances Verbs are everything to the electronic pop, pop, popping. Gently, ever gently, nudging aside the scarred brain tissue, Dr. Ducker moves along the carotid toward the Circle of Willis, near the floor of the skull.
This loop of vessels is the staging area from which blood is distributed throughout the brain. Three major arteries feed it from below, one in the rear and the two carotids in the front.
The first aneurysm lies ahead, still buried in grey matter, where the carotid meets the Circle. The second aneurysm is deeper yet in the brain, where the hindmost artery rises along the spine and joins the circle.
Eyes pressed against the microscope, Dr. Ducker makes his tedious way along the carotid.
“She’s so scarred I can’t identify anything,” he complains through the mask.
It is 10:01 a.m. The heart monitor pop, pop, pops with reassuring regularity. This implies that irregularity is not reassuring, and foreshadows trouble ahead. When the heart slows, the reader will know instantly something is wrong. He won’t have to have an explanation, which would slow him down
The probing tweezers are gentle, firm, deliberate, probing, probing, probing, slower than the hands of the clock. Repeatedly, vessels bleed and Dr. Ducker cauterizes them. The blood loss is mounting, and now the anesthesiologist hangs a transfusion bag above Mrs. Kelly’s shrouded Note the switch from “covered” to “shrouded.” This kind of foreshadowing operates on the reader’s mind at a subconscious level. With such subliminal devices the reader never knows what hits him. But hit him it does form.
Ten minutes pass. Twenty. Blood flows, the tweezers buzz, the suction hose hisses. The tunnel is small, almost filled by the shank of the instrument.
The aneurysm finally appears at the end of the tunnel, throbbing, visibly thin, a lumpy, overstretched bag, the color of rich cream, When you’ve taken the reader to an alien and frightening place, it’s necessary to use as many familiar images as possible. But they have to be very apt. If it’s the almost-right word, you end up looking like an idiot swelling out from the once-strong arterial wall, a tire about to blow out, a balloon ready to burst, a time-bomb the size of a pea. Relate sizes to something the reader knows
The aneurysm isn’t the monster itself, only the work of the monster, which, growing malevolently, has disrupted the pressures and weakened arterial walls throughout the brain. But the monster itself, the X-rays say, lies far away. This should have been foreshadowed, first, very early in the piece. Another example of deadline-related awkwardness
The probe nudges the aneurysm, hesitantly, gently.
“Sometimes you touch one,” a nurse says, “and blooey, the wolf’s at the door.”
Patiently, Dr. Ducker separates the aneurysm from the surrounding brain tissue. The tension is electric.
No surgeon would dare go after the monster itself until this swelling killer is defused.
Now. A paragraph is, most of all, a unit of thought. If the thought is elegant, the paragraph is short
A nurse hands Dr. Ducker a long, delicate pair of pliers. A little stainless steel clip, its jaws open wide, is positioned on the pliers’ end. Presently the magnified clip moves into the field of view, light glinting from its polished surface.
It is 10:40.
For eleven minutes When you’ve got rapid action, keep writing down times in your notebook. Later, you can select what you need for pacing Dr. Ducker repeatedly attempts to work the clip over the neck of the balloon, but the device is too small. He calls for one with longer jaws. Soon that clip moves into the microscopic tunnel. With infinite slowness, Dr. Ducker maneuvers it over the neck of the aneurysm.
Then, in an instant, the jaws close and the balloon collapses.
“That’s clipped,” Dr. Ducker calls out. Smile wrinkles appear above his mask. Action can sometimes be heightened by hinting at it. The alternative would have been, “He smiled behind his mask.” That’s a more direct statement of fact, but has less dramatic impact. Both statements are accurate The heart monitor goes pop, pop, pop, steady. It is 10:58.
Dr. Ducker now begins following the Circle of Willis back into the brain, toward the second, and more difficult, aneurysm that swells Word choice can be used to bolster imagery. In this case, the word tends to remind the reader of the nature of the aneurysm at the very rear of the Circle, tight against the most sensitive and primitive structure in the head, the brainstem. The brainstem controls vital processes, including breathing and heartbeat.
