2.04.2009

Doctors as Writers

I am often surprised to learn that a writer whose work I admire had been trained as a physician. I think of Somerset Maugham, Anton Chekhov, and Walker Percy. I’ll never forget reading Percy’s Moviegoer and then enjoying it just a much a few years ago when I read it again.

There are also more contemporary novelists like Ethan Canin, Rivka Galachen and Daniel Mason all of whom studied in medical school. Similarly, several well-known non-fiction writers such as Robert Coles, Oliver Sachs, and Theodore Dalrymple were trained as doctors.

Among my favorite New Yorker short story writers was Auturo Vivante whose romantic stories of Italian life entranced me in my earlier New Yorker days. One day I wrote him a letter to that effect and he even had the courtesy to reply.

And if you had the good fortune of reading Annals of Medicine who can ever forget the epidemiological “mysteries” that Berton Rouche wove? Although Rouche never formally studied medicine, you’d never know it from reading his memorable accounts.

And now the New Yorker has two eminent doctors—Dr. Jerome Groopman and Dr. Atul Gawande--on their staff who write brilliant essays about their medical experiences and recent advances in their science. Groopman recently wrote a deservedly popular and important book about medical decision-making titled How Doctors Think that I very much enjoyed and Gawade has also written two volumes that I’ve not yet read—Complications and Better: A Surgeon’s Notes on Performance.

Why do so many doctors write so well? When asked a similar question, William Carlos Williams, who practiced medicine and wrote poetry throughout his life, replied:

"When they ask me, as of late they frequently do, how I have for so many years continued an equal interest in medicine and the poem, I reply that they amount for me to nearly the same thing."

When I think about this question I realize both medicine and literature are concerned with the individual, not generalizations that apply across a large number. Both disciplines focus on the individual in intimate detail—suffering, illness, personal crisis, birth and dying.

Kathryn Montgomery, a professor of literature, is quoted in a May 15th article in the Times as saying: “Doctors are storytellers. They spend all day long listening to stories and telling stories.”

Perhaps that is why there are so few, if any clinical psychologists who write novels. While they listen all day to stories, it is rare for them to tell one in return.

In a letter written in 1899 to a fellow physician in Moscow, Chekhov wrote: “I have no doubt that my involvement in medical science has had a strong influence on my literary activities; it significantly enlarged the scope of my observations and enriched me with knowledge whose true worth to a writer can be evaluated only by somebody who is himself a doctor…”

Finally, Theodore Dalrymple recently passed along the following advice to a group of resident doctors:

“I had only three pieces of advice to give: firstly, that they should continue in the hospital for a few more years, because human nature was concentrated and distilled there as if for the express purpose of training writers; secondly, that on no account should they consort with academics of the humanities departments of any university, for to do so was the primrose path to stylistic perdition; and finally, that they should read a great deal.”

“Read a great deal.” Good advice for anyone, regardless of the “primrose path” they have taken.