Where do your ideas come from?

The initial idea for a story announces itself quietly, seeming to lie in wait until I’m ready to find it, deeply tucked into my subconscious. My first book Daughter developed gradually as homage to the many patients I met as a GP who carried loss with great dignity.  I had to think of a plot and drew the idea of a missing daughter from my own deepest fears.

My second book, The Drowning Lesson, grew from  a fascination with African folk medicine and the people I’d met and landscapes I’d encountered on journeys through that stunning continent.

How Far We Fall, my third novel, came out of a life -long obsession with Macbeth. The modern plot was inspired by my husband’s work as a neurosurgeon: the operating which I watched, the equipment he has invented, and the research he is involved with.

The spark for my fourth novel, Little Friends, came from the film Dunkirk. I was fascinated by the use of multiple points of view, and wanted to create something similar  albeit with a very different context which came from the years we spent in West Dulwich in London.

There, as in many parts of London, the population demographic varies widely in a very small area. I wanted to explore how interesting very different people would find each other, should chance or fate bring them together.

The themes in the book came as a response to Couples by John Updike, a book I loved but one that raised questions for me.  The children in his narrative are used to bring adulterous couples together; the kids are then  totally ignored. I wanted to find out what happened to those children who scampered off obediently to play in the woods while their parents flirted over the barbecues; they were never named and barely described. Even at the time of reading these stories I knew there was the potential for danger, those kids would be up to something something wicked I suspected.

Little Friends allowed me to explore my suspicions and ground them in horror.

You were a doctor – what made you change to writing as a career?

The question really should be: You are a writer what made you decide on a career as a doctor first?

I was brought up in a medical family with the unspoken assumption that I would follow in my father’s footsteps, though my favourite subject at school was English.

I adored writing essays and stories and won the sixth form story prize, but a gap year in Zimbabwe in a mission school and hospital at the idealistic age of eighteen confirmed, at least to me, that medicine was the moral choice.

I’m not sorry. The life of a doctor is one of huge privilege you are allowed to be with people at the key moments of their life, birth, and death as well as the stresses and illnesses in between. I knew I could continue reading, which I did, and thought I would be able to write one day when I had time. I didn’t realise how long it would take for that day to come!

Has being a doctor influenced your writing?

I suppose every life experience influences your writing, and being a doctor has certainly influenced mine. Medicine is filled with stories, and as a GP you hear so many. You are also duty-bound to be empathetic and that’s a skill which you need for writing too. To be able to deeply imagine the life of a patient and the experiences they are going through makes you a better doctor, and a better writer.

How do you manage to be disciplined enough to write?

Again, my past experience of being a doctor helps with that. I used to drive through the city go to work, creating a separation of home and work. I became a doctor once I arrived at the surgery and my home mother-wife self faded into the background.

In the same way I try to separate my work as a writer now, becoming a writer as I go into my room and sit at my desk. It’s easier now, of course, that our children have grown and gone. I am so admiring of writers who can continue despite having young children medicine was easy in comparison. As a doctor, I’d put my bag in the corner when I came in and become the mother. Stories are much harder to lay down.

Do you use your family in your books?

I remember being asked that question at the launch of Daughter and I can answer truthfully now as I did then: the families I talk about in my book come from my deep imagining  they allow me to do all sorts of things that I could never do with my own. It’s enormous fun creating what they do, or think, or say; what they eat and wear and think about.

The only emotions I use, however, are my own my deepest fears and joys.

Why is there always a dog in your books?

The quick answer is that I love dogs and, having a spaniel of my own, I am able to describe dogs (especially spaniels) with some authenticity!

The longer answer is that dogs are useful; most readers love dogs so it’s a good way to bring the reader on board with the story and help them empathise with the family or character who owns the dog. If the reader can imagine themselves in the story – stroking the dog, worrying about whether it’s time to take it out for a walk – then you are half way there.

Dogs are also sensitive to atmosphere, so writing the dog’s response is another way to convey unspoken menace in the scene. For example, the dog will notice danger first: the hackles on its neck will rise and  the reader will be put on their guard. The protagonist may not have noticed this, and is unaware of the man hiding behind the curtains, creating tension and a desire to read on.

Describing a dog allows a little softness into the novel, too: the eyes, the coat, the way the ears are one up and one down – all ways to capture the reader and help them through a tough scene.

A dog might also get the protagonist out of the house, changing the scene and potentially leading to the protagonist bumping into other people they might need to meet.

I love using wild animals in my books too. In the Scottish scenes in How Far We Fall there are little groups of deer with fawns. The female protagonist, yearning for a child, is captivated by them. But, at the same time, she recognises the otherness of the wild life this was interesting and powerful to write.