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Poor Historians

Some Notes on the Medical Memoir

ISSUE:  Winter 2016

Construction by Stephen Doyle I’m not superstitious, but when I go for my mammogram every year, I perform a private ritual. As I wait in the dark for the tech to return and tell me that the radiologist has said all is well, I force myself to imagine that all is not well. I imagine the request for additional images, the biopsy, the consultation with the oncologist and the surgeon, the sessions in the reclining chemotherapy chair, my head bald. I try on various cancer personalities: brave and dignified versus whining and cowardly. In my mind I wear jaunty baseball caps and Hermès scarves. I feel the plastic lump of the catheter in my upper chest. I believe that the more clearly I imagine these things, the less real they are likely to become. I believe, against all reason and everything I know as a physician, that misfortune always surprises, and that I can prevent cancer simply by expecting it.

For many years, my ritual worked. Then, one year, a glitch. The tech returned and said “additional images.” She said there was an area of concern in my right breast and that the radiologist wanted to get a better look. Barely had she uttered these phrases when they italicized in my mind, angling deep into the fear center of my brain. Then the tech took another round of pictures and excused herself, leaving me in the cool, dimly lit room, half naked, the shadow of my doom glowing on a computer screen.

Imagining the worst as I stood and waited did nothing to assuage my fear. But imagining how I might write about imagining the worst did. I began composing an essay—or the first chapter of a memoir, I decided, if things turned out really badly. With each sentence I grew less anxious. A couple of hours later, when a needle aspiration proved the “area of concern” to be a benign cyst, I was already quite calm.

Writing makes people feel better. This may sound strange to anyone who’s struggled with a class assignment, or to many professional writers. But research begun in the 1970s, much of it done by James W. Pennebaker, a psychologist at the University of Texas at Austin, has shown that writing as little as thirty minutes a day for four days in a row can ease anxiety and depression and help people recover from illness and trauma. In one study of what Pennebaker named “expressive writing,” participants who wrote about stressful experiences were less likely to require urgent medical care than students who wrote about more mundane subjects, like their dorm rooms or their shoes. In another study, people with asthma or rheumatoid arthritis who wrote about the most traumatic events of their lives had fewer flare-ups of their diseases. Writing can boost immunity, relieve pain, improve liver and lung function, and lower blood pressure.

No one is really sure how this works, but it may be similar to how psychotherapy does. In ways which elude our full understanding, putting emotions into words changes brain chemistry and brain architecture, which, in turn, affects the rest of the body. Writing rather than speaking or thinking those words seems to have a particularly profound influence on the brain. If I’d had a way to jot down my thoughts in the mammography room that day, I might have felt even calmer. And there’s some evidence that putting pen or pencil to paper is even more helpful than typing.

In explaining his findings, Pennebaker emphasizes the toxicity of keeping secrets. One of his early studies showed that people who wrote about their traumas were less likely to have physical symptoms than those who didn’t articulate them, a validation and amplification of Freud’s work on conversion disorders and hysteria a century earlier. In thinking about my medical practice and my own experiences as a patient, I’ve wondered if writing restores, even if briefly, a sense of control. To be ill or injured is to lack control, and the humiliations of the hospital routine compound a patient’s feeling of helplessness. (My mother once commented, upon having her clothes, eyeglasses, jewelry, cell phone, and wallet confiscated before surgery: “This is how they treat prisoners.”) Writing can transform what feels like a shapeless, endless, and meaningless experience into something with structure, finitude, and implication.

Just recently a patient of mine told me through tears that she was having a tough time after a major illness and the death of several family members. She rebuffed my offers of counseling and medication and said, “I don’t need any of that. I have my journal.” As she said this, the woman pantomimed hugging her journal, as if she could limit her pain to the notebook-sized space between her own hands—which, in fact, she felt she had.

Writing also offers a chance to reengage the person you used to be before you got sick, to reassert what doctors sometimes call—awful phrase—your “premorbid personality.” A medical student once told me that when he arrived in an emergency room hallucinating, a psychiatrist quizzed him about what his diagnosis might be. He told me he didn’t find the psychiatrist’s grilling insensitive but, rather, a helpful acknowledgment that he wasn’t only mentally ill—he was also a medical student. Writing likewise places some distance between the ill and healthy selves. In The Cancer Journals, her memoir about breast cancer, Audre Lorde fantasizes rising above her own sickbed:

Another part of me flew like a big bird to the ceiling of whatever place I was in, observing my actions and providing a running commentary, complete with suggestions of factors forgotten, new possibilities of movement, and ribald remarks. 

