Author Chat: Larry Kramer on Where the Road Ends

Welcome to a new feature on Trish Talks Books: Author Chats! Today I chat with Larry Kramer about his book Where The Road Ends (Pottersfield Press, 2023)

My thanks to the author for sending me a complimentary copy of his book for review.

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There are so many stories that hide themselves from view in everyday life. In author Larry Kramer’s debut novel Where The Road Ends, Dr. Nathan Jericho keeps the stories of the brutal events he witnessed as a Canadian Air Force trauma surgeon well hidden until they refuse to be suppressed. Kramer’s novel tells the story of Jericho’s PTSD and quest for healing in this compassionate yet unflinching account. It was published by independent publisher Pottersfield Press earlier this year.

Kramer is a retired family physician and hospitalist who has turned to writing in recent years. His first book, An Imperfect Healer: The Gifts of a Medical Life, was published by Pottersfield Press in 2019 as a memoir of some memorable patient encounters. This is his first foray into fiction, and I was lucky to be able to chat with him about Where The Road Ends and his writing process.

Trish: Thanks for joining me on Trish Talks Books! I found Where The Road Ends to be an engaging, enjoyable read, though at times harrowing. You’ve chosen a challenging topic to bring to your first novel. PTSD is such a common, and often underdiagnosed condition, so when I picked up the book, I was really pleased to see this as the main focus for your character Nathan Jericho. He’s a trauma surgeon working at the Kandahar Airfield Hospital as a member of the Canadian Armed Forces (CAF) in the early 2000s. What brought you to this particular story?

Larry: Thank you Trish for your interest and for the opportunity to talk about my novel. A few years ago I began to think about working on another book after An Imperfect Healer. I thought fiction would be fun to write and would present many new challenges. This was shortly after Canada had withdrawn from military involvement in Afghanistan and there was a good deal of press about PTSD and suicide in CAF Veterans returning from that conflict. I wanted to write a contemporary story that would have particular relevance to some, and general interest to many. The topic and the time seemed right and I was convinced there was a good story there. So I started to do the research and began creating plot lines and writing text.  A year or two later (I began writing it seriously when COVID-19 struck) I completed the manuscript and, with the help of Pottersfield Press, the book was born in April 2023.

Trish: I thought one of the real strengths of the book was the medical detail. The cases you included added so much interest, and the narrative showcased how medicine works in the real world. It lent so much authenticity, and brought some of the more traumatic events close to me as a reader. How much did your medical training play a role in writing the book? Did you draw on any real-life cases?

Larry: Write what you know certainly played a key role in creating this book. Putting those scenes into words was much easier than generating the ones I had to manufacture from scratch. Fortunately, I think, there is a public fascination with all things medical, so maybe people would like this aspect of the book, even if they found the rest wanting. And yes, I did draw on some real life experiences. I’m sure all physicians have cases they can’t or don’t want to forget. One or two of the flashback sequences and a couple of chapters were drawn from my past, although most were the product of an overworked imagination and grisly research.

Trish: Indeed, I thought the trauma scenarios were a very necessary part of the book so that the reader could understand the severity of what Jericho went through. And just because he’s a doctor doesn’t mean he’s inured against psychological injury. One of the most riveting scenes was Jericho’s suicide attempt; it’s a pivotal moment in the book. It was written very realistically, and that made it a visceral reading experience. It was difficult to read but I couldn’t look away. How did you approach this challenging scene?

Larry: The suicide scene was very difficult to write. It had to be believable and consistent with the character of Jericho. At this point in the writing I began to appreciate something I had only read about: characters take on a life of their own, and, in a way, tell the author what to write. I tried to become Jericho and imagine how he would proceed. He had to return to the place where he felt most comfortable and do what he did best. And he would steel his resolve by recalling medically comforting and instructional thoughts. I had a lot of problems deciding how the scene would end without Jericho’s death and still be believable. It took a while to come up with the intervention of “Mik.” I hope it worked.

