A compelling premise
This is the most important part of any medical suspense thriller. A great deal of time needs to be spent on making sure that the premise of the story will engage and draw the reader into your story. The premise should be something that is fresh. It is possible but very difficult to use a premise that everyone has used in a suspense thriller and make it exciting for readers.
A central character that the audience is rooting for
A central character is very important in terms of creating an emotional attachment between the reader and the story. A central character that the audience likes and wants to succeed will make the reader want to continue your novel. However, some very effective and enjoyable novels can be created with heroes that are less than perfect or even central characters that the audience wants not to succeed.
If the audience is not very emotionally engaged to the central character the story has to be constructed so that it creates interest and the reader wants to know how it ends.
Constant series of exciting events with tension
Events that are unpredictable are essential to hold the interest of the reader in the story. A person keeps reading a novel because they would like to see how the story progresses. Using too many standard techniques and scenarios will bore the reader, especially readers who read a great deal in your genre.
It is preferable in the quest to keep events exciting to avoid chance and coincidence. Although dumb luck and coincidence do occur in real life, in many stories especially if overused they create a very artificial feel and the reader may become disenchanted.
Tension mounts when each building block of the story is placed on the next, increasing the stakes and the difficulty which the characters face.
Unpredictable ending
Trying to create an ending that is not easily seen by the reader can make a book very enjoyable. I always try to fully understand how my novel will end before I begin writing. I may change the ending when I write, but often the ending is very similar to what I had envisioned when I started the story. When thinking about the ending it may be valuable to sketch out a couple of scenarios.
Well-paced story
When I use the term pacing the story I am referring to bringing out critical elements of the story at the appropriate time. If you bring out all the exciting elements too early or too close together the reader will then be left with long passages of the story where other less exciting details are presented that are essential to the story but may not hold the readers interest. Sometimes it is helpful to create a diagram or a “story map” to see where all the elements of your story occur. By analyzing this it is then possible to play with the placement of certain elements of the story to see if they could be better placed elsewhere. Also sometimes for the reader to understand what is happening there is need for background information or very technical information that is didactic. Looking at the story in a diagrammatic form may help you position these elements beside or within the context of more compelling action in the story. I also try to create and ebb and flow to the story that is unpredictable.

Dr. Matthew MacAulay is a Facial Transplant Surgeon at a prestigious New York hospital. His friend and mentor, Tom Grabowski, dies under mysterious circumstances. Matthew is forced to investigate. He uncovers his friend’s secret. A new technique that allows perfect facial transplants. No incisions, no scars. The surgeon is able to transplant one person’s face to another with the perfect result. Tom was able to accomplish this monumental feat with the help of Alice, a supercomputer robot with almost human abilities. While trying to find the people responsible for murdering his friend Tom, Matthew realizes he is the prime suspect. Matthew must flee for his life with the help of Dr. Sarah Larsson, a colleague and reluctant helper who has a secret of her own.
Alice helps them make sense of a baffling series of seemingly unrelated events. Matthew is forced to undergo a facial transplant to hide his identity and help to uncover the truth. The clues carry Matthew and Sarah around the world. Matthew stumbles onto a sinister plot of monumental proportions, the real reason Tom was murdered. This discovery leads Matthew all the way to The White House with a dramatic conclusion. Matthew never wavers in his quest for the truth and perseveres against all the odds. He must race to stop a major catastrophe, ratcheting up the excitement until the thrilling conclusion. The Face Transplant is a powerful medical suspense thriller of the first order. The novel was written by a surgeon. The novel has a realism that only a surgeon can bring. The plot weaves politics, medicine and espionage into a tightly paced, intelligent thriller. The novel crescendos page by page to a totally unexpected conclusion.
Excerpt:
“There are only 3 types of bleeding that are important when performing surgery. One: bleeding you can’t see. Two: bleeding that you can hear. Three." After a long pause for effect, a quiet silence filled the operating room theater as nurses, anesthetists, medical students and visiting surgeons strained to hear. With a sense of the dramatic Myles lowered his voice. “Three…,” then roared, “Your own!” With the final comment the operating room burst into applause and laughed, it was vintage Myles, perfect delivery, perfect intonation. He had a flare for the dramatic. The Professor pulled off his gloves with a flourish and left Matthew to close the incision with the scrub nurse.
About the author:
Robert was born in London, United Kingdom. His early formative years were spent in Toronto Canada. Robert attended the University of Toronto Medical School. After obtaining his Doctor of Medicine degree he completed surgical training in Otolaryngology-Head and Neck Surgery at the University of Toronto and obtained certification from the American Board of Facial Plastic and Reconstructive Surgery. Robert Mounsey practices surgery in private practice in Toronto.
R. Arundel studied Film Studies at Ryerson University, after this he began writing screenplays and novels. The Face Transplant is his debut novel.
R. Arundel is married and lives in Toronto, Canada. When not writing or practicing surgery, Robert can be found cycling. For more information, go to Arundel's website or follow him on Twitter. The Face Transplant is available in paperback at Amazon and Barnesandnoble.com.