Playing Doctor

I did something earlier this week that most English majors never get to do. I submitted an essay to the Journal of the American Medical Association. Three days later I received my rejection letter but I’m happy for the experience. I was able to utilize, for myself, the manuscript submission website that I see our doctors use all the time. It was fun to fill out all of the conflict of interest paperwork and such that I also see our faculty doing. It made me feel like a professional writer. So even though JAMA passed on it, I still like this essay and thought you all might enjoy it as well. I never did come up with a good title so I’ll let the essay speak for itself.

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I work at a university hospital in radiation oncology and read a substantial amount of research in the field as part of my job. My background as an English major makes it easy for me to read the articles quickly and understand most of what I read. It wasn’t long before I developed the itch to make a literature contribution myself. Then I read an essay written by Reshma Jagsi, one of the faculty members in my department, as part of the “A Piece of My Mind” and I knew I’d found my opportunity. Her essay relied more on novel observations, beautiful phrasing, and a unique perspective than on her medical background. I’d spent much of my time in college honing my ability to develop novel observations and craft beautiful phrases, and I certainly knew I had a unique perspective to work from, I just had to find a subject to write about.

It was shortly after this I found out my wife was pregnant with our first child. I inevitably developed a hyper-awareness of the end of the life details that surrounded me even as I focused my outside attention on bringing new life into the world. I started noticing the tiny babies who come in for treatment and the ever present pediatric anesthesia teams hovering ominously around the treatment rooms. There were also the patients with small children and spouses that made me contemplate my own family. I was simultaneously relieved that I had a healthy spouse and, so far, a healthy baby and also grieved that I was using the suffering around me for emotional gratification and, worse, writing material. I was staring too long at the extreme cases, trying to note the details that would make for stunning prose, or avoiding eye contact in an awkward alleviation of guilt.

I didn’t think about the project for a while until I started transcribing batches of faculty evaluations and the focus of many of them was on the coming research and writing projects for the year. I’d gone into my project with one goal and had run into resistance and obstacles but instead of giving up, maybe I needed to look at the project in a different light. Maybe it wasn’t the essay that should be the focus, rather the process by which the essay is created. One of my favorite fields of study in literature and writing is post-modernism where the topic of a story or novel is the creation of that story or novel. I’m fascinated with processes and thought that might make an excellent focus.

Once I started examining the process, I had to finally admit to myself what my true aim of this project was. I wasn’t trying to hold myself to any sort of high standard or make a true contribution to the field. I was trying to impress our faculty members and our chairman. My dream wasn’t to have my essay somehow impact the field of radiation oncology and influence future research, it was to have the doctors in my department read it and pass it around and look at me in a new, improved, light. Essentially I wanted to be treated as a peer when the only effort I’d put into was an essay that didn’t even require any research.

Now the conclusion: Why am I still writing this essay if it’s nothing more than an exercise in narcissism and poor self-esteem management? Because above all else, more than being a student, or a researcher, or an admin, I’m a writer. An honest writer never shies away from looking like a fool and an honest writer never wonders how his writing will be interpreted in the future or what his place will be in the literature. He observes his surroundings, reports what he sees, and leaves it to the reader to determine the role of the piece. And maybe he harbors a little bit of hope that a doctor will think his essay is kind of cool.