Just The Facts

September 26, 2019 § 8 Comments

By Sandra Hagar Eliason

“Just the facts Ma’am” was the theme of my writing for 30 years. Not as a detective, like Sgt. Joe Friday; I spent my time looking for medical clues. If I acted as a reporter, it was not the human-interest type, but the anchor speaking into the camera without strong emotion or personal comment.

My 30 years as a doctor were spent reporting “facts”—honing the skill of writing notes on medical charts, using a method called S.O.A.P. charting.

Subjective: what the patient tells you.

Objective: your “objective” findings.

Assessment: your diagnostic conclusion.

Plan: what you’re going to do about it.

My writing was analytical; I did not allow emotion to cloud my judgement. When I started practice, the notes had more information. I hoped to capture the whole person on paper. With insurance changes came pressure to see more patients, and my notes grew briefer. As the “physician-patient” relationship evolved into a liaison with the computer in the 2000s, the format (with more typing and tabs and new windows to open, all to be completed in non-increasing time slots) necessitated getting directly to the point, no embellishment. The human being I had just seen got lost in rapid finger movements noting recalled “facts.”

S: Mr. Jones is a 62yo man who appears older than his stated age. Patient states he has been drinking over a pint of vodka daily since his wife died six months ago. He was found on the floor by a niece, who went to his house when she couldn’t reach him by phone, and brought to the Emergency Department.

O: Past Medical History is positive only for hypertension. Family history noncontributory. Blood pressure elevated, pulse thready.

Heart: Regular rate and rhythm, S1, S2, no murmur.

Abdomen: Distended, with spider veins and a fluid wave. Liver two finger breadths below the right costal margin.

Ankles edematous.

A: Alcoholic liver disease

P: Admit

When I began to write creative nonfiction, readers said I sounded cold and clinical. I had mastered writing without feeling, observing from a distance, to describe what I saw. Where was I in the story, a reader asked? I realized I was the remote watcher. I had to learn a new skill: to show up in my writing. Not as the clinical observer, reporting another’s pain, but as someone who felt it. The medical barrier between myself and the other had to come down; I had to turn the “patient” back into a person.

Mr. Jones was unmoored when his wife died suddenly six months ago. He had relied on her to fulfill his daily needs—cooking, cleaning, laundry—while he built his business empire. It was she who arranged outings with friends, bought theater tickets and kept track of his work socializing. She filled the house with conversation and music. He had planned to retire next year, and use the wealth he had spent his life accumulating to show her the world.

Now she was gone, and he didn’t know how to do anything. He pretended to cook for a while, then gave up. He stopped doing laundry when his white shirts streaked blue, instead wearing the same clothes for days at a time. Not sure how to arrange time with friends, he didn’t. He missed her laugh, her smell, her warmth in bed at night. One day he stopped going to work, just didn’t show up; his manager knew how to do it anyway, he rationalized.

A glass of wine with his improvised dinner turned to two, then three, then the bottle. When that no longer satisfied his need for oblivion, he turned to vodka, more each day. He had lain in bed drinking for the past week, and this morning couldn’t make it as far as the bathroom. When he collapsed, he wasn’t sure he would bother to get up again. If his niece hadn’t found him, he might have chosen to stay on the floor.

To write about a whole person, I needed to be vulnerable—to understand how I felt about a heart, an abdomen, the life of a person on the floor. Without feeling, I was describing events, not capturing life. Life has meaning; cold facts do not. Without meaning, the story is empty.

Breaking out of the old skill set takes practice. I needed to recognize that “objectivity” and emotion-free analysis are myths the medical profession tells itself. They provide a mask of clinical words to hide behind, keeping the real story untold.

It should be obvious that it takes emotion to write emotion. But I had to acknowledge my own feelings before I could write with empathy—about myself or anyone else. Adding that missing piece can transform a narrow skill into art. Which is, of course, the goal of all good writing. It’s like going from sketching to painting with oil. Writing as a doctor, I sketched the bare outline of the patient. As a creative nonfiction writer, I have to fill in the details, the nuances of a person, add the brush strokes that paint a complete story of a person and a life.

