Monday, February 7, 2011

Why We Write

Recently I read an essay in the Canadian Medical Association Journal that focused on an interesting topic arts topic. The article entitle "Why we write (and how we can do it better)" discusses why clinicians decide to write and publish their experiences, focusing around five common errors that the author, Allen Peterkin, MD (founding editor of Ars Medica) sees as he reviews submissions.

"I've been forced to reflect on why doctors write, how and when we do it and whether there are mistakes we make as we go along. It occurs to me that this new wave of composition is not always honest, helpful or even benign. As educators, policy-makers and clinicians, we should reflect on what writing and sharing stories means to us, how we approach the task and then contemplate what the risks are to our integrity as physicians"

He starts off with some more basic writing-for-publication type issues. One mistake he sees is too much cutting to the chase, writing more of a case report than a story. He find that doctors "favour tidy endings, epiphanies and accounts of patients who exhibit courage and triumph over adversity." He feels stories about our failures are much more honest and interesting. He also sees that often doctors forget who they are writing for. The story may be more for the author and not for the reader.

As an example of the fourth error, he gives a story told by novelist Margaret Laurence. While at a dinner party, a neurosurgeon told her that he planned to write novels after he quit surgery. She replied "What a coincidence- when I stop writing, I plan to take up brain surgery." He finds that the clinician (specifically physician) writer often lacks humility and patience for the writing process.

The most serious error that he sees is that the clinician feels that the stories heard and experienced in the clinical setting belong to him/her. This error is the ethical and professional issues surrounding publishing a patient's story without permission.

This article really focuses on the patient centered narrative writing we do to be published. I think there is a lot of writing that we do just for ourselves. I don't keep a journal but every once in awhile I do sit down and write out a story. It's always for myself, most often trying to get out some emotion that I didn't feel I could have expressed at the time. It's no great work of literature and often gets erased a few days later. But I think that was Peterkin's point. Not to discourage writing but to point out that there should be a difference in the kind of writing we do in patient charts, for case studies, for ourselves and that which we do and submit for public consumption. For anyone interested in this type of writing, it definitely gives you something to think about.

Thanks to Thomas Quinn who sent me this article.

Works Cited: Why we write (and how we can do it better) Peterkin CMAJ.2010; 182: 1650-1652

4 Responses to “Why We Write”

kathy kastner said...
February 8, 2011 at 8:10 PM

I've found some of the most compelling writing in Family Medicine - much of it GPs experience with the experience of patients dying. (if I could figure out how to link to a PDF example, I would) One section's Life in 55 words, so I can quote one called Pointless. "Operating on a severely disabled adult just afford a few more months or years of meaningless existence. 'I would never do that!' the senior surgical resident fumed.. He didn't realize, of course, that my severely disabled sister is precious to me. An elegant reminder to myself to reserve judgment on the choices my patients make. Jennifer Frank MD U Wisconsin

Risa Denenberg said...
February 10, 2011 at 9:39 AM

I think that it's possible to complete a medical education without learning how to write, and that's a shame. And yet, I am always awed by the many physicians who do write well and effectively, past and present, who have made real contributions to both literature and medicine. Atul Gawande or Danielle Ofri or Abraham Verghese for example in the present. Or Kobo Abe, Chekov, AJ Cronin, William Carlos Williams.

Not to mention the nurses and social workers.

Tim Link said...
February 12, 2011 at 11:40 AM

Amy. What was that movie you reviewed months ago about an Asian cellist who went to work for a funeral company? It sounded interesting. Tim

Amy Clarkson said...
February 12, 2011 at 11:51 AM

Tim... The movie is Departures. I highly recommend it!