Truman Capote wrote a real-crime, real-investigation best seller, IN COLD BLOOD (1966). It was such an explosive hit that it cast him into writers block - how to follow up?
In two alternative realities:
1) First, Capote pitches his publisher that he needs a big advance for a new blockbuster: a book about the 14 Day Rule.
2) Second, the opposite. Capote's publisher, getting fed up with the writer's block, reaches out to Capote and pitches him, here is the next big one: The Fourteen Day Rule.
From prior blogs, the 14 Day Rule is an obscure bit of Medicare laboratory policy law from 2006.
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Here’s how such a letter might read — Truman Capote, in his baroque, ironic, confessional style, pitching The Fourteen Days to his publisher, angling for an enormous advance, and treating Medicare regulation with the same novelistic gravity as murder in Kansas.
Letter from Truman Capote to [Publisher’s Name], ca. 1970
My dear [Publisher],
You have been patient with me. Painfully patient. Ever since In Cold Blood (which—let us admit—was not merely a book but a revolution in the way truth could be told) there has been an air of suspended expectation. The public leans forward, as though I am a magician who has yet to pull another rabbit, a rarer rabbit, from the battered silk hat. For years I have stalled, staggered, dissembled, teased. But now, at last, I have it.
The new book.
It will be called, provisionally, Fourteen Days. Or perhaps, The Rule. Or, to lend it the true biblical gravity it deserves: The Gospel of Fourteen Days.
And what is it? you ask. A crime story, of course. Not the clumsy, bloody kind with shotguns and bodies in barns, but a bureaucratic crime: bloodless, paper-bound, committed in the quiet corridors of the federal government. A crime of commas. A crime of dates. A crime that trapped cancer patients in the amber of regulation and sent laboratories into bankruptcy while senators blinked in incomprehension.
It happened in Baltimore, of all places—not the Kansas plains, not a mansion in Montauk—but a gray government building where the Centers for Medicare & Medicaid Services met to decide something that should have been inconsequential: the date of service for a laboratory test. Do you know how boring that sounds? Catatonically boring. But out of this soporific seed sprouted one of the most consequential, misunderstood, absurd little tyrannies in modern health care: the infamous “14 Day Rule.”
The beauty, dear [Publisher], is in the contrast. In In Cold Blood I showed you blood pooling on the linoleum of a Kansas farmhouse. In this new book, the horror is quieter, subtler: it is the horror of a widow whose husband’s genomic test is delayed not by villainy but by a number—by the fact that day thirteen is bundled and day fifteen is not. Kafka by way of The Federal Register.
And do not think the cast of characters is any less rich for being bureaucrats. I will introduce you to Mary Sullivan, a woman in sensible shoes who became, without ever seeking it, the Mother of Fourteen Days. To congressional aides who confess, over bourbon, that they cannot brief their senators without a flowchart. To lobbyists who sip martinis in K Street bars and smirk: “Fourteen is survivable.” To patients who stand in drab meeting rooms, telling stories so raw that even the most lacquered hospital lawyer looks away.
This is my talent, as you well know: to transform what appears banal into opera, to render the invisible visible, to find the gothic in the fluorescent-lit. In Cold Blood made you feel the dust of western Kansas. Fourteen Days will make you smell the government coffee—weak, bitter, endlessly replenished—and understand how a nation’s fate can be hidden in the steam.
The public will come to this book for the same reason they came to Holcomb: to stare at the collision of innocence and cruelty, of the ordinary and the catastrophic. They will ask themselves: how could something so small—a definition, a date—reshape cancer care? They will discover the absurd power of language, of a single clause in Title 42 of the Code of Federal Regulations. They will laugh, then shudder, then laugh again.
And I, Truman Capote, will give them prose that makes it unforgettable. I will show you the brass bands of New Orleans clashing with the silence of a CMS conference room. I will show you bureaucrats who believe themselves humble servants and yet whose commas dictate billions. I will show you, in exquisite detail, how America governs itself not through speeches or elections, but through the accidental poetry of regulatory footnotes.
So: I ask for what I deserve. One hundred thousand dollars in advance. A pittance, when you consider the genius about to be unleashed. Do you doubt the public’s appetite? They lapped up four hundred pages about a murder in Kansas. Will they not devour four hundred pages about the slow strangulation of laboratories, the Kafkaesque calendar arithmetic of a government that tells oncologists, Wait two weeks or starve?
I can already hear the reviews: A sui generis masterpiece; Capote does for bureaucracy what he once did for bloodshed. They will say, In Cold Blood invented the nonfiction novel; Fourteen Days perfects it.
Do not be timid, my dear [Publisher]. Genius must be financed, and time—fourteen days, fourteen years—waits for no one.
Yours, as ever,
Truman
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ALTERNATE REALITY:
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Here’s a version of the publisher’s letter to Truman Capote, nudging him out of inertia, teasing him back toward the road and the typewriter, and framing the odd leap from In Cold Blood to the saga of the Fourteen Day Rule.
