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Author Freida McFadden.KIERAN KESNER/The New York Times News Service

For quite a few years, Freida McFadden was a doctor who also happened to self-publish novels on the side.

She’d been able to put “bestselling author” on her books – but so can anybody else who’d topped one of the oddly specific categories you can find on Amazon, such as “Books that have three characters and are exactly 258 pages.”

Her output had been as varied as it was prolific: There was a drawn-from-life novel about the medical profession, The Devil Wears Scrubs, and several psychological thrillers – such as Suicide Med, The Surrogate Mother and Do You Remember? – that often drew on McFadden’s real-life expertise in traumatic brain injuries.

And then came 2022′s The Housemaid, McFadden’s darkly comedic, twisty tale of a young woman – with a complicated past of her own – who takes a housekeeper job in a suburban mansion. At first blush, the book has a standard “perfect facade hides dysfunctional interior” feel to it, until McFadden springs a twist that cleverly challenges assumptions we make about certain kinds of women.

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The Housemaid, plus the two sequels that followed, caught the attention of BookTok, and soon McFadden was a New York Times bestselling author. It has been picked up by Lionsgate Pictures for a film adaptation, and recently McFadden left her practice to write full-time. As of late August, around the same time The Housemaid marked 10 straight weeks on The Globe and Mail’s bestseller list, her publisher shared that her books have sold 10 million copies worldwide – and that’s not including e-books.

“I’m still me, but my life is a lot different,” says McFadden from her home in the United States. “When you’re self-publishing, you control everything. It’s at your own pace, and you can put your brakes on anything you want at any time.”

Now that she’s working with a publisher (The Housemaid was actually the first time she worked with one, something she initially did thinking it would get her a few thousand more readers) McFadden is beholden to someone else.

“We have a busy schedule, there are a lot of eyes on my books, the editing is a lot more extensive,” she says. “You feel more pressure, too.”

The Globe and Mail chatted with McFadden – a pseudonym, by the way, adopted to keep her writing and her medical selves separate – on her unexpectedly young readers, going from indie to traditional publishing and switching genres.

It sounds funny to say because you’re such a successful writer, but do you ever mourn the physician version of yourself?

I didn’t want to leave, and I still work one day a week. It felt like such a big part of my identity. I’ve been a doctor for about 20 years, and it felt like, how could I leave that? Even when I would talk to people and they would say, “You’re a writer,” I’d say, “No, I’m a doctor, but I also write.” Now I’m sort of transitioning, and when people ask me what I do, I don’t know what to say any more.

Do you have a sense of who your readers are?

It runs the gamut. My readers are a little on the younger side, and that could be partially because a lot of the hype around my books has come from social media. I was looking at the stats for my Facebook group and the two big age ranges were 20 to 30 and 30 to 40. Now that I’m working with Sourcebooks, they’ve been getting my books distributed in paper more and I turned my books into audiobooks. I think because of that I’m reaching an older audience, which is great.

I was struck when looking at your website, one of the FAQs was, ‘I’m writing a book report on one of your books.’ Should people who are young enough to be doing book reports be reading your book?

I get a lot of fan e-mail because I put my e-mail in one of my books before I realized I was going to sell millions of copies. I didn’t realize what a big mistake that would be, but it’s also been fun at times because I get letters from really young people. When somebody says they’re 12 or 13 and say, “I never liked reading but …” I’ll always write back to say, keep reading. It makes me so happy to see young people get into reading because of me.

Your books are massively entertaining, but they also can touch on very serious things. The Housemaid, for example, touches on coercive control and domestic abuse. Have you witnessed that impacting readers?

Definitely. Some people have told me that The Housemaid gave them courage to do something in their own lives, or made them remember their own situation and it made them happy to see somebody else triumphing. My favourite theme in a book is girl power, and that’s something I love about The Housemaid. That’s probably a spoiler, but it is such a girl-power book. When you read all my books, women triumphing is a theme you see in a lot of them. I love the idea of inspiring young girls.

Often thrillers revolve around ‘dead girl found in woods.’ There’s a lot of dead women and violence against women in these books. What’s cool about The Housemaid is that there is a taking back of agency, even if you don’t agree with the methods entirely.

Part of what I love about books is that life can be so unfair, and shouldn’t happen that way. In fiction, you can take it back. You can give the satisfying ending. The good guy can win in the end. I want that ending where the good guy triumphs, and the really bad person got what they deserved.

Do you ever see yourself transitioning out of thrillers, maybe writing a comedy?

I just wrote a novella, The Widow’s Husband’s Secret Lie, that’s basically a satire of all my books, basically making fun of myself for 150 pages. I think laughter is really important, and I never take myself too seriously.

Are there any parts of being a writer that feel absurd or just silly?

The whole thing to me is absurd. Here I am, just self-publishing on Amazon, and now all of a sudden I’m a No. 1 New York Times bestselling author. Is this really happening? I have this joke that I made on my Facebook group. I was in a car accident a number of years ago, and it was kind of bad. And I joked, I’m in a coma and this is all a coma dream.

This interview has been edited and condensed.

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