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Tavis: Dr. Ian Smith is a long-time medical correspondent and writer who's currently the health columnist for "Men's Health" magazine and the "New York Daily News." He's also a regular guest on 'The View,' and I'm proud to say the medical correspondent for our radio show on NPR. That'd be 'The Tavis Smiley Show.' But his latest project is a work of fiction called 'The Blackbird Papers.' A piece of fiction here. There you see the cover of 'The Blackbird Papers' on your screen. Dr. Ian, nice to see you.

Dr. Ian Smith: Good to see you, Tavis, in person.

Tavis: Nice to see you on the West Coast. I'm always talking to you with a set of headphones on, you know, from New York. Now I see you in person. How's the tour going?

Dr. Smith: It's good, man. It's 16 cities. We're nearing the end of it, but it's been really good. You know it's exhausting. You've written, you've toured. It's a grind, but it's a good grind. You get to meet people and talk about something that's passionate. So I'm happy.

Tavis: The last time I had a chance--I've been talking to you every week on our radio program--the last time I had a chance to talk to a group of young African American doctors, were the three brothers who you know from Newark, New Jersey. Wrote this wonderful book called 'The Pact.' These three young brothers who grew up in Newark and were in harm's way as kids found themselves in juvenile detention together and made a pact with each other that they would all become doctors. And all three of them came up out of the ghetto in New York. It's a great book called 'The Pact.' You gotta read it. But I'm always fascinated because I'm so proud when I see young African American brothers who've survived that grind of medical school and end up not just practicing, but in your case, you're commenting and corresponding about medicine. So, uh, you all that, huh?

Dr. Smith: Well, I don't know about that. I mean, you know, medicine is a grind. You know, I've gone to some tough schools in my day. I went to a lot of schools. And medical school in and of itself, regardless of what school you go to, whether it's an Ivy League school or it's not an Ivy League school, it's just a tough grind. Just the actual mechanics of medical school are very tough. And I remember when I was in the middle of it, I said that forever I would always respect anyone who had an M.D. behind their name and had earned a diploma because I know that regardless of how good or bad the school was, they worked very hard to get that, so it's--it's tough.

I'm lucky because when I was in the middle of medical school, also I realized that there was more I wanted to do in life, other than just be a 9-to-5 doctor. And I think a lot of that is part of managed care and the insurance debacle that the country's in right now. But another part of that also is lifestyle. Like I--you know, when you put so much time into something, you say, 'Where did all that time go?' And all my friends were in the city, making a lot of money--investment banking. And I was in school studying for exams and living on a student budget in a small little room. And I just felt like, you know, I love being a doctor. I love helping people. But I want to do other things in my life. And I'm happy that I opened myself up to doing things like writing books and correspondence and stuff.

Tavis: Is it worth the time you put in? We make jokes about people like you. To your point, which is what I was trying to say in a very long-winded way earlier on, I just have great respect for anybody, but certainly a black male who can stick to the grind and become an M.D. You got an M.D. behind your name. You deserve being called Dr. Smith. But is it worth it these days to go through all of that, with all the malpractice and et cetera, et cetera? Is it worth going through all those years?

Dr. Smith: I think it depends on what you want to get out of it. If you want to get into medicine to make money and to live a very comfortable lifestyle, you have to rethink things. There is a financial disaster right now in medicine. If you want to get in it to help people, which I think is most people's goals, it's still a great thing to do. It's just a lot of headache.

I mean, patients have a problem. Doctors are having problems. And it's beyond the money. It's having to call insurance companies to decide whether or not you can give someone treatment. I mean, here I am. I've trained all these years, and I'm calling some 800 number to find out whether or not they will cover a certain treatment that I think the patient needs. It's frustrating on both sides of the table. And I think that people are really considering it.

One problem, though--I know this isn't on our talk--but one problem is, I think, that some of the best students, some of the best talents, are actually veering away from medicine because they don't want to deal with the hassle that medicine has become, and that will affect all of us in the long run. That's a bad thing.

Tavis: How does that--to that point, before I move on to the book, how does that reality or that pending reality as you see it, impact the delivery of service, particularly when you talk about the need for culturally competent care in the most multi-cultural, multi-racial America ever?

Dr. Smith: Well, I think it will impact it dramatically. I think it hasn't happened yet. There's a lag because it takes a while for the medical school admissions for those classes that are going in now before it'll be affected later. But in the next 10 to 15 years, if the rate of declining admissions and matriculations, if that continues at this rate, then it's gonna impact us tremendously.

I mean, people are--you know, something about 'opportunity cost.' You know, why spend this much time, dedicate all of this, to end up in a situation where you're fighting with insurance companies, patients aren't getting the care that they want, you are underequipped, emergency rooms are understaffed, nurses don't have the proper resources? Who wants to deal with that? It's a headache. You know, it's a headache. I'm trying to save lives and help people, and at the same time, I'm spending half of my time fighting. And people just don't want to do that.

