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An Interview with Kate Ledger

Author of Remedies


Bonnie Brody had the opportunity of interviewing Kate Ledger, author of Remedies. Kate lives in Minnesota with her husband and three children. She is currently working on a new novel that is about family and is connected to medicine, two topics close to her heart. The questions in this interview all pertain to her novel, Remedies.

This interview was conducted by Bonnie Brody for (MF). Read Bonnies's review of REMEDIES as well.

Remedies by Kate LedgerMF: How did you get the idea for this book?

KATE LEDGER: I’ve written for years about health and medicine. I was a senior writer at Johns Hopkins Medical Institutions and I decided to turn to freelance writing and to begin that novel I’d always wanted to write. In the course of magazine writing, I’d met many doctors and researchers who’d come up with amazing treatments that were incredibly beneficial to patients, though some of those treatments ran counter to common thinking and even to traditional medicine. I became interested in writing about a doctor who comes up with a treatment for pain, a therapy that he believes in even though he doesn’t necessarily have proof (beyond what his patients tell him) that it works. Then I began to wonder: what kind of person comes up with a treatment? What kind of person believes he’s right and that an entire body of medical literature is wrong? What would his personality be like? I began to develop Simon Bear’s character, someone intent on easing his patients’ suffering at any cost. After a while, it occurred to me that his desire to treat his patients’ pain came from his inability to address his own. His pain, it seemed, was tied to his family, and the novel took shape from there.


MF: Your philosophy about pain relief isn't shared by many. I agree with you about the importance of opiates in alleviating pain. How did you get to feel so strongly about this?

KATE LEDGER: My intention was to write literary fiction—which is about characters and the beauty of language. I didn’t set out to write a novel with a platform or a political agenda. I did a lot of reading about pain in my research for the book. I spoke with patients whose lives had been up-ended by chronic pain, the kind that goes on for months, even years, often with no known source. I also talked with prominent doctors about how they treated pain. I stumbled across the conflict about opioids—drugs like Oxycontin that have become the focus of debate. Many of the people I spoke with asserted that opioids remain the gold standard in pain treatment. I also stumbled across accounts of doctors whose offices had been raided by the DEA and who had been prosecuted for alleged overprescribing of pain medication.

As I was writing, I felt that Simon Bear, the doctor I had created, would feel full-heartedly that patients shouldn’t suffer. He believes that pain doesn’t have properties that help healing, and that there’s no point in “bucking up” or just dealing with it. He believes that patients should have access to opioids, as well as other treatments, if they believe that will help them. Since this is a work of literary fiction, Simon is a character who has flaws and who doesn’t always act in the best way, and that complicates his good intentions. In the course of writing, I developed a sense of the kind of health care I’d personally like to have available to me, not necessarily for pain, but for all health issues: treatment that’s patient-directed, compassionate, individualized, based on a relationship with a doctor who really cares that I feel good. I think many people agree that chronic pain goes undertreated in this country. I hope that the book raises the topic of pain treatment, the drugs that are used and the problems that arise, the pressures that are placed on doctors, the involvement of the government, and I hope the book provides an opportunity for people to discuss what’s going on.


MF: Why do Simon and Emily never talk about their dead son, Caleb?

KATE LEDGER: Simon and Emily have an exquisitely complicated relationship. I think, like many married couples, they know where each other’s wounds are. They’ve both suffered the loss of their child, but out of deep respect for each other, they avoid discussing the topic. The problem is, any topic that’s avoided, doesn’t necessarily go away, so they’re constantly trying to have that conversation—without having it. Simon is always doing things that will provoke Emily, and perhaps will provide a confrontation. He’s waiting for confirmation that he’s responsible for not having been able to save his son’s life. For instance, he knows, on some level, that she’s going to be annoyed by his grandiose plans to make wine. But he’s not just making wine; he’s trying to engage her in a way that ultimately may escalate into a fight. Only then, when she’s out of control, might she dare to blame him. She’s so resistant to the idea that he might be at fault, or that she might still be angry at him fifteen years later, that she can’t bring up her son’s name.


MF: Do you think that anyone truly recovers from profound loss?

KATE LEDGER: I think we can learn ways to incorporate loss we’ve suffered into our lives. We may not be the same as we were before, we may be profoundly changed as a result, but that doesn’t mean we’re not okay. It’s when we pretend that it didn’t happen, or that we’re just moving on, that we risk another kind of destructiveness to ourselves and to each other.


MF: Why do you think that Emily stayed with Simon for fifteen years? Was it just the surfacing of her ex-lover that brought her to the knowledge that the marriage wasn't working or was their more to it than that?

KATE LEDGER: Simon and Emily have achieved a working balance in their marriage. It’s not necessarily healthy, and it doesn’t necessarily feel good, but it functions. They’re professionally successful people, and—deep down—they don’t want to hurt one another. But then Emily bumps into Will, who was her lover long ago. He represents to her what she was like when she was young, before she’d lost a child, before any suffering entered her life. I feel she wouldn’t have been intrigued by any man who appeared suddenly in her life, but Will represents a means for her to touch her past.


MF: Their daughter, Jamie, is a lost soul, looking for attention. Why do you think, especially after the loss of their son, that she is so ignored by Emily and Simon?

KATE LEDGER: There’s no doubt Jamie is the one who suffers most from the tragedy that occurred even before she was born. Emily wants to be a good mother to her, but she’s scared. Jamie is angry, and Emily retreats from confrontation. The angrier Jamie gets, the worse their interactions are and the more Emily wants to distance herself. What Emily encounters in the course of the book is a vision of what her relationship could be like with her daughter. She comes to realize what she’s missing out on. And she realizes, if she wants that relationship, she’s going to have to put work into it.


MF: Do you think that Simon is obsessed with the "cure" or do you think he really believes it will work?

KATE LEDGER: That’s a tough question to answer. I believe Simon is a person with integrity; he’s smart. Simon wants passionately to help his patients. While I was doing research for the book, I read about the placebo effect, which is when something as simple as a sugar pill seems to offer help in treating disease. It turns out the placebo effect has been known to cure things as complex as kidney disease. It’s not that “it’s in your head” but that the mind is incredibly powerful. I think this is the case for Simon too.


MF: Simon has good intentions but is bad with follow-through? Do you think that his relationship with his daughter would have been much different if he'd followed through with his wine project, for instance?

KATE LEDGER: Yes, I think any one-on-one with Jamie would have made a big difference. I think children need attention. I became a mother during the years I was writing the book, and this point came clear to me the older my children got. One of my sons was awed when he and I went, just the two of us, to the hardware store to buy a shovel. That one outing made a huge impression. It doesn’t necessarily matter what the event is—you don’t have to make wine, for example—but just the opportunity to do something together tells them that they’re important. The worst thing to do by far, and Simon is guilty of this, is to make a promise as a parent and then not come through.


MF: Simon's relationship with his parents is so broken. What is his part in that? What is theirs?

KATE LEDGER: They have a complicated relationship that’s affected his relationship to himself and to the entire world. His parents have never paid attention to him, respected him, or given him his due. Because of that, he’s spent his life proving his worth.


MF: Thank you Kate for your thoughtful and thorough answers. I look forward to your next novel.


Read our review of Remedies at