Planning a Novel: Lessons in Strategy from Healthcare to Fiction

“Everything has to be perfect, and all contingencies have to be considered at every step in the completion of the exercise.”

Kate (It Could Have Been Murder) 

When people think of writing a novel, they often imagine a burst of inspiration leading to pages effortlessly filled with words. 

But for me, writing It Could Have Been Murder wasn’t a spontaneous creative outpouring—it was a carefully planned operation. And I can thank my years in healthcare for that.

Working in large healthcare systems teaches you one thing above all: planning is everything. 

Whether running a hospital or writing a novel, success depends on understanding the big picture while obsessing over every small detail. 

It was this mindset that shaped my approach to writing.

Setting Goals and Adapting Along the Way

At the start, I aimed to write 30,000 words. 

A manageable goal, inspired by a Ted Talk about tackling challenges in small, consistent steps. The speaker claimed you could accomplish anything in 30 days, and I believed I could hit 1,000 words a day. 

But as I reached 25,000 words, I realized my story was much bigger than anticipated.

Suddenly, my “30-day challenge” became a months-long marathon, with a new target of 70,000–80,000 words. 

Like in healthcare, where plans often need adjustments, I reset my goals to meet the evolving demands of the project.

Kate’s reflection in the book mirrors my journey: 

“When I reached 25,000 words, I wondered how the heck I was going to get to 50,000 words, let alone 70,000. Then I reached 65,000 words, and I wondered how the heck I was going to end the book in the next 10-15,000 words.”

Writing is rarely straightforward, but being flexible kept me moving forward.

Structure as a Creative Tool

Healthcare systems thrive on well-designed processes, and I applied the same logic to my novel. 

Writing 1,000 words a day wasn’t just a random goal—it was part of a structure I created to ensure consistent progress. Each day’s work built on the previous one, like pieces of a puzzle fitting together.

The same strategic mindset influenced the way I developed the plot and characters. 

Much like a hospital’s careful contingency planning, the story needed backup plans for every twist and turn. 

Kate describes this perfectly: 

“You HAVE to know every place where there can be a kink in the chain, and you have to be able to fix the chain as quickly and smoothly as possible without losing any of your momentum.”

In writing, as in healthcare, preparation is key. 

The more you plan, the more freedom you have to adapt when things are unexpected.

Finding the Humanity in the Process

While strategy was crucial, writing also required heart. Healthcare is about people first—patients, families, teams—and so is writing. 

At its core, It Could Have Been Murder isn’t just about thorough planning; it’s about the characters and their relationships, decisions, and emotions.

Kate’s journey reflects the balance between strategy and emotion. 

As she says: 

“I don’t think whether the target is morally corrupt is important to you. I think it’s the power and the game.”

For me, this line resonates because it captures how personal motivations drive every decision, in life and in fiction.

Lessons for Aspiring Writers

1. Set Manageable Goals: Start small—whether it’s 1,000 words a day or a single chapter outline—and build from there.
2. Be Flexible: Just as healthcare plans change with new information, be willing to adjust your writing goals as your story evolves.
3. Structure Your Process: Create a routine or framework that keeps you consistent, even when inspiration wanes.
4. Stay Human: Never lose sight of the emotions and relationships at the heart of your story. Strategy gets you to the finish line, but heart makes the journey worthwhile.

Planning Isn’t Just for Plots

Writing a novel isn’t that different from planning a surgery or running a hospital. Both require a combination of preparation, adaptability, and a deep understanding of the human experience. 

If you approach writing with the same level of care and thoughtfulness, you can turn even the most daunting project into something achievable—and maybe even enjoyable.

As Kate might say: 

“Everything has to be perfect, and all contingencies have to be considered.”

It’s not always easy, but it’s always worth it.