Trish: As I read the scene, it was very believable, and though Mik–the hospital cleaner– was a minor character, he was well drawn and complimented the story. As you say, that Jericho fell back on rote medical training indicated to me a sort of distance and resolve to suicide, and perhaps that’s why it was like a gut punch to me while I was reading.

On another note, I loved that the book took me to unexpected places. In a literal sense, it took me to “where the road ends,” in a far-flung small town in Newfoundland. On the way, Jericho rubs up against different types of treatments for PTSD but none seem to fit well. Eventually the story took Jericho to a place where he may be able to heal: Resurrection Cove. This struck me as a wonderful example of a “found family” narrative (and I love a good found family story!). How did you decide on Jericho’s path to healing in the book, and how do you see the importance of social connection and community in healing from trauma?

Larry: Again the character of Jericho led the way. How would he, as someone who had never experienced a strong feeling of social connection or of community, look for relief from his suffering. I sensed that after his suicide attempt he would try to step outside of himself, to physically leave the army, medicine, his life in Ontario, and even a budding relationship. I think he may have known that he needed people and community but he just didn’t know how to make that work. So running away, leaving it all behind was his answer. He could escape everything but himself. I don’t think he knew he would eventually find comfort in the compassion and kindness of strangers.

Trish: That sense of running away from something without knowing just what he needed to heal makes a lot of sense, and it’s fascinating to me as a reader to hear how Jericho led you, the writer, along his path. Finding a community brought him a sense of purpose, meaningful daily activity, social connection, neighbourliness and–not least of all–a sense of responsibility to others around him. In this sense, the interconnectedness and reciprocity of community relationships was good and necessary medicine.

Just for fun, I loved playing around with some of the names in the book. Resurrection Cove is pretty meaningful as a place to heal. But I wondered about Nathan Jericho. I had ideas of the biblical walled city of Jericho with its fortifications. Am I close, or just reaching?

Larry: I originally thought “Resurrection Cove” was too much, but, after reading about place names in Newfoundland, it wasn’t all that extraordinary. As to “Nathan Jericho,” your perceptive association with the biblical walls of Jericho is impressive. I didn’t consider this association (but I now wish I had thought of it!). In fact a writer friend of mine suggested I needed stronger names. I think I started with a John Smith sort of name for my protagonist. Nathan Jericho just seemed a bit more unusual, and, well, just a cool name for the main character of a novel.

Trish: I’m curious about your journey from medicine to writing a novel. What motivated you to become a writer? Was it difficult to find a publisher?

Larry: I heard Michael Crummey do an interview on CBC some time ago. He had a great quote: “There is only one reason to write and that is because you can’t not.” I have been writing things down for most of my life. It has been of tremendous therapeutic value and I suspect I would not have gotten through forty years of medical practice without it. I find comfort in putting words on paper and over the years have had a number of pieces published in various newspapers and magazines (The Medical Post, CMAJ, Globe & Mail, Hamilton Spectator, and several others).

Yes, it was difficult to find a publisher. Short articles are hard enough, but books are many orders of magnitude more difficult to get into print. I found a small literary publishing house, Pottersfield Press, whose founder, Lesley Choyce, is a well known Canadian writer. He saw some merit in my work. Good fortune on my behalf.

Trish: It’s clear that writing is so necessary for you! Thanks so much for chatting with me about Where The Road Ends, and congratulations on the book. Do you have any plans for an upcoming novel?

Larry: I was pretty spent after completing Where the Road Ends but now the itch to begin writing something again is nagging at me. I have been fascinated with sailing, particularly long distance solo or minimally crewed voyages. Bernard Moitessier’s 1973 journal (The Long Way) of the first non-stop single handed round the world yacht race in 1968 was captivating. I would love to write a novel about sailing. Just have to come up with a good story. Otherwise nothing specific other than some short stories I am trying to pull into a collection for publication. And thank you very much. I enjoyed our chat.

Trish: Thanks so much for agreeing to talk with me! I’m glad we were able to discuss Where The Road Ends, and I wish you much success with your writing endeavours.