To “provide a running commentary,” to write about your own catastrophe, is to be a step removed from it. A few years ago, during a very painful recovery from shoulder surgery, my only solace (besides Percocet, which made me itch) was writing about how miserable I felt. I sent some of these efforts to my orthopedic surgeon because, as I wrote in a cover letter, I thought they might interest him. I later understood that the real reason I sent the surgeon my writing was that I wanted desperately to remind him—and myself—that in addition to being his patient I was someone else, someone who wrote, someone resembling the intact person I was before I mangled my shoulder. 

Expressive writing is not necessarily meant to be shared. Research subjects and patients participating in expressive-writing exercises are instructed not to worry about spelling, handwriting, or whether what they write is “good” or even makes sense. But more and more personal writing about illness is shared. Blogs, essays, and memoirs in which authors record the most intimate details of their physical and emotional afflictions have proliferated in the last few years, often leaping to the top of most–e-mailed and bestseller lists.

Such writing has broad appeal, and may help the writer feel better, but is it literature? In a 2010 New York Times article about the recent upsurge in writing about illness, physician and writer Abigail Zuger brushed the question aside:

Few of these efforts rise to the level of great literature, but that may be beside the point. Should memoirs of illness be held to the same standards as other writing? Or do reader and writer form a different relationship when the health crisis of one becomes the theater of the other, a relationship in which a reviewer has very little business meddling?

Zuger is correct in pointing out that even the most dramatic story—and medicine is certainly full of those—doesn’t become great literature in the hands of a mediocre writer. But excellent writers sometimes fall ill, too, and in recent years, as memoir has become more popular, many have written about their illnesses.

Illness is a natural subject for literary memoir. In a review of Ben Yagoda’s Memoir: A History, Daniel Mendelsohn writes that though the genre took a decidedly secular turn between Augustine and Jean-Jacques Rousseau, memoir never lost what he calls its “essentially religious DNA.” Memoirs, as opposed to autobiographies, are, at heart, stories of redemption, of adversity faced and overcome, or at least outlasted. Cancer and neurological and psychological conditions (including alcoholism and addiction) are the most frequent topics of illness memoirs. I’m not entirely sure why. Granted, we think of cancer as the disease most threatening to life and diseases of the mind and brain as most threatening to the self. (A good story needs high stakes, and what higher stakes than those?) But it’s curious that congestive heart failure, for which the prognosis is worse than most cancers, has inspired no great memoir—especially given the metaphorical resonance of the heart. Similarly, inflammatory bowel disease, which threatens life as well as its sufferer’s sense of self and sexuality, has never found its way into a great memoir. It seems unlikely that no worthy writer has had these diagnoses. Maybe some conditions just aren’t inherently memoir-worthy. Even John Updike couldn’t eke a memoir out of his lifelong struggle with psoriasis, though he did write “At War With My Skin,” a fine essay about it.

Illness can be painful and terrifying. But for a writer illness also can be good material. Anatole Broyard, in the opening lines of Intoxicated by My Illness, a memoir about his prostate cancer, writes:

So much of a writer’s life consists of assumed suffering, rhetorical suffering, that I felt something like relief, even elation, when the doctor told me I had cancer of the prostate. Suddenly there was in the air a rich sense of crisis—real crisis, yet one that also contained echoes of ideas like the crisis of language, the crisis of literature, or of personality. It seemed to me that my existence, whatever I thought, felt, or did, had taken on a kind of meter, as in poetry or in taxis. 

Not only good material, illness may be an auspicious state in which to write. For all its many downsides (to say the least) illness often removes a person from the usual duties and concerns of daily life, slows down time, makes one hyperobservant and acutely present. It’s not a retreat one would sign up for gladly, but for a writer illness may not be entirely infelicitous. In Swimming in a Sea of Death, a memoir about his mother Susan Sontag’s leukemia, David Rieff recalls Sontag’s belief that her cancer might offer some literary benefit:

[M]y mother began to believe not only that she really might survive, but that living in this new realm—the kingdom of the sick, as she called it—might actually be a context for writing better, becoming a better person; in other words, that there was fulfillment to be had as well as death forestalled.

