Jill, Grimes, MD shares insights on writing her new book, The Ultimate College Student Health Handbook.
Inception of The Ultimate College Student Health Handbook
Lisa: I just love The Ultimate College Student Health Handbook! You mention the book started as a medication list for your daughters as they headed off to college. How did it evolve?
Jill Grimes, MD: Around ten years ago (before our girls were even in high school), I started making personalized first aid kits as high school graduation gifts. Initially I included one index card with a few “cheat notes” about which medications to take when. But these instructions expanded steadily as I tried to include answers to common texts that I received from these kids throughout the year. Before long, I was up to a twenty-page booklet, and I realized I really needed to expand to an actual book. I’m continually delighted when parents tell me their now “grownup” kids are still asking for “first aid kit refills” even several years after their college graduation!
Influence of students and parents
Lisa: What role did students and parents play as you planned the book and made revisions? What feedback did they provide? Did you have specific questions you asked all of them?
Jill Grimes, MD: Students played a huge role in shaping the book- not only the family friends (plus the bonus friends, roommates, frat brothers and sorority sisters of the original group) who texted me their questions, but all of my patients. I work on campus at the University of Texas, so 100% of my patients are current students. I wanted to include the most common concerns, the questions we hear over and over every week. Equally important was including medical facts, issues or ailments that consistently come as a total shock or surprise to students (because they’d never heard of them before, or at least didn’t think it happened in their age or friend group.)
Parents played a lesser role, at least consciously. Truth is, mom conversations tend to focus on our kids, so as more and more of my friends launched their kids off to college, their concerns and questions were a steady hum in my ears. Many asked for copies of my first aid kit contents and booklet to share with their friends and family across the country. Others wanted to be sure I included my “straight talk” about sex, STDs, excessive alcohol, ADD medication abuse and pot. Overwhelmingly, though, parents were anxious for me to “package up” my practical advice so their kid would have a trustworthy guide when they were off on their own — whether it was a basic “Tylenol vs. Advil” question or perhaps something more awkward they’d rather not ask their parents.
Goals of The Ultimate College Student Health Handbook
Lisa: What were your main goals for The Ultimate College Student Health Handbook to achieve?
Jill Grimes, MD: My primary goal is for college students to have an immediately accessible, trustworthy, medically accurate guide to help them know how to help themselves before seeing a doctor, and to figure out if and when they really need to be seen. Additionally, the practical tips for common stressors and anxieties (test anxiety, public speaking, insomnia, etc.) will give students an immediate starting place to help themselves as well as a frame of reference to normalize their experience.
My secondary goal is for parents to have a quick reference book when their kid is ill, injured or stressed, and they are calling or texting home asking for advice. I hope this book will help parents decide what follow up questions to ask, and to build confidence that these young adults can learn to more independently navigate their own health care.
Organizing and Researching a Health Handbook Tweet This
Lisa: Did you set the rules yourself about how long an entry could be, or did you just write what each entry seemed to need and fine-tuned the length later?
Jill Grimes, MD: Initially I wrote out a list of roughly one hundred ailments/injuries/issues, and started writing topics in the same basic pattern (what was the “story”, what is it medically, treatment, worst-case, etc.) going as long as seemed appropriate for the topic. I was about a third of the way through writing these topics when I signed a book contract, which then set the total word count at 50,000 – about 30,000 shorter than I had anticipated.
I had to choose between cutting topics or significantly shortening everything, and ultimately did a bit of both, eliminating about twenty less common topics and tightening up any lengthier completed topics. I kept a running spreadsheet with topics and word counts, so moving forward I had a rough idea when I went “over” or “under” on each chapter. Fortunately, my publisher was able to allow an additional 12,000 words, which saved me hours of editing angst.
Lisa: What kinds of research did you do in writing the book?
Jill Grimes, MD: They say, “write what you know,” and indeed, much of my research was purely doing my job, treating college students and listening to their common concerns. The bulk of my traditional research was critically evaluating studies to be certain every medical recommendation in the book was backed with the most current evidence-based studies. Additionally, I sought, received and incorporated feedback from underrepresented groups of students to be sure my language and tone were inclusive.
Refining a template
Lisa: I like how you organized each entry by the simple questions a student might ask: What most likely happens, what’s going on, treatment, worst case scenario, prevention. Did you begin with this template for each health issue or did it come to you over time?
Jill Grimes, MD: The template evolved very early in the project, because I definitely wanted there to be a predictable cadence and approach to each topic. I was constantly tweaking and renaming different sections, fine-tuning until the category name worked across the board. Two of my prior books followed this pattern, and the Q&A seems to work very well for medical conditions. Honestly the most challenging topics to write were the few that did not fit the template, such as the smoking/vaping/pot topic. I had so much information to cram in, but using the full template would have taken up extra word space we didn’t have.
Achieving the right tone in a health handbook
Lisa: Can you talk a bit about tone and voice? What were you going for and why?
Jill Grimes, MD: The tone and voice in this book completely reflect my actual voice in the exam room. I appreciate how intelligent and well-educated my college student population is, and never want to insult anyone by appearing to talk down to them. At the same time, I want to be sure patients fully understand every procedure, diagnosis and treatment, so I try to keep my language plain while explaining medical issues and diseases. I think the Q&A format helps convey the natural back and forth conversational flow that you would share in person. As a bonus, I’m immersed in the college age world through our daughters, their friends and our shared social media, so hopefully my language and word choices reflect my comfort level and cultural awareness of the issues, social media platforms, abbreviations, and slang of this age group.
