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How to Create a Killer Medical Thriller

Do you enjoy reading stories where you can feel the tension between characters as they try to find the solution to a medical emergency? Do you love the intense conflict and suspense as the stakes continue to rise as you read? If that sounds like you, then you may just find yourself loving medical thrillers. Perhaps you have your own idea for a new medical thriller and want to take a stab at writing it.

If you don't know where to start, don't worry. We've got you covered! Medical thrillers give you that edge you crave, and they're certainly not for the hypochondriacs out there! Let's begin by defining medical thrillers and then explore the absolute necessities to crafting a successful and suspenseful medical thriller.

What is a medical thriller?

This subgenre seeks to explore questions of the human body or solve a medical mystery, which typically includes an instance of medical malpractice. The storyline usually centers around a protagonist in the medical field. Popular protagonists include amateur sleuths, medical staff, and doctor detectives who work to answer the questions posed throughout the plot. At times, this subgenre also seeks to uncover human greed and selfishness, exhibited through the antagonist's actions, rather than scientific breakthroughs.

Before you begin

close up of a gloved hand using a microscope
You should always take setting and characters into consideration before writing. Hospitals and labs are popular settings for medical thrillers. Photo by andrey_orlov.

Before you begin writing, consider the plot, characters, conflict, and — most importantly — experience. We don't mean to suggest that you'll have more to worry about if you're new to writing, but medical thrillers in particular require a base of knowledge that many other genres don't.

  • Research: You may find it interesting to learn that many medical thrillers have been written by medical experts-turned-writers. This may be why so many books within this subgenre seamlessly integrate complicated medical jargon with high-stakes plots. This doesn't work for everyone. Unless you're a medical expert, you're going to have to do some research on whatever you choose to write about. For example, if you want to focus on a question surrounding vaccines, you should do some research on vaccines, such as the process of creating vaccines, the testing process, and the results of the vaccine. Meanwhile, to create a believable medical professional, you're going to want to incorporate some medical vocabulary, particularly vocabulary commonly used in whatever field you focus on.
  • Don't go overboard: We know we just finished telling you to do your research on whatever medical topic you've chosen for your story, but you shouldn't go overboard with this. While some people reading your story may be medical professionals in some capacity, we'd wager that the majority of your readers are not involved in the medical (or crime) field. Tell your readers what they need to know, limiting your technological, medical, and scientific language to what is absolutely needed for the story to make sense and be understood. Remember, the focus of your story is a medical mystery. You're writing a story, not a college lecture.
  • Consider ethical/moral questions: You've chosen your central topic, whether it be cloning or genetic manipulation. If there's one truth in science and medicine, it's that new procedures and experiments raise ethical and moral questions. Is it ethical to change your unborn baby's hair and eye color through genetic manipulation? Is build-your-baby the next big business? We don't know, but it doesn't stop research on these areas from being done. Topics that raise moral and ethical questions are the best to include in medical thrillers because they make the readers think and play an active role in your story. They also allow for continued conflict in your story. If your reader thinks "hey, someone definitely didn't submit an ethics application before beginning their research," then you've chosen a smart topic.

Picking your professional (or amateur!)

coroner swipes beneath a body's fingernails to collect DNA
Popular protagonists include traditional medical professionals like doctors and surgeons, but they can also include coroners and detectives. Photo by Elnur.

As you may expect, many protagonists in medical thrillers are doctors. This doesn't always have to be the case, however. In fact, many medical thrillers combine medical and law settings and professions to create the perfect team for solving a medical mystery. In addition, medical doesn't have to mean doctors or surgeons. Here's a list of potential protagonists you can include in your story:

  • Amateur sleuth doctor/traditional medical professional: These are the types of professionals we immediately think of when we hear the word "medical." These are doctors, surgeons, and other medicine specialists. Even though they aren't law professionals, they use their scientific and medical knowledge to uncover clues that law enforcement cannot. They act as amateur sleuths. You might even consider a pharmacist as a medical specialist because they deal with medication and drugs (sounds like a perfect topic to explore in a medical mystery — just saying!).
  • Medical student/resident: This is similar to having a doctor or other official medical professional as your protagonist, but it adds an interesting new layer. Students are curious by nature, but they aren't equipped with as much medical knowledge and experience as a licensed doctor. However, their smaller role in the hospital allows them to be more subtle and slip by unseen and unheard, so they can secretly investigate a mystery.
  • Forensics professional: Forensic medical examiners perform autopsies, so they can determine whether a death was natural or unnatural. They're seen in crime shows as professionals who examine a body to find clues as to what could've happened to the deceased. They make for great protagonists in this subgenre because they hold information others are incapable of discovering on their own. Other forensics professionals include forensic specialists and technicians. These professionals are directly involved in analyzing crime scenes for clues, so they also make excellent protagonists in these stories.
  • Retired police officer/private detective: Being involved in law enforcement gives these protagonists knowledge about crime scenes that others are not privy to. Like Harry Bosch from Michael Connelly's Two Kinds of Truth, these police officers-turned-undercover-detective types can infiltrate suspicious groups of potential antagonists and face the mystery head on.

We love to hate them

view from below of three surgeons with scalpels performing an operation
It can be interesting to flip what we know on it's head and make the doctor the villain of your story. Photo by Gorodenkoff.

Antagonists are the villains in your story. There are lots of possibilities for your antagonist's identity. They should blur the lines and raise questions about what is ethical and unethical. Maybe they're morally ambiguous and think their actions are for the best, even if they hurt people in the process.

