.....Doctors are storytellers.....


Doctor-writers are plentiful throughout history, spanning the ancient Greek physician and historian Ctesias, the 15th century Polish astronomer and physician Copernicus, the 18th century Romantic poet John Keats, and encompassing hundreds of doctors writing in every genre recognized today.


Some doctor-writers earn a degree of distinction, like Sir Arthur Conan Doyle, who created Sherlock Holmes; Walker Percy, who won the National Book Award for his novel, The Moviegoer; and Michael Crichton, author of Jurassic Park and founding writer of the long-running television series E.R.


.....Why so many doctor-writers?.....


Some have suggested it's because the doctor's approach to the patient is similar to a writer approaching her characters. In most clinical encounters, a doctor seeks the patient's story then renders that story for the patient's chart, for specialty consultants, or other clinical staff such as the social worker. Like writers, a successful doctor must sympathize with the patient and discover the elements of humanity in each patient's case.


A variety of studies have demonstrated the salutary benefits of telling stories, particularly emotionally stressful stories. Some scholars suggest that a doctor "bearing witness" to stories of suffering can enable a patient's healing. A number of medical schools now encourage medical students to write their own stories as a way to reflect professionally on clinical experiences. Whether these exercises have any impact on professional development is yet unproven.


Nevertheless, writings about medical training have become a thriving genre. Every year new memoirs are released about medical school, residency, and clinical practice. Some sell quite widely.


Professional gatherings for those in the medical humanities include the annual meeting of the American Society for Bioethics and the Humanities; more specific to doctor-writers is the Examined Life Meeting, hosted by the U of Iowa Carver School of Medicine and the Iowa Writer's Workshop.


A number of literary magazines devote their content to the physician-writer; the best known is the Bellevue Literary Review, based at NYU and edited by author Danielle Ofri. A number of medical journals publish short narratives by physicians on their clinical reflections including JAMA, Annals of Internal Medicine, and Journal of General Internal Medicine.


.....Ethics and the Doctor-Writer.....


The practice of writing about one's clinical experiences, which typically involves patients, inevitably raises questions of patient privacy and physician ethics. Some scholars like Rita Charon suggest obtaining pre-publication permission by offering patients the option to read their story in its entirety; she believes that such a practice may also provide therapeutic dividends.


Other doctor-writers like Jack Coulehan recognize the physician-author's obligations not only to patients but also to readers, who expect doctor stories to be "substantially true". Coulehan notes that stringent forms of patient consent may limit published stories to those with happy endings. He describes considerable gray area around how to alter a patient's identity.


.....Who Has the Time?.....


Many wonder how doctors have the time to pursue writing careers. As the Russian short story writer and playwright Anton Chekov famously said, medicine was his "lawful wife" and literature his "mistress". Many doctor-writers write before the office opens in the morning, or late at night after children are put to bed. Others work part time or leave medical practice entirely to focus on writing.


.....Learning to Write.....


Every doctor-writer finds his or her own path. Some engage in writing classes and workshops; some are lucky enough to cultivate mentors in the literary world. Others slug it out alone. Everyone learns from reading other writers. Emily Transue, a fellow doctor-writer, adapts material from Natalie Goldberg's Writing Down the Bones for her writing students. One book I find quite helpful for inspiration and advice is Mark Kramer and Wendy Call's Telling True Stories, a guide for narrative non-fiction writers.


Among my favorite works by doctor-writers are Lewis Thomas' Lives of a Cell and Camus' The Plague. Perri Klass' A Not Entirely Benign Procedure is one of the better memoirs of medical training. I'm a big fan of Ethan Canin's short stories, collected in Emperor of the Air and The Palace Thief. And I'll read anything written by Atul Gawande; his recent New Yorker piece about solitary confinement was remarkable.