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Sandra Hager Eliason is a recently retired Family Practice physician, now writing full time. She has published creative nonfiction in Minnesota Physician, Student Health Spectrum, and was the winner of Minnesota Medicine magazine’s 2016 writing contest for her essay “The Vacation.” She lives with her husband in New Brighton, Minnesota, where she writes about the interactions of patients with the medical system, and is working on a memoir about her years in medicine. Find her on Twitter at @SandraHEliason1.

Untangling Environmental Stories

September 20, 2019 § 1 Comment

Ana Maria Spagna Craft PhotoIn the craft essay from our new issue, Ana Maria Spagna explains how the complicated threads of environmental stories can be untangled by embracing contradictions. She acknowledges that tackling these vital stories is a challenge and hopes her contradictory lessons will compel more creative writers to explore this theme.

Here’s an excerpt:

So often what draws me to environmental stories is the sheer energy of people fighting on the fringes, exploring solutions, working with shovels and saws, with computers and maps, with megaphones and musical instruments. Super heroes proliferate on the big screen, in the realm of so-called make-believe. They also surround us every day: sheep shearers, oyster farmers, citizen scientists, teachers, students, writers. Always writers.

Read the rest in our latest issue.

 

Writing What Doesn’t Belong Only to You

September 19, 2019 § 1 Comment

Haley Swanson Photog Credit Jaimie JohnsonIn the Craft Essay section of Brevity’s just-released September 2019 issue, Haley Swanson discusses how acknowledging emotional commonalities between the writer and reader is “the key to writing about what doesn’t belong only to you.” Here’s an excerpt from Swanson’s essay:

Knowing other people have lived iterations of your experience, undergone versions of the same emotions, requires a vulnerability impossible to access in the moment. After the moment passes, when it’s time for reflection, consider letting that knowledge—someone felt this before you, someone will feel this after you, someone else is feeling it now—fill the gap an essay is sometimes believed to close. Then, the writing might come.

Read the full essay in Brevity’s new issue.

Writing Biography as Creative Nonfiction

September 12, 2019 § 8 Comments

By Christina Larocco

“Oh, I hated history in school.”

“That sounds so boring.”

These are the two responses I get most frequently when I tell people I’m a historian. How rude, as my hero Stephanie Tanner would say. But here’s the thing: I secretly kind of agree with them. History is fascinating, but some history books are boring. Bestseller lists teem with 800-page biographies of the founders, but these tomes are not for everyone. They are not for me, in fact.

I’ve never been particularly drawn to narrative nonfiction, popular history or biography. So when I crashed and burned in academia, I flailed around for a bit looking for a kind of writing that would draw on my scholarly background but encompass my interest in creative nonfiction. In the meantime, I devoured essay collections, and when I began writing again, the essay was the form I turned to. Eventually, it occurred to me that the way historians are trained to think and write is far closer to the essayist than to the narrative-nonfiction writer: rather than follow a story from beginning to end, we approach an overarching question or problem from many different angles, trying to weave these pieces into a whole greater than the sum of its parts.

Now I’m writing a biography of Martha Schofield, a nineteenth-century Quaker, abolitionist, and feminist, best-known for founding a school for freed people during Reconstruction. What I’m trying to do, though—following Christy Wampole’s 2013 piece in the New York Times­—is to “essayify” the biography. Here are three methods I’ve developed for doing so, along with some of the authors who have inspired me along the way.

Find Your Voice. In Orlando: A Biography (not a biography), Virginia Woolf pokes fun at the genre. Occasionally, her narrator breaks in to bemoan the biographer’s limited role or even to trace, in a pages-long digression, the provenance of a certain document or piece of information. Cynical, sarcastic, and witty, the voice is very different from the “objective” distance we expect from biographers.

Orlando’s narrator, of course, is not Woolf, and my voice—Serious Lady Essayist Who Is Also a Jaded Millennial (and Jokes about It to Avoid Her Feelings)—is not me. Readers expect this in fiction, and, following Vivian Gornick in The Situation and the Story, we understand that the “I” of a nonfiction narrative is not the writer per se, but a persona.

Biographical and historical narrators are personae, too. This narrative persona can establish distance from the subject through the exploration of diverging experiences, which I find much more interesting, natural, and valuable than scholarly remove. A present, well-developed persona can also reveal their feelings about the subject in a way that traditional biographical narrators can’t.

