Yesterday I started to write a scene that occurs in a new environment. What I mean by this is that I have to write a scene in a hospital, and I've never thought about what a hospital would look like in Varin. So I figured, why not work my thoughts out here on the blog? That way I can really show the amount of preparation and thinking that I put into working out this sort of thing. I swear, this is why my writing process is so slow (ha)! In any case, I thought a vision of my process might give you ideas for some things to think through as you enter a new environment in your own world.
The first challenge as I enter this process is to bring up what I know about hospitals from this world, with all my gut reactions and all of the details that I fill in instinctively, and then take a step back and look at these things as foreign. When I start a scene like this I absolutely must keep my mind from slipping into "House" or "Law and Order" or "The Girl who Kicked the Hornet's Nest" (or anything else for that matter). Varin has a level of technology very similar to ours, but that technology expresses itself very differently, because Varin's history is completely separate from that our world.
So I started my research by speaking with a fabulous writer friend of mine, Deborah J. Ross, who has (lucky for me) personal knowledge of what goes on in a cardiac ward. She told me about what kind of machines a patient would be hooked up to (heart monitor, IV, possibly nasal oxygen) and whether the patient would be likely to be able to speak (important for what I would like to have happen in the scene). Then I went through those details and asked whether Varin would have each one. I concluded that the answer was predominantly "yes." I actually wasn't too happy about this - if I'd been able to omit one, the scene would have appeared more different. Instead, I have to think about how to include everything familiar, but find one or two very salient details to alter in order to jar readers out of their normal perception.
It's actually not that hard to jar people off of their expected models - if you do it deliberately, first thing. I've done this already with one of my characters. He has obsessive-compulsive disorder, but in Varin, they don't call it OCD. Instead, he "suffers compulsive obsessions." You'd be amazed how just changing around the expected phrasing causes it stop bringing up all of the expected real-world associations.
At that point I realized I needed to get closer to the scene (i.e. start writing it) so I could work on the detail level rather than the general level of expectations and equipment. The other thing that writing the scene allowed me to do was bring in another huge tool for creating difference: deep point of view.
After all, I don't just need to know what this environment is like. I need to know how my servant-caste character, Aloran, experiences this environment. Immediately, more questions open up. How much medical experience does Aloran have? Answer: he has a lot of training, but essentially none of it with hospital doctors, who come from the knowledge-worker caste immediately below his. Instead he has learned his medical training from other servants who have undergone the same training. What about his own experience going to hospitals as a patient or friend of a patient? Answer: he has no doubt been to a hospital before, but it would have been one geared toward people of officer-caste and lower, not a hospital designed specifically for the nobility. Thus, the things he notices about the hospital will be 1. those things that make it unique to the knowledge-worker-caste doctors who are in charge there and 2. those things that make it a hospital for nobles, rather than a hospital for everyone else.
So I started writing. Tagret and his mother Tamelera get the news that Tagret's father, Tamelera's husband and the Master of the house, has had a heart attack and gone to the Health Center. So Aloran escorts Tagret and Tamelera over there.
Difference #1 (behavior and layout): In this hospital, the patients are far, far more important than the doctors and nurses who serve them. Thus, they are received instantly by a doctor's assistant, the moment they walk in the door. Since none of them is a patient, this person escorts them to the patient's bedside. If they were patients, this person would ask questions and fill out paperwork for them. This entire first room is dedicated to instantly serving the people who come in: after the assistant's desk beside the door is a row of "triage chairs" on either side, where a nobleman or noblewoman can come in and have a seat anyplace that's open. The first-line nurses sit back against the walls behind these (well-spaced) chairs, each with a rolling cart of equipment he or she can bring forward to the chairs to do an initial evaluation.
Difference #2 (technology): You probably already noticed this one: the triage chairs. These are made of steel, and adjustable, so that a patient can be reclined and even wheeled (wheelchair-style or gurney-style) into the back treatment rooms as necessary. The triage chairs are a piece of technology that arose spontaneously when I tried to collapse the steps that we take entering a hospital: admission, initial evaluation, and being moved into a treatment area.
Difference #3 (technology saturation/judgment): One of the things that each receiving nurse has on his or her equipment cart is a device with a small computer screen. This is a testing device, but I make no mention of its use as they walk past. It's attached to a number of different measurement devices (blood pressure cuff, pulse counter, etc) that I don't need to go into. If someone from our world were to walk past this thing, if anything they might notice that the screen was awfully small. In Varin, the culture has a deeply ingrained religious bias against "capturing faces," and this has hampered the acceptability of photography and the development of live cinema, and also the development of screen technology. Aloran therefore notices the presence of the screens, because despite extensive medical training, he's only seen one or two of these comprehensive measurement devices in his life. The use of this device, with the screen attached to it, is seen as the province of the knowledge-worker-caste doctors almost exclusively. I think of this quote from Alexander Graham Bell, about his invention of the telephone: "The telephone is so important that, one day, every town will have one." Obviously the saturation of telephones went far beyond that, but the point is we can't always anticipate the level of saturation a particular technology will achieve. There are plenty of technologies whose use is restricted to particular limited contexts in our world; and this is one of those for Varin.
Difference #4 (manners): The assistant who escorts them to the Master's room calls Tagret sir, calls Tamelera Lady, and takes leave of Aloran with a set phrase: "May your honorable service earn its just reward, sir." These are social rules of the Variner caste system that show up in basic interactions between castes, so they show up here.
So here we are, the family hasn't even arrived in the hospital room, and already there are four major differences set before a reader to say unequivocally, "We aren't in Kansas any more." By this time, the fact that this place isn't like "House" should be so obvious that the similarities we do encounter will be significantly blunted. Add to this the fact that the Master is being treated in his own private room with stone walls and a steel door, and I suspect that the heart monitor, the IV, and the oxygen tube will have been largely stripped of their usual associations. I will leave them mostly as is, and probably change just a few tiny things about where they are placed/how they are supported, to make them more Varin-like.
Difference #5 (sound): The one thing that strikes me as so iconic to the real world that I have to change it at all costs is the peeping of the heart monitor. So my idea is to mix up my experiences just a bit, and have the heart monitor in fact relaying the rhythmic rushing sounds of the heart beating - a variation of what I experienced when I was allowed to listen to my unborn children's hearts beating.
And after thinking all of those things through, I feel much more confident about continuing into the scene. In fact, I'm pleased that there will be fewer differences from our own expectations when we hit the treatment room itself, because that will let me put more focus on the interactions of the characters, which after all are the really important part for driving the plot forward.
I hope this talk-through/think-through, written as I have been preparing and just beginning to write the hospital scene in Chapter 27 of For Love, For Power, has given you some ideas about what you can do to create interesting worldbuilding effects in your own worlds.