Still, the illness memoirist faces challenges. One is the uphill climb to literary respectability faced by all memoirists. Mendelsohn has called memoir “the black sheep of the literary family.” He traces memoir’s lesser status to our Puritan roots, our guilt about our large appetite for, among other things, knowing other people’s business. Readers like memoir, but we’re not sure we’re supposed to. Critics, and even many memoirists themselves, are similarly ambivalent. One prolific memoirist I know admits to having what she calls “memoir shame.” And a recent review in the New York Times described one writer as a “serial memoirist,” as if she were a career criminal.

Writing a memoir about illness poses additional challenges. Few things are more interesting to the teller and less interesting to the listener than stories of illness, except maybe detailed descriptions of dreams. And, while great memoirs always resonate beyond the self, the ill self is often a small self. A colleague of mine once referred to the sad devolution of the ill person, especially the elderly ill person, as “me and my bowels and my bowels and me.” Yet several writers have used the experience of illness as a telescope rather than a microscope—often by telling the truth but telling it slant, as Emily Dickinson advised. It pains me, as a doctor, to admit that the “straight” story, the one that must be slanted to become art, is often the one imposed upon the patient by the medical profession. In the hospital or doctor’s office, to tell your own story in your own, slanted way is to risk being a bad patient, a “poor historian.”

I first heard this term many years ago as a second-year medical student. In a course called Clinical Skills, we practiced interviewing and examining hospitalized patients, and then writing about them. Our instructors required us to include at the top of our reports an assessment of whether the patient had been an excellent, good, fair, or poor historian. “A fifty-eight-year-old man was admitted with fever and cough. The history is obtained from the patient, who is a good historian.” We reserved a “poor” grade for those whose ability to communicate had been impaired by dementia, stroke, or mental illness. But sometimes “poor” simply meant that the patient rambled on, relating events out of chronological order, insisting on his or her own wrongheaded opinions regarding cause and effect. “And ever since they took my appendix out I’ve had this problem with my ears,” for example. 

A few weeks after I completed Clinical Skills, in the summer of 1984, medical ethicist and poet Dr. John L. Coulehan published an editorial in the Journal of the American Medical Association suggesting that doctors jettison “poor historian,” which he found patronizing and inaccurate, a sneaky semantic attempt to blame patients for doctors’ shortcomings. After all, Coulehan pointed out, it’s the doctor, not the patient, who’s the historian, the one who gathers the data and crafts the written record. If the history is poor, it’s the doctor’s fault. And besides, who’s to say that only one way of describing the experience of illness is “excellent”?

One person may use dramatic expressions that defeat an attempt to pinpoint such mundane features as the sequence or description of symptoms. Another person’s story may be fraught with obsessive detail, a third patient may minimize or deny symptoms. The intern’s rational, well-organized, and unemotional style might seem a standard with which to compare the chaos of patient styles. But isn’t there a range of normal here, as with serum magnesium and amylase?

The use of “poor historian” persists today, along with the attitude it reflects: that the doctor’s version of a patient’s story is more valid than the patient’s. Correctives, such as inviting patients to coauthor their own medical charts, have been slow to catch on. Doctors say we’re concerned that if we ceded our control of the medical narrative, patients would clutter their medical charts with irrelevant information. I’ve said it myself. I’ve wondered, though, whether what we really fear is that what patients—even poor historians—have to say is relevant, but that sifting through a “chaos of patient styles” would be tedious and time-consuming.

The best illness memoirists are the worst historians, rejecting standard medical narratives and creating their own. Consider two excellent memoirs of childhood illness: Lucy Grealy’s Autobiography of a Face and David Small’s Stitches. A childhood marked by serious illness is often thought to be an exceptional childhood, a childhood set apart. Pediatric wards feature “child life specialists” tasked with making sick kids feel as normal as possible. In the memoirs by Grealy and Small, though, illness is an intensification of, rather than a hiatus from, childhood. Illness is the realization of every child’s fears and fantasies.

Lucy Grealy had sarcoma of her jaw removed in a series of reconstructive operations beginning when she was nine, leaving her face deformed. Her parents and her doctors were concerned, of course, about whether she would survive, but that was not Grealy’s main concern. In her thirties she writes:

I spent five years of my life being treated for cancer, but since then I’ve spent fifteen years being treated for nothing other than looking different from everyone else. It was the pain from that, from feeling ugly, that I always viewed as the great tragedy of my life. The fact that I had cancer seemed minor in comparison. 

