Writing a book can be a challenge—but the sweat (and maybe tears) is worth it on the
J. David Prologo, MD, FSIR
other end. Three published IRs, J. David Prologo, MD, FSIR; Ziv J Haskal, MD, FSIR; and Kumar Madassery, MD, FSIR, shared their journey of writing and seeking publication during a Compelling Conversation at the SIR 2024 Annual Scientific Meeting.
Among other works, Dr. Prologo wrote two books at opposite ends of spectrum, one for the lay public and one textbook on pain management. Dr. Haskal recently published an “Extreme IR” coffee table book as well as a general topic IR playbook, and Dr. Madassery produced a book on limb salvage with over 60 expert perspectives.
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Ziv J Haskal, MD, FSIR
What was your incentive to write your first book?
Kumar Madassery, MD, FSIR
J. David Prologo, MD, FSIR: I wanted to be famous. I had seen other doctors like Dr. Atkins who published a book and were off to fame and fortune. But I learned it’s the other way around—you need fame and fortune first to have a platform to sell to the general public. You can’t publish first and then have that platform suddenly materialize.
My lay book was a labor of love. I’m glad I did it and would do it again.
The textbook, which is more recent, was an answer to questions I get 10 times a day. I wanted to make a comprehensive resource on advanced pain management. This book was an altruistic endeavor, but it was a nightmare. You think you’ll outsource to 30 experts, and they’ll give you back a chapter ready to go. Instead, we ended up with 55 chapters that had to be reformatted and edited.
Ziv J Haskal, MD, FSIR: The IR Playbook came to be when a resident said they wanted to write a book. Like every student who wants to write a paper, you agree to it, but not many will follow through. But she kept coming back, so I kept assigning her tasks. I had her look at the market, then do a SWOT analysis of the need and the competitive landscape. Then she wrote an example chapter, approached publishers and kept knocking down every mile marker. We designed something that had a niche.
In making Extreme IR, I wanted a coffee table book with over 200 authors that captured the excitement of the SIR annual meeting “Extreme IR” session and JVIR series.
Kumar Madassery, MD, FSIR: I would get questions and say go read about it and tell me what you find, and then realized people didn’t know where to go for these questions. There’s so much out there, but no good source or book. So, if someone wants to know something in this space, why not have an abbreviated version?
How did you find a publisher?
JDP: For the textbook, the publisher came to me. Now that it’s done, I’m proud, and people are seeking it out and reading it so there’s some good. But the lay public book was the opposite scenario. In that process, you have to find an agent because the publishing companies won’t take your call. I thought for sure since I’m a doctor they would be clamoring to publish my book. I must have sent out 250 emails that were rejected before finally getting an agent that would pitch my idea to publishers. I already had the book written, but had to write a proposal, get an agent, have them pitch it, approve it and make a deal. That’s how the lay public book worked.
ZH: I contacted a publisher I knew, made a proposal and they said no. So then I went to another publisher and they said yes. That’s just how it is. You can’t take it personally; that’s the approach in medicine as well.
How did you project manage the creation of the book?
JDP: For the textbook, it was like herding cats. Think about all of the emails you receive. Now you’re the one sending those emails, trying to get extremely busy people to stick to a deadline. It was a lot of reaching out, texting and calling to remind authors of deadlines. A lot of that is so you can get people to turn in their work, just so you can rewrite it.
KM: Once I realized how much work this would be, I bought a large, magnetic dry erase board and wrote down things to do. I had to find 65 people I trust, whom others will also trust, and reach out. I have a great co-editor and she did that work in terms of organizing and keeping on top of things. If you’re going to do this, find someone on the academic side to help. You must find someone who will stick with you and organize, email and contact people. Pick the right co-authors who you have connections with and who you can reach out to personally.
It’s important to give co-authors a very clear explanation of what you’re looking for. Outline what you want, then be prepared to redo it, or send it back and ask for edits. It’s your vision. Make sure it fits what you asked for.
ZH: The IR Playbook was split into different pieces that each person was in charge of, and then we did an overarching review of the entire product. I highly recommend a template of the chapters to send to people so they can follow a skeleton, but you’re going to be rewriting. You also want to create a house style for your book, so everything reads similarly.
KM: Also keep in mind that since the space changes so fast, I had to update, add subsections and have people change their chapters, especially those who sent their work in early. They got penalized for being first, unfortunately, but you must have recent and updated information.
You will put a lot of time into this. As long as you’re passionate and have a good reason, it will be worth it. Project management is essential.
Any advice for negotiating with publishers?
JDP: A regret I have in negotiating with publishers is that they wanted to turn my passion into something they thought would sell. In order to get a deal, I caved in to some things I did not want in that book and regret it. I encourage you to stick to your guns.
ZH: For the IR Playbook, the publisher wanted the book to match a series they had. When the deal was nearly done, I met with the publisher and said the proposed cover wouldn’t work. We negotiated and they did an entirely different cover for us. We fought for that, and they listened. There is negotiation in all of these types of things, because this is your product and you have a vision for it. You can move them toward it.
What does the financial return look like?
ZH: You won’t make money on a book unless you write a monster textbook or crush it with a lay book. Your book will be sold as an e-book most commonly, and you’re unlikely to get a royalty for e-books, and instead will get a lump sum. Royalties are tricky, because if you’re selling 90% of your book in digital format, it’s a very different revenue steam. If someone buys it from Amazon, you get some money, but if a university purchases a large number directly from the publisher, you might get nothing. Do your best to negotiate money up front as best as possible. For the second version of the playbook, we asked for more money because the first one went well.
Also keep in mind that co-authors get nothing; only editors get paid. Co-authors are just authors who want their name in the book. You’ll need to find people you know who are interested in educating for free. For example, Extreme IR had over 200 authors. They got e-books, and a small number of very active co-authors got a hardcover copy.
KM: My publisher offered either a small lump sum or royalties, and I took the lump sum and put it toward the residency program. You have to be willing to write a book where you, your spouse and your parents will be the only ones who buy it. If you’re comfortable with that, then it’s of value.
JDP: There is no revenue stream on a lay book unless you sell a million copies. You do it because you want the information out there and enjoy writing. But unless you have a platform and sell a million copies, you won’t make royalties.
Think of all the things we do without money in mind. All of us do so many things not for the money. That’s what gets us out of bed, and this falls into that category. I’m glad I did it and would do it again, despite the work.