Your antagonists should never be one-dimensional. You should always strive to give them some kind of backstory. After all, very few people do bad things for the sake of being bad. What's their motive? Here's a list of potential antagonists you might think about including in your story:

  • Doctor/medical professional: Wait a minute, aren't doctors supposed to be the good guys? Yes, they are, but that's what makes it so interesting when they're the bad guys. It's what the readers least expect! Medical malpractice is a common trope in medical thrillers because it opens the door for endless consequences. Maybe your doctor is performing some horrible illegal experiment on other human beings because they're trying to find the cure for some illness. Or maybe your antagonist is part of underground organ smuggling ring and they're using surgery as a way to collect organs to sell. We know it sounds horrible, but that's kind of the point.
  • Virus/disease/sickness: You may not think this is possible because a virus or sickness isn't a physical person, but that doesn't matter. Inanimate objects like illnesses can be characters, if written correctly. You can use personification to bring your virus to life. We're all familiar with how new viruses can appear seemingly out of nowhere (déjà vu, right?) and take over our everyday lives, so use this to your advantage when writing your thriller. This can also go hand in hand with a human antagonist. While some viruses do seem to appear out of thin air, it's no secret that people have experimented and tampered with creating man-made strains. This is especially horrifying because it could happen in reality, so such a storyline will surely add another layer to your thriller.
  • Murderer/criminal: Just because you're writing a medical thriller does not mean that your antagonist has to be a medical professional. Your antagonist can be a criminal who has a knack for science/medical experimentation, murder, or drug smuggling. If the crime loops the conflict back into the medical world, then the profession of your antagonist does not matter so much.

Choosing a conflict

close up of hands exchanging packets of pills
One potential conflict for your medical thriller may be the misuse/spread of addictive, prescription drugs. Photo by Davit85.

Determining your topic may be a bit difficult simply because there is so much information out there to choose from. One thing you can always do is find something new. New scientific and medical questions are raised every year. Try to stay on top of hot topics of debate in medical current events so you can stand out from the existing pool of medical thrillers. Some of these topics currently include genetic manipulation, mutations, and cloning.

It's not bad to write about a medical problem that's already been examined in other books within the subgenre, but you need to add your own new and unique spin on it if you choose to go down this path. Examine topics through a new lens and offer a different perspective on potential ethical issues that could be raised. Here are some topics that will help you begin thinking about what you want your central conflict to be:

  • Organ smuggling
  • Underground drug ring
  • Experimentation with dangerous drugs
  • New virus unleashed
  • Patients disappearing from their hospital beds
  • DNA cloning gone wrong
  • Genetic mutation leading to fatal consequences

These are just some of the topics you can explore in your own story. Use these as a starting point or as a source of inspiration for your own topic. Remember, there's so much out there. You just have to be willing to do the research.


Pacing is especially important to keep in mind when writing any kind of thriller story, but this is particularly true of medical thrillers. Let's be honest: Sometimes medical jargon and technicalities can be boring and confusing. We've certainly zoned out during biology and chemistry classes because we were lost (there's a reason we aren't doctors…).

This is why we mentioned the importance of including only what is necessary for your story to make sense and for your reader to understand the plot. The only slow moments in your story should be moments of explanation that establish background knowledge for your reader. In every other moment, your story should move at a fast pace.

How do you write a fast-paced medical thriller that will keep your readers' attention? There are a few ways to accomplish this:

  • Solid opening: You want to captivate your readers right off the bat. We don't just mean the first couple of chapters. We're talking about the first couple of lines. In a time when people are constantly being distracted by the next best thing, we even struggle to watch a video if it's longer than 15 seconds. Readers are ruthless, so don't waste their time with a boring opening. Use those first few sentences and paragraphs to draw them into your setting. Make them feel invested right from the get-go, as if they were a character in your story.
  • Suspense: Once you've successfully grabbed your readers' attention from your clever opening, then what? You have to keep the story moving or you risk losing your readers' attention. After all, you can't call a story a medical thriller if there is nothing thrilling about the plot or characters. You should introduce your conflict early on in the story, so you can add twists and turns as the plot develops. Your readers should be on the edge of their seats, desperately turning page after page to see what happens to your protagonist next. To achieve this, write the unexpected.
  • Continuous action: If you're still a little unsure about how to make sure your story is super suspenseful, don't worry. We've got just the thing. Some writers think thrillers don't need action until the very end of their story, when the protagonist is confronting the antagonist. This isn't true. In fact, if you want to create a fast-paced medical thriller, you need to have action sprinkled in throughout the story, not just in one or two places. Thrillers incorporate some kind of pressing danger. Your protagonist(s) are at risk, so including scenes where they face danger will keep the story moving. As always, make sure your action is necessary for the plot and not just filler.
  • Likeable characters: Wait a minute, what do likeable characters have to do with your story? Well, more than you might think! For a medical thriller to be successful, you need characters that your readers will be invested in. It doesn't matter how fast-paced your story is if you have characters your audience doesn't care about (even if you think they should). Unlikeable characters will slow down your story. A thriller demands your reader's full attention, and you want them to be excited to read what comes next. This is why you need to spend a good amount of time on characterizing your characters. Don't ruin your fast-paced plot by boring your readers with boring characters.

Time to write

Now that you've got the basics down, it's time for you to hit the books, grab a pen and paper (or a laptop), and start writing a medical thriller that will leave us on the edge of our seats! We look forward to agonizing over fictional illnesses and morally ambiguous doctors that could exist in real life… On second thought, maybe we weren't meant to read medical thrillers.

Header photo by Gorodenkoff.

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