Nurse tells how she uses her medical knowledge to kill off characters – in grisly but accurate ways – in her thriller novels

A nurse who has dedicated her life to saving lives also uses her medical knowledge to find accurate ways to kill off the characters in her terrifying thriller novels.

Alexandrea Weis, 57, who lives in New Orleans, Louisiana, USA, with her husband of 30 years has written 37 books – and she has used her medical training to create perfect fictional murders in many of them.

The advanced practitioner nurse, who works as a clinical consultant, has killed off her characters by suffocation in the library, gunshots and poison.

Alexandrea said: “Gunshots are really cool.”

And she added: “The different type of wound can completely alter the person’s death and suffering.”

Making her deaths medically correct also makes her books better, she believes.

Alexandrea has become a successful novelist. (Collect/PA Real Life)
Alexandrea has become a successful novelist. (Collect/PA Real Life)

She said: “I think making thriller books medically accurate makes them scarier.

“As a nurse, it’s important to me that my books are factual, otherwise it just becomes a comedy.”

For Alexandrea, her interest in writing was sparked from an early age.

She said: “I was always a writer – I started writing ghost stories aged eight and throughout school I was on honours programmes but I pursued nursing because I wanted to be able to support myself with a stable career.

“I got married and worked my way up in the medical world but all the while I was still writing, and it got to the point where I’d written five books from historical fiction to romance.

“My husband was the one who urged me to get them published.”

Alexandrea says medical accuracy makes her thriller stories scarier. (Collect/PA Real Life)
Alexandrea says medical accuracy makes her thriller stories scarier. (Collect/PA Real Life)

In 2007, when she was 47, Alexandrea had her first book ‘To My Senses’ published – a thriller romance set in New Orleans among high society.

Working as a part-time nurse, she also kept writing compulsively every day, even finding time in the middle of the night.

“Since Covid I’ve had a lot of work on as nurse,” she said.

She added: “But I try to write every day, mostly in the evenings – sometimes I’ll even write at midnight.”

For inspiration, she often draws on her hometown and the spooky houses she lived in as a child.

She said: “I’m from New Orleans and I was raised in the French Quarter which is famed for being haunted.”

Alexandrea, pictured here with her cousin and agent, Dallas Smith. (Collect/PA Real Life)
Alexandrea, pictured here with her cousin and agent, Dallas Smith. (Collect/PA Real Life)

She added: “I grew up in many haunted houses where there were noises at night, figures moving, people appearing in mirrors. We had cats and every cat would raise their head in unison and watch as a ghost walked across the room.

“I’m not kidding, there would be knocking at night, lights turning on and off, but it was just normal to us. We were used to it.”

But of course growing up around paranormal activity gave her plenty of material.

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She said: “I love my hometown and all the spooky history surrounding it. I always try to incorporate that into my work.

“I like to take all aspects of my life and use them for writing inspiration.”

And her nursing background is instrumental to Alexandrea’s novel planning.

She said: “There’s a lot of plotting and thinking and planning that goes into it. In a way, it’s very scientific and involves a lot of critical thinking.

“I find figuring out all of the intricacies and details really fun. It’s a challenge.”

Her nursing knowledge, for example, has come in useful when writing about poisonings.

When she is not killing off her fictional characters, Alexandrea works as a nurse. (Collect/PA Real Life)
When she is not killing off her fictional characters, Alexandrea works as a nurse. (Collect/PA Real Life)

“I always do a lot of research on poison,” she said.

“The type of poison that can kill someone quickly – or very slowly, to the point they don’t notice.”

And there are parallels with what she does to care for her patients – though in that case she is saving lives.

“I do that with patients as a nurse. If we put them on a new drug we’re always looking at signs and symptoms.”

But reading other writers’ work can be frustrating for the fact-focussed author.

She said: “The problem is, there are a lot of novels written where authors don’t bother to look at the medical reasons of how people die, and what they write doesn’t make sense.”

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She added: “Such as when they put people on ventilators. That’s the biggest frustration in books for me.

“There’s so much people get wrong about patients in ICU, they don’t just have a tube down their throat, so much more goes into it.

“Some people think it’s too much detail but it’s not. If you want to make it real, you’ve got to show what that’s person going through.”

Alexandrea says she is inspired by her hometown of New Orleans. (Collect/PA Real Life)
Alexandrea says she is inspired by her hometown of New Orleans. (Collect/PA Real Life)

She continued: “For me, it’s really getting behind there. As a medical person, I know all too well how people die and what happens through the process.

“I think it adds to the reality of what somebody’s reading and then it really hits home.”

And Alexandrea is now also asked to help other writers get their death details correct.

She said: “I have two or three editors that contact me a couple times a month on books they read, and they’ll be like, ‘Alex, is this medically right?’

“My husband and I are both medically trained so there will be movies we watch which are meant to be horror but turn into comedy because we know how unrealistic some of the plotlines are.”

There is a serious side to getting the details right too, however.

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She said: “As a nurse, I see people at their worst times in life, with the emotions that people go through and the things they deal with.

“I think that’s inspired me to put more emotion in my work because I understand it all a little bit more.

“It’s tough watching somebody die, and it’s tough being a family member and standing there knowing there’s nothing you can do about it.”

She added: “And it’s the same thing for medical people, trying to do the best you can for somebody and keeping them as comfortable as they can, so that lends itself to the writing.

“I really do believe that nursing made me a better writer.”

And the grisly reality of death is prevalent in Alexandrea’s latest book, ‘Have You Seen Me?’

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She said: “There’s a particular scene in my new book where there is a death by asphyxiation, but it’s really oxygen depletion.

“When I was doing my research, I found it fascinating that there are special fire deterrence systems which suck oxygen out of the room and replace it with carbon dioxide.

“If you’re stuck in there, you suffocate because there’s no oxygen.”

She then brought her nursing knowledge of how you feel when you know you can’t get oxygen into play.

She explained: “There’s nothing more terrifying than not being able to breathe.

“You start to get tingling fingers and toes, and you start to lose your ability to move, and then your mind starts playing tricks on you and you think you see things.”

Alexandrea’s latest novel is now available. (Collect/PA Real Life)
Alexandrea’s latest novel is now available. (Collect/PA Real Life)

She added: “Then the desperation comes and you’re clawing at everything you can to get air.

“I think making the books medically accurate actually makes them scarier because this could really happen to someone.”

But despite spending her free time killing off her characters, Alexandrea’s top priority remains saving the lives of her patients.

She said: “I only understand my characters and the pain they go through so well because of the people I’ve met in my profession.

“I was an ICU nurse for four years and I’ve had a lot of patients that were on a ventilator, it’s a terrible time for them and for their family.

“It was my job to keep them calm and to take care of them. I take that job very seriously.”

She added: “Watching somebody go through the process of recovery and getting to see them leave hospital is the most incredible feeling.

“My patients have made me the writer I am today, I wouldn’t trade my job for the world.”