Somewhere in Boston there is a doctor who treats disorders of the brain: a brilliant woman, a Harvard graduate, a mother of two. But she has a dark secret.
Unbeknown to her colleagues or her patients, she is also a writer of thrillers, churning them out at a terrific rate, nearly all of them bestsellers. Four were on the Sunday Times list of top-selling books of 2024. One, The Housemaid, is being turned into a film starring Sydney Sweeney and Amanda Seyfried; another is set to be a film too, while a third is to be a television series. Across all formats, and including translations, she has sold 17 million books.
Do the hospital receptionists have any idea? Apparently not. To them she is just a common-or-garden brain doctor. She writes under the pen name Freida McFadden and avoids book tours and signings. Some people have wondered if she is in fact AI or a team of writers. “She has published 15 books in the last four years!?” someone wrote on Reddit. “Something super fishy about her …”
I thought this too, reading the biography on her website, which said that McFadden lives “in a centuries-old three-story home overlooking the ocean”. It sounded like another fiction.
But here’s the twist: she’s real.
To the hospital receptionists she is just a common-or-garden brain doctor.
McFadden appears before me on a video call, pale with curly auburn hair that I suppose might be a wig, as someone on Reddit suggests, and oval glasses. These could be part of her disguise too — like the fake specs the heroine wears in The Housemaid to disguise the fact that she is a total hottie and a possible threat to her boss’s marriage.
Behind McFadden is a dining room with a black table and a couple of chairs and above it a black wrought-iron light fixture. I look at all this rather suspiciously. Is this really an old house near the ocean?
“It’s not really that near the ocean,” she concedes. “I was kind of being dramatic. I figure in Boston, the ocean — it’s close enough.”
A man with dark hair appears behind her in the kitchen, dressed in a T-shirt and yellow trousers.
Is that her real husband?
“Yeah,” she says. “I told him to put pants on.”
She does not sound particularly guarded. “It’s not, you know, like I’m in witness protection,” she says. She has told her friends about her double life; recently she even told her book group.
“Most people in my life do know,” she says. “It’s more that I would like to continue to work without it becoming a thing — I just want to focus on being a doctor.”
McFadden, who is in her mid-forties, grew up in midtown Manhattan with one sibling who is now a music producer. Their parents, who divorced, both worked in a hospital — their father as a psychiatrist and their mother as a podiatrist.
From the age of three McFadden began announcing that she wanted to be a doctor too. In her teens she got into a stellar New York high school that still has a fearsome reputation. McFadden thinks that writing several books a year while working as a doctor is a breeze compared with “finals time” while there.
It was at school that she met her husband, now an engineer, “in a computer science class — if that could be any dorkier”. She majored in mathematics at Harvard before going to medical school, all the while writing and sending manuscripts to publishers and agents.
Then she discovered self-publishing, and put out her first title, The Devil Wears Scrubs, drawing on a diary she had kept as a medical intern. “It’s definitely very much based on reality, which is also scary,” she says. The heroine works 30-hour shifts for a dreadful female boss. “And the woman in the book is based on my senior resident at the time.”
At the time she was a mother of two young children, writing late at night, early in the morning or while they were napping or sometimes “with one of them asleep on me”.
She took, as her pen name, the acronym for the Fellowship and Residency Electronic Interactive Database, which helps medical students to find hospital placements. She chose McFadden because she “wanted something a little humorous sounding”. “I didn’t know I was going to be a thriller writer. That was not in the plan.”
The Devil Wears Scrubs is funny, although she is a little disparaging about it now. “It has no plot,” she says. “When you finish it, you might be like, oh, is that it?” This was also true of her next two books, she says. “Realizing that books need to have a plot — it was like a big lightbulb moment.” She began thinking like a mathematician, with the plot “as a puzzle and the twist the solution”; she noted her readers’ comments and took them on board.
She discovered self-publishing, and put out her first title, The Devil Wears Scrubs, drawing on a diary she had kept as a medical intern.