The going becomes steadily more difficult and bloody. Millimeter, millimeter after treacherous millimeter the tweezers burrow a tunnel through Mrs. Kelly’s mind. Blood flows, the tweezers buzz, the suction slurps. Push and probe. Cauterize. Suction. Push and probe. More blood. Then the tweezers lie quiet.
“I don’t recognize anything,” the surgeon says. He pushes further and quickly finds a landmark.
Then, exhausted, Dr. Ducker disengages himself, backs away, sits down on a stool and stares straight ahead for a long moment. The brainstem is close, close. Again, repetition emphasizes. If you’re interested in rhythmic techniques, by the way, read Edgar Allan Poe’s poetry. Bells bells bells bells bells bells bells. And not one single bell more.
“This is a frightening place to be,” whispers “Whispers” is a word that amplifies the nature of the frightening place in which Dr. Ducker finds himself. Reserve this category of attribution trick for dramatic passages only. Usually, the word “said” will suffice. Repetition of the word “said” is rarely a serious problem the doctor.
In the background the heart monitor goes pop, pop, pop, 70 beats a minute, steady. The smell of ozone and burnt flesh hangs thick in the air. Pacing images are used to put the reader into the scene while also serving to slow the story action down. This implies that you’ve got to have enough action that you can afford some slow passages. If you don’t have enough action to withstand the imagery slowdowns, you’ve probably got a boring story It is 11:05 a.m., the day of the monster.
The operating room door opens and Dr. Michael Salcman, Minor characters do not have to be introduced at the top of a story but, if not, they must be foreshadowed. In this case that was easy, since Dr. Salcman came in and hung around for a while before he started taking important (structural) action. the assistant chief neurosurgeon, enters. He confers with Dr. Ducker, who then returns to the microscope. Dr. Salcman moves to the front of the television monitor.
As he watches Dr. Ducker work, Dr. Salcman compares an aneurysm to a bump on a tire. The weakened wall of the artery balloons outward under the relentless pressure of the heartbeat and, eventually, it bursts. That’s death.
So the fragile aneurysms must be removed before Dr. Ducker can tackle the AVM itself. Dr. Salcman crosses his arms and fixes his eyes on the television screen, preparing himself to relieve Dr. Ducker if he tires. One aneurysm down, one to go.
The second, however, is the toughest. It pulses dangerously deep, hard against the bulb of nerves that sits atop the spinal cord.
“Technically, the brainstem,” says Dr. Salcman. “I call it the ‘pilot light.’ That’s because if it goes out … that’s it.”
On the television screen the tweezer instrument presses on, following the artery toward the brainstem. Gently, gently, gently, gently it pushes aside the gray coils. For a moment the optic nerve appears in the background, then vanishes. A glance at something he’s met before, in this case the optic nerve, gives the reader the sense that he understands where he is. That is strictly smoke and mirrors, of course, but it puts his mind at rest and he can read on. After all, the reader isn’t here to learn brain anatomy. He’s here to find out what happens, and how the story comes out. The moral of the story is don’t explain any more than the reader needs to understand the story. Explanations beyond that are flab
The going is even slower now. Dr. Ducker is reaching all the way into the center of the brain and his instruments are the length of chopsticks. The danger mounts because, here, many of the vessels feed the pilot light.
The heartbeat goes pop, pop, pop, 70 beats a minute. And the beat, now in a separate paragraph, begins to take on a life of its own
The instrument moves across a topography of torture, scars everywhere, remnants of pain past, of agonies Mrs. Kelly would rather die than further endure. And a tip of the hat to Abe Lincoln. Immature poets, some guru said, create. Mature poets steal. When possible, steal from the masters. Steal from romance novels and other trash at your peril. Dr. Ducker is lost again.
Dr. Salcman joins him at the microscope, peering through the assistant’s eyepieces. They debate the options in low tones and technical terms. Going too deeply into the technical would only confuse the reader, and is not necessary to the action. Deciding what to leave out is one of the writer’s most important functions. The iron rule is that if you don’t need it to make the climax work, then you don’t need it at all. Some of the best stories are written backwards. This one was, sort of, and at times A decision is made and again the polished tweezers probe along the vessel.
