Program DevelopmentTeaching

The Seven Doctors Project: Creative Writing As Inspiration And Intervention

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

Commentary by Steve Langan, author of a collection of poems, Freezing (New Issues Press, 2001) and a chapbook, Notes on Exile and Other Poems (Backwaters, 2005); executive director of ALS in the Heartland in Omaha, Nebraska; teaches in the University of Nebraska MFA in Writing Program and is working on a Ph.D. in literature and medicine.

A “Typical” Night

I just returned from a meeting of the Seven Doctors Project, a writing group I started at the University of Nebraska Medical Center to see what would happen if I encouraged mid-career physicians to begin, return to, or sustain projects in creative writing. I pair each willing doctor with a local writer who serves as his or her mentor and guide. Tonight, even I feel like writing. I usually come home from work, check e-mail, check it again, worry about stuff I couldn’t finish at work, eat dinner, pitch in on the dishes, worry about not writing my dissertation, yell at my son for not getting his homework done, walk the dogs with my wife, watch The Daily Show, then crash. But not tonight. Dr. M., who works in the E.R. and tends the grapes in his small vineyard when he has time, presented two poems, a weak tamed-down narrative about being stuck for two long days on jury duty and a stunning lyric, his version of the Garden of Eden, which included an expected mention of the loss of innocence (though it had a “nice twist,” another doctor mentioned, that made it “seem fresh”).

“Have we lost our innocence?” his colleague, the internist Dr. K asked. “Is it because we know too much about the secrets of the body?”

We flowed into and through this conversation. Nothing is off limits in this space we’ve established. Trust has been developed. With the doctors in the room, we reviewed some of the stark facts of their specialized training, and one of the doctors said, “I think we are people who used to be more fun.” We had a lot of laughs tonight, too. One of the participants admitted to having a crush on one of the writers! This is intimate work, revealing, potentially life changing. I’ve been trying to deny its power, but it’s no use. The evidence has been collected. Even in our tucked away classroom on this undernourished campus in our middling state, the lives of many of the doctors have changed, it seems, as a result of being part of this writing project. That’s what they keep telling me. And all I’m asking the doctors to do is to write poems and stories (their mentors help in a variety of ways, including emphasizing the need for revision) and submit them to the group during their designated week for all of us to discuss. We don’t dismiss “reflective” work, but it’s not our aim. We hold each other to trying to make the best poems and stories we can—using the aesthetic principles that are at the core of teaching and learning creative writing as our foundation and default. That’s why the writers have been indispensable. Further, if “therapy” comes out of the writing project, that’s not our fault. Whatever energy or therapy or good feelings the doctors receive from being part of the project—doing this writing in earnest and turning it in—should be attributed to the rigor that the writers have helped enforce and the high standards that we seek and help maintain.

The Players

I’ve worked with a public health doctor who just earned her MFA in poetry, a convert; a plastic surgeon with a background in music composition who has become fearful of writing and so dedicated herself to writing poetry—and submitted a poem that included a stanza about how she only worries about her patients; an oncologist who loves the band Genesis and puts on his headphones once a week and jams on his Hammond organ; a transplant doctor who has completed one novel and has another in progress; a psychiatrist who wanted during college to be a poet…who wrote his first poems in many years, including a poem about his relationship with his powerful father; an OB/GYN who started by wishing to narrate incidents from his career…and began to consider some of the opportunities for metaphor that fiction allows and demands; the Chief of Infectious Diseases, who has dedicated about an hour during his workday to sitting in his office writing poems; the concerned internist, who taped a poem she loved onto the door of her office—then, five minutes later, fearing being labeled “creative,” tore it down; and the E.R. doc, who recalled for us when life used to be more fun. Their average age is 52. If we’re not being generative in mid-life, Erik Erikson said, we may lapse into despair. I even invited a university lawyer, who in the early Sixties helped edit an avant-garde literary journal, to participate. We don’t discriminate. These men and women have become as real to me as characters in an engrossing novel—which means, to me, they have more roundness and substance than many of my acquaintances, family members, colleagues and neighbors. They’ve been telling us more. It seems, for the members of the Seven Doctors Project, a lot depends on, using a word coined by Samuel Beckett, saying and writing what is “ununsaid.”

The Inner Voice

Through literature, and especially through the lyric poem, one gets to hear the “inner voice.” It becomes necessary, even addictive—an antidote for many of us to the language of the academy, politics, government…and church, school and the workplace. I’ve encouraged mid-career doctors to take time out of their busy lives (“Busy little me,” one of the doctors referred to himself in his poem) to indulge the inner voice and work to place it on the page. They say writing makes them “happy” and gives them “energy”; they can’t wait until next week. Confronted by the power of poems and stories—their own and others—the doctors have been forced to pause to make a variety of evaluations—about themselves and their profession, primarily. They’ve developed friendships with their mentors and other members of the group. Some of the doctors say it’s nice to have something to talk about other than work with colleagues. They see each other in the halls and chat about the poem they’re working on for next week. Poetry has become a secret handshake. And it has resumed its original place, as agent of inspiration, for the doctors and the writers. Writers learn over time to achieve effects (which is not the same as being driven to make something new because you have to, because you have no other choice). So it has been inspiring to the writers to watch the doctors revel in the deep thrill of the new.

