All Things Considered

Story Specialists: Doctors Who Write

By Lynn Neary

Published November 17, 2009 10:45 AM

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It's not uncommon for writers to have a day job. Lawyers write. Soldiers and teachers write. But there seems to be a special connection between the medical profession and the art of writing. The list of doctors who are also novelists, playwrights and poets is long, and quite impressive: Anton Chekhov, William Carlos Williams, Walker Percy, W. Somerset Maugham and Arthur Conan Doyle, to name just a few.

Doctors continue to add their names to that list. For Abraham Verghese, writing and medicine are inextricably entwined. Verghese, who is the senior associate chair for the theory and practice of medicine at Stanford University's School of Medicine, based his first book, a memoir called My Own Country, on his experience as a doctor treating AIDS patients in rural Tennessee.

Terrence Holt is a specialist in geriatrics and a professor at the University of North Carolina School of Medicine. In the Valley of the Kings is his first book.

"I think I was drawn to medicine with a strong sense of medicine being a romantic pursuit, a calling," Verghese says. "I still really am very much in love with medicine, and I love what I do. And I often think the writing emanates from that stance of being a physician. And I worry that I would become mute if I ever left medicine and tried to write."

In his writing, at least, Verghese is inching away from his own direct experience. He published his first novel, Cutting for Stone, this year. It tells the story of a family of doctors, a saga that takes readers into hospitals and operating rooms from Ethiopia to America.

Terrence Holt, who has a new book of stories called In the Valley of the Kings, comes from a family of doctors, but he was a writer and a teacher long before he decided to go to medical school. Holt's new book reflects his fascination with language rather than his life as a physician, but he insists that being comfortable in the world of literature is enormously helpful in the practice of medicine.

"You are used to dealing with ambiguities if you are familiar with literature, and a lot of medicine is ambiguous," Holt says. Even more important: "You get, vicariously, but in a very useful way, experience with other people that you couldn't get any other way, with seeing the world as other people see it."

Holt, who is on the faculty at the University of North Carolina School of Medicine, thinks writing can help reframe the experience of being a doctor.

"Patients bring us stories," he explains. "We drop into the middle of patients' stories and try to change the plot for the better. First we have to understand it, however. The first thing that happens when a patient comes in is they start telling a story, and you try to figure what it means."

"I think narrative is huge in medicine," Verghese says. He adds that if you listen carefully, you will hear clues needed to make a diagnosis: "It's very rare that some extra piece of knowledge in my brain solves the puzzle. Much more often it's the fact that the story I am hearing resonates with my collection of stories. Or there is an element in that story that reminds of something in my catalog of stories, and I go seek out the other element."

In Cutting for Stone, Verghese set out to create an epic story that encompasses family, politics, history, culture and love against a backdrop of life in and near hospitals. In an effort to reveal the inner workings of the world of medicine, Verghese spares no details in his descriptions of often complex medical procedures and the human emotions that surround them.

Visiting a hospital, Verghese says, means that, "Suddenly you are in this crucible where every human emotion, every passion is exaggerated; where great truths and mysteries are revealed for the first time, sometimes to close family. So I think hospitals are inherently places of great drama."

Holt's fiction takes place far away from hospital life, though one of his stories is about a plague that first appears on its victims in the form of a word. In another, a man is so obsessed with the idea that he is dying that he ends up in a tomb from which there is no escape.

Because doctors deal with death more than most people, Holt says, it should be no surprise that the ones who write would end up exploring the concept in their art.

"I think it is true that death is the mother of beauty," he says. "And an appreciation of human suffering and our limited tenure on this Earth is essential to seeing our lives and seeing the world we inhabit."

In a hospital, where the routine can quickly become a matter of life or death, there is precious little time to sift through the events of the day to uncover what it all means. In their time away from hospitals, it is little wonder that some doctors would turn to that most contemplative of arts, where they can be alone with their thoughts, searching for just the right words to find release or understanding.

View Transcript

ROBERT SIEGEL, host:

It's not uncommon for writers to have day jobs. There are lawyers who write, soldiers who write, teachers who write, and the list of doctors who write is long and impressive: Anton Chekhov, William Carlos Williams, Walker Percy, Somerset Maugham, Arthur Conan Doyle, to name just a few from the past. NPR's Lynn Neary was curious about the connection between medicine and literature, and she spoke with two doctors whose books were recently published.

LYNN NEARY: For Abraham Verghese, writing and medicine are inextricably entwined. Verghese's first book, "My Own Country," was a memoir based on his experience as a doctor treating AIDS patients in rural Tennessee. His latest book and first novel, "Cutting for Stone," is the story of a family of doctors, a saga that takes the readers into hospitals and operating rooms from Ethiopia to America.