Balancing information and support in a health handbook
Lisa: The guide is, not surprisingly, comprehensive. It covers everything including assault. Especially in these chapters there was an element of emotional support—making sure the assaulted student understands it’s never their fault, in addition to providing medical information. Was it challenging to move between technical information and support?
Jill Grimes, MD: The main challenge was the word limit. And inability to observe the subtle reactions of the reader, which in person, might have changed my tone or expanded my questions. These delicate conversations are so challenging, regardless of a clinician’s training and experience.
Interestingly, the assault topic was the one most affected by parent input. Adults who had experienced date rape or other sexual assault during their college years specifically asked me to repeat the “it’s not your fault” multiple times, to be sure that young people would hear that message as clearly as possible. I’m glad to hear that came through. Additionally, many parents of boys (who have heard me speak to their sons) wanted to be sure I included my warnings that drunk or buzzed consent was not actual consent.
Illustrations in The Ultimate College Student Health Handbook
Lisa: Do you have a favorite chapter? If so, which and why?
Jill Grimes, MD: Ooh, you know that’s like asking which is your favorite child! Since I’m a visual learner, I’ll pick two that both have illustrations — Insomnia and Strep Throat. “Insomnia” is a favorite because I enjoy showing that there are so many different, helpful interventions. (I’m all about changing behaviors rather than using medications whenever possible). Strep throat as a diagnosis is always a doctor favorite because it is very specific, usually easy to diagnose, and curable. This chapter in particular is one of my favorites because it was the very first illustration for the book. I’m very proud that our daughter Nicole, who is a junior animation major at Loyola Marymount University, did these drawings (including revising them over and over until they looked on paper how I had envisioned in my mind).
Lisa: Can you talk about the publisher’s role—at what point they came into the process and what input they had.
Jill Grimes, MD: In January 2019, I signed with Skyhorse Publishing (negotiated by my agent, Jeanne Fredericks). About six months prior to that (in order for my agent to pitch to publishers), I completed a lengthy, very in-depth book proposal that, of course, included a table of contents, chapter summaries and several sample chapters in addition to the requisite marketing strategies and author platform. As such, the meat of the book was fairly set. As discussed earlier, the publisher set a word count lower than anticipated, but they allowed me to decide content within their parameters. My editor at Skyhorse was available throughout, but mostly jumped in to the process once I gave her my completed manuscript. The Skyhorse team did all the formatting, content and copy editing, and then patiently allowed our extensive input on the book cover design.
Working with a literary agent Tweet This
Jill Grimes, MD: Attracting a literary agent (or publisher) is largely about being prepared. Have your 30-60 second pitch down, know your platform, and know your specific market (hint, your book is not for “everyone”). If you don’t know how to do those things, it’s time for a conference or a book coach. The next step is chemistry. You want an agent that is genuinely excited and interested in your idea, someone who immediately starts expanding on your concept and helping you stretch it. Finally, you need to actually talk with people who have worked with that agent before, and ask them what has been most challenging. Some of the best creative minds are the worst financial ones, and money flows through your agent.
Creative process of writing a health handbook
Lisa: Can you share a bit about your creative process, such as the time of day you write and anything you do to get into that writing zone?
Jill Grimes, MD: I always fantasize about going away to a mountain retreat and writing nonstop for a week and cranking out a book. Pro-tip: that almost never happens! Life always interrupted when I planned these retreats. How I get books written is to carry my laptop with me everywhere and grab minutes here and there to write whenever I can. When the girls were young, I wrote sitting in my parked car, waiting in carpool line for school to let out each weekday. I found that if I could squeeze out even one paragraph sitting there, and then another the next day, before long, I had several pages and a chapter, and then that success propelled me forward.
These days our nest is empty, and I work part-time, so I have the luxury of more writing time. Or maybe the curse. With less pressure to squeeze in writing, I often find myself “procrasti-cleaning” before getting focused. Ideally, I use my morning dog-walking time to hash out what I want to write about, then be sure I’ve showered and eaten so I’m mentally and physically prepared to write when I actually sit down to work.
The Effect of COVID-19 on a Publishing Launch Tweet This
Lisa: How has COVID-19 and sequestering at home affected your launch?
Jill Grimes, MD: My planned book launch had been very travel-heavy, with book store and college campus (freshman orientation) events planned in multiple states. Obviously all these events and travel are now at best postponed, and many cancelled. We were looking forward to bookstores featuring their graduation displays just as my book would be released, which would have been ideal timing. Fortunately, my publicist and I are working together to promote a virtual book tour with bloggers, podcasters, and radio shows across the country. We are pitching this book for graduation gift lists and gift baskets. Everything is different than we had planned, but we are fortunate to have online sales and media to move forward.
Lisa: Best of luck with it. I think this handbook is destined to be a classic for high school graduation gifts and anyone starting college. Every college bookstore should carry it! Hope our kids will be back to college soon!
The best advice: “write the book”
Lisa: Is there anything else you’d like our readers to know?
Jill Grimes, MD: Best writing advice for total novice writers (especially those with a day job in another field) came from my friend and best-selling author, Jeff Abbott. Sounds simple, but his advice was “write the book”. Stop talking about writing a book, and sit down and start writing. Stop fretting about formatting, looking for agents, wondering which publisher is best, and just start writing. Be a writer with real words on paper (okay, at least words typed on your laptop document) and then start asking questions.
About the Author
Jill Grimes, MD, FAAFP, is a nationally recognized medical media expert, award-winning author, and proud mom of two awesome collegiate daughters. After two decades of private practice, Dr. Grimes now works at the University of Texas at Austin. She also enjoys speaking at American Academy of Family Physicians, Pri-Med®, and Harvard Medical School conferences.