I’m a brain surgeon who has spent a career caring for the sickest of the sick in the ICUs and operating rooms of major medical centers. After decades of breaking news—good and bad—to terror-stricken families, doing battle with recalcitrant bleeding in the middle of traumatized brains, and savoring the more-rare-than-I-would-like miracle of pulling someone back from the brink of death, I was determined to find a way to share what it was like to be in the thick of my world.

As I began to write the book that would tell it all, I found to my surprise that fiction better enabled me to immerse readers into the scenes of my universe: to place the scalpel right in their hands; have them peer through the operating microscope at a ready to explode aneurysm; put them in the trauma bay as a dying child is wheeled in. I discovered that blurring the lines between the real and the fantastical—the scientific and the spiritual—would best tell my story.

In adopting that approach, I found myself creating a medical paranormal page-turning thriller. The story blew wide open, allowing the entry of ghosts—spirits, wraiths, the undead. And why not? The human brain is a miraculous organ that can create any scenario, any image, any sensation out of thin air. We all experience it in our dreams, even sometimes in our daydreams. In surgery, stimulate the appropriate region and a patient will hear Mozart. Another, and they will smell a bouquet of wildflowers.

So why couldn’t a physician, bedraggled, exhausted, surrounded by death and dying, not be prone to some hallucinatory cerebral misfiring? Why couldn’t he begin to see ghosts?

I’ve spent the last 15 years studying the effects on healthcare professionals of incessant stress, crushing work schedules, constant need for peak performance, and relentless exposure to human suffering. I co-wrote three books on how easy it is for doctors, nurses, physician assistants, and the like to sag, to burnout, or to break under the strain. To become people their young, idealistic, premedical selves would never have recognized: withdrawn, angry, disengaged, griping, snarling, barking, numb, nihilistic, narcissistic. And sad. Deeply sad, for having lost all that once motivated them, once inspired them to rush into the hospital in the middle of the night and do their best. And if work in the healthcare universe could precipitate such wreckage in practitioners’ psyches, I had to ask, why couldn’t it generate some otherworldly visitors as well?

On the other hand, I wondered why said visitors would have to be a figment of the imagination at all, a glitch in the cerebral processing, a concoction of an ailing mind? After all, plenty of sound minds believe in such things. My Scottish mother and grandmother certainly did, and they would recount their histories of ghostly encounters to prove the point.

Perhaps this is the reason I’ve always questioned why science has to be so darned antithetical to the concept of an afterlife, to a spiritual world beyond our own, to souls that exist beyond this existence. I’m a scientist, and I can’t entirely discount such things. I mean, isn’t science built upon challenging all accepted “truths?”

As I began to write the book that would tell it all, I found to my surprise that fiction better enabled me to immerse readers into the scenes of my universe.

So I posed, were such entities, such beings, to exist, why wouldn’t some seek to hold onto their previous existences, to sneak back over the bridge between life and death, to reach out to those on the life side? And who better to reach out to than someone—a brain surgeon, perhaps—who so frequently loiters about said bridge, trying desperately to block the march of souls going the other way?

Such are the contemplations I’m hoping to leave with readers as they take the plunge into my world. I hope they will ask themselves how they would respond to the constant strain and the relentlessness of it all. What is actually more terrifying: a paranormal world filled with interfering spirits and wraiths, or the very “normal” world of a modern-day medical center? How would they react to seeing ghosts—would they believe they were cracking up, or would they accept it and start trying to figure out why?

Writing this novel certainly helped me process both the horrors and the joys of a long career out on the frontlines of the medical/surgical battlefield. It also unfettered my necessarily rational and science-disciplined brain, let it wander into the unknown—and in so doing, invite in a few ghosts.

Gary Simonds is a retired neurosurgeon and the author of three nonfiction books. Death’s Pale Flag (BQB Publishing) is his first novel.