Make It Personal. In H Is for Hawk, Helen Macdonald charts her attempts to raise a goshawk while grieving for her father. It’s primarily a memoir, but hidden within it is a mini-biography of The Sword in the Stone author and falconer T. H. White, who becomes Macdonald’s central antagonist. Eventually, she realizes that they share more similarities than she would like to admit—and that she must write about him because he helps her understand what she herself is experiencing.

Forming a relationship with your subject can help clarify the stakes of your biographical project: What are you trying to figure out by writing out this subject? and Why is it urgent that you do so? I was halfway through my own project before I realized all of the ways in which my life parallels Martha Schofield’s—and then only because a fellow workshop participant pointed it out. But in 2017, when I started writing, I needed to see how a woman like me confronted a time of national crisis.

We don’t need to resemble our subjects; we don’t even need to like them. We just need to need them. When tackling a new subject, think about what draws you to it. Keep digging until you find something personal. My personal story starts with me adrift in authoritarian America, searching for something to anchor myself. That something became Martha Schofield.

Show Your Work. Another way to include more essayistic elements in your biography is to comment on the research process itself. Even formally trained historians do this, often in prefaces, introductions, and conclusions. Jill Lepore’s books, especially Book of Ages: The Life and Opinions of Jane Franklin, provide great examples of this.

It’s also possible for the book’s spine to be the research process itself. John Edgar Wideman adopts this strategy in Writing to Save a Life: The Louis Till File. He puts his own experiences growing up black in America into conversation with the murder of Emmett Till in 1955, when both Till and Wideman were fourteen, continuing police and extrajudicial brutality against black people, and Wideman’s attempts to track down information about Till’s father, Louis, who was executed by the army in 1945 on unfounded charges of rape and murder. As Wideman leads readers up to dead ends, through bureaucratic red tape, and on his journey with the file itself, he also shares his interactions with the documents, connecting their materiality and content with his own bodily and emotional experiences.

Most of us aren’t Jill Lepore or John Edgar Wideman, but we can still implement some of these strategies by keeping, alongside our research notes, a process journal dedicated to our research experience. What are you finding/not finding in the archive? What do the room and the documents look like? What is your internal and/or physical experience within this space? We like essays in part because of their “thinking on the page” quality. Making the discovery process itself—learning about a subject and figuring out what you think about it—part of the work extends this quality to history and biography.

Now get out there and essayify, and be sure to tell me what you learn along the way.

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Christina Larocco received her PhD from the Department of History at the University of Maryland, College Park. She lives in Philadelphia, where she is editor-in-chief of a scholarly journal and a prose editor for Cleaver Magazine. Her creative nonfiction has appeared in Hotel Amerika, Avidly, Feminine Collective, Drunk Monkeys, and elsewhere.

You Know That Book I’m Writing? You’re in It

September 9, 2019 § 28 Comments

lsellgeBy Lisa Sellge

We try to have lunch together every few years, or that’s what we tell each other. But this time it’s been more than a decade. Once we’ve settled with our not-too-fattening salads, black beans, avocado, we get to the details of life. We tell tales of strange husbands, weird children, we dump our weaknesses on the table and leave behind the Facebook perfection. Life is a struggle. Lunch becomes a one-upmanship of misery. When we get to the part where we tell each other the here-and-now of it, I reveal my MFA endeavors. I try not to go into detail, but they press.

What kind of MFA, they want to know.

Writing.

What kind of writing?

Non-fiction.

So, you’re writing about true things.

Yes.

Like what?

Well, actually, memoir.

It feels silly to say. I try to explain myself. I pull out the old standby: It’s a cautionary tale. It’s a warning. It’s interesting because ballet is a hidden world. Or it was in the eighties.

You’re writing about ballet?

Yeah, you know, our studio. (There, I said it.)

“There was a lot going on there that you guys didn’t know about,” I tell them.

Hannah is looking at me from across the table, a concerned frown pulling at her forehead.

“Am I in it?” asks Julia.

“Only in reference,” I say, “And the names are changed.” Or will be.

“Is my brother in it?” asks Jane-Ann.

“Well, yes, he’s a minor character. But it’s all good stuff. Nothing he would mind.”

We were together through elementary, junior high and high school. Most of us danced at the Center of Performing arts through at least part of childhood. We married and had kids around the same time. Hannah drove south from Long Beach, Jane-Ann flew in from Vermont. Julia never left. Everyone is chattering and inquisitive about my project except Hannah. She’s sipping unsweetened iced tea through a straw. Her silence is deafening.

