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.
"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.