Seven Reasons Why Doctors Write

January 4, 2009 at 1:05 pm

A pair of round glasses on a sheet of writing, Wellcome Library, London, Photograph 2004

Commentary by Tony Miksanek, M.D., family physician, short-story author, and coeditor, Literature, Arts, and Medicine Database

As a profession, physicians are a remarkable group of writers. What doctors lack in good penmanship is more than compensated for by their skill in penning stories and poems. Their literary accomplishments are even more impressive given a lack of formal training in the art of writing. Only a few physician-authors have MFA degrees. Most medical students do not major in English or literature while in college. Doctors become talented writers the old-fashioned way. They practice. They also teach themselves via voracious reading with attention to style and technique. They occasionally attend writing workshops.

It helps that doctors are immersed in stories. If the business of medicine is taking care of patients, then the currency used in the transaction are the narratives of illness told by patients and received by physicians. Doctors spend a good chunk of their professional lives listening to stories. It's only natural that doctors would retell versions of these tales or craft their own new ones. All the elements of a story are readily available to any doctor: plot, protagonist, antagonist, setting, dialogue, and theme. Physicians witness struggle - disease, death, and suffering - all the time. Writers call it conflict. Physicians regularly observe cures, acts of heroism, and even miracles. Writers refer to it as denouement. Doctor-writers have oodles of experience to tap from. They have a rich pipeline of poignant images, unforgettable language, colorful characters, and vexing irony in any single day. In addition, physicians get plenty of practice writing and editing office notes, consultations, and histories & physicals.

There is an elite roster of physician-writers for readers to drool over. Anton Chekhov, John Keats, Arthur Conan Doyle, William Carlos Williams, A.J. Cronin, W. Somerset Maugham, and Mikhail Bulgakov are a few names that immediately come to mind. There are also many recognizable physician-writers including Michael Crichton, Robin Cook, and Frank Slaughter who may not get the love (critical acclaim) but certainly get the money (commercial success). There is a sizeable but unquantifiable group of practicing physicians who engage in creative writing without fanfare. These doctors take their writing seriously whether they consider it a hobby, diversion, or passion. I estimate that as many as 4-7 percent of all practicing physicians in the United States are currently working on a poem, story, or novel.

With hectic, unpredictable, and stressful jobs, why do doctors want to write? Given the demands and responsibilities associated with a career in medicine, why do so many physicians make time to write? The short answer is that doctors write for many of the same reasons that non-physicians do: They feel compelled to write. They have something to say. They love words and language. They are excited by the process and gratified by the result. They are inspired.

Here are seven special reasons (ranked from most important to least important) why doctors write:

1. Therapy - Physician heal thyself. Nothing promotes healing like writing a poem or short story or even a single glorious sentence. Writing helps a doctor get things off their chest in a much more productive way than yelling at a nurse, ranting at a patient, or being grouchy at home. Poems and stories written as a form of therapy are easy to spot. They have a confessional quality.
2. Exploration - Doctoring is hard. Creative writing is an opportunity for physicians to make sense of what they do. Stories written for the purpose of searching sometimes have themes that focus on medical ethics and boundary issues.
3. Sharing - Doctors can pass along knowledge and experience by writing in clever and vivid ways. Humor and compassion provoke memorable moments in literature. A perfect example is The House of God by Samuel Shem.
4. Joy - Writing is fun. Okay, maybe not always - rewrites, editing, and the evil "writers' block." At some level (the spark that begins the project or reading the finished manuscript), there is euphoria. Would you settle for glee?
5. Honor - Writing allows physicians an opportunity to memorialize patients and colleagues. These literary works feature a fictionalized version of a character or an amalgamation of a few people. Creative writing can immortalize someone. P.S.: Doctor-narrators also reap literary longevity.
6. Atonement - Doctors make mistakes. They sometimes behave badly. They have regrets. Stories and poems can be part of their penance. Think "Brute" by Richard Selzer.
7. Notoriety - Let's not lie to ourselves. Who among us would not want to be a rich and famous author? I don't know any doctors who would turn down a Pulitzer Prize, National Book Award, or an appearance on The Oprah Winfrey Show. Good luck with that.