Grealy’s deformity becomes a kind of talisman, a physical expression of the isolation, shame, rage, and grandiosity that many children feel. Grealy recalls that at various points in her treatment and its aftermath her cancer conferred upon her unique powers. “All I had to do was perform heroically and I could personally save my entire family,” she recalls. Grea-ly imagines that her desire to be exceptional may even have caused the cancer. “When I was younger, before I’d gotten sick, I’d wanted to be special, to be different. Did this then make me the creator of my own situation?” This dual self-blame and self-congratulation is a common feature of childhood. The kid who thinks he or she caused her parents’ divorce, his grandmother’s death—oh the guilt, the pride!

Cancer has an upside for Grealy: “Without the arena of chemotherapy in which to prove myself, how would anyone know I was worthy of love?” As an adult, once cured, she loses the crutch but not the need. Affairs, drugs, intense friendships, and writing never make her feel whole. Years after the doctors are done with her, satisfied with their work, Grealy remains wounded.

This singularity of meaning—I was my face, I was ugliness—though sometimes unbearable, also offered a possible point of escape. It became the launching pad from which to lift off, the one immediately recognizable place to point to when asked what was wrong with my life. Everything led to it, everything receded from it—my face as personal vanishing point. 

For David Small, cancer served a similar purpose. In fact, even before he was actually ill, Small feigned illness. In his harrowing graphic novel, Stitches, Small portrays a miserable childhood in which no one communicates, while the family tiptoes around a perennially angry mother. His father works out his stress on a punching bag in the basement, his older brother beats a set of drums, and little David is always ill. “I, too, had learned a way of expressing myself wordlessly…getting sick. That was my language.” 

Small has upper-respiratory infections so often that his father, a radiologist, treats him with x-rays to the sinuses, a common practice in the 1950s. Small suspects that he may be responsible in some way for his own abuse. When his crazy grandmother deliberately scalds him with boiling water, he ruminates: “On the one hand, I felt the fear, humiliation and pain…While on the other, for reasons I could not quite understand…I felt that she was justified…and that I deserved everything I had gotten.” When a guest at his mother’s bridge party notices a lump in David’s neck, his mother huffs, “A fine end to my party!” and complains about the cost of the doctor he’ll now need to see.

As a child, David understands his illness as another example of his misbehavior, his tendency to enrage his mother. When, after years of foot dragging and misdiagnosis by his father’s medical cronies, Small finally has surgery for what proves to be thyroid cancer, he feels similarly to Grealy: “No one can love a hospital, but those bland, functional spaces and fixtures were a part of my life. There, I felt safe.” Pediatricians and child-life specialists don’t usually think of severe illness as an escape to normalcy. 

With the help of maturation, a psychiatrist, and art, Small comes to terms with some hard truths—the source of his mother’s fury (she’s a closeted lesbian) and the fact that she doesn’t love him. As a teenager, his father tells him another truth: “I gave you cancer.” One senses that he’s not only apologizing for the x-rays, but for the legacy of anger and abuse that erupted in David’s neck, the silencing that resulted, after surgery, in David actually losing his voice.

Sarah Manguso is a master of disjointed, nonchronological narrative—that is, she’s a terrible “historian.” Her memoir, The Two Kinds of Decay, consists of numerous short chapters, scenes from the years she suffered with a rare neuropathy that frequently left her unable to walk or eat. These vignettes are not in sequential order. “Narratives in which one thing follows from the previous thing are usually imaginary,” she pronounces. “I remember things in the order that they make sense.” Manguso’s idiosyncratic storytelling leads her to make connections that, certainly, her doctor wouldn’t. For example, she falls ill just before performing in a college choral concert. She has a cold, but the strict British choirmaster “didn’t accept a head cold as a valid excuse for missing a rehearsal.” Manguso nurses the cold for weeks, dragging herself to rehearsals and then finally performing in the concert, earning special notice from the choirmaster, whose words of praise Manguso writes down. Then she gets really sick—or rather, she surrenders herself to the illness she’d been fighting. There is no physiological explanation, but who hasn’t had the experience of holding illness or pain at bay until after a big job or event? “I’d kept the virus hidden in my blood for weeks. The next day I let myself get sick and prepared to let the head cold run its course.”

Unfortunately, the course the head cold runs is not what Manguso expects. Her limbs become numb and weak. She can’t walk. Her mother drives her to the hospital where she was born, a fact Manguso includes to signal that serious illness in young adulthood, when a person is on the brink of independence, can force a cruel regression. At one point, convalescing in her parents’ house, she is soothed by gazing at the mobile once suspended over her crib.

Years of plasmapheresis and immunosuppressive medication finally cure Manguso—or so the medical chart would claim. She attributes her recovery to a one-night stand during which she seduces a handsome college classmate who’d flirted with her before she was ill and who, mercifully, ignores the scabs on her chest where a catheter had been inserted. They then write to each other for years. She says, “Our letters were intimate, but I didn’t get around to explaining to him that I’d recovered from my disease only because he had selflessly had intercourse with an ugly version of a girl he’d once had a crush on. A little less than seven years after I was cured of my disease through the mystical power of intercourse, Victor had an aneurysm and died.”

Manguso’s memoir-in-fragments allows her to draw her own conclusions about cause and effect, and to juxtapose emotions in an unexpected way—in the way people actually experience them. On one occasion she receives an intramuscular injection that leaves her arm aching for the next five years. What she remembers most of that episode: the lovely Irish brogue of the doctor who administered the shot.

At the end of The Two Kinds of Decay, Manguso explains her curious title. “There are two kinds of decay: mine and everyone else’s… Most people consider their own suffering a widely applicable model, and I am no exception. This is suffering’s lesson: pay attention. The important part might come in a form you do not recognize.” The “important part,” Manguso implies, often comes in a form doctors don’t recognize, either.

To be a patient is not only to lose one’s voice but, worse, to have one’s words replaced, to be issued, along with a hospital gown and an IV, a new vocabulary. Suddenly one’s sentences are filled with acronyms and jargon—some neutral: chemo, rehab, cath; and some self-incriminating: my counts are down, my vein is blown, my temp is up.

Some illness memoirs challenge this new language. These memoirs are often political. Audre Lorde experiences her mastectomy as both a patient and an activist. (That a black woman would be given a pale pink breast prosthesis after the mutilating surgery is the least of her grievances.) Eve Ensler, in her memoir In the Body of the World, sees her own cancerous uterus as a symbol of a polluted and unjust planet. Susan Sontag’s objection to traditional metaphors about illness (cancer happens to repressed people, TB to sensitive people) had to do with her sense that patients were being blamed for their own illnesses. But when a radical feminist like Lorde has a radical mastectomy, or when the author of The Vagina Monologues develops a gynecologic cancer (a fact, Ensler told me in an interview, she found “too fucking ironic”) or—as was the case with the AIDS epidemic, suppressed minorities have a disease of immunosuppression—illness can provide a rich entry into a larger political argument, often centering on a resistance to medical language.

Lying on a gurney in a hospital hallway after learning that her CAT scan showed ovarian cancer, feminist literary scholar Susan Gubar felt a strange sense of calm—even relief. For one thing, she’d never end up demented and in a nursing home, like her crabby, difficult mother had. And, she’d have a slow enough death so that she’d have time to say goodbye to her family. Also, she experienced the scholar’s pleasure in knowing—even knowing that she had an often lethal form of cancer. Plus, she’d been stumped about a topic for her next book.

Gubar weaves three strands in Memoir of a Debulked Woman, a book about her illness: One is the miserable state of ovarian-cancer detection and treatment. The second is what Gubar calls “ovariana,” the cultural history of the ovary—from nineteenth-century pathologist Rudolf Virchow’s comment that “Woman is a pair of ovaries with a human being attached; whereas man is a human being furnished with a pair of testes,” to the Victorian conception of ovarian disease as a signal of mental illness or too much libido, to the modern-day underfunded “silent killer” that disproportionately attacks women—as some delight in pointing out—who have put their careers before childbearing. The third strand is Gubar’s need to tell her experience in graphic terms, to reclaim the language of her own body, to rebel against the language that has been forced upon her, beginning with the name of the surgery in which her pelvic organs are removed. “Debulked: what an ugly adjective,” she writes. “[It] conjures up a censorious debunking of a patient’s massive flab (bulk mail, buying in bulk, bulk food) or hulking muscle (bulking up).” She unsparingly describes the bags and tubes, the blood and pus, the yowls of pain. She writes what she can’t say aloud, even to her own family.

Too often, it seems to me, squeamish euphemisms glamorize the fight against cancer and thus bracket or inhibit efforts to deal with suffering and degradation, deterioration and death. Why I can report on a computer keyboard what I cannot bear to say aloud remains a mystery to me, but so it goes. 

Many memoirs by doctors have described the experience of being on the other side of the bed, often a kind of Scrooge-on-Christmas-morning revelation of one’s own misspent life (How important kindness is! How unkind I have been!). The best illness memoirs by doctors, though, are those in which a great clinician-writer turns his or her keen eye and pen on the experience of illness from a closer vantage point, close enough to see his or her own self as not entirely noble or even nice.