Back on course, Dr. Ducker works his tunnel ever deeper, gentle, gentle, gentle as the touch of sterile cotton. Finally the grey matter parts.
The neurosurgeon freezes. When your action is being carried along by active, fine-scale description, then action is defined not as motion but as change. Thus freezing in the face of danger is, in this story, a very active thing for Dr. Ducker to do
Dead ahead Symbolism can be layered on top of symbolism. The word “dead” is symbolic in its own right, and the phrase “dead ahead” is a term used for navigating across topography the field is crossed by many huge, distended, ropelike veins.
The neurosurgeon stares intently at the veins, surprised, chagrined, betrayed by the X-rays.
The monster.
The monster, by microscopic standards, lies far away, above and back, in the rear of the head. Dr. Ducker was to face the monster itself on another day, not now. Not here.
But clearly these tangled veins, absent on the X-ray films but very real in Mrs. Kelly’s brain, are tentacles of the monster.
Gingerly, the tweezers attempt to push around them.
Pop, pop, pop . . pop … pop … . pop … . pop. Consider the foreshadowing that led up to this
“It’s slowing!” warns the anesthesiologist, alarmed.
The tweezers pull away like fingers touching fire.
… . pop … pop . . pop . pop, pop, pop.
“It’s coming back” says the anesthesiologist.
The vessels control bloodflow to the brain stem, the pilot light.
Dr. Ducker tries to go around them a different way.
Pop, pop, pop . pop . . pop … pop … .
And withdraws.
Dr. Salcman stands before the television monitor, arms crossed, frowning.
“She can’t take much of that,” the anesthesiologist sa ys. Note the absence of the phrase “told this reporter.” Unless you’re writing about yourself, stay out of your story “The heart will go into arrhythmia and that’ll lead to a … call it a heart attack.”
Dr. Ducker tries a still different route, pulling clear of the area and returning at a new angle. Eventually, at the end of a long, throbbing tunnel of brain tissue, the sought-after aneurysm appears.
Pop, pop, pop . pop . . pop … pop … .
The instruments retract.
“Damn,” says the neurosurgeon. “I can only work here for a few minutes without the bottom falling out.”
The clock says 12:29.
Already the gray tissue swells visibly from the repeated attempts to burrow past the tentacles.
Again the tweezers move forward in a different approach and the aneurysm reappears. Dr. Ducker tries to reach it by inserting the aneurysm clip through a long, narrow tunnel. But the pliers that hold the clip obscure the view.
Pop, pop . pop . . pop … pop … .
The pliers retract.
“We’re on it and we know where we are,” complains the neurosurgeon, frustration adding a metallic edge to his voice. “But we’re going to have an awful time getting a clip in there. We’re so close, but …”
A resident who has been assisting Dr. Ducker collapses on a stool. He stares straight ahead, eyes unfocused, glazed. This makes Dr. Ducker’s fatigue more real
“Michael, scrub,” Dr. Ducker says to Dr. Salcman. “See what you can do. I’m too cramped.”
While the circulating nurse massages Dr. Ducker’s shoulders, Dr. Salcman attempts to reach the aneurysm with the clip.
Pop, pop, pop . pop . . pop …pop … .
The clip withdraws.
“That should be the aneurysm right there,” says Dr. Ducker, taking his place at the microscope again. “Why the hell can’t we get to it? We’ve tried, ten times.”
At 12:53, another approach.
Pop, pop, pop . pop . . pop … pop … .
Again.
It is 1:06.
And again, and again, and again.
Pop … pop … pop, pop, pop … pop … pop-pop-pop …
The anesthesiologist’s hands move rapidly across a panel of switches. A nurse catches her breath and holds it.
“Damn, damn, damn.”
Dr. Ducker backs away from the microscope, his gloved hands held before him. For a full minute, he’s silent.
