The Big Idea: Mia Tsai

Victories are dramatic, but victories don’t have to be the end of the story. In today’s Big Idea for her novel Bitter Medicine, author Mia Tsai looks beyond the usual climax of a tale to find another part of the story.


There are a lot of hooks floating around in Bitter Medicine: xianxia-inspired magic, the blend of mythologies and cultures, the romance, even its plot structure (it’s a two-act, not a three-act), but what often remains in the background is, for me, the biggest idea of all.

Today, I’d like to talk about Asian American women, mental health, and fantasy.

Bitter Medicine, being set in a contemporary world but with a hidden magical world, offered me opportunities to comment on real-world issues while retaining the elements of a fantasy. While contemporary fiction can and does explore the immediate reverberations of critical plot events, oftentimes, in fantasy, we don’t get to see what happens immediately after those events. Climaxes such as confrontations are usually the end of a story or an arc, and if there are lasting effects, they play out in the long term. In a genre like fantasy, it’s not particularly heroic nor propulsive to have a hero laid up in the hospital, spending most of their day in a medicated haze. It’s especially not propulsive for an author to shine a light on those moments.

But I find myself curious about them all the same. The character who triumphs in battle still needs to count the dead the next day. The ferocious joy of winning can be quickly and easily eclipsed by pain and loss, by a body and mind reacting to its situation to protect itself. And that was the part I wanted to highlight in Bitter Medicine, especially with an Asian American woman carrying the loneliness of being diaspora and the burden of family trauma.

What did I do? I granted my character a pyrrhic victory, then trained my lens on her in the ringing hollow after the thunderclap, during the frozen, shocked stillness post-trauma. It’s in these moments where pure emotion carries the story. I wanted to see what happened next, because so rarely are we shown it.

So I wrote toward that. I wanted, more than anything, my character’s friends and family to step up for her, to have community care be the most effective treatment in a reality where mental health services were unavailable. I wanted to know what the other characters would do when one of their own was suffering quietly; I wanted to witness what they would do because they knew she’d back herself out of the spotlight and pretend everything was fine. I wanted to see her loved ones fight for her the way she fought for them. I wanted her to have a group of people who cared for her look at her and it’s tell her it’s their turn, now. It’s okay to rest. It’s okay to grieve what was lost.

Fantasy is, like any other genre, about human emotion. Of course, the allure of the setting beckons—anyone who reads this genre and says they hate magic and wonder is lying. But fantasy is, at its heart, about connections, needs, desires. And that’s the kind of fantasy that draws me the most—stories about people and communities that are wrapped in genre trappings.

This doesn’t appeal to everyone, and I’m sure there are readers out there who would rather the book not slow down in parts to deal with something deeply internal and sit with someone who is so clearly grieving. It can get ugly. Actually, it did; I had to revise to strip out parts that made people too upset. Sometimes, too much verisimilitude is detrimental. Regardless, there is grief and depression in this book, viewed through an unflinching camera that keeps rolling during my character’s worst, most vulnerable moments, and a community that comes together to get her through it rather than demand more of her. And that’s the big idea.

Bitter Medicine: Amazon|Barnes & Noble|Bookshop|Powell’s

Read an excerpt. Visit the author’s site. Follow her on Twitter.

4 Comments on “The Big Idea: Mia Tsai”

  1. Wow, this sounds absolutely fascinating! I’ve long been very interested in “the aftermath” in fiction – I prefer it when the climax is much earlier than its conventional placement in the story, and tend to be really disappointed when it falls on the second-last page. There’s ample precedent, it seems to me – in Jo Walton’s Among Others, the climax is basically placed before the entire novel, and that one was an award winner.

  2. Aha! Somebody who’s finally answering “then what happened?” I have wondered…

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