The lure of MedLit

Barbara Kay, National Post · Wednesday, Feb. 2, 2011

Last year, The Abaton, a Des Moines University literary and arts journals devoted to the healthcare professions, inaugurated a prize for medically themed writing. The prize is named for Richard Selzer, a now-retired surgeon who in midlife embarked on a parallel, successful literary career.

The announcement caught my eye because I got hooked on medical literature for lay people in the 1970s through Dr. Selzer's exquisite writing: first his non-fiction about a surgeon's life -- in particular, Mortal Lessons: Notes on the Art of Surgery, and Taking the World in for Repairs -- and then his short fiction.

His stories never stray far from the lives and quandaries of doctors. In one, the protagonist, a surgeon, is making love to a woman he has no interest in beyond transient sex. Exploring the young woman's body for erotic pleasure, his sensitive fingers find a minuscule, but (to his practiced hands) suspicious, lump in her breast. He is conflicted. The surgeon's knight-like urge to protect vulnerable prey from a marauding disease wrestles with his selfish human wish to escape further involvement with a woman in whom he has no emotional investment. The not-so-subtle message: The good doctor is the better man.

The market for eloquent, moving MedLit is already large, and demand for more will doubtless increase in this touchy-feely culture of ours, as an aging population's health wanes and urgency in pushing back medical frontiers waxes. Doctors who write beautifully are everywhere today, it seems to me (Google "doctors, writers," and you'll agree). When you consider that in most cases the writing is accomplished in patches of time stolen from a particularly demanding profession, the literary polish and sophistication on display is astonishing.

At the apex of the genre, Oliver Sacks has achieved worldwide fame for his profoundly empathetic sojourns into the interior worlds of the neurologically impaired. He continues to work as a neurologist, but mainly, one suspects, to provide material for his greater passion, writing. Prize-winning novelist Ethan Canin took a degree in English literature before attending Harvard Medical School, and after publishing his third novel, quit medicine to teach writing at the Iowa Writers Workshop.

Canada has produced gifted doctor-writers, such as Vincent Lam, a Toronto emergency-room doctor who won the 2006 Scotiabank Giller prize for his book, Bloodletting and Miraculous Cures; and psychiatrist Norman Doidge, who hit pay dirt with his 2008 book for lay people on neuroplasticity, The Brain that Changes Itself.

Both artists and doctors are drawn to the existential mysteries of life, so it is no surprise that there are more doctor-writers than, say, dentists or accountants. Doctor-writers are a demographically diverse group, but they have in common constant exposure to human nakedness in all its manifestations: They see people at the beginning and end of life, in their darkest and their most hopeful hours, at their most craven and at their most heroic.

Writers who have studied medicine are not an exclusively modern phenomenon. But in the past, most writers with medical degrees tended to write about life, not medicine. Rabelais, Somerset Maugham, Oliver Wendell Holmes, Arthur Conan Doyle, William Carlos Williams and Anton Chekhov used their superior powers of observation gleaned from medical training to enhance their literary powers, not as primary creative fodder. As Chekhov put it: "Medicine is my lawful wife, and literature is my mistress."

Medical writing per se is popular today because in our secular culture, science and an obsession with physical health have taken the place of God and concern for the soul. It was only fairly recently in human history, after all, that disease and suffering (relatively) submitted to human control. In other words, it wasn't until medicine became more about healing and hope than pain and fear that doctors became heroes rather than placebo-potion mongers and butchers, and medical professionals could exploit their domain aesthetically with pride.

Poet John Keats's is surely the saddest writer-doctor story. Keats spent six years of his cruelly short life -- he died at the age of 25 in 1821 -- studying medicine, but never practising it. He did make a single, tragically correct diagnosis, though. One day, weak and exhausted, driven to

bed, he noticed the stain on his sheets from a fit of coughing, and announced to a friend: "I know the colour of that [arterial] blood ... that drop of blood is my death-warrant. I must die."

No physician can heal himself, ultimately. But for gifted doctor-writers, at least their words are immortal, a forever-healing balm to the world's existential angst.

bkay@videotron.ca