Medical drama
There is a growing popularity of fictional and factual writing about the experience and effects of illness. For a brief account of the history of medicine-related stories, see Sam Goodman's article.
It is interesting to see how real doctors react to medicine depicted in popular fiction, shows or movies. How factually accurate are television dramas? In this video, one doctor ranks the shows in terms of their accuracy.
There is another category of medical fiction that is written by physicians and inspired by real world encounters. Factual accuracy isn't the main issue in such cases. The question is, what prompted physicians to write fiction? American psychiatrist, Samuel Shem (real name Stephen Bergman) is one such example of a writer.
"The long June evening ushered in a serenade of crickets, and the dusk lingered in the air like a dozing kitten's purr."
"At peace, at the level of love, I watched the silver liquid moonlight flow over the orange stucco roof of lthe House of Zock, reminding me of the stuccoed farm-houses of France."
Aren't these sentences beautiful?
Samuel didn't start out to be a novelist, and he isn't just a novelist. For catharsis, he compiled the stories he encountered during his medical internship on 'slips of paper with coffee stains', and submitted them as a play. The publisher turned this, seven rewrites later, into his famous novel, "The House of God". Several books later, Samuel hasn't stopped writing literary works, but he has also made a Broadway play related to treating alcoholics. He was then well-established as a medical specialist in that field.
Writing impacts physician in a big way. If not for writing, Samuel said he could have become one of the disgruntled and divorced neurosurgeons at Harvard. Unlike authors that started out with an MFA, writing didn't come naturally. Samuel was given a F- in an essay at school, and was told that he could be many things, but not a writer. As a medical fiction writer without relevant formal degrees, I find that very reassuring. The only formal qualification I have in creative writing is a short course conducted at LaSalle College of the Arts in Singapore.
I'm moved by Samuel's life experiences. Like Samuel, I feel there is more to medicine than just practising it the way we've been told to do. He is also not conventional in his personal life in the sense that he is not a practising Jew but a Buddhist. He adopted a daughter from China. I'm a Catholic and also adopted a daughter from a different country. Samuel said, "I don't want to be a scientist." and "I want to be a writer." In my case, I have become a clinician-scientist, then I became a part-time novelist. Samuel found love for psychiatry, and started writing during his career as a psychiatrist. Like Samuel, I'd gotten bored with writing and reading only non-fiction, so I deep dived into fiction.
Samuel Shem's book "The House of God" says everything wrong about the internship system in the US. Adam Kay's "This is going to hurt" is a very damning description of the National Healthcare System written by a physician who had first hand experience of British medical training. I quote this from the book:
"Every doctor makes their career choice aged sixteen, two years before they're legally allowed to text a photo of their own genitals. When you sit down and pick your A levels, you're set off on a trajectory that continue until you either retire of die...holding anyone to their word at that age seems a bit unfair, on a par with declaring the 'I want to be an astronaut' painting you did aged five a legally binding document."
The house officer is essentially the equivalent of the American intern physician, and here is how Adam Kay described the job of a house officer:
"you see a patient with pneumonia who was admitted with liver failure, or a patient who's broken their leg falling out of bed after another epileptic fit. You're a one-man, mobile, essentially untrained A&E department, getting drenched in bodily fluids (not even the fun kind), reviewing an endless stream of worryingly sick patients who, twelve hours earlier, had an entire team of doctors caring for them. You suddenly long for the sixteen-hour admin sessions. (Or, ideally, some kind of compromise job, that's neither massively beyond nor beneath your abilities.)"
Fiction is inspired by the writer's experience. Teaching medical students made Samuel wrote the latest book "Man's Fourth Best Hospital." Going to ward rounds after many years of absence, Samuel saw how medicine had become about "money and screens." He considered screens to be highly undesirable, because they reduce eye contact with patients, and are designed for maximising billing healthcare services (through diagnostic and treatment codes). Like Samuel, I've had frustrating experiences with electronic medical records, but largely related to their inefficiency, poor design and difficulty accessing information.
Medical care is such an important topic in our lives and everyone is interested in it. I have upset many people when I said that the way medicine is developing, we're all going to spend 80% of our life savings in the last two weeks of our lives. If we had to be admitted to a typical modern hospital and had 'everything necessary done' before our demise, which could include expensive chemotherapeutic drugs or a stay in the intensive care unit. How can anyone not be upset with this? Can anyone not be interested to know how we have collectively arrived at such a real scenario?
As a writer of medical fiction, I'm inspired by challenges in my profession. For example, innovation is stifled by the check-box mentality of administrators and it often ground to a halt by processes of security and accountability. Some people thought creative and innovative people spend most of their time with 'thinking' activities. In reality, at least half the time involved business-type activities, for example, raising funds through grant writing, media engagement, and philanthropy. In a similar way, self-published authors may have to spend up to half their working hours to build a community by researching their target audience, maintaining their webpages, writing blogs and newsletters, and developing email lists.
To summarise, challenges in scientific research and those faced in healthcare drive and motivate my fiction writing. I'm inspired by other writers like Samuel Shem.