The Background; Mentorship

When I had the hunch and presented the idea to my advisor, I figured the doctors would hate the project and start squirming in their Gucci loafers. Distracted doctors, their beepers hemorrhaging, and all of them late for class because they couldn’t resist billing one more hour. Even if they hung in there, I assumed they would present themselves as irritating showboats and know-it-alls unwilling to accept the writers’ suggestions. Instead, I’ve developed deep affection for each one of the doctors, all of whom have worked hard to improve their work and participate in a conversation that has not always made sense to them. The subtext of creative writing theory and practice is “freedom.” The quest for originality is necessary and a movement toward the sublime. Further, ambiguity has bearing in medical diagnosis, it seems, but is not something one frivolously rolls around in. Making the instant correct decision about a situation is king. After a long day, it was fun to watch the doctors start to delve into the text in front of them…and make an instant and simultaneous collective decision in response to the questions the writers began to ask them about what they were reading. Whoa! we frequently cautioned them. Let’s take a little time here to think of all the possibilities, okay!

At this point, deep into phase two and assembling participants for phase three of the Seven Doctors Project, even I can’t really deny its genuine effects. From observations, interviews with my subjects, responses to assessment questions and word of mouth, the project has helped and inspired my subjects at work and at home. We keep being congratulated for the project, and we keep congratulating ourselves. But maybe it’s just a placebo, I keep thinking, or a niche that we could’ve filled with woodworking. Sure, the writers are wonderful, gifted and helpful, but I know all of them well enough to know some of their insecurities. They aren’t publishing enough, they aren’t smart enough, they’ll never finish that story, collection of poems, novel. A writer’s well-honed inner voice repeats, I’m a fraud, an imposter, a dilettante.

The project allows the writers to have a deadline for new work (the writers submit during the same week their “student” submits), but it’s more than that, really. How often do any of us get to show doctors what we can do? The writers get to turn the tables on the doctors, and the doctors not only get to wonder what it’s like to live more fully in the realm of the imagination, they get to practice doing this work, too, and play the role of the artist at least once a week and during time they squirrel away to work on their writing. Except for in one pairing, the writer-mentors have become heroes to the doctors. They wonder how the writers think. They’ve started to consider what the writers would say in response to the text they’re working on…and revise accordingly. A recurring comment made by the doctors after their poems and stories have been workshopped is to give all the credit to their mentors.

In Conclusion

I’m not a social scientist or anthropologist or genuine medical humanities advocate or strict devotee. At this point, I’m not really an academic thinker at all. I’ve collected information and results on the study, but I’m just learning how to put it into serviceable academic order. And I’m certainly not a physician. As I shadow my subjects at work (partly as a way to learn more about the medical system but mostly to determine how they do their challenging work with such skill and creativity on a day to day basis), I’m sometimes asked if I want to become a doctor. My tongue in cheek response has been, “No, thanks. I have enough problems.”

On the page and also in our conversations, I keep hearing, more than a minister or therapist or shrink might, the challenges of the doctors—the mistakes they’ve made and witnessed, the things they wish they were able to accomplish, the holes in their lives. I feel privileged to have become their interlocutor, a role I’ve assumed, I think, because, really, what kind of threat is a poet to a doctor? Plus, as I said, I care about them. I really do. And I used to be afraid of doctors; I used to think, as a character in one of Denis Johnson’s stories, says, that “Good health depends on the ability to fool doctors,” I’m grateful to be able to present, along with my writer-colleagues, the practice of writing and the imagination as a kind of intervention in their lives. The doctors have taken the medicine; they keep following our orders. They continue to refer us to their colleagues, who call me to ask if they can join us at the next session.

Toward the end of class last night, I asked Dr. M. what it felt like to present his poems to the group. He told me he had been nervous all day. He was relieved, he said, after we finished talking about his poems. Which is a good outcome, because, though we admired his courage and the fact that he took a lot of time to do his work, one of the two poems wasn’t very good at all. It needs a lot of work. He told us he’ll try to revise it; his mentor reminded him that he’s there for him. As we came to the end of our two hour gathering, time that members of the group keep telling me flies by, Dr. M. said, “You know what it felt like? I felt like one of my patients sitting on the table in a gown with my backside exposed.” Oh, the joy—to be that vulnerable again, even a little desperate and in need!

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