[Letterhead: Random House, New York, NY]
March 12, 1970
Mr. Truman Capote
United Nations Plaza
New York City
Dear Truman,
We have waited long, and we will wait longer if we must, but it would be dishonest not to say it aloud: the world waits for you. In Cold Blood was not simply a book, it was a phenomenon, a genre sui generis as some critics rather desperately phrased it. You proved that the novel of fact could be as compelling, as haunting, as any work of the imagination. It is no wonder that since then you have felt the weight of your own invention. How do you follow genius? How do you improve on a sui generis?
Permit me, then, a provocation.
While you have been searching for the proper subject, a curious story has been unfolding in the bureaucratic labyrinth of Washington. It is not a murder in Kansas, but it has its own kind of blood—blood samples, tissue blocks, and genomic tests that now govern the fate of the ill. The Centers for Medicare and Medicaid Services, in its joyless cubicles, has enacted something that sounds duller than dull: the “14 Day Rule.” And yet—here is the hook, Truman—it is a regulation that decides whether a woman with breast cancer learns the genomic truth of her tumor today or two weeks from now; whether a laboratory keeps its doors open or closes; whether the nation’s new science is liberated or smothered by a calendar.
A crime without criminals, a drama without a stage—exactly the sort of story only you could tell.
The public may balk at the distance between Holcomb, Kansas and Baltimore, Maryland. But I insist: the leap is not so wide. In Cold Blood exposed how ordinary lives are undone by a shotgun blast in the night; Fourteen Days (as I imagine we might title it) would expose how ordinary lives are undone by a comma in the Federal Register. One murder, one definition—each grotesque in its banality, each revealing America’s deepest truths.
I would like you to imagine yourself once more on the road—not in a Kansas motel this time, but in a budget hotel off I-95, Baltimore’s neon buzzing outside your window. Imagine yourself at a hearing where hospital lobbyists drone in monotone and patients rise trembling to speak of lost weeks, lost husbands. Imagine, Truman, those long, seductive conversations with the woman at the center of it all, Mary Sullivan—the mid-level bureaucrat who became, unwillingly, the Mother of Fourteen Days. There is character here. There is pathos. There is absurdity so extreme it verges on the tragicomic.
And there is you. Only you could make readers turn the pages, breathless, to discover what happened on day thirteen and day fifteen.
Do not think of this as a retreat from the heights of In Cold Blood. Think of it as the logical continuation: an American story told in a new key, an absurdist realism that will confirm your invention of a genre. If Holcomb was Gothic realism, Baltimore will be bureaucratic surrealism—In Cold Blood’s younger, slyer sibling.
We are ready to commit, Truman. To advance. To travel with you again, metaphorically, as you return to motels and typewriters and your genius for seeing what others dismiss. The amount—we can discuss—but I assure you, it will be six figures, as befits an undertaking worthy of your name.
Think on it. Mock it, if you must, but do not dismiss it. The American people, Truman, will line up for your next book, no matter its subject. Give them the 14 Day Rule, and I promise, they will think it a murder mystery. And they will be right.
With admiration and impatience,
Yours,
[Publisher’s Name]
Random House
CAPOTE REPLIES TO PUBLISHER
Wonderful. Here is Truman’s imagined reply — arch, sly, both dismissive and intrigued — in his unmistakable voice.
United Nations Plaza, New York
March 20, 1970
My dearest [Publisher],
I have read your letter (twice, aloud, for the drama of it) and I am not sure whether to send you a bouquet of roses or a bucket of ice water. The 14 Day Rule? Really? After In Cold Blood, after the cathedral of dust and doom I built out of Holcomb, Kansas, you want me to pack my bags for Baltimore? Baltimore! And not even the interesting Baltimore of Edgar Allan Poe, but a Baltimore of fluorescent lights, water-stained ceiling tiles, and clerks arguing over commas.
You are out of your mind. And perhaps, so am I.
Because, as I set your letter down, I could see it. I could see the story you want me to tell: the widow in Ohio waiting for her husband’s test, the oncologist marking days like a prisoner marking his cell wall, the bureaucrat in sensible shoes carrying a burden she cannot name. It is absurd, yes, but then again, what is America if not absurd?
You are correct about one thing: the leap from Kansas to Baltimore is not so wide. Murder with a shotgun, murder by definition—both are sudden, both final, both indifferent to the humanity left in their wake. Holcomb had its killers in boots; Baltimore has its killers in binders.
I will confess, the perversity of it seduces me. To take what is boring, anesthetizing, dead on arrival—and to breathe into it life, horror, comedy. To make readers tremble as they follow the fate of a single clause. To make them laugh, then cry, then laugh again, until they realize they’ve been staring into the black hole of our national life: bureaucracy as fate.
But let me be plain. If I am to do this—if I am to rise from the velvet couch, leave my martinis unfinished, and consign myself once more to the motels and stenographers and the endless talk of the condemned—then it will not be for the thrill of charity. It will be for $100,000. At least. Paid promptly, without negotiation, as tribute to the mad experiment you are asking me to undertake.
