Dr. Knox Q & A

Dr. Knox

Q: When did you first get the idea or inspiration for Dr. Adam Knox?

A: The character of Dr. Knox had been percolating in my head for years before I wrote the first words of the book, and arose from my long interest in the parallels between the doctor and the fictional detective. There are the similarities in their observational and deductive skills, of course (recall that Dr. Joseph Bell was one of Conan Doyle’s inspirations for Sherlock Holmes), and also, I think, in their worldviews. Both are privy to some of life’s most grim and intense moments, and see human experience stripped of pretense and nicety. Because of this, they stand at a remove from the workaday world, and are both empowered and isolated by this distance. In Dr. Knox, my desire was to create a character who isn’t a traditional detective but has some of those same talents, and who shares something of the hardboiled P.I.’s perspective, world-weariness and stubborn appetite for justice.

Q: This new novel is set in Los Angeles. What drew you west?

A: My choice of setting for Dr. Knox, Los Angeles, has roots in my childhood. I lived in L.A. for several years in the late sixties, and saw the city through the eyes of a largely unsupervised child. To my gradeschool self, it was mysterious and impenetrable, and also vast, glamorous and frightening. To some extent, I still see the city through that lens—and so L.A. remains endlessly fascinating to me, equal parts alluring and appalling. The lovely climate and landscape, the fantastic diversity of its citizens and of its ever-morphing neighborhoods are irresistible. So is its sunny mythology as the land at the end of the rainbow, where every fantasy of fame, fortune, self-perfection and reinvention might be realized. On the other side of the ledger, there’s the brutal strip-mall cityscape, hellish traffic, simmering racial tension, and the city’s dreadful homeless problem, all the more shocking, hallucinatory even, for the wealth and beauty that exist—as in a parallel dimension—all around it. These dichotomies under the sunshine—of rich and poor, hope and despair, bright fantasy and dangerous delusion—are part of why L.A. looms so large in the landscape of crime fiction—the setting of choice for Chandler, MacDonald, Ellroy and so many others—and why it’s arguably the capital of the kingdom of noir. I could think of no better locale for Dr. Knox, and no better home for his storefront clinic than L.A.’s Skid Row, a place where rosy fantasies and reinvention narratives vaporize on the baking pavement.

Q: What kind of research went into this novel?

A: Quite a bit of research went into Dr. Knox, all of it interesting. While I haven’t lived in Los Angeles since the late 1960s, I visit often, and read the local papers to keep up with current events. I’ve read widely about the history of L.A.’s Skid Row and about the current state of homelessness in and around Los Angeles (the Los Angeles Times has done some excellent reporting on this over the years), and I’ve spent a good deal of time in Knox’s Skid Row area. To say that it is a shocking and deeply sad spectacle—a disgrace, and an indictment of our massive societal failure to deal with such issues as extreme poverty, substance abuse, mental illness and affordable housing—would be vast understatement. While developing Knox’s backstory, I read a lot about the Central African Republic, its long, tragic history of conflict, and about the heroic work that such NGOs as MSF (Doctors Without Borders) have done there. To write Knox himself, I read a number of memoirs by physicians, and spoke to a number of doctors I know. But my most valuable research in this area involved talking to my parents—both doctors, dedicated clinicians of the old school, both retired now. They helped with the medical facts (my mother, like Knox’s, ran an E.R. in a small hospital), but more importantly they shared their insights into the burdens and satisfactions of primary care medicine—the intellectual challenges of diagnosis and treatment, the fascinating, often heartbreaking glimpses into so many different lives, the difficulties of preserving empathy while avoiding emotional burnout and the constant, sometimes crushing weight of responsibility.

Q: Dr. Knox chooses to live in a gritty and rough neighborhood of Los Angeles, and often expresses disdain toward the looming presence of gentrification. Essentially, he chooses to disregard the wealthy and comfortable lifestyle of many doctors—what does this say about him and how he views his work?

A: Knox’s work as a doctor—on Skid Row and in Africa before that—has, on a regular basis, shown him life at its most capricious, brutal and tragic—life without the window-dressing. Consequently, he has a good deal of scorn for that window-dressing, for all the things he views as “comforting fiction, protective distraction from the realities of life: the nasty, brutish, and short parts, the horribly random parts, the parts where we’re powerless to protect our loved ones from anything.” Which accounts, in part, for his residence in an emphatically un-lovely part of L.A. But disdain for bourgeois comfort isn’t all that keeps Knox in his Skid Row adjacent digs. As Knox explains to his friend Nora, while there are certainly people in need of care in more upscale neighborhoods than his, there are plenty of doctors in those places, too. Of Skid Row he says: “if I didn’t show up, no one else would.”

Q: In the sense that he takes money from rich clients (off the books as they are seeking discretion) to fund his clinic, Knox is a sort of Robin Hood figure but his story is much less cut and dry. He pretty much puts the welfare of his friends and employees in danger to serve his sense of what’s right. Would you say he’s a morally complicated guy?

A: Dr. Knox is decidedly not a monolithic character. He has altruistic, even heroic impulses that in the abstract would be laudable—if not for the fact that they put those closest to him in grave danger. Knox’s heroism exists alongside his selfishness, and it serves his unhealthy appetite for risk. Knox has keen powers of observation, but they live alongside an almost willful blindness to his own motives and limitations. I would say that Knox is indeed morally complicated. Put another way: he’s very human.