Consider, for example, this passage from Raising the Dead, surgeon-writer Richard Selzer’s memoir about his infection with Legionnaires’ disease. Selzer lapsed into a coma and then became psychotic for several days thereafter. Finally out of the ICU and in a regular hospital room, which visitors have tried to brighten for him, Selzer asks, with his signature mix of lyricism and crankiness:

Wherever did the notion come from that flowers gladden the heart of the sick? The man has not been in his new room for more than an hour when there is delivered an ill-wrapped, ungainly parcel that, peeled down, proves to be an arrangement of seven tulips, all of the same waxen, corpselike shade of white…Placed on the window ledge, the evil heads are in a constant state of motion, nodding or shaking as if to vote yea or nay in the matter of his fate. At night the shadows of these flowers are magnified and thrown upon the wall—seven bald witches lunging for his thoughts.

Oliver Sacks, the great neurologist-writer who died this past year, was a “serial memoirist.” He often wrote about his own illnesses and traumas. In Uncle Tungsten, about his boyhood in wartime London; in The Mind’s Eye, about his visual impairment; in Hallucinations, about his history of amphetamine addiction; and in his final book, On the Move, about the pain of being, for decades, a closeted gay man. In A Leg To Stand On, Sacks recounts an accident that occurred while he was mountain climbing in Norway in his forties. His quadriceps was badly injured and for a time, echoing some of the curious neurological symptoms Sacks observed in his patients and often wrote about—he did not sense his leg as his own. Sacks associates this feeling of otherness with his feeling about being a patient. The alienation from self begins the moment he falls, running down the mountain to escape a wild bull. “I had encountered this phenomenon in others—in my patients who had been suddenly stricken or injured, and now I was to encounter it in myself. My first thought was this: that there had been an accident, and that someone I knew had been seriously injured.” Later, in the hospital, supplied with a gown and an identification bracelet, he feels (as my mother once did) “One is no longer a person—one is now an inmate.” The process of healing, then, he discovers, involves not only the repair and rehabilitation of his leg, but the restoration of his integrity as a person. When his surgeon says, offhandedly, “‘You’ve been disconnected. We reconnect you. That’s all,’” Sacks muses:

What he meant, in a purely local and anatomical sense, had, I now felt, a much vaster (if unintended) sense—the sense in which E. M. Forster says “Only connect.” For what was disconnected was not merely nerve and muscle but, in consequence of this, the natural and innate unity of body and mind. The “will” was unstrung, precisely as the nerve-muscle. The “spirit” was ruptured, precisely as the body. Both were split, and split off from one another. 

When I had the privilege of interviewing Sacks in honor of his eightieth birthday, I told him A Leg to Stand On was my favorite of his books and he seemed both delighted and surprised. I wondered if Sacks’s self-professed lifelong shyness, or even a touch of “memoir shame” caused him to write such a modest inscription in the paperback I’d brought with me: “Thank you for liking this.”

It so happened that around the time of my mammogram scare, the literature-and-medicine group that meets once a month at my hospital was reading Intoxicated by My Illness. I have always loved Broyard’s lean and witty style and, given my experience with the mammogram, felt renewed appreciation for one particular sentence from his memoir’s first page: “When you learn that your life is threatened, you can turn toward this knowledge or away from it. I turned toward it.”

Rereading this I understood that what I’d hope for, should my fear of cancer ever actually be realized, would not be to be bold enough to wear an Hermès scarf, or to keep practicing medicine, or even to be unafraid, but to be capable of removing myself enough from my own terror to feel the open-eyed elation Broyard described: to turn toward the experience. To write well about it.

But many of the doctors and nurses in the group reacted differently to Broyard. They found him arrogant and demanding, and one observed that as a patient, he must have been a total pain in the ass. 


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Vasudevan's picture
Vasudevan · 8 years ago

A fine write up.   One comes across rarely these days a person in medical profession

writing so beautifully, the literary value in the writing and putting forth apt words

to vent the emotion.  I thoroughly enjoyed reading and patiently read it though long. 

Deborah Sewell's picture
Deborah Sewell · 8 years ago

Excellent!  Enjoyed immensely!

Carol LaChapelle's picture
Carol LaChapelle · 8 years ago

I made so many marginal notes as I read this rich, inspiring, and informative article. (And was reminded again why I so enjoyed Broyard's book.) I will share Dr. Kovcn's good insights with my writing clients, many of whom are writing memoirs.


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