Putting words on the page can help physicians heal themselves

Several years ago, I received a phone call the night before a creative writing workshop I was leading for physicians. The concerned caller warned me that one of the workshop participants had been behaving erratically and might disrupt our class the next day. My workshop sponsor raised the possibility of postponing the class, but I decided not to. When the student I had been warned about arrived the next morning for the workshop, her anxiety was obvious. She appeared worked up and jittery.

We quickly began some in-class writing and exercises. She became engrossed in her work and the class discussion and her anxiety eased. The workshop finished without a disruption.

That episode convinced me of the power of creative writing to relieve stress and emotional turmoil. In the 14 years I have coached and led writing workshops for physicians and other healthcare professionals, I have often heard physicians comment that this expressive outlet has reduced the burnout, disconnection and strain they feel from their daily work. Their sense of purpose is heightened. Writing has helped them become better listeners and observers, better colleagues, and better physicians.

My path to working on writing with physicians was unintended. In 2005, I published?The Lobotomist,?a nonfiction book that plunged into a dark and intriguing episode of psychiatric medicine. Speaking at medical conferences and in grand rounds presentations to promote the book, I certainly expected questions from the physicians in attendance. But I did not expect many of the questions I heard. There was something important on the minds of many of these doctors that I did not predict—and it was writing.

Wherever I spoke, physicians would approach me at the end of my presentation to talk about their own writing. They spoke quietly and furtively, as if they were not sure they wished their colleagues to overhear. These physicians were writing essays, nonfiction books, novels, short stories, poetry, and screenplays. They wanted to know how to persist and improve as writers, find time for writing, judge what they wrote, revise, and publish. The available guidance for physician-writers is limited and those not affiliated with medical schools have even less. Hearing their questions about writing hinted at the need of many physicians to express themselves. As I addressed medical audiences, it gradually dawned on me—and I would have been a blockhead not to notice it—that many physicians want to write and would benefit from guidance from a professional writer.

Soon, I began leading in-person writing workshops for physicians and other healthcare professionals through the Medical Humanities Department of the Mayo Clinic and the University of Minnesota's Continuing Education programs. These classes opened my eyes to the distinctive concerns and preoccupations of doctors engaged in writing. Physicians wondered about the ethical quandaries of writing about patients and colleagues, whether their colleagues would judge them harshly for writing about medicine for nonmedical readers, whether their specialties would even be interesting to general readers, how writing fiction and poetry would affect their professional image—and how to find time to write when their working schedules were already full almost beyond endurance.

Why do physicians make good writers?

My experience with physicians convinced me that nearly every one could learn to write creatively and reap the benefits.

After years of teaching creative writing in Minnesota at the Loft Literary Center and in the MFA program in creative writing at Augsburg University, I’ve recently focused my attention on serving as a writing coach for individual physicians, many of whom lack institutional affiliations and support.

I help physicians feel comfortable about writing creatively in whatever genres interest them, give them inspiring models, and guide them in producing work that can serve as starting points for future writing. My clients have ranged from people early in their careers to retirees.

Many of us are familiar with the acclaimed physician-writers of the past, including Anton Chekhov; Sir Arthur Conan Doyle; Oliver Wendell Holmes, Sr.; W. Somerset Maugham; and William Carlos Williams. New generations of prominent writers—Danielle Ofri, Atul Gawande, Nawal El Saadawi, Rafael Campo, Siddhartha Mukherjee, Perri Klass, John Collee, Rivka Galchen, and Vincent Lamb, among many others—have enriched the list. The?Belleview Literary Review?is one of many journals that specializes in regularly publishing the writing of physicians.

Physicians have a deep well of experiences to draw from in their writing. They are part of dramatic episodes of heroism, cures and failures. They see unforgettable scenes, hear devastating words, make difficult decisions, and witness the responses of people at important moments in their lives. They often encounter high-stakes situations. Most importantly, they continually think about cause and effect – one action produces a resulting action – which are building blocks of fiction and nonfiction. Intriguing fiction, nonfiction, poetry or performed works come out of these experiences.

In addition, physicians can learn to write in the same way they’ve learned to practice medicine: absorbing from others with more experience, practicing, and repeating the same exercise many times. There’s a venerable tradition of mastering writing using those same approaches.

Benefits specific to physicians

Whether wanting to publish or not, anyone who writes creatively benefits from exploring thoughts and feelings, better understanding life and its experiences, sharing discoveries and observations, having fun, and feeling satisfaction. But physician-writers gain from a special set of benefits that can improve their practice of medicine. (For decades, researchers publishing in peer-reviewed medical journals have found evidence of the benefits of writing and other creative activities for physicians.) For the 60-plus% of physicians who now report to be suffering from career burnout (according to a 2021 survey by the Physicians Foundation), writing provides a contemplative focus simply not possible during the working day. It can heighten awareness and bring a renewed excitement about working with patients and understanding their inner lives.

Working in any of the genres of creative writing leads physicians to think and observe beyond their immediate concerns, carrying them into the realms of behavior, culture, relationships, and feelings. Venturing outside accustomed paths of thought brings new perspectives. Being able to write about feelings, motivation and decisions triggers reflections that can make physicians better at communicating with their patients and colleagues. Good writing is often about ethical dilemmas, and physician-writers can grow better at appreciating the difficult decisions unfolding all around them in their practices. Through writing exercises and discussions, I help physicians I coach uncover their own concerns, conflicts, and dilemmas that can evolve into stories.

The stresses of the COVID pandemic only intensified the need of physicians to have a creative outlet. There is more to medicine than science, and physicians who try creative writing can feel their doctoring strengthen as they explore on the page what it means to be observant, compassionate and curious. When I coach physicians in writing, I ask them what they want writing to look or feel like in their lives, which skills and techniques they want to work on, and what they want writing to do for them. With an awakened imagination, they see their own lives and the experiences of others in a new light. They regain their original purpose in pursuing medicine as a career. Complementing their grounding in science, they reclaim their grounding in humanity.

Jack El-Hai has contributed hundreds of articles to publications and is the author of the medical popular-history books?The Lobotomist?and?The Nazi and the Psychiatrist.