Q: Without giving anything away, how does Adam’s time in Africa inform his actions and this novel?

A: Dr. Knox walked away from a conventional life—complete with a conventional wife—to work with an NGO, work that took him to disaster areas and war zones, and immersed him in life stripped of its conventional niceties. The work was rewarding in one sense, but also punishing, bringing Knox face-to-face with the limits of his abilities to protect his patients—many of them children—from the harsh realities of the conflict raging around them. His attempt to shelter one group of patients ended catastrophically, and ended Knox’s career in Africa. When he arrived in L.A., he came with baggage: bitterness and guilt over what had happened in Africa, and a resolve to make amends for what he views as his past failure.

Q: Nora warns Adam: “Few things are more reductive than rescue fantasies—or more dangerous. What does she mean by that?

A: Knox’s friend and lover, Dr. Nora Roby, is a skeptic, and she particularly distrusts the seemingly heroic. She believes that little in the world is simply black or white, and that almost no one has motives that are unalloyed. As Nora goes on to say: “Actual people are complicated, and their motives and intentions are almost always tangled and obscure, even to themselves. Especially to themselves.” Nora is not speaking hypothetically when she talks about “dysfunction channeled into heroic behavior.” She’s talking about Knox.

Q: Sutter, Adam’s partner and friend says to him, “The world is full of all kinds of wrong—take five paces in any direction; you can’t help but trip over it. Read a newspaper and you choke on it. You want to fix that shit—fine, but it’s a full time job, brother, the pay is lousy and nobody’s gonna thank you.” Tough love or is there some truth to that?

A: Both! As a soldier, a private security contractor, and a gun-for-hire, Ben Sutter has seen firsthand many of the ills of the world, in hot spots abroad and at home, and he knows the considerable forces that seem always to be arrayed against anyone trying to right them. He’s gone up against those forces himself on occasion—has paid his dues in doing so, and was lucky to come away intact—and as a result he now pursues a (relatively) quieter life and simpler pleasures. He is skeptical (or so he tells himself) when it comes to the heroic, and he worries about what he views as Knox’s impulsiveness and naiveté.

Q: The relationship between Knox and Sutter is terrific. Were you inspired by any particular stories of great sidekicks in crime literature?

A: While I love the “buddy” dynamic in mystery and crime fiction (Holmes and Watson, Nick and Nora, Mulder and Scully, etc…), I didn’t have any particular duo in mind when I paired Knox and Sutter, nor did I conceive of Sutter merely as a sidekick or as a convenient plot device. While it’s true that Sutter’s background (former Special Forces, former corporate mercenary, former hired-gun for organized criminals, former bodyguard, sometime technical consultant to Hollywood and full-time house-flipper and real estate investor) and skills differ from Dr. Knox’s—and are most helpful when the guns come out—Sutter is more than simply a useful psychopath. He and Knox are friends and equals, who recognize courage in one another, and a shared impulse to help those in need. That said, they are dispositional opposites: where Knox resists contentment and comfort, tending instead toward isolation and a certain asceticism, Sutter is more extroverted and grounded—merrily hedonistic, entrepreneurial, less suspicious of happiness. Sutter sees Knox more clearly than Knox himself does, understands the contradictions in the doctor’s character—the courage and the craziness—and values Knox despite (or perhaps because) of them.

Q: There are some hilarious Hollywood antics here. Was it fun to be among the rich and famous and crazy?

A: In his off-the-books, no-names-exchanged, cash-only medical practice, Dr. Knox’s patients include those whose celebrity makes calling 911 a potentially embarrassing, career-killing proposition, and treating them involves travel to the heart of Hollywood Babylon. It’s a timeless land of those with too much money and privilege, too many enablers, too few inhibitions, and much too little sense. Misadventures abound, involving sex, drugs, animals…. It’s a playing field on which it’s hard for fiction to compete with reality, but I try.

Q: Adam gets tangled up with Bray Consolidated, a pretty nasty company run by a nasty family. You think a private corporation could really yield the kind of political (and even military) influence the Brays exert?

A: Bray Consolidated and the Bray family are entirely fictional—based on no actual firms or people. That said, history has taught us—too many times to count—that the prime directive of power is to preserve and extend itself. So no one should be surprised that ultra-wealthy people and corporations use their money to buy (more) access and influence across a range of activities—including politics (hard to imagine, I know). Indeed, it would be a surprise if they did not do so. It’s also true that the ultra-wealthy employ private security—sometimes a lot of it—not only to protect themselves and their assets, but also to advance their interests more aggressively. People (and corporate persons) with that kind of power and resource can insulate themselves from most any disagreeable thing, and can steamroll most anything that runs counter to their agendas. All the levers of power are at their disposal—the legal, the quasi-legal, and the wholly illegal. So, do the Brays and their many companies—their arrogance and entitlement and influence—strain credibility much? I don’t think so.

Q: Who drinks more coffee, John March or Adam Knox?

A: Hard to say. Knox is well aware of caffeine’s many health benefits, while March has a deep passion for the bean!

Q: Will we see more of Dr. Knox?

A: Absolutely! Dr. Knox is the first in a series of crime novels featuring Dr. Adam Knox and Ben Sutter. Even now I’m at work on the next one.