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Explaining
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Editor's note:
"Rosie Franklin loves a good mystery but never expected one to hit so close to home. The day after Brown Intermediate's annual field day festival, three of Rosie's classmates are out sick. The next day, three more students are missing from class, and then another the following day. While the rumors fly, nobody knows what is making the students sick. Luckily for Rosie, her Aunt Liv is an epidemiologist-a disease detective. Rosie learns that unraveling the mystery gets more difficult as time passes and the stakes grow higher. It is up to Rosie to grab her best detective fedora, lean into her curiosity superpower, and join forces with friends (and an arch-nemesis) to reveal the illness' true identity. We follow Rosie to school, a disastrous softball game, and even a public health laboratory as she learns more about both epidemiology and herself on her first adventure as a disease detective." - Amazon.com
publication-worthy to say. If you read nothing else in this article, I hope you leave with the renewed sense that we all have worthwhile stories to tell. As a brief personal introduction, I am an epidemiologist and Director of Infection Prevention at Tufts Medical Center. As of October 2025, I also became a published middle-grade epidemiology mystery author. Like many of my Millennial cohorts, I do not remember receiving much, if any, formal education around epidemiology until my post-secondary years as a Biology major at the University of Texas. While efforts to improve scientific literacy in the field of epidemiology have increased in the last few decades (and have received an enhanced focus in the wake of the COVID-19 pandemic), it is still an emerging topic of interest in public school settings. As the needle slowly moves from essentially no epidemiology education to punctuated pilot modules or a topic to integrate in other core subjects (e.g., science, math) to more substantial/standalone course content, I can't help but think about other ways of introducing the field to younger generations. Epidemiology professionals are no strangers to navigating health communication nuances to the public. We often distill complex scientific processes into accessible and actionable content which is sensitive to the lived experiences of diverse communities. Fiction, though typically seen as a separate domain from public health communication, can be an equally powerful vehicle for engagement. Stories allow readers to imagine themselves in roles they may not have considered before. For the purpose of my story, the mystery genre lent itself well to the process of guiding young readers through the basics of disease transmission, outbreak investigation, and evidence-based reasoning. Fiction does not replace formal education, of course, but it plants the seeds of curiosity. Perhaps for some children, exposure to a compelling fictional protagonist is at least as influential as exposure to formal classroom content. Before I learned about epidemiology in college, I was transfixed by Richard Preston's The Hot Zone in middle school. I also loved stories with smart, independent female protagonists, like Anne Shirley and Nancy Drew. While performing some cursory research for this article, I learned that since 1930, Nancy Drew and her deductive reasoning skills have been inspiring readers like Hillary Clinton, Judy Blume, Oprah Winfrey, and Supreme Court Justices Sonia Sotomayor and Ruth Bader Ginsburg. In the words of Billie Jean King, "If you can see it, you can be it." As I thought about the desire to get younger generations curious about epidemiology, I considered the potential impact it could make on children if epidemiology had its own Nancy Drew. What if more epidemiology professionals could discover their calling earlier in life? Shortly before the pandemic started, I was inspired to write the contemporary epidemiology mystery novel I wished had been available when I was younger. I knew I wanted to focus on an infectious disease with gastrointestinal symptoms since children seem rather universally fascinated by poop and associated bathroom humor. After witnessing the societal burnout that followed from the COVID-19 pandemic (and experiencing a little of it as a healthcare leader), I'm considerably relieved I didn't change course during the writing process. Crafting the protagonist was equally important. I wanted a character who was relatable, curious, and resilient. Someone who approached problems with tenacity rather than genius-level giftedness. I drew inspiration from the bright, determined, unapologetically strong-willed girls and women in my life who embody the type of protagonist I would have gravitated toward as a young person. Rosie, my main character, became a touchstone for many narrative decisions, guiding the tone, pacing, and emotional authenticity of the story. Balancing creativity with scientific accuracy posed its own set of challenges. Epidemiology, particularly at the middle-grade level, required careful calibration. Too much jargon and the narrative became inaccessible; too little, and the story lost a bit of its educational value. I spent time thinking through the mechanics of clues, how to embed realistic (but simplified) versions of case investigations, and how to show epidemiological reasoning without overwhelming young readers. While balancing a more-than-full-time job during the pandemic, it took me approximately one year to finish writing my 84-page middle-grade mystery novel. Al though the operational demands of healthcare Infection Prevention left relatively little energy for creativity, writing became a source of grounding for me. I made the wise decision to include family, friends, and children in the middle-grade age range as reviewers, and I paid for an editor before I knew whether I would self-publish. Although I ultimately signed a contract with a traditional publishing company with editors of their own, this is a decision I would repeat every single time. I began the querying process to find a publisher who might be interested in the book and able to work with an agent-less author in December 2022 and ultimately signed a contract in early 2024. While this process certainly varies in duration for authors, it's important to prepare for rejection and keep track of sent/received communication. After the contract was signed, it took over a little over 18 months for the book to be published. I am currently in the marketing phase, so it is certainly a labor of love and a journey that never truly ends. In an effort to demystify the process of publication, I find it interesting to reflect on the volume of literature being churned out worldwide. The United Nations Educational, Scientific, and Cultural Organization (UNESCO) estimates that approximately 2.2 million books are published each year, or a little over 6,000 books per day. While Amazon's Kindle Direct Publishing (KDP) limits the number of daily published titles to three in order to manage the volume of low-quality and AI-generated books, there is a wealth of content available from a wide array of sources. Furthermore, unless an author publishes their book through a large traditional publishing agency, they will likely encounter several system-level barriers in retail and marketing access. Authors who self-publish or publish under smaller agencies generally need to hustle locally to obtain retail shelf space since it is difficult to project their demand. Large publishing agencies have publicists with media relationships, established influencer and reviewer networks, and advertising budgets. Without access to those resources, authors can find themselves paying for ads, running their own social media, and cold contacting media personally. While this is all technically achievable, it is considerably more labor-intensive and expensive for the author. Books published via large publishing agencies benefit from source credibility bias as well. Some prestigious literary awards will exclude indie/self-published book titles from consideration entirely (e.g., Pulitzer, Booker, Newbery, Caldecott, etc.). These realities are not meant to discourage but to contextualize. While this may not be the case for everyone, understanding the current landscape of the book industry helped me manage my expectations and prioritize my time on the elements of publishing and distribution that mattered to me personally. I do not expect to become a full-time novelist; I identify as an epidemiologist so strongly that I can't imagine pivoting too much at this stage in my life. I've focused my efforts on marketing to local bookstores, libraries, and schools and remain open to adjusting my plan as needed. My hope for the book (and for any future epidemiology-focused fiction) is that it encourages readers to view public health not as an abstract institutional entity but as a dynamic, exciting, human-centered field filled with problem-solvers, investigators, and advocates. Additionally, representation profoundly matters. When young readers see characters who investigate disease mysteries, use evidence to solve problems, and engage with their communities constructively, they may begin to imagine themselves capable of the same. For epidemiology professionals or enthusiasts interested in writing, I encourage you to explore the narrative potential of your own experiences. Epidemiology certainly offers no shortage of compelling stories. When you reach the publication finish line, do not hesitate to reach out to fellow colleagues to review or otherwise amplify your message. Accurate and engaging science communication is incredibly important, and epidemiology thrives on collaboration. ■
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