I met with my client yesterday to review the third version of the book proposal for his medical memoir. This time we went over the chapter summaries, which I had significantly reworked and beefed up to create a better sense of how the completed narrative will flow. We are hopeful that this one will be the clincher, and that our editor/agent will put her stamp of approval on it. But if it does pass final muster, we will face the daunting task of deciding on a subtitle that might instantly hook some editor’s interest, and make that gatekeeper to publication read on.

I was reminded that all authors struggle with this task by a post on a blog I follow, Writer Unboxed, appropriately entitled  “Untitled,” by author Anne Greenwood Brown. I plan to go back to this post and try out some of the amusing techniques she tested in her own endeavors to come up with a title for a new book. Just to give you a hint of what those techniques might involve, think algorithms.

The good doctor and I have been thinking about subtitles for over a year now, having agreed long ago on a title for the original manuscript, one we will keep now for the new book. To come up with that main title, I had researched extensively the titles of new releases from major publishers. I noted the convention of using one or two key words in the main title, and threw out some possibilities. My client did not like my first choice among all the suggestions that referenced his profession as a spinal neurosurgeon. But his wife loved it, and so did the editor, and he finally came around. The double meaning of the word is what clinched it; it is a word that very effectively evokes not only the author’s profession but also his values and the character strengths that allowed him to overcome great adversity in his youth.

Now, before I reveal that main title, and give you a chance to weigh in on a subtitle, let me run a few of the early contenders for title by you. Remember, my client, the ostensible author of this medical memoir, is an internationally known and respected spinal neurosurgeon who contributed significantly to the evolution of his profession. So for starters we played with the word “spine,” another word that suggests courage or strength of character. The subtitle (included on the first example below) reflected the original trajectory of the life story, from birth until reaching the height of his career. That subtitle won’t work for the reworked medical memoir. Hence, our search for a new subtitle. Here are those early candidates for title:

Early Contenders for Title

1. Spine: A Journey From Refugee to Neurosurgeon
2. A Spine Man
3. A Strong Spine
4. Spine and Spirit
5. Spine and Soul
6. Anatomy of a Spine Surgeon
7. The Miracle Spine
8. The Balanced Spine
9. The Whole Spine and Nothing but the Spine
10. The Honest Spine
11. The True Spine
12. The Straight Spine
13. The Proud Spine
14. Nothing But Spine
15. The Spinemaster
16. The Stalwart Spine
17. Spine

Well, we eventually ditched the word “spine.” And, whether or not it was simply my repeating to him endlessly my own preference, my author decided, after enthusiastic reactions from friends, family, and the editor, to go with my suggestion. The working title is (drum-roll) . . . BACKBONE.

Now however, we are stymied over the selection of an appropriate subtitle, one that hints at the career of a spinal neurosurgeon who made game-changing contributions to the evolution of spinal neurosurgery. Some of our current attempts are below.

Current Contenders for Subtitle

1. Backbone: Tales from the Dawn of Spinal Neurosurgery
2. Backbone: Adventures in Spinal Neurosurgery
3. Backbone: Pioneering Neurosurgical Inroads to the Spine
4. Backbone: A Near Decapitation, a Summons from a Queen, and Other Tales from the Annals of a Spinal Neurosurgeon
5. Backbone: Changing the Face of Neurosurgery, One Vertebra at a Time
6. Backbone: The Inspired Life of a Neurosurgeon
7. Backbone: One Neurosurgeon’s Courageous Quest to Conquer the Spine
8. Backbone: A Neurosurgeon’s Memoir of Brains, Bones, and Battles with the Spine
9. Backbone: The Triumphs and Defeats of a Spinal Neurosurgeon
10. Backbone: The Making of a Spinal Neurosurgeon
11. Backbone: A (Spinal) Neurosurgeon’s Journey, One Vertebra at a Time
12. Backbone: Courage, Hope, Hard Work and Other Timeless Tools in the Trade of a Spinal Neurosurgeon
13. Backbone: A Tool in the Trade of a Spinal Neurosurgeon
14. Backbone: Scaling the Heights of Spinal Neurosurgery in Game-changing Times
15. Backbone: A (Neurosurgeon’s) Story of Breaking Barriers between Brain and Spine
16. Backbone: The Life and Game-Changing Career of a Spinal Neurosurgeon
17. Backbone: The Struggles and Triumphs of a Spinal Neurosurgeon
18. Backbone: Twists, Turns, and Triumphs on the Road of a Spinal Neurosurgeon

So, is your mind all agog now? Or perhaps it’s numb. Mine sure is. But I’d love to hear your take on the subtitle in the comments section. Give me your top five choices from the above list, or  if you would like to submit your own subtitle—or even suggestions for an entirely new title—I welcome all efforts heartily. Happy Wordsmithing!