JL Lycette - Exciting Medical Thriller Featuring Artificial Intelligence
JL Lycette is a novelist, award-winning essayist, rural physician, wife, and mother. She has a degree in biochemistry from the University of San Francisco and attained her medical degree at the University of Washington. Mid-career, she discovered narrative medicine in her path back from physician burnout and has been writing ever since. Her essays can be found in Intima, NEJM, JAMA and other journals; at Doximity and Medscape; and her website https://jenniferlycette.com. She is an alumna of the 2019 Pitch Wars Mentoring program. Her other published speculative fiction can be found in the anthology And If That Mockingbird Don't Sing: Parenting Stories Gone Speculative (Alternating Current Press). The Algorithm Will See You Now is her first novel. As our Author of the Day, she tells us all about her book, The Algorithm Will See You Now.
Please give us a short introduction to what The Algorithm Will See You Now is about.
The Algorithm Will See You Now is a speculative medical thriller set in near-future Seattle, where the implementation of A.I. algorithms to guide—and limit—healthcare turns out to be, in the end, subject to its human creators' flaws.
What inspired you to write this story? Was there anything in particular that made you want to tackle this?
In my day job, I'm a hematologist/oncologist (a specialist in blood and cancer medicine). During the 2010s, there was a lot of talk about IBM's Watson (a machine-learning A.I.) having a role in helping oncologists sort data and test results for our patients and helping us define treatment. But in the mid-2010s, that all fizzled out without much fanfare.
Meanwhile, the amount of data we're obtaining on our patients is ever-increasing, along with options for cancer therapies. I would welcome a smart tool like A.I. to help me on many days on the job. Many things keep oncologists up at night, but chief among them the constant rethinking and wondering, "Could I have done something differently?" If A.I. could help with that, sure, who wouldn't want that?
A little over six years ago, I first had the idea for the novel when I was reading about some of the mistakes A.I. tools were making. Like the misclassification of photos on Google, revealing the datasets used to train the A.I. had led to racist and sexist outputs. I thought, uh oh, what if we did one day achieve the goal of a very advanced medical A.I., but because of inherent implicit bias in our society, it turned out to be ultimately flawed at a very deep level. Mix this with the increasing corporatization of healthcare in the U.S., and my premise was born. I suppose very much a classic trope of the science fiction thriller, which is the question of ultimately what fault lies in the technology versus what responsibility lies with humanity.
Tell us more about Hope Kestrel. What makes her tick?
Dr. Hope Kestrel came into being as I thought about a character who would be a doctor who had lost her belief in hope, yet she's saddled with the name. She's 29 and a senior surgical resident at the fictional Seattle corporation "PRIMA," Prognostic Intelligent Medical Algorithms. At eleven, she lost her mom to cancer, and she was smart enough at the time, even as a child, to understand that much of what her mom went through resulted in more suffering than benefit. Hope thus devoted her life and career to becoming what she considers a better kind of doctor, one who wouldn't offer "false hope." She embraces PRIMA as the way to achieve that goal. But she's never truly faced her grief; she's buried it in her work. So when she's confronted with the possibility that PRIMA might not be everything she believes, she not only has to examine what that might mean for her career but confront the grief she's avoided for eighteen years—and figure out if she's strong enough to finally face it and how that's going to change her (or not… no spoilers…).
Besides writing, what other secret skills do you have?
I once crocheted an actual sweater—with sleeves and everything. But mostly, I stick to crocheting blankets, as the patterns are much more manageable.
A.I. is a hot topic right now, and your book explores the dangers that our reliance on technology may bring. Why did you find it important to write about?
The past decade in cancer care has seen tremendous advances in "precision medicine," which allows oncologists to target our therapies down to the level of a DNA mutation in the cancer cell. It's been an inspiring and rewarding time in cancer medicine. At the same time, unfortunately, it's currently only a minority of our total patients who we discover can benefit from these precision therapies.
Many future-thinking leaders in the field envision a time when we will have a precision medicine report on every patient and an A.I. tool to match the information to the treatment. (Currently, we do have what's called "NGS" (next generation sequencing), but it requires manual (human) review by the oncologist to interpret and apply to each patient's situation).
For the past decade, I've practiced as a rural community oncologist. I see daily the challenges in an under-resourced system and the disparities in care that occur in our own country between urban and rural regions. Combine this with the concerns over unintended inherent systemic bias in A.I. systems, and insurance companies increasingly putting profits over patients, and these are the conflicts I set out to explore in the novel.
What was your greatest challenge when writing this book?
It was, at first, difficult to write medical scenes and make them "believable." Even though I was drawing on my firsthand experiences as a physician, I had to rewrite my opening sequence countless times. I kept receiving feedback from my beta readers that they didn't find the scene believable (and not from a technology perspective, but the characters' behaviors toward each other). At the same time, the accurate portrayal of women in medicine was an essential part of the book, and I'm proud of my cast of complex female characters. But I had to learn that in writing fiction, you have to come at it through story. As many others have said, you can't be so precious about your writing. You have to adapt.
Where do you go for inspiration?
Books. I read across genres, nonfiction and fiction. Before I was a writer, I was a reader. I was one of those kids who just taught themselves to read at an early age, like in preschool. Books are my happy place.
When starting on a new book, what is the first thing you do?
I spend a lot of time in my head just thinking about characters and plot. I randomly type things into the notes app on my phone when an idea comes to me (often in the middle of the night). I let the ideas slowly germinate in a quiet corner of my mind for months before attempting a first draft.
Do you have any interesting writing habits? What is an average writing day like for you?
I'm sure some people will find this appalling rather than interesting, but I don't write every day. Because I have a demanding day job, I'm often too spent, mentally and emotionally, to write on the days I'm in the clinic. So instead, I do long writing sprints a few days a week. It's my creative and emotional release, so I don't mind it this way. When I first drafted Algorithm, I didn't know it was unusual (for some people) to write more than 1000 words a day. Some weekends, I wrote 10,000-15,000 words in a weekend. I haven't done that in a long time, though.
What are you working on right now?
I'm wrapping up final revisions on book 2, The Committee Will Kill You Now, a prequel to The Algorithm Will See You Now, and will be published in November of 2023. Although each book can be read as a standalone, this next book features two of my characters from Algorithm in their younger years. It essentially tells the "villain origin story" of the antagonist in Algorithm, Dr. Marah Maddox, wrapped up in a historical thriller about the inhumanity of physician training in the 1990s interweaved with the true-life history of the medical rationing of the first kidney dialysis in 1960s Seattle. It will also be published by Black Rose Writing Press.
Where can our readers discover more of your work or interact with you?
Social media links: