By Leslie Lindsay
Recently released in paperback, GIRL UNDERWATER (August 2016, Dutton/RandomHouse) takes readers on a harrowing ‘what-if’ of an major airline crash in the Rocky Mountains. Author Claire Kells writes with viscerally deep hand, and there’s good reason: she’s also a practicing physician. It’s at once a story of survival, but also the after-effects, how one can ‘pick-up’ where she left off, making sense of what happened in order emerge a better person. 
The novel follows Avery, a competitive college swimmer, who boards a red-eye flight from the West coast to East, along with two team members and two hundred strangers. When the plane goes down over the Rockies, only Avery, three little boys, and her teammate Colin Shea—whom she has been avoiding since her first day of freshman year—survive.
For five days, Avery fights the sub-zero weather, the unforgiving landscape, and creates a make-shift shelter, forages for food, protects those boys and waits for rescue. When that rescue comes, it’s just the beginning. GIRL UNDERWATER looks at what life is like after survival, and how one can come to terms with the blows.
Join me as we welcome Claire Kells to the blog couch.
Leslie Lindsay: Claire, thanks so much for taking the time to pop by. I understand there are a lot of truths in GIRL UNDERWATER for you—you’re also a seasoned swimmer, and while in the story it’s the father who is an ER doc, you, too are also a physician. But the story is not a memoir, or is it?
Claire Kells: Thank you for having me, Leslie! GIRL UNDERWATER is indeed a very personal story, and much of it was inspired by my own experiences, but no, it is not a memoir. I have never successfully woken up before dawn to swim, for instance. I’ve set alarms. I’ve tried packing all my things the night before. I even added it to my list of “life goals.” Nope.
L.L.: I really had to keep reminding myself (and flipping to the back jacket) that this was your fictionalized account—a deep-seated fear, really—of what might happen if your plane went down while you were on [medical] residency interviews. Can you talk about that process a bit? The one of interviewing for residencies. I can imagine it’s sort of a disaster in itself! And where are you practicing now?
Claire Kells: Interviewing for residency is a pretty miserable experience for a nervous flyer! I remember I once had four interviews in one week—in Vermont, St. Louis, Los Angeles, and Philadelphia—and the travel really took its toll on me. I always seem to get sick on planes (doesn’t everyone?), and after that whirlwind tour, I had bronchitis for a month and swore 
never to fly that much again. I endured it, though, because you really have no choice when it comes to residency applications. These programs want to get to know you beyond your resume, which is important, really, because in most medical specialties (mine included), you spend a lot of time interacting with people in difficult situations. I enjoyed the actual interviews; in some ways, I felt like it was my time to shine.
Right now I’m in my last year of residency in San Francisco.
L.L.: Like you, I’ve always wanted to be a writer but I’ve also been very fascinated with medicine; I was a child/adolescent psych R.N. for several years. Some will say you’re either right-brained, or left-brained, meaning art and science are two very distinct disciplines, but I always felt as if I can meld the two. Can you speak to that, please?
Claire Kells: I’ve always been fascinated by the way people think, and like you, I’ve come to 
understand that while most people are left- or right-brained, exciting things happen when we learn to access the other side. When I first started writing in medical school, [writing] became for me a necessary creative outlet from the exams and memorization; now, nearing the end of my training, I’ve found ways to incorporate my artistic side into medical practice. It’s been very satisfying to find that niche, although it took years to get there. I’m also constantly surprised by the number of writers in medicine! I shouldn’t be, though, because medicine is very much narrative-based. Every patient comes into clinic with a story.
L.L.: I’m curious about structure these days, because there are myriad ways a story could go—and be told. In the case of GIRL UNDERWATER, you chose a dual-narrative approach in which readers flip-flop between Avery’s survival in the Rockies and her ‘present-day’ story of surviving post –survival. How did you come to this decision? What advice would you give to writers when they are trying to structure their own story?
Claire Kells: I will be completely honest with you here and admit that I wrote the story in the traditional three-act format, and my agent, Stefanie Lieberman, suggested the alternating timeline structure. I’m not sure I had the confidence early on to plot and execute a novel with an unconventional narrative structure. When Stefanie proposed it, I understood right away how it could work. I would encourage writers to keep an open mind, especially during early drafts. It often takes me many drafts before I really “break” the story. I’ve learned to be patient and trust the process.
L.L.: There’s a huge component to GIRL UNDERWATER that focuses on the psychological toll survivors feel following a major life experience. Can you talk a bit about your PTSD research and how that was integrated into the narrative?
Claire Kells: Every October, Fleet Week comes to San Francisco. I remember rotating in the psychiatric unit at the SF Veteran’s hospital that week during my third year of medical school and thinking how fortunate I was because the hospital is situated on the cliffs overlooking the Golden Gate bridge. We had a perfect view of the fighter planes, etc. As I was leaving work that Friday, though, one of the attending psychiatrists looked frazzled. “Gonna be a long weekend,” she said. “Fleet week is the worst time of year for these vets.”
And then I understood: Fleet Week was a nightmare for military veterans with PTSD (and there were many veterans in that psych unit with PTSD). I would say that that experience really spurred my interest in the subject and inspired me to incorporate it into Avery’s story. I was fortunate in that much of my research was based on my experiences with the patients and providers at the VA.
L.L.: For you, being a swimmer, this story is organic. For me as a reader, I was suffocating with any suggestion that I get into that frigid water and swim to safety. Water terrifies me; yet it can be symbolic of new life, amniotic fluid; still it’s unpredictable, there’s a certain loss of control…can you speak to that, please?
Claire Kells: My mom never learned to swim. I know she had those same fears you mentioned, and she told me later that was partly why she signed me up for swim lessons as soon as the YMCA would take me. I don’t remember those first few days in the water, but I’ve watched young children learn to swim. They fear the water, too, until suddenly, astonishingly, they learn to trust themselves. I’ve seen that moment and honestly, it gives me chills. It’s such a beautiful kind of transformation that takes place. Because you’re right, swimming in deep water requires the ultimate concession of control. I swam across Lake Tahoe this summer as part of a relay, and that lake is over 1,600 feet deep! But what an incredible 
experience it was, swimming in a body of water like that. The water is so blue, you feel like you’re flying.
L.L.: What’s obsessing you these days? What has your attention?
Claire Kells: I’m definitely obsessed with story. As part of our residency requirements, we spend a lot of time reading textbooks, so during my free time I try to consume story other ways. Lately it’s been television. Wow—there are so many exceptional shows out there right now! The Night Of, The Americans, Stranger Things, and Game of Thrones are the shows I’ve followed this year. I’m absolutely in awe of these writers.
L.L.: Are you writing other books? Can you share?
Claire Kells: I’m working on another book now, but that’s all I can say. Sorry to be cagey about it!
L.L.: Is there anything I forgot to ask, but should have?
Claire Kells: These were all such thoughtful, interesting questions. I also want to thank you and your readers for taking a chance on a debut author—you’re the reason we keep writing. So thank you.
“Skillfully interspersing flashbacks with current events, debut novelist Kells has written an absorbing tale that will grip anyone who enjoys survival stories or psychological dramas.”
– Library Journal (starred review)
L.L.: Claire, it’s been a pleasure to connect. Best wishes with this and future books!
Claire Kells: I really enjoyed being here! Thank you again.
For more information on GIRL UNDERWATER, or to connect with Claire Kells, please see:
- Twitter: @kathkells and @DuttonBooks)
- Facebook: Claire doesn’t have a Facebook page, but feel free to tag @DuttonBooks
- Author websiteAuthor website
ABOUT THE AUTHOR: Claire Kells was born and raised outside Philadelphia. She received a degree in English from Princeton University and a medical degree from the University of California. Currently in residency, she lives and works in the Bay Area. This is her first novel.
You can connect with me, Leslie Lindsay, through these social media channels. But not water.
Facebook: LeslieLindsayWriter
Twitter: @LeslieLindsay1
Email: leslie_lindsay@hotmail.com
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[Special thanks to B. Odell at Dutton Books. Author and cover image courtesy of Dutton/Penguin/Random House. Images of Lake Tahoe and The Golden Gate Bridge retrieved from Wikipedia on 10.24.16. Right-brain/left-brain image retrieved from on 10.24.16]
Leslie A. Lindsay| Writer & Creative 