Interview with writer Amanda Skenandore

I met Amanda Skenandore last year at my local indie bookstore and was instantly captivated. She was on book tour for her latest historical novel, The Medicine Woman of Galveston. As Amanda circulated black and white photographs around the room, she brought history to life through lively conversation about the role of women in medicine in the late 19th and early 20th centuries, the “Great Storm” of Galveston – America’s deadliest natural disaster – and the curiosities of traveling medicine shows.

One of the central themes in Amanda’s book is the concept of impossible choices and the resilience required to face them. This theme is reflected in the experiences of her characters, particularly in her protagonist Dr. Tucia Hatherley, a female physician, who must navigate difficult decisions during personal crises and during the Galveston hurricane of 1900. Amanda reveals parallels between historical and contemporary issues, emphasizing that the human experience of facing and overcoming adversity is timeless. Both then and now, victims of disaster – both environmental and deeply personal – show resilience in their strength to rebuild and recover.

Katy: Something I find really fascinating about you is that you are both a registered nurse and a writer of historical fiction. Which reminds me of the Icelandic writer of crime fiction, Yrsa Sigurðardóttir, who’s also a civil engineer. In Iceland, 1 in 10 people have published a book, which is wild!
How does your work in medicine inform your work as a writer?

Amanda: I spent the first three years of my career working as a neonatal nurse and hating my job. We take our brand-new nurses and kind of throw them out into the water and hope they’ll swim and watch as they flail. During this time, I took a short story class and loved it, so I decided to quit my job as a nurse and become a writer. I bought a laptop and wrote my first book which was never published; it was a training wheels book. I realized publishing a book was going to take a lot longer than I thought so I went back to nursing to help pay the bills. And I’m still working as a nurse today. Now I do infection prevention, which I love.

But as I continued to write, I found more and more of the medicine part of my life spilling over into my writing. My second book is about an undertaker. I think that was my first foray into historical medicine, and I found it so fascinating. Health, well-being and disease play such a huge role in our lives and so I just kept going in this direction, finding bits of interesting history that I glommed onto.

Katy: It sounds like you love the research process. A writer friend once told me that research is crucial for any sort of writing but that the reader should never know how much research is involved, and if they do know, then you’re doing it wrong.

Amanda: The research is a joy! I work within a framework of the facts for historical fiction, and it’s such a balance to know what I can bend for the purpose of narrative and what needs to stand as a pillar. For this book, it all started with the medicine shows. They kind of hover on the periphery of American consciousness.

So far, with all of my books, I’m drawn to something like a moment in time or a particular place, then I structure a story around that. But the medicine show itself didn’t give me the anchor I needed. Medicine shows existed for decades and in all kinds of forms. Eventually, the Galveston storm of 1900 became my anchor in time and place for this story. I’ve been very lucky that, for most of my books, I have been able to go to the place where the story is set. In the case of Galveston, I could test the quality of air and what it feels like to be on an island. I did archival research at the Galveston library, the Galveston & Texas History Center and UTMB (The University of Texas Medical Branch).

And as with every historical fiction writer, I strike a bargain with my reader: this is fiction but grounded in the truth, in the facts. I want my readers to be able to trust what’s there.

Katy: Speaking of trust, the inclusion of a traveling medicine show in your book allows you to explore ideas relate to healthcare and the trust we place in healthcare providers. How does Tucia’s decision to join a traveling medicine show erode the trust she has in herself as a physician?

Amanda: When I wrote the first draft of the novel, Tucia wasn’t a physician but a medicine show operator. But the book never came together that way. I had to take a step back and be honest with myself and realize that it wasn’t worthy of my readers. I had to dismantle everything and figure out what wasn’t working.

I went back to the drawing board and made the decision that Tucia would be a doctor. There’s the question, of course, of how you get someone who’s a physician and who believes in medicine to take part in a traveling medicine show. The stakes would have to be high if she is willing to sacrifice her principles. I thought, a mother would do that, right? So, Tucia joins this medicine show as a physician and as a single mom to support her disabled son when she can no longer find employment any other way.

Katy: This iterative process of refining your characters ensure they have depth and authenticity. Tucia’s character really reveals itself in this exchange: Dr. Kremer tells her, “Sometimes medicine presents us with impossible choices,” to which Tucia responds, “sometimes life does as well.”

After the deadline hurricane in Galveston, Tucia must choose whether to stay and rebuild, or move on. I see her decision as a metaphor for the way she lives her life. Your entire cast of characters – including the marginalized figures of the medicine show troupe – are faced with impossible choices.

Amanda: Certainly, the characters working these medicine shows were by and large very marginalized. The way they got there oftentimes was out of desperation or coercion. I wanted to show that and put the idea forward that we make so many snap judgments about people as soon as we see them. I wanted to play with the idea that what you’re seeing, those knee-jerk reactions, are usually not at all or only a tiny sliver of the truth. Delving into each person’s past highlights for the reader just how varied and interesting these people are.

Katy: Looking at your central character, Tucia, we are reminded of how complex and multilayered we all are. In Tucia’s case, she suffers from PTSD and the obsessive-compulsive disorder Trichotillomania. Not only that, but she is responsible for and takes great joy in caring for her son, Toby, who has Down Syndrome. The result is that Tucia develops great empathy for others, which is a quality that all healthcare providers should ideally possess. Your representation of mental health challenges and disability speaks to a diverse range of human experience.

Amanda: Sometimes we read or see things about the past where everyone is presented in this perfect way. Everyone seems healthy and whole, and I just think that’s a terrible way to depict the past. Back then, there wasn’t a name for PTSD, and it’s the same with Trichotillomania. I wanted to present characters that were scarred in a way, to highlight the diversity of human experience. For me as a modern reader, seeing these things reflected in the past can be helpful. It feels less alienating. Like, we aren’t the first people to be going through this.

Katy: Right! And language itself feeds into this continuity of human experience. Lawrence, a member of the medicine show troupe, is presented this way: The snake leader’s words were “a kind of poetry. They reached inside him [Lawrence] the way a sapling’s roots reach into the earth, sucking up its medicine and giving life to something new. Passion. Conviction. A zeal Lawrence had never known he possessed.”

Amanda: I’m a lover of language. Finding those right words spoken in the right context with the right reflection can be so momentous for a person. I love that language is both informed by our experiences and also our experiences inform language. Language can be a powerful tool for both healing and harm, depending on how it’s used.

Katy: As is medicine. I’ve always thought of books as a form of medicine. Literature has the power to heal, inspire and provide solace during difficult times. Your roles as a nurse and a writer reflect this belief, as you use both medicine and literature to help others.

Amanda: My work as a nurse has brought a lot to my writing, but it works both ways. Being in a character’s skin really exercises your empathy which is so important as a healthcare provider. You see a patient’s chart and make all sorts of assumptions about their life. Being a writer has helped me step back and look at patients, first and foremost, as people with their own unique backgrounds. I think writing has made me a better nurse. I’ve been lucky enough to do both.