I start to wonder if Julia, still the local, has any contact with those long ago personalities that figure so prominently in my story. Would she mention this? The Center of Performing Arts has changed hands since our day. Three of the people concerned are no longer on the planet. Another is quite old.

“No one is recognizable,” I throw in, in case anyone is nervous. But I’m not sure about that.

sellgeSpecifically, Rebecca, absent from this discussion and the focus of my memoir, is quite recognizable. How many seamstresses worked for a ballet company in our town in the eighties? Realistically, less than three.

So, anyone recognizing my name on a memoir, seeing the cover as I envision it: a white tutu-clad torso in front of a window, hands with needle and thread darning pleats, would pick it up, read the back, wonder, leaf through it skimming for names, recognize none. Perhaps put it down and walk away. I’m holding my breath through this thought. Yes, walk away. Put it down. It’s not for your eyes. Then whose eyes is it for?

Two years and 250 pages had passed when I was 99% sure my memoir was complete. Remembering my best friend Hannah’s silence, I decided to send the online link to her. But before I sent the document, I sent a text:

Hey Han, remember a while back I told you I was writing a memoir? I have a meeting with an agent coming up and, while I’m not sure how that will turn out, I wondered if you’d want to read it since your character as “my best friend” is prominent. This project began as a creative thesis for my MFA but since a few people have said I should submit it for publication I’ve decided to change names and some situations and go for it. You’ll recognize a lot of it even though everyone is disguised somewhat.

I waited. When Hannah didn’t answer right away, I began to panic. I imagined her scorn. Her eye rolls at the self-indulgence of it all. How could I explain that memoir is about perception and individual experience? Not a documentary or autobiography. Not journalism. But an attempt to make sense of life through writing with the intent to share a unique perspective.

I mentally scanned my manuscript for scenes of Hannah. I began to worry that perhaps she’d find a scene insulting or too revealing. Was I giving away her secrets by revealing mine? And yet these things are key to my story. I re-read it as if she were standing over my shoulder. My older sister, who also stars in my small coming-of-age circle, was the first to read it and signed off on my memories as either valid or too long ago for her to challenge. Would Hannah do the same? And what of Rebecca? And yet, this is not about her, it is about me.

About a week later my phone buzzed an incoming text from Hannah. Relief spread over me as I read:

Hey, I’m so sorry not to have replied sooner. Of course, I remember you telling us of your book! It sounds fabulous and I’d love to read it. Please send the link.”

And so, I did.

When I began my memoir, I had a story to tell about passion and obsession. And about death. I had a story to tell about growing up with strict discipline, both in a German household and a ballet studio, and what it was like to rebel against rigidity, looking for freedom of expression. Some of the things in my story are universal, and the things that are not, are intriguing. Or at least I think they are. Most people experience first love in those early adolescent years.

If anyone did pick up my memoir from a bookstore shelf, say Rebecca herself, what would she think? Have I represented her fairly? Have I made her someone she is not? Writing from journals that were as obsessive as my focus, I believe I captured her quite realistically, but perhaps not thoroughly. After all, I was caught up in my vision of her. I can’t know exactly how she saw herself or even how she saw me. I can guess that she might remember me as a troublemaker. Never one to fly under the radar, for better or worse.

Last spring, Moby, the nineteen-eighties musical maverick, slammed into public shame with the publication of his 2019 confessional memoir, Then it Fell Apart. Weeks after its release, actress, Natalie Portman, who is profiled as a love interest in the memoir, claimed in an interview with Harper’s Bazaar that the alleged relationship never occurred. Moby was left to defend his work in the public eye.

Initially brazen and self-righteous on social media, he quickly buckled. “As some time has passed,” Moby wrote in an Instagram post on May 25, 2019, just weeks after publication, “I’ve realized that many of the criticisms leveled at me regarding my inclusion of Natalie in Then It Fell Apart, are very valid. I also fully recognize that it was truly inconsiderate of me to not let her know about her inclusion in the book beforehand.”

