Volume 196 - Issue 2
Doctors and writing: stranger than fiction?
Author: Dawn Barker
Med J Aust 2012; 196 (2): 141. || doi: 10.5694/mja11.11323
Published online: 6 February 2012
Published online: 6 February 2012
Why doctors and writers are on the same page.
The close relationship between the science of medicine and the art of writing
Today, a patient walked into my psychiatric clinic clutching a referral letter from her general practitioner. We sat down, she began to tell me her story, and I was plunged into the middle of her crisis. As we talked, I discovered things about my patient’s past that had shaped her character. Later, after work, I went home and opened a novel. I knew a little about the story from the back-cover blurb, but it wasn’t until I read the first page that I entered the world of the protagonist. I learned about her background and how it had contributed to her current predicament. As I continue to see my patient, and as I keep reading the main character’s story, I follow them both as they try to solve their problems.
Medicine and writing have a long shared history. Human illness has often been a theme in literature, with some of the greatest works having medicine, including psychiatric illness, as a central theme: Tolstoy’s Anna Karenina, Flaubert’s Madame Bovary, and Shakespeare’s Macbeth and Hamlet.
However, medicine doesn’t only provide themes for great books — many doctors have also been successful fiction writers, including Khaled Hosseini, Michael Crichton, Anton Chekhov, and Australians Nick Earls and Peter Goldsworthy. The science of medicine and the art of writing may not be careers that are often associated with each other, but there are many reasons why doctors can make good writers.
Writing any piece of fiction takes a long time, usually years. A novel goes through many drafts before it is ready to send out to literary agents and publishers, and the publishing industry is notoriously slow. Writers must be hardworking, dedicated and have long-term vision, just like doctors.
Doctors are also in a unique position to find ideas to fuel their writing. Every day, they meet people of all personalities from every section of society. Doctors are frequently faced with ethical dilemmas so unique that they are indeed “stranger than fiction” — ideal central premises for stories.
Writing has a cathartic effect too. My own novel was inspired by my involvement in a distressing clinical case; writing allowed me to explore my reactions and emotions in a safe way. I frequently encourage my patients to use writing to externalise their symptoms, and we too can use this method to deal with the stress of our clinical work.
Many more doctors read fiction than write it; but the act of reading books in itself can be beneficial for our profession. Some universities — including Harvard Medical School — use literature to help medical students understand the effects of illness on patients. Reading provides an escape from the stress of our jobs and a means of relaxing, but it can do more than that: books allow us to experience different cultures and worlds. Khaled Hosseini’s The kite runner taught me far more about the recent history of Afghanistan than reading newspaper reports ever could; as did J M Coetzee’s novel Disgrace about racial tensions in South Africa, and Jeffrey Eugenides’ Middlesex about the personal experience of someone with an intersex condition. Fiction brings these experiences to life through the eyes of the characters. This enriches our understanding of the world and, ultimately, our patients.
When the novel I am reading ends, I will have watched the main character find her way out of her predicament and overcome the flaws that led her there in the first place. When I have finished working with the patient who walked into my consulting room today, I will have watched her solve her presenting problem. In the book, the work occurs in the imagined space between the words written on the page and the reception of them by the reader. In the clinical case, something similar happens in the therapeutic space between the doctor’s advice and the patient’s interpretation of it. No two readers will have the same experience of the same book, and no two patients presenting with the same illness will ever be identical. Ultimately, the relationship between doctors and writing is a close and successful one because, in clinical medicine, we deal with patients’ narratives — their stories.