And I will need time. Not fourteen days. Fourteen months, perhaps, of wandering those halls, listening to the monotone testimonies, coaxing from Mary Sullivan and her tribe the fatal poetry of their lives. I will need bourbon with lobbyists, midnight calls with senators, long silences in government cafeterias. And from this stew, perhaps, I can serve up something worthy of your expectations.
Do I believe this will rival In Cold Blood? No. Nothing can. But do I believe it could be something sui generis again, something to make critics scratch their heads and readers line up just to say they’ve read it? Yes, perhaps.
So—very well. I will consider your madness. I will consider Baltimore. I will consider fourteen days.
But if I do this, remember: when I turn a comma into a crime scene, when I make a nation weep over an obscure clause of federal law, you will owe me not only the advance, but your eternal gratitude.
Yours, amused and appalled,
Truman
👉 Would you like me to push this one step further and draft a sample “book proposal synopsis” in Capote’s voice — the kind he might sketch out for himself after this exchange, outlining Fourteen Days as if it were already a true-crime narrative?
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Perfect. Here is a sample book proposal synopsis — written as Truman Capote might have drafted it for himself after the exchange, half blueprint, half performance, promising a sui generis masterpiece out of bureaucracy.
Proposal for a Nonfiction Novel
Working Title: Fourteen Days
Author: Truman Capote
Conception
In Cold Blood revealed how a brutal crime in a Kansas farmhouse could illuminate the entire American condition: loneliness, violence, the thin membrane of civilization. The new book, Fourteen Days, will perform a similar act of transformation. Out of a bureaucratic rule —a comma, a clause, an interval of time—will emerge a story of absurd cruelty and comic tragedy, an American fable of how lives are lost not to bullets but to paper.
The “14 Day Rule” was promulgated in 2006 by the Centers for Medicare and Medicaid Services. It defined when a laboratory could bill for tests performed on hospital specimens. It sounds unendurable in its dullness. But in practice, it delayed cancer testing, bankrupted laboratories, and bewildered patients. It is a crime without killers, a calamity without villains, and precisely for that reason, it is the most American story of all.
Method
I will do what I did before: leave my apartment, leave my parties, and live inside the subject. I will sit in Baltimore motels, drinking weak coffee in CMS conference rooms. I will interview Mary Sullivan, the mid-level bureaucrat who authored the regulation and became, by accident, the Mother of Fourteen Days. I will listen to the oncologists, the patient advocates, the hospital lobbyists who fought in those rooms. I will travel to Ohio, to meet widows who lost their husbands while paperwork lingered in drawers.
The same novelistic techniques will apply: scene, dialogue, atmosphere. But here the tone will shift from Gothic realism to absurdist realism. Kansas was blood on a linoleum floor; Baltimore will be fluorescent light on a regulation page. The menace is subtler, but no less fatal.
Characters
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Mary Sullivan, a bureaucrat in sensible shoes, carrying the tragicomic burden of defining a date.
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The Hospital Men, suited, solemn, intoning the sanctity of “bundling.”
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The Lab Men, frantic, pleading, carrying folders of unpaid claims like ransom notes.
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The Patients, rising one by one in drab hearing rooms to tell stories of lost time.
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The Congressional Aides, bewildered, confessing over bourbon that they cannot explain any of it to their bosses.
These are not murderers, but their decisions carry the same weight of life and death.
Themes
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Bureaucracy as Fate. How ordinary lives are governed not by leaders or laws, but by definitions in the Federal Register.
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The Absurdity of Power. How one number —fourteen—became gospel, not for its reason but for its arbitrariness.
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Comedy and Tragedy Intertwined. Doctors waiting to order tests until day fifteen; patients who discover that mortality can be scheduled by regulation.
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The American Condition. That our cruelties are often bureaucratic rather than violent, committed with binders instead of shotguns.
Audience
The audience that devoured In Cold Blood will recognize the same Truman Capote signature: the high style of fiction wedded to the weight of fact. They will come to see how even the driest clause contains drama, absurdity, and tragedy. Reviewers will call it sui generis again. College students will carry it as a talisman of absurdist American literature. Policymakers will read it and weep, not for what it reveals, but because they recognize themselves in its pages.
Working Structure
Part I: The Comma
The origins of the date-of-service definition, negotiated rulemaking of 1997, and the slow creep of molecular diagnostics.
Part II: The Rooms
The CMS listening sessions in Baltimore: hospitals, labs, patients, and the invention of “14.”
Part III: The Fallout
Confusion in Congress, laboratories collapsing, patients in limbo. The number becomes legend.
Part IV: Fourteen Forever
The persistence of the rule, the permanence of the temporary, and the meditation on America’s obsession with definitions.
Conclusion
This will not be a “policy book.” It will be a novel of fact, a murder mystery without a body, a bureaucratic In Cold Blood. I will give the reader not only information but atmosphere: the smell of stale coffee in CMS, the whine of a brass band in New Orleans where Sullivan now lives, the creak of motel beds where I will write the night’s pages.
If In Cold Blood showed how crime unravels a family and a town, Fourteen Days will show how policy unravels patients and an industry. Both are stories of American fate, one bloody, one bloodless, each cruel in its way.
Advance requested: $100,000.
