Atul Gawande on doctors and writing

Have you ever wondered why there is a centuries-old tradition of doctors who can write, and write well, while most authors can’t manage even a botched spot of brain surgery? Atul Gawande, 48—professor at Harvard Medical School, New Yorker staff writer and author of the bestselling Being Mortal—explains his influences and offers a theory.

When I was in medical school there were three doctor-writers who were really important and influential for me, implanting the idea that there’s a legitimate place for doctors to write about what they see day to day and the larger stories and morals they find in it: Oliver Sacks, Abraham Verghese, and Sherwin Nuland all had books around that time. Sort of blew the top off my head because they each were doing different things. Sacks would use case studies—The Man Who Mistook his Wife for a Hat and An Anthropologist on Mars—and then there was Sherwin Nuland who came out right around that time with his amazing book How We Die. But Abe Verghese was a young Indian doctor, a guy sort of like me, who went to Johnson City, Tenn., and wrote his first book (My Own Country) about practising in a rural area when an unknown epidemic began killing off young men—that turned out to be AIDS—and so he chronicled this history of the plague coming to a Southern small town, while he himself was a kind of outsider to everybody as an immigrant doctor. It was all very influential, and percolated for a while. A couple years later it later led to me saying yes when a friend offered an opportunity to write online.

I think what links doctors who write is that they are at the messy intersection between science and humanity, and they see art in that. These are rich, incredibly dramatic moments and the doctor is having a personal struggle with the quotidian, with “Yeah, but I gotta leave and get my kid from soccer practice.” You have this inner struggle that I think ends up, in some doctors, manifesting as writing as the way of resolving some of them. A lot of writing comes out of conflict, and different people have different conflicts and struggles. The nature of the work in medicine creates a lot of people who’ve been taught to be keen observers of detail who also have to be observers of their own reaction to the detail. I don’t know if they’re more inclined to see the humanity in the scientific reductionist detail than some other doctors, but they are more apt to notice the conflict and the contradictions, the inconsistencies, and then to find in writing a way of attempting to resolve them, or at least name them.

Click here for a full Q&A with Gawande about hospice care and the “barbarism” of medicalizing mortality.