Her audience gets ever more demanding, she says. “Back when I started reading thrillers … small twists really hit hard. You’d be like, ‘Wow! That diary wasn’t real!’” Now every reader thinks the diary might not be real.
On her website McFadden advises would-be authors that you cannot simply have A, B, C and D as suspects “and A is the killer. It’s not even enough to say E is the killer,” she writes. “It has to be E is the killer because he is actually B, and was the victim’s mother and his daughter, and also was dead the whole time.”
Even then readers claim they knew what was going to happen all along, she says. They did this even with her 2019 book The Ex, which has an ending so complicated that McFadden is not quite sure she understands it. “I would like to revise it further,” she says. “It’s a good twist, but it’s still a little confusing.”
When McFadden has a twist worked out in her head, she tries it on her husband, who is good at poking holes in things. The first draft goes to her mother, who highlights all the swearwords. “She comes up with alternative words,” McFadden says, “which I do not ask her to do.”
Last year she wrote four books. When we speak, she tells me that she spent New Year’s Day working a morning shift at the hospital and then coming home to finish her latest thriller. In the self-publishing world this is a rather sedate schedule, she points out. “There are indie authors who publish 24 books a year,” she says. “You get into a rhythm.”
Once she was signed by the digital publisher Bookouture in January 2022, there was a back catalogue they could reissue. She also had a draft of The Housemaid that didn’t quite work. An editor suggested an alteration “and I was able to fix it”, she says. “I needed somebody to zero in on the problem.”
The Housemaid is about a young woman named Millie, fresh out of a ten-year stretch in prison, who takes a job as a maid in the Long Island mansion of a handsome financier and his wife. There is an upstairs room where she is to live, where the door locks from the outside, and a little girl with pale eyes that look right through you.
McFadden is not the kind of author who is afraid to drive her point home with a sledgehammer. That said, the book has an excellent twist. When it came out, people wanted to read everything she’d written, including early works that she was slightly embarrassed about.
McFadden is not the kind of author who is afraid to drive her point home with a sledgehammer. That said, the book has an excellent twist. When it came out, people wanted to read everything she’d written,
One, Suicide Med, featured a character with an eye on his bottom. “It was embarrassing me every day,” she says. She performed surgery on the book, removing the “butt eye” and retitling it Dead Med, and tried to get it taken down — but Amazon would not remove the original until it had sold out. At this point the “butt-eye” book began selling like crazy. “All of a sudden it’s No 1 on Amazon. People were like, ‘Wow! What a great marketing strategy!’ Now you can find it on eBay for hundreds of dollars,” she says, ruefully. “This terrible book that I wrote.”
She decided to go part-time as a doctor. “I spent for ever debating with my husband and other people: what should I tell my boss when he asks [why]?” she says. “He didn’t ask.” She’s fairly confident he has no idea. “Authors are, like, low on the celebrity totem pole.”
McFadden is not the kind of author who is afraid to drive her point home with a sledgehammer.
It was only last summer that she decided to unmask herself to her book group. “They said, ‘Oh, what’s your name?’” McFadden suggested, coyly, they look at the bestseller list. They asked if she was Rebecca Yarros. Had she written The Silent Patient? “I’m, like, ‘I’m not Alex Michaelides,’” McFadden says. Michaelides is a British Cypriot, and a man. “These are well-read ladies,” McFadden says. “They’re literally in a book club.”
It just shows you can go about your business, as a bestselling author, and no one will notice. The other day her daughter spotted her on a street corner and shouted “Mom!” she says. “Then she started calling my real name and I didn’t turn. Then she called ‘Freida!’ and I did.”
There are just certain places where she would like to go incognito. One is her workplace, where she practices what she describes as “the most mathy thing that I could do in medicine”. The other is her yoga class. “I’m terrible at it. I can’t do anything. People twice my age are stretching their feet over their heads. I don’t want everyone in the room to know that Freida sucks at yoga.”
So when people ask what she does for a living, McFadden hesitates. “Should I say I’m a doctor? Should I say I’m a writer? They’re going to ask me what I write. And then, what if I’m bad at yoga?”
Will Pavia is the New York correspondent for The Times of London
