“How do I know what I think until I see what I say?” — E. M. Forster
“No thinking — that comes later. You must write your first draft with your heart. You rewrite with your head. The first key to writing is… to write, not to think!” — Sean Connery in the 2000 movie “Saving Forrester”
“Lancing boils for pus — there’s got to be a column in that!” It is my curse and blessing as a physician writer to walk around with such strange thoughts in my head. They come unbidden, sometimes unwelcome, like family that I love to see, then love to see gone. But I can’t shut such thoughts out, nor would I shut them out if I could, for that would feel like a life of eating without tasting.
When I make rounds at the hospital, I see my surroundings a little differently than most, and look for the meaning and significance of most everything. Consider three things that might seem unrelated: the light steps of the retired surgeon who has found a new calling in care of the terminally ill, the inspiration a young woman finds to finally kick her addiction in the adoration of her new son and the recovering surgical patient slowly shuffling down the hall surrounded by the life-force field of his happily babbling grandchildren. Others may have seen them and made no connection. After a little time in my head, those loose threads have been woven together into a potential column about finding what inspires each of us to our own self-renewal.
I see art in the bright blood layered on creamy pus from a freshly lanced boil, and beauty in the beasts of ORs, ERs and ICUs. I can find a song in the asynchronous symphony of hissing respirators, dinging alarms and tapping medical computer keys, and imagine that, if I listen carefully enough, that song will tell me — and only me — what it’s singing about.
Sometimes the threads weave a darker tapestry, however. Most of us in health care don’t want to ponder much about death; the writer wants to know what it’s thinking, and who it’s thinking about. So I look for it, and I see it, lurking at bedsides in some patient rooms, dancing at the edges of worried conversations in others, but always around. It can seem like a very tardy friend to the tired, old woman gasping for air from the struggle to simply sit up and eat, and a thieving, evil bastard to the young mother whose husband died suddenly a month after their son was born. I wonder when it will seem like my friend?
Each patient has a story, or is a story, in such a heated head. Most will never see the light of day, but that’s OK, because the translation of an idea into a column is just half the fun. Every potential column idea is to be turned round and round under the the twin lights of thought and inspiration in order for me to discover what truth is revealed when the light hits the subject just right. Half the thrill is in the turning and thinking, revealing my truth to me, and only half in revealing my truth to you.
It is in the writing, however, that I find my understanding of the significance of what I see. It is in the translation of my thoughts and feelings into a coherent column that I often find what I really think; that’s why what I thought before I had to write about it sometimes turns out not to be what I really believe.
That’s true of all of us, I think, not just the writer with the overactive imagination and access to a newspaper. The unexamined feelings and thoughts we have are often incomplete and require more work before we can really know what they are. They must be put into words, words must be strung together into coherent sentences and paragraphs, paragraphs must be laid out in a logical sequence, then the expressed ideas re-examined as a comprehensive whole, before we really know what they are. Writing, then, like thoughtful reflection, is a wonderful tool given to us for finding our truth.
Erik Steele, a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems.