Anatomy of a Suspense Novel

Anatomy of a Suspense Novel

Anatomy of a Suspense Novel

I’ve been a doctor for more than twenty years now, but I can still remember my very first day of medical school. As I walked into the room, the smell of formaldehyde burned my eyes. A group of us stood around the table, organizing our tools and nervously chatting. Finally, we slid open the metal cabinet. There I stood, a scalpel trembling in my hand, ready to cut into the leathery skin of a dead body.

Why am I telling you this?

Well, I’m a doctor, but I’m also a suspense writer, so I had to freak you out just a little bit. But even more, I would like to propose an unlikely metaphor: the body as a suspense novel. This may seem like an odd idea. But if you think about it, every suspense writer is like Mary Shelley creating her own Frankenstein. I am just filling in the atlas of the book’s vital organs.

Let’s dissect this a bit, shall we?

In brief, we have the skeleton, the blood, the lungs, the suprachiasmatic nucleus (bear with me, I’m a neurologist), the heart, and finally the brain. The skeleton is the plot, the structure that holds up the whole book. The characters are represented by blood flowing throughout the novel. The lungs are the writing itself, fueling the work with oxygen. The suprachiasmatic nucleus sets the pace of the novel. The heart gives the book an emotional resonance. And finally, the brain provides all the twists and bumps along with way.

Got it? Okay, everyone, turn to page one and get out your scalpel.


  • The Plot.

In anatomy, we studied the skeleton from plastic replicas as well as fake, anatomically correct skulls. For our purposes here, the skeleton serves as the plot, carrying and shaping the book. If the plot is meandering or convoluted, the novel quickly droops into an amorphous blob. Don’t get me wrong; the skeleton is anything but straightforward. The plot may exit through a surprising hole in the skull, jog around a rib, and crawl down a long femur on the way. Still, with a healthy set of bones, the narrative moves seamlessly from the top of the cranium through the sustaining marrow right down to the the calcaneus (a.k.a., the heel) at the end.


As for our corpse, we couldn’t actually see any blood, only the rubbery, collapsed tubes (thin for veins, thicker for arteries) that kept the stuff in our bodies. (Though, throughout our training, we would see more than enough of it anyway.) Blood represents the characters in the story, coursing along the pathway of the skeleton. Boring, clichéd characters will make the story anemic, weak, and forgettable. On the other hand, overbearing, unbelievable characters will weigh it down, causing the cells to sludge through the veins. Well-rendered characters with quirks, fears, and credible motivations are like the perfect level of hemoglobin, feeding and strengthening the book.


  • The Writing.

Lungs are surprisingly spongy, like squishy bellows in the body. The lungs are the words that breathe air into your story. Boring, cookie-cutter writing will slow the book down, deadening all the other organs. On the other hand, overwritten “purple” prose will blow the lungs into hyperinflation. With the right oxygen level, the words will surprise and thrill readers, drawing them in, and sometimes, paradoxically, leaving them short of breath.


This one is cheating a bit because it’s microscopic. We couldn’t see it during a dissection, yet this nucleus is no less important. The suprachiasmatic nucleus is the body clock, stored right in the middle of your brain. The SCN sets what time you go to sleep and wake up, when your hormones shoot off and your gastric enzymes flow. This is the pacer of the novel. Too slow, and the reader gets bored and snoozes too early. Too fast, and the reader drops the book, unable to handle the tension. But when the SCN is on target, some chapters will fly, while others will creep forward menacingly. The best pacemaker, however, erases all sense of time, forcing the reader to stay up until morning to read just one more page.

Anatomy of a Suspense Novel

The heart is a knobby thing, left of center behind the sternum, fitting like a puzzle piece into the thoracic cavity. The heart represents the emotional resonance of your novel, in other words, “all of the feels.” This organ makes the reader care for the characters, laughing when they joke, crying when they cry, and screaming “no!” when a character is about to do something unthinkably dumb. When the heart beats too slowly, the reader is tempted to say “meh” and throw the book in the DNF pile. When the heart pumps at the right force, the reader becomes invested in every scene, gets the “book hangover” when it ends, and then preorders the next book as soon as humanly possible.

You may not know this, but reading a Stephen King thriller can actually stop the heart. (Okay, I just made that up, but it could be true.)


  • The Twist. This brain is a magically folded puzzle, chalky gray on the inside and pearl-white on the outside, with the consistency of a medium cheese. As a neurologist, I’ll admit, it’s my favorite organ. The brain is in charge of all the trickery in your novel. The cortex lays out the puzzles, clues, and red herrings. If the novel is stuck around the brain stem, the read will be predictable, the whodunnit obvious on page 73. Gather up enough neurons, and the reader will fall for all the subterfuge. The big reveal will be not only shocking but believable and, hopefully, the book will end up stored in the reader’s amygdala for years to come.


The anatomy lesson is over. You may put down the scalpel and close your book. Maybe you learned something, or maybe you just thought “wow, that was a really over-extended metaphor!” Either way, you are now ready to give birth to your own little book-baby. All you need are the right parts: strong bones, pulsing veins, a touch of genius, pure oxygen, a good ticker, and a worthy heart. Then, under the gorgeous skin of your cover, all of the organs will work in silent harmony, bringing your novel to life.


SANDRA BLOCK is an International Thriller Award finalist and author of Little Black Lies, Girl Without a Name, and The Secret Room. She graduated from Harvard, then returned to her native land of Buffalo, New York, for medical training, and never left. She is a practicing neurologist and lives at home with her husband and two children. What Happened That Night will be published by Sourcebooks Landmark in June 2018.


Visit Thrillers That Give You Shivers and enter to win a $1,000 gift card and other items from your favorite Sourcebooks authors.




Posted in Young Adult.

Leave a Reply