Last updated Sunday, October 30, 2011
First off, many thanks for the interview. Regarding the writing workshop, I think my original motivation, to be honest, was revenge. I’d been writing since my teenage years, but the urge grew irresistible for some reason during my second year of medical school. I’m not complaining, but it’s hard to imagine a lousier environment wherein to nurture literary ambitions.
Don’t get me wrong—the material is there. It’s just hard to let your spirit soar when your mind is caged in by the need to study. It boiled down to choices like this: do I let my mind spread its wings this evening, or do I continue stuffing my cortex full of pathophysiology for tomorrow morning’s test?
John Keats said to hell with delayed gratification and walked out of medical school just before his qualifying exams. He knew that if he took the safe path, he might never achieve the greatness he felt roiling inside. But my model was William Carlos Williams, so I stuck it out, and actually managed to get a few things published before I graduated (they weren’t very long).
About a dozen years after graduating I found myself as a teacher back at the same school, which in the meantime had created a division of Medical Humanities. Remembering my own frustrations, I straight-away proposed they let me slip a creative writing workshop for med students into the curriculum. I had picked up an MFA in writing along the way and that gave me some academic creds. And I argued (truthfully) that the practice of both medicine and creative writing have points of contact: a good bedside manner involves sensitivity to the nuance of language—the ability to artfully craft your words and tone. They said, “Hmmm, okay.”
We began offering it as an elective for first year students and the program was so well received we added it to the second year schedule. Before long we started gathering student pieces in a literary magazine and conducted readings. After doing it for a decade and a half, the demands on my time burgeoned and I passed the torch a couple of years ago. But what pleasure it was! I’d also been a flight instructor in college after getting out of the army and the same thing was true with that endeavor—the rewards of teaching are the learning you yourself receive, along with watching people stretch and succeed.
2) Your work, particularly your poetry, transcends mere experience and gets into a kind of philosophical interpretation of moments and happenings. Do you consciously seek to interpret your experiences more universally? And does writing about your experiences (even if re-imagined) provide you with a form of catharsis or perspective that you otherwise would not find?
The process of creative writing is so multifaceted that it’s hard to define without using metaphor. But I think you hit the nail on the head. In the act of re-imagining things, we discover something new and greater truths.
I often think of T.S. Eliot’s comment about the way bad writing is conscious when it should be unconscious, and vice versa. When our writing is going along well—when we are creating images and events that will resonate with readers—we are somehow to one extent or another swimming in the collective unconscious of our species.
I think we can easily miss the mark of creating something great if we try too hard to make it universally appealing. Good writing lives in the particular and the individual.
To wildly paraphrase William Blake, we can best call up a vision of the universe by carefully describing the grain of sand on our fingertip. I think when you succeed at describing your own experience, you can somehow feel it radiating outwards and touching everything and everyone else, which is both cathartic and elevating.
3) How has writing your non-fiction books helped you in writing your fiction/poetic works, and vice versa?
Writing non-fiction has been very helpful in learning how to manage voice and pacing. In the kind of medical writing I’ve done I’ve tried to keep it as interesting as possible by striking a brisk, friendly attitude, varying the sentence structure, avoiding passive construction, using strong verbs, being stingy with modifiers, and keeping the prose as crystal-clear as I can.
I also go light on the esoteric jargon when I don’t specifically need it. It’s great exercise and doesn’t have the same number of frustrating moments you encounter during the writing of fiction and poetry, where you’re literally grabbing your subjects out of thin air or waiting for things to bubble up.
4) What do you think is missing in much of the medical fiction on the market today? Or, perhaps better asked, is there anything you hope to see more of in the genre?
I think Tess Gerritsen is getting close, but the modern medical fiction genre doesn’t yet have a Graham Green, a John LeCarre or a Robert Harris. We’ve got some slam-dunk wonderful storytellers now who can do miracles with the doctor-discovers-conspiracy-and-saves the day formula, no doubt about it. I’d love to see another Walker Percy come along and bridge the gap between medical suspense and literary fiction.
5) Can you give us the details about how Final Mercy came about: when and why you decided it was time to write a novel, how long it too you to do it, and any challenges in terms of time management or distraction management that you overcame?
Like most of us, I’ve got a big brown box in the attic full of half-baked novels. Since internship I’d probably started six or seven that never crawled beyond the rough draft stage. My ambition was to write a literary story, you see, but all my efforts drifted into being mysteries, and that didn’t jive with what I believed to be my quest.
Then one day about six years ago I looked in the mirror and said “What’s wrong with mysteries? Life’s a mystery. People like to read mysteries, including you. You are apparently drawn to the writing of mysteries. So, finish the damn thing. Just try and make it a good one.”
As an emergency doctor, I’m usually able to carve out at least a few hours of a few days a week for writing, and when the juice is flowing, I’ll write in spare minutes or take a couple of weeks off and write for a good stretch. It took about two years to get a marketable draft of Final Mercy finished. I was then blessed with a wonderful editor, Liz Burton, at Zumaya Publications. It required about two months of polishing, a type of final editing that I found a pure pleasure—watching the story finally gel.
6) Jack Forester: Who is he? (as in, who is he based on, is he an amalgam of people you know, is he representative of someone you would like to be or would like more doctors to be?
Jack is my more attractive, interesting, charismatic, lucky and socially adept alter ego. (But I can play guitar better than he can.) The story grew out of my experience working in the emergency department at the University of Rochester, though I threw a lot more problems at Jack than I ever encountered. He catches the ball pretty well. He’s not perfect, but he’s at least as good a physician as I am.
7) What are you working on now as a writer?
I have just finished the rough draft of a sequel to Final Mercy with the working title Bedside. A new and somewhat shady medical device is about to be introduced at the medical center and it has attracted the attention of a domestic terrorist. I’m planning a third book in the series, called The Shaman Only Rings Twice. Jack becomes dean of the medical center and is embroiled in a scandal. I’m also working on a new collection of poems.
I would finish this, if I might, by mentioning some writers who inspired and influenced me. Antoine De Sainte-Exupery. Hemingway. Vonnegut. Tolstoy. Chekhov. Dickens. Williams Carlos Williams. Billy Collins.