• Rosalind Kaplan, MD

What Writing (a lot) Has Shown Me

I'm returning to posting after a kind of long break. I've been busy working on my MFA thesis, and wanted to stay in the writing headspace I needed to get this done. I've written a group of essays about life as a physician/mother/wife/daughter/sister - in other words, the conundrum of being a woman and trying to be and do everything- the exhaustion and exhilaration and hopes and dashed hopes of 'having it all' in 'modern' America. When I submit my thesis, it will be about 120 pages of clean, hopefully well-written creative nonfiction- my memories, observations and reflections.

Writing this work has been eye-opening for me. My professors, mentors and colleagues in my writing program have helped me learn a tremendous amount about finding my voice and about finding my truth. The more I wrote, the more I realized that what I had written often wasn't the full story. There was always more digging to do- sometimes asking others in my life, friends or family, how they remembered things, sometimes questioning my own memories, often questioning my beliefs, more and more frequently looking for new perspectives on events and relationships I thought I understood. My mentors read and questioned and questioned some more. My colleagues in workshop challenged me to be as honest and as open and as outspoken as possible in my work.

I am more convinced than ever that writing, for me, is a path to increased awareness and empathy. It is also a path to increased peace and acceptance in my life. In creative nonfiction, we write about actual events, but 'borrow' craft elements - language, characterization, structure- from other genres such as fiction and poetry. So I had to look at myself and the other people in my 'true stories' as 'characters'. Characters have inner lives- and so I had to allow everyone I ever wrote about to have an inner life, and to be whole. I might not know everything about that character. I might not be able to fill them in completely. But I then have to admit what I don't know, and what I don't understand. That admission is a big part of empathy. I can pretend to know what motivates others, pretend to know what is in their hearts and minds, but that's not truth. The more I know about someone, the more curious I've been and the more I've let them show and tell me about themselves, the better I can characterize them. That curiosity, that openness to learning about someone, is also a big part of empathy.

Here's an example: I wrote about a relationship with an extended family member, someone who died a number of years ago. I was angry at him when he died- I had been for a long time. My initial story of what happened between us was full of my assumptions that he was self-centered and entitled and cruel. And in some ways, I still believe he was. But as I wrote his character as a self-centered and entitled person, I realized that the character was flat. He had been given no history of his own, no life other than the one he had in our relationship. And I knew that was dishonest. So I dug around for what I knew of his history, for other things about him. His other relationships with his family of origin, his partner, his child, even his dog. And I started to see him as not just entitled and cruel. I saw him as afraid and hurt and abandoned. As joyful and hopeful and expansive and smart. As disappointed and eventually a little desperate. That's not only more interesting, but also much more empathic. After I'd dug around like this, I wasn't really angry anymore. I didn't get off scot-free, of course. I had a bunch of other emotions to process- but they turned out to be a whole lot more useful to me than the anger I'd been holding onto.

In the midst of doing this work, I taught an elective class in writing at a medical school. I had six sessions, a total of 12 hours, to help a small group of first-year medical students create short memoirs relating to their relationship with wellness, illness or the medical world. I realized that some of what I learned in my MFA program could help them write really good memoirs. I needed them to learn a little bit of writing craft, so their language would be crisp and the structure of their essays sound, but more they needed to understand the nature of memory and reflection in forming perspective. So that's what we concentrated on.

Perhaps I just had a group of excellent writers to begin with, but I have to believe that the process we went through in class was worthwhile. The final products were amazing! The beauty and honesty and compassion expressed in these short pieces were inspiring. One student found empathy for herself as a younger person as she wrote about a difficult loss. Another explored the fraught relationship between medical student and cadaver in the anatomy lab. Yet another was able to find resilience and humor in the story of caring for a relative with dementia. When the students, who started as a group of relative strangers, shared these stories in class, they also found and expressed compassion and caring for each other.

When I graduate from my MFA program in June, I will have devoted the better part of two years to writing and revising a body of nonfiction work. I had a lot of time to think and reflect and imagine and re-imagine and remember and reflect some more. But I don't think one needs all that time to take advantage of the 'empathy factor' that writing offers. I think that every time we sit down at the computer or with our pen and paper, we can flex that empathy muscle just a bit. We can dig a little for the truth- about ourselves, our patients, our colleagues, our lives. We can look for that wholeness in the situations, characters, and relationships that make up our stories. We can use that wholeness to heal ourselves and to heal others.

#patientoutcomes #selfcare #physiciansatisfaction #physician #compassion #narrativemedicine #physicianwellness #physicianburnout #doctor #writing #creativenonfiction #health

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