You have been praised by critics for your in-depth character development as well as for your edge-of-the-seat plots.  To what extent do you use reality (and research) for your plots and characters?
 
I have succeeded as a writer for the same reason I have thrived as a doctor--because I genuinely love and care about other people. I care about what they are feeling when I have to tell them they are seriously ill. I care when I get to tell them they have responded to treatment. When I teach writing students, I often tell them that they will know they have done their best with a character when they see the blood on their own hands from reaching inside their chests to pull out their hearts. Succeeding at that aspect of writing is a feeling equal to any I have known. As for plots, I am constantly looking for a twist or an angle that I haven't encountered before . . . at least not too often. Originality is always a problem in this game, and I often find myself plagiarizing from books I have previously published! Sometimes, I just say, oh, what the heck, if it was good once, it will be good again, and leave it in. The three attributes I have that have served my writing the best are discipline, a genuine caring for people, and my often uncontrollable imagination.

Over decades as a practicing doc, I have amassed a pile of stories to draw from and, of course, embellish. This is fiction, after all. My research, when I need it to be, is exhaustive. I never cut corners and make things up when the real answer is out there in a book, or on line, or with an expert. The most important question I ask myself and my experts is "is it possible?" That's all I need something to be in order to make it believable--possible.

Former president Bill Clinton, no less, called your thriller, THE FIRST PATIENT (out last month in premium paperback) "an exciting thriller full of surprises."  Most writers and readers would agree that such twists are a key element of the genre.  As you write, do such surprises or a "shocking conclusion" [Publishers Weekly on THE FIRST PATIENT] surprise you also, or do you have to work hard to create them?
 
I work hard at everything. Occasionally, the characters make it easier for me, but mostly I sit here with a pen and legal pad, making lots of arrows and sketching out countless possibilities and chronologies. For me, writing is a long sequence of tiny surprises, surrounding a few really big ones. I am constantly amused by what I see on the page, but I also know all the rejected notions that went into each successful one. I have always been the one accepted into various school and training programs to prove they don't always just take the best students. Four or five students ahead of me in high school didn't get into Wesleyan. I have no idea what that's about except maybe that my cousin was the football coach J. Very little comes naturally to me, but I do know that my sense of story is unique to me and that when all else is elusive, it will still be there, supporting me and my writing like bedrock.

Your February release, THE SECOND OPINION, includes a fascinating look at Asperger syndrome.  Not only does your main character have this syndrome, but she triumphs despite it.  Can you explain the syndrome and what drew you to use Asperger syndrome in a novel?  Also, please fill us in on your unique book-launch event for the Asperger's Association.
 
Thanks for asking about this aspect of THE SECOND OPINION. Here are a few words from the Author's Note at the end of the book:
 
Fourteen years ago, my wife and I sat numbly in the office of a child development specialist and listened to him tell us that our beautiful four-year-old son had Asperger syndrome, a form of autism. He said much, much more, but as you might suspect, the only word we really heard that day was AUTISM.
 
We did not know it at the time, but we were on the edge of what was about to be an explosion in the field of so-called autism spectrum disorders, as well as an alphabet soup of related diagnoses such as ADD (attention deficit disorder), ADHD (attention deficit hyperactivity disorder), PDD (pervasive developmental disorder), PDD-NOS (not otherwise specified), NVLD (non-verbal learning disabilities), and others.

Now, after years of groups, therapies too numerous to mention here, specialists, and intense parental involvement, Luke is a witty, creative, sensitive, kind, insightful, and utterly interesting young man, who has been a joy to be around, and has been accepted into a great college in performing arts. There are and always will be situations that are challenging for him, but the same is true for all of us.
    
Because of what I have learned from Luke and so many others, I knew someday I wanted to write about Asperger's. And because of the help the Asperger Association of New England has been to us and so many others, I wanted to raise money for them. Hopefully my book launch party on February 18th (see www.michaelpalmerbooks.com for details) will accomplish that. Joe Finder, Tess Gerritsen, Mark Vonnegut and other writer friends will be there, and, in addition to live music, great desserts, and books by all for purchase and personalization, John Elder Robison, author of the Asperger memoir Look Me In the Eye, will speak. It would be great to see you all there.

New York Times and USA TODAY bestselling author Karen Harper has been published for 25 years. She is the winner of the 2006 Mary Higgins Clark Award.  A former college and high school English instructor, Harper currently writes contemporary suspense for Mira Books and historical novels for Putnam. She and her husband divide their time between Columbus, Ohio and Naples, Florida.