Q: How did you come up with the idea for Do No Harm, and for your character Emma?
A: I’ve wanted to write a book that centers on the opioid epidemic for a number of years because my brother has struggled with addiction for most of my adult life. Watching someone you love go to war with themselves is a special kind of hell, and it has profoundly changed me and my view of addiction and opioids.
Then a few years back I read an article about a podiatrist who was the key figure behind a major oxycodone trafficking ring. Doctors have sometimes been implicated in cases involving illegal prescriptions, but they’re not usually the leaders of the drug-trafficking ring. I wondered what drove him to do that. Was it power? Money? Or something else, like love?
We’re all capable of going to extreme lengths for love. Would a mother start selling drugs in order to save her child’s life? Would a doctor? I needed a character who you’d never suspect of doing something like this. A mother. A police officer’s wife. And to be able to have close access to prescriptions, I knew she needed to work in the medical industry. And I realized she had to be a doctor.
As a doctor who’s taken a vow of “do no harm,” I wanted this choice for Emma to be something that she chose not for herself, but for someone she loves. To save their life. And as I started writing the story, Emma grew and became her own person with a backstory and quirks and dreams and motivations. She was magic to write.
Q: What do you think the book says about the opioid epidemic and its impact on families and society overall?
A: In writing this book, I really wanted to explore the many sides of the opioid epidemic, from the individual people who are addicted, to the people who inadvertently (or otherwise) get them addicted. I wanted to get people talking about the opioid epidemic, discussing the driving factors behind it.
There is such a stigma around addiction, whether that be to drugs, alcohol, gambling, etc., and I feel like if we talk about it more, if we stop treating addiction like a dirty little secret, then we can start focusing more on how to help. People aren’t just addicts. They are a human first, with reasons and motivations for how they’ve come to be addicted.
Even Emma, who is arguably addicted to saving Josh, has a reason for being addicted. I’m not saying she had other choices she could’ve made, just that no matter what the addiction, there’s a reason behind it.
My worldview of the opioid epidemic is pretty negative. I don’t think enough has been done at any level to help addicts, their families, their children, from societal to medical to political. The pharmaceutical industry pushed this epidemic on our society out of greed, and yet haven’t been pushed to the extent I think they should be.
When I sat down to write this book, I wanted to show that people—and industries—still can and do take advantage of the system for their own personal gain. Their own individual addictions.
Q: How was the book's title chosen, and what does it signify for you?
A: Do No Harm is my first book where I’ve chosen the right title from the very beginning and it hasn’t been changed at any stage of the publication process, and I think the reason for that is it hits the theme, and the tension, of this book so hard. Doctors, mothers, fathers, we all want to do no harm, but then, what if we have to for those we love?
It also fits really well with the Hippocratic oath that doctors take, which is to first do no harm. And in order to save her son, Emma has to break that oath.
Q: What do you hope readers take away from the story?
A: First of all, I hope readers have fun with the plot and have a genuine emotional connection to my characters.
Second, I hope they recognize, like my characters do, that opioids can provide life-saving pain relief, but that they can also cause lifelong addiction that endangers people. Things are rarely all good or all bad, there are a lot of shades of gray in there. And I hope it makes them think differently about the opioid epidemic.
Q: What are you working on now?
A: I’m working on a new book, but as I’m in the very early stages, I can’t say much more than that, I’m afraid!
Q: Anything else we should know?
A: I have a bookclub I run on my author website if anybody would like to join me! https://christina-mcdonald.com/book-club/
Or readers can find me on all the usual socials:
Instagram and Twitter: @christinamac79
--Interview with Deborah Kalb. Here's a previous Q&A with Christina McDonald.