Literature and medicine are not opposed pursuits but rather one in the same endeavor to find sense in messy, human stories.
The Man Who Mistook His Wife for a HatThe Man Who Mistook His Wife for a Hat
What am I without my memories? How much of me is just neurons and neurotransmitters?
Through Sacks, I learned how to find humanity in the biomedical model, a product of the Scientific Revolution that reduced patients to broken machines and physicians to mechanics. By considering historical and psychosocial factors, Sacks’s holistic narrative approach asserts the value of subjective experience in addressing medicine’s task of preventing and easing suffering. This is the mission of narrative medicine, a nascent movement that sees patients as storytellers and their life histories as testimonies that demand close reading. Like Sacks, practitioners of narrative medicine understand that in profit-driven healthcare institutions that resist efforts to humanize medicine, words matter.
Some people roll their eyes at premeds who have known that they’d become doctors since conception. Some people pity them. Some assume that their idealism has sheltered them, that these premeds have formed their ideals of medical school in a state of naivete—under the promise of upward mobility or the privilege of coming from a family of physicians—that inevitably are replaced by disillusionment. The reality is that medical school is grueling; the healthcare system is broken and racist. For me, medicine demanded the best years of my life. The requirements were unending and demanded an absurd level of perfection; one flaw in a medical school application could scar an entire career. The model of the inscrutable, unfeeling physician was not just a trope but a method of survival.
For many of my first-generation immigrant millennial peers in “The Big Three” professions (doctor, lawyer, and engineer), exchanging autonomy for parental approval is exactly all they want. At the same time,meeting a stereotype is shameful. Wanting to please your parents is like saying “please bully me.” People don’t also want to be held up as model minorities because, as ex-premed Weike Wang wrote in The New Yorker, “A model-minority label is already a kind of erasure, because it discounts individuality.” Those who satisfy the model minority’s requirements of excellence aren’t immune to prejudice.
As a premed student, I was regularly instructed by doctors, “You don’t have to do this if you don’t want to.” As a medical student, patients greeted me with “Your parents must be so proud.” (Also: “Do you speak English?”) Colleagues assumed that I would specialize in anesthesiology, pathology, or radiology because they believed that Chinese Americans had no intrinsic desire to actually speak with patients. When I announced my plans to pursue geriatrics and described my love for talking to older adults, I was met with raised eyebrows. On the other hand, when I told my parents I wanted to study writing, they reacted as if I’d committed a crime. My parents believed that art and science were mutually exclusive endeavors. Art was a pastime; science was a career. I kept my writing under wraps, using my Chinese name “Xi Chen” to anonymize essays I published on my Medium blog or poems I sent to the university paper. Even now, I rely on my legal first name as a sort of pseudonym to demarcate my “professional” life as a doctor from my life as a writer.
Exposure to the medical humanities blurred these distinctions. In the preclinical years of anatomy and physiology lectures, I learned that medical school was fundamentally about learning a new language. I learned to like clinical descriptions for their often-comical coldness and precision. Hearing doctors tell tales about patients became as enjoyable as reading. When I started clinical rotations, I found myself surrounded by stories and bombarded with moments of meaning. Seeing patients until discharge made me happy, and I often wrote about my experiences to better understand them. For the first time, I genuinely understood why medicine was considered a calling.
While some clinical experiences electrified me, others gutted me. I spoke to dying patients across the scratched surface of a face shield. I met patients who pretended to not understand the “foreign language” I was speaking when I spoke English. Several asked if I was from Wuhan, and a couple requested that I be excluded from their management even after I said no.
Loving literature didn’t translate into being good at speaking with patients, and when I tried to convey their stories to supervisors on morning rounds, I was scolded for lingering in my patients’ social backgrounds.
There were doctors who did in fact love literature. However, the monopolizing nature of hospital life barred literature from being a hobby anymore. When I mentioned that I liked reading, they would sigh and say, “Oh, reading; I used to like books too . . .” When I saw the lives the residents were leading, I was reminded of my workaholic mother after a streak of overtime shifts, exhausted and stuck. In those times, my mother seemed correct. Art and science were incompatible then. Slowly, my romantic vision of life as a physician-writer fell apart.
There’s no doubt in my mind that medicine benefits from literature, and vice versa. The reality is that regardless of liking medicine or not, most people burn out at some point. This was especially true during the pandemic, which saw healthcare workers quiting in droves and an increasing concern about medical errors and physician suicide rates. Of course, my parents didn’t know any of this—my burnout, my disillusionment—when I told them about the leave. They had no idea that I was a writer or that I had applied for graduate writing programs. I’d waited until a month before I moved to New York before telling them of my decision. They didn’t understand where this love of literature came from, even though it had always been a part of me.
There’s no doubt in my mind that medicine benefits from literature, and vice versa.
For model-minority providers who are discouraged from betraying perfectionism, art serves as a space for connection, community, and expression. In the process of applying for my leave, I needed to recognize myself as another vulnerable other. Disentangling my personal hopes and desires from societal expectations and institutional forces continues to be hard. Becoming a doctor often requires sacrificing the self in the service of others and prioritizing the person immediately in front of you. But through writing, I can see myself as a complex person who doesn’t fit the mold of a singular identity like doctor, writer, or person of color. Like my patients, I am the sum total of all my identities and more; my body and voice make up a unique story worth telling.
Self-knowledge and narrative are not only important for my well-being but also instrumental in preparing me for a career in a data-driven, cost-conscious bureaucratic medical institution that has historically placed the scientific and humanistic methods of care at odds. Practitioners of narrative medicine are more equipped, as its founder Dr. Rita Charon put it, “to listen to their patients, to understand as best they can the ordeals of illness, to honor the meanings of their patients’ narratives of illness, and to be moved by what they behold so that they can act on their patients’ behalf.” However, this level of vulnerability requires an understanding of myself as a fellow storyteller, in need of community and connection.
Looking back on Oliver Sacks’s career as I’m anticipating my return to medical school, I understand why writing was vital to him, when his life was flooded by thousands of patient narratives filled with both suffering and joy. As a queer man from a wealthy family of doctors, Sacks knew what it meant to be a character in someone else’s story. Like his patients in The Man Who Mistook His Wife for a Hat, Sacks’s body was read by society as an other, and this sense of marginalization drove him to think about what other voices may be lost within the confines of medical science and society at large. By bringing literature into the embodied spaces of medicine and medicine into the imagined worlds of literature, Oliver discovered a new kind of close reading, one sensitive to language as a corporeal act.
Sacks was not only an alternative to the tension between medicine, art, and my ethnicity, but also a catalyst for a burgeoning community of writers that includes patients and providers. By carving a space for people like myself, I hope to make openness to the humanities and self-reflection the norm in medicine rather than the exception. Literature and medicine are not opposed pursuits but rather one in the same endeavor to find sense in messy, human stories.