Dr. ABRAHAM VERGHESE (Author, "Cutting for Stone"): Well, I think I came to medicine with a strong sense of medicine being a romantic pursuit, a calling. And I am still really very much in love with medicine, and I love what I do. And I often think that the writing emanates from that stance of being a physician. And I worry that I would become mute if I ever left medicine and tried to write.

NEARY: Terrence Holt comes from a family of doctors, but he was a writer and a teacher long before he decided to go to medical school. His new book of stories, "In the Valley of the Kings," reflects his fascination with language rather than his life as a physician. Being comfortable in the world of literature, Holt says, is enormously helpful in the practice of medicine.

Dr. TERRENCE HOLT (Author, "In the Valley of the Kings"): You are used to dealing with ambiguities if you are familiar with literature, and a lot of medicine is ambiguous. But I think maybe the most important thing is that you get, vicariously, but I think in a very useful way, experience with other people that you couldn't get any other way, with seeing the world as other people see it.

(Soundbite of elevator bell)

NEARY: Now a specialist in geriatrics, Holt is on the faculty in the school of medicine at the University of North Carolina. One recent morning, he went on rounds with a group of residents and interns.

Unidentified Woman: Mr. S. He's our 50-year-old guy, history of alcohol and marijuana abuse, presenting from (unintelligible), found to have an MRI finding suggestive of (unintelligible), and�

Dr. HOLT: Patients bring us stories. We drop into the middle of patients' stories and try to change the plot for the better. First we have to try to understand it, however. I mean, the first thing that happens when a patient comes in is they start telling a story, and you try to figure out what it means.

Unidentified Man: He was a little bit more spastic this morning than I've seen him. He was having some pretty significant (unintelligible) in his upper extremities, and I hadn't seen that before. And I asked him if that was usual for him, and he says that happens fairly frequently. He says it particularly happens when he's around women. He says he gets a little nervous and starts shaking when he's around women, so...

NEARY: Abraham Verghese also says a patient's history is like a story. If you listen carefully, he says, you will hear the clues needed to make a diagnosis.

Dr. VERGHESE: I'm always struck that when I'm called in as a consultant, it's very rare that some extra piece of knowledge tucked away in my brain solves the puzzle. Much more often, it's the fact that the story I am hearing resonates with my collection of stories, and - or there is an element in that story that reminds of something in my catalog of stories, and I go seek out the other elements. So I think narrative is huge in medicine.

NEARY: In "Cutting for Stone," Verghese set out to create an epic story that encompasses family, politics, history and love, all set against the backdrop of life in and near hospitals. He spares no details in his descriptions of often complex medical procedures and the human emotions that surround them.

Verghese says he wanted to reveal the inner workings of the world of medicine.

Dr. VERGHESE: You come to a hospital, especially as a patient, and all of a sudden, you are in this crucible where every human emotion, every passion is exaggerated, where great truths and mysteries are revealed sometimes for the first time to close family. So I think hospitals are inherently places of great drama. So I think it's a perfect setting for a novel because you can get right to the action, so to speak, and right to the heart of what makes people tick.

Unidentified Woman: She definitely does not want the EUS done today. She...

Dr. HOLT: Does she understand what the implications of that are?

Unidentified Woman: Yeah, she did, but you know, I want to talk to her daughter. I got a page that her daughter is here, this morning.

Dr. HOLT: Yeah, her daughter is there. Her daughter wants it, and she doesn't. So what do you do?

NEARY: Holt's fiction takes place far away from hospital life, though one of his stories is about a plague that first makes an appearance on its victims in the form of a word. And in another, a man is so obsessed with the idea that he is dying that he ends up in a tomb from which there is no escape. It should not be surprising, says Holt, that he would explore ideas of death in his writing, since death is a reality that doctors deal with more than most.

Dr. HOLT: I think it's true that death is the mother of beauty, and an appreciation of human suffering and our limited tenure on this earth is absolutely essential to seeing our lives and seeing the world we inhabit. And what makes me write is that I find this world an absolutely wonderful place, and the fact that mortality shows up as a ground to that is, I think, inevitable.

NEARY: In a hospital, routine can quickly become a matter of life or death, and there is precious little time to sift through the events of the day to uncover what it all means. Perhaps, then, it's little wonder that some doctors would turn to that most contemplative of arts, writing, where they can be alone with their thoughts, searching for just the right words to find release or understanding. Lynn Neary, NPR News.

Unidentified Woman: Ms. E, she's our 77-year-old African-American female with a past medical history of... Transcript provided by NPR, Copyright National Public Radio.

Source: NPR

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