Behind the Pages Q & A with Christina McDonald author of Do No Harm

Christina McDonald joined us for a Q & A in our Behind the Pages Goodreads Group and I am excited to share her answers to our question here with you all!

Brenda: You bravely and boldly took on a hot topic here in Do Not Harm and I thought you handled it so well by showing us a few different sides to addiction and the opioid crisis. How did you come up with the idea for the story? Was there anything that motivated you to write this story?

Christina I’ve wanted to set a thriller against the backdrop of the opioid epidemic for a long time because I’ve spent much of my adult life watching my brother’s addiction to opioids. The experience profoundly changed me and my view of addiction and opioids.

Then one day I saw a news story about a podiatrist in Indiana who’d been arrested for starting an opioid ring, and it got me thinking: why do people start selling drugs? Is it money, power, status? The only thing I believed I could ever understand, given that I’d watched my brother’s descent into addiction, was love. My children. I would do anything for them. And that was the moment I first thought of the story for Do No Harm.

My protagonist, Emma, does a lot of ruthless stuff in Do No Harm. Her character arc is a corruption arc, and that’s intentional because I wanted to show that there are many sides to the opioid crisis, and many in the oxy supply chain to blame—manufacturers, distributors, governments, politicians, pharmacies, and even doctors all to ready to write a script—but until the system is fixed, there are opportunists who do and will continue to use the opioid epidemic for personal gain. And I really wanted to spotlight that.

Brenda: You delve into the devastating cost of cancer treatment. What research did you do on that?

Christina: I did a lot of research in medical journals, pharmaceutical websites, and official sites online, as well as interviewed an actual doctor before in order to write Do No Harm.

I knew Emma was going to start selling opioids, but I wanted to make her motivation noble and relatable. Having a sick child would push any mother to the edge. When I read about CAR T-cell therapy, which truly does cost between $400,000-$500,000 and isn’t covered by insurance, I knew this would be a hugely motivating factor in my story.

I also had a doctor read through the finished first draft to make sure all of the medical aspects, including what it’s like and treatment for getting stabbed in the stomach, were completely authentic.

Brenda: How did you come up with the idea of the characters and create them? So many of them showed us different sides to the opioid crisis. Did you know when you started what you wanted to show us or did it come to you as you were writing?

Christina: The only character I really knew when I started was Emma, my protagonist. I knew she was going to do a bad thing (selling opioids) for a good reason (to save her son’s life). So I instantly had an external plot goal right there. But her internal character took a little bit more time to work out.

As I wrote, I learned more about Emma’s husband, Nate, through Emma’s eyes, and I decided it would be good to give him some chapters as well. I tried to figure out in what way he could bring more tension to the story, and I realized if he were a cop investigating Emma, it would really heighten that tension.

But all of that happened as I was writing. I would realize something about a character or the plot and I would go back and edit a previous section, then continue writing, then go back when I’d realize something new. My writing process is very messy! lol

Brenda: You explored one of the biggest questions to Motherhood here with “what a mother is willing to do save her child”. Here it’s bigger with causing harm to other and what a mother is willing to risk to save her child. Did you start with some questions you wanted readers to ask themselves about motherhood and then the opioid crisis or the other way around? Why did you want to explore “Does the end ever justify the means?”

Christina: I’m not sure the exact moment I decided to focus on the theme ‘Do the ends ever justify the means’. I knew from the beginning that I wanted Emma to go through a corruption character arc in her quest to save her life, and at some point while exploring that plot and Emma’s character arc I realized what the way to sum it up was with the phrase ‘Do the end ever justify the means?’

While the story definitely highlights how far a mother will go to save her child, it is also about how much a woman and wife and doctor will risk to get what she wants. I was always focusing on the broader life that Emma wanted to maintain – the sanctity of her family unit, not just Josh as an individual – due to her lonely childhood after her parent’s died. Emma wants to *belong*, and belonging to her family unit ends up being the most important thing about her life to her.

Debra: Do you know ahead of time how this book was going to end? Did you have it mind what would happen to the characters or did that come about as you wrote the book?

Christina: I never know the endings of my books before I sit down to write. I’m not a plotter in any way, so I find out as I’m writing. I have a general idea of what the story will be about and a good idea of the plot goal, but as I get to know my characters better and understand what their choices will be, it shapes my daily writing. So what happened to the characters, particularly at the end of Do No Harm, happened as I wrote the book. 🙂

Debra: Has the current pandemic altered in any way how you write?

Christina: Very much! I have two young children, so I’ve had to pivot to homeschooling during the day instead of writing. I realized early on that I was never going to get anything written that way, so I started getting up at 5am to write for a few hours before my kids got up and I had to start homeschooling. I wrote an entire book that way, but it wasn’t easy! It did show me, however, that I’m capable of more than I think, and that if I want something enough, I can make it happen.

Debra: Are you currently working on a new book?

Christina: I am, but it’s too early to say much about it, unfortunately! Stay tuned! 🙂

Brenda: What would you like readers to get out of reading this story? Is there anything else you would like us to know?

Christina: First and foremost, I always want my books to entertain my reader and provide an escape from the every day. But beyond that, I also want to get people thinking about the opioid crisis and seeing how complicated and nuanced it is, with very few clear villains, quite a lot of gray areas, and a whole lot of victims.

Addiction is an issue that is very close to my heart so I I wanted to help start conversations about it that we as a society need to have. So many have been affected by the opioid crisis, or know someone who has, so it’s a very important issue. But also I recognize that as readers we like to escape and be swept away. Hopefully Do No Harm does both.