When people hear that Ruben J. Nazario, MD, a pediatric hospitalist at Kentucky Children’s Hospital in Lexington, writes in his spare time, they assume he writes for children. “But my writing is very non-pediatric,” he says. “I’m two people in one.”
A native of Puerto Rico, Dr. Nazario primarily writes poetry in English and stories in Spanish. His short stories and novels deal with what he calls “the fun stuff”: passion, violence, death.
For example, a speck of tomato sauce falling on the floor when his wife served him a plate of spaghetti became the inspiration for a story in which the same thing happens. But in his story, the characters argue and the husband licks up the sauce from the floor. “That part didn’t really happen,” he laughs.
One might imagine writing as merely a hobby or diversion for practicing hospitalists. But those who indulge in the craft say it hones their medical skills.
Ron Grant, MD, pediatric hospitalist at the University of Arizona Medical Center in Tucson says writing affects his mood, which subsequently affects his practice. “It allows you to speak out [about] frustrations that arise, interesting situations that arise, and I find that very valuable,” he says.
The therapeutic experience is common to hospitalist writers.
Sandi Verbin, MD, a pediatric hospitalist at Holy Redeemer Hospital in Meadowbrook, Pa., says writing brings out her sense of humor, which helps with everything in medical practice. “Fortunately, with pediatrics, most of our patients get better,” she says.
But of course that’s not always the case. When a 7-year-old patient, who was in his care on and off for three years during his training, died of leukemia, Randy Ferrance, MD, a hospitalist at Riverside Tappahannock Hospital in Va., filtered the experience into a story.
“The piece was mostly biographical, but I put it in a fictional context,” says Dr. Ferrance. “I wrote it to say some of the things that I never did say, and work through things I never had worked through, with the patient and family. Writing helps me to clear my head and put things in a better perspective. It’s worth the time I carve out. It doesn’t affect the medical end of things, but it helps my ability to continue doing what I do.”
Many hospitalist writers say their art makes them more empathetic.
Joseph Geskey, DO, the division chief of pediatric hospital medicine at Penn State M.S. Hershey Medical Center in Pa., has published poetry in the Journal of the American Medical Association, an anthology in a book, essays, and fiction. “Writing allows you to clarify your thoughts, so it allows for some epiphanies, not only [regarding] writing but about life in general,” he says.
Preliminary studies suggest writing may have medical benefits such as reducing stress catecholamines and inflammatory markers. Though hard data are still to come, Dr. Geskey believes writing has made him a better physician. He says he is more patient, a better listener, and lets patients digress in their stories, revealing information he might not otherwise have learned. “If I’m able to use my rudimentary senses in my writing to evoke a scene or an image, how do I use those same senses to color in my interaction with patients, to help them feel better?” he asks.
The Trend Grows
There are a number of doctors who teach creative writing around the country, and writing workshops for physicians are popping up in and outside medical education curricula.
In Durham, N.C., Dr. Geskey participated in a Duke University poetry and medicine conference that he describes as “probably the most creative three or four days of my life.”
For three years, Bryan R. Fine, MD, MPH, pediatric hospitalist at Children’s National Medical Center in Washington, D.C., ran a creative writing elective for fourth-year medical students at George Washington University. Dr. Fine often writes during down time at work, especially on the night shift. He writes stories, nonfiction essays, and songs, which he performs publicly on occasion, including a few weeks each year at Club Med and other Caribbean locales.
Dr. Verbin has taken seminars in writing for children. “I’ve made some baby steps in that direction, but progress has been slow and mostly relegated to someday,’” she says.
In 1998, Dr. Grant left the University of Arizona, where he was practicing as a hospitalist for Cleo Hardin, MD, section chief of pediatric hospital medicine and herself a writer. (She is revising a memoir she wrote a couple years ago and beginning a novel about mothers and daughters). He traveled to Israel and Poland and wrote about that experience, then realized he wanted more. He returned to his school to pursue a master’s in creative writing. A year ago, at Dr. Hardin’s urging, he returned to medicine, now describing himself as a part-time hospitalist and full-time writer.
“I was overwhelmed by a lot of strange sensations when I went back to the hospital—all of which really informed my writing,” says Dr. Grant.
He is working on a memoir about leaving medicine after becoming uncomfortable with the ethical and personal dilemmas he faced as a pediatrician and as a father. “It’s hard to watch children die, but unbearable when you have children of your own,” he says.
Dr. Grant works nights, teaches medical students an elective in creative writing, and occasionally teaches at a community college. His most exciting teaching outlet is as an instructor in the Czech Republic at the prestigious Prague Summer Program, a study-abroad program offered through Western Michigan University. Those who take his the two-week memoir-writing workshop bring complete manuscripts for review and critique.
“The whole philosophy behind teaching writing and taking humanities classes is that there are unexplored areas of the brain that get withered as you go through medical school and residency,” Dr. Grant says. “Re-exploring that creative side allows us to become better physicians. Becoming more in touch with your own humanity allows you to be a more human practitioner, Even though I only practice part time, I’m certainly different as a practitioner than I was before [I started writing].”
As a full-time writer, Dr. Grant is the exception. But Dr. Nazario recalls a quote from physician Anton Chekhov that may sum things up for other hospitalist writers: “Medicine is my lawful wife, and literature is my mistress. When I get fed up with one, I spend the night with the other.” TH
Andrea Sattinger is a medical writer based in North Carolina.