Tavis: One last question about medicine before we get to this book, 'The Blackbird Papers.' You think that the industry, the medical profession, is making any progress, as it were, in not just delivering culturally competent care, but in shrinking this disparity--we talk on our radio show often, and it distresses me to see that even on the healthcare front there's such a huge gap in the delivery of service, in life expectancy, in life span, in recovery time, based upon nothing more than race. You make any progress in shrinking that gap?

Dr. Smith: I think that the progress we're making is we're at least bringing it to the forefront. Everyone's talking about it. You're talking about it. Tom Joyner talks about it. A lot of important people in the media are talking about it.

The problem is this: It's a basic problem, that is it's one of money and it's one of allocation of resources. This issue of insurance is more than just lip service for politicians. There are people on a daily basis who are dying, who are not getting basic, simple care simply because they don't have insurance.

And regardless of what the political propaganda is right now and the season that we're in, the bottom line is we have to decide as a country whether or not we're gonna make basic healthcare a right for every American. We have to decide that. It's not about Democrats or Republicans. It's about what's right and what's moral in the richest country in the world. So I think that while we are giving a lot of attention to it from the media standpoint, the question is the follow-through, and the follow-through has to come at the level of the people, talking to those who are governing and making legislation.

Tavis: So--pardon the phrase--is writing a book, then, like 'The Blackbird Papers' therapeutic for a doctor?

Dr. Smith: Well, you know, people say why would a doctor write a novel, a murder mystery? Michael Crichton has done it. Others have done it. Robin Cook did it. I think the reason why doctors--and lawyers, like Grisham--end up writing novels is because it taps into your creative side. And you spend so much time in a very onerous kind of position, a very stress-induced environment, and this allows you to tap into purely creative, to allow your imagination to run wild. People look at doctors and say, 'You wrote a book?' Well, doctors love movies, too. We love stories. It's just a matter of me tapping into that creative side.

Tavis: Were you impressed with what you came up with? I ask that because, to use your word onerous, because you are in a very perfunctory lifestyle--every day you're seeing patients who oftentimes have the same things. You know what the treatment is the minute you see it. You scribble it up and nobody can read it. And then you send them off to the drugstore to try to decipher your handwriting. But were you impressed that you really had something creative to offer?

Dr. Smith: Well, I've been wanting to write for a long time, since reading John Grisham's 'The Firm.' I love mysteries, I love thrillers, I love page-turners. So I knew I wanted to write this. And I knew I could write it.

It was an issue of sitting down, taking a year and a half off from television--you and I have very similar schedules, very crazy schedules. I took a year and a half off and wrote this book about this Dartmouth Ivy League professor that I had an idea way back in medical school. I knew I could do it. A lot of people didn't think I could do it. But my close supporters did, and I sat down and did it, and I guess I just feel good that I did it and I feel even better that it's getting such great reviews and people are receiving it very nicely. It's a good feeling. I got more in me, but it's a good feeling when that first one comes out and people like it.

Tavis: I've read the book. Give me a little bit more about the story without giving too much of the story away.

Dr. Smith: The story very simply is about a black professor up at Dartmouth who's heading home from the mansion of the president after winning a big science award. He stops to help two stranded motorists on the side of the road and is never seen from again.

Tavis: Mmm.

Dr. Smith: That's it. His younger brother is an FBI agent who lives in New York City who goes up to the small mountain town to figure out what in the heck has happened to his brother.

Tavis: I've always said that people who write--I'm a non-fiction writer--I'm always impressed, as I said to you before, with folk who write fiction because I don't know where you get this stuff. You sit around in the woods at Dartmouth? Y'all up in the woods somewhere at Dartmouth. I been there. You sitting around the woods and thinking of stuff is just--where's it come from?

Dr. Smith: There's not much to do up in Hanover, New Hampshire. You know that. It's all mountains, and it's the big Connecticut River. But the thing is, I've always just loved mysteries. I love action and I like page-turning plots, so I just felt like--this story just came to me.

Let me tell you: the story itself, the central premise, without ruining it for people. The blackbirds--I was researching blackbirds on the Internet, and I found this story about this major controversy that's existing in the country right now about blackbird populations that no one's talking about. No one talks about it except for maybe a few environmentalists. And I was like, this is a fascinating controversy that no one talks about. What a perfect central premise. And then I built my murder mystery around that. So 'The Blackbird Papers' really is a real story. I don't want people to go to the Internet before they read the book, but if you read the book and then go to the Internet, you'll actually see how much of this is really based on reality.

Tavis: So the bug has bitten you. Is there a sequel to this?

Dr. Smith: There is. It's a medical thriller that takes place in Chicago.

Tavis: Ooh!

Dr. Smith: Next year.

Tavis: Ian Smith. 'The Blackbird Papers.' A novel by this medical doctor. Ian, congratulations. Nice to see you.

Dr. Smith: See you on the radio.

Tavis: I'll see you on the radio. Exactly. That's our show for tonight. As always, you can catch me, speaking of the radio, on the radio with Dr. Ian on NPR. I'll see you back here next time on PBS. Until then, thanks for watching. Good night from Los Angeles, and as always, keep the faith.