“There’s an old dictum in medicine,” he finally says. “If you can’t help, don’t do any harm. Let nature take its course. We may have already hurt her. We’ve slowed down her heart. Too many times.” The words carry defeat, exhaustion, anger. It is better to let action carry emotion, even if the action is no more than inflection on words
Dr. Ducker stands again before the X-rays. His eyes focus on the rear aneurysm, the second one, the one that thwarted him. He examines the film for signs, unseen before, of the monster’s descending tentacles. He finds no such indications.
Pop, pop, pop, goes the monitor, steady now, 70 beats a minute.
“Mother nature,” a resident growls, “is a mother.”
The retreat begins. Under Dr. Salcman’s command, the team prepares to wire the chunk of skull back into place and close the incision.
It ends quickly, without ceremony. Dr. Ducker’s gloves snap sharply as a nurse pulls them off. This punctuates the end of the action. It is a specific, active, concrete, sensual (sound is used) symbol It is 1:30.
Dr. Ducker walks, alone, down the hall, brown paper bag in his hand. In the lounge he sits on the edge of a hard orange couch and unwraps the peanut butter sandwich. His eyes focus on the opposite wall.
Back in the operating room the anesthesiologist shines a light into each of Mrs. Kelly’s eyes. The right pupil, the one under the incision, is dilated and does not respond to the probing beam. It is a grim omen.
If Mrs. Kelly recovers, This paragraph and the two short paragraphs that follow are worse than unnecessary. They bring up images that are irrelevant (Mrs. Kelly is going to die and Dr. Ducker knows it), and distract the reader. Some readers were left uncertain as to whether or not Mrs. Kelly died. These paragraphs are the culprit. Together they constitute the worst structural failing of the story, and if the rest of it hadn’t worked well enough to offset the problems the piece as a whole would have failed says Dr. Ducker, he’ll go ahead and try to deal with the monster itself, despite the remaining aneurysm. He’ll try to block the arteries to it, maybe even take it out. That would be a tough operation, he says without enthusiasm.
“And it’s providing that she’s in good shape after this.”
If she survives. If. If.
“I’m not afraid to die,” Mrs. Kelly had said. “I’m scared to death … but … I can’t bear the pain. I wouldn’t want to live like this much longer.” Flashbacks late in the story provide dramatic perspective. It is time that the reader remembers that Mrs. Kelly went into this with her eyes open. Otherwise, our hero becomes tarnished by failure. One of the points of the piece is that he is not tarnished, because he tried
Her brain was too scarred. The operation, tolerable in a younger person, was too much. Already, where the monster’s tentacles hang before the brainstem, the tissue swells, pinching off the source of oxygen.
Mrs. Kelly is dying.
The clock on the wall, near where Dr. Ducker sits, says 1:40.
“It’s hard to tell what to do. We’ve been thinking about it for six weeks. But, you know, there are certain things … that’s just as far as you can go. I just don’t know …”
He lays the sandwich, the banana and the fig newtons on the table before him, neatly, the way the scrub nurse laid out the instruments. Foreshadowed, this becomes a very dramatic, human action
“It was triple jeopardy,” he says finally, staring at his peanut butter sandwich the same way he stared at the x-rays. “It was triple jeopardy.”
It is 1:43, and it’s over.
Dr. Ducker bites, grimly, into the sandwich. He must go on. Food symbolizes life The monster won.
***
Jon Franklin won the inaugural Pulitzer Prize for feature writing in 1979, for this story. He won again six years later, in Explanatory Reporting, for a series on brain science. His “Mrs. Kelly’s Monster” annotation also can be found in the appendix of his classic Writing for Story: Craft Secrets of Dramatic Nonfiction by a Two-Time Pulitzer Prize Winner. His latest book is The Wolf in the Parlor: The Eternal Connection between Humans and Dogs, and he is also the author of books including Molecules of the Mind and Not Quite a Miracle: Brain Surgeons and Their Patients on the Frontier of Medicine. Franklin is a University of Maryland writing professor emeritus and is at work on a novel.
*This piece is a reprint of a Sept. 26, 2011, post from the Tumblr feed The Story of A Story.