It’s been about a week since I emailed the finished memoir to Hannah. And though I am not holding my breath or wringing my hands over her possible responses, in the back of my mind is the expectation that someday soon I will receive some sort of feedback and there will most likely be a mixture of positives and negatives. But I have made peace with the fact that writing is a public business and I am not the only personality at stake here. It’s a load off my mind to know she will not be taken by surprise someday in a bookstore if all goes well. And if she hates it, I will listen and alter what concerns her if I can do so without writing her out completely. But if I know Hannah, she would hate that even more.
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Lisa Sellge is a classical ballet instructor and writer in the final throes of a Master of Fine Arts from the University of Alaska. Her work has appeared recently in Atticus Review, 3rd Street Beach Writers Anthology, and NatureWriters.com.

 

 

Watch One, Do One, Teach One

September 2, 2019 § 11 Comments

roy-bornsteinBy Carolyn Roy-Bornstein

It may be horrifying for lay folks to learn this fact, but there is a mantra in medical residency called, “watch one, do one, teach one.” As an intern, I did not have the luxury of watching scores of intravenous insertions before I tackled my own. Lumbar punctures are done less frequently. If I had been supervised just once by my senior resident doing a spinal tap and deemed competent, chances are when the next one came along, I’d be supervising someone else doing one. It may not have always been literally one procedure under my belt before I’m teaching it, but it sure wasn’t much more.

That’s why it doesn’t strike me as strange or unusual that after publishing one memoir, I find myself teaching a memoir-writing class at my local adult education program. And after giving one key note speech, I feel qualified to teach a speech-writing class at Grub Street, Boston. I also have no problem teaching a workshop at the University of Iowa on creating a portfolio career in writing, even though my unpaid writing gigs still outnumber my paid jobs. And I’m lecturing doctors at Harvard University about medical journalism even as I work hard to advance that aspect of my career.

Now, full disclosure, I have given many smaller speeches in addition to the keynote, and even though my paid jobs lag behind the unpaid ones, I still have dozens of publications to my credit. I’m not a total fraud. But it’s also true: just one memoir.

But there’s another saying in medicine: teaching is learning twice. So, as I research my lessons and prepare my hand-outs for the classes and workshops I teach, I’m learning, too. I learned that when I was repeating those central elements in my keynote speech, I was using the rhetorical technique called anaphora. I had to learn the difference between direct and indirect dialogue before I could teach the students in my memoir-writing class. I was fuzzy on the precise statistics on physician burn-out before I started fact-finding for my University of Iowa writing workshop. And I didn’t know much about blogging software until I had to incorporate its use into my talk at Harvard.

All of this, I hope and believe, is making me a better writer. Watch one, do one, teach one may sound like so much chutzpah to non-physicians. But in the writing world, a little chutzpah may be in order. If JK Rowling had been discouraged by rejection and not believed in herself, we never would have met Harry Potter. Likewise, Joseph Heller and his character Captain Yossarian. Both Catch-22 and The Sorcerer’s Stone were rejected multiple times before being published. All writers need self-assurance. We have enough critics and skeptics in our lives without being doubters of our own abilities.

So I will continue watching one (in the form of reading great writers’ works), doing one (by continuously working on my craft), and teaching one (by sharing what I’ve learned along the way with other writers). As one of my medical colleagues told a group of young physicians who wanted to know how to make the big discoveries in cancer research, “Look for the question… (Then) make the answer important.” I can think of no better advice for a writer.

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Carolyn Roy-Bornstein is a physician, writer and mom whose work limns the places where those worlds intersect. Her essays have been published in The New York Times, The Boston Globe, The Writer, Poets & Writers, the Journal of the American Medical Association and many other venues. Her forthcoming third book. Last Stop on the Struggle Bus: A Memoir of Foster Love, is about taking chances, making commitments and redefining love.

What a Waste

August 29, 2019 § 26 Comments

One of my favorite Leonard Bernstein songs (lyrics from Betty Comden and Adolph Green) is a cheerful, upbeat ditty about the wreckage of broken dreams in New York. In verse after verse, a bright young thing comes to the big city from the cornfields, experiences a measure of success, then works a drudge job while never creating again. The actress flipping flapjacks, the opera singer tossing trout at the fish market, the writer who hasn’t written a word. All their dreams in pieces at their feet.

But here’s the thing about pieces: you need them to build other things. I led a writing retreat this week for three memoirists, and we got talking one night about the ways we’ve been burned, by relationships, by family, by unscrupulous writing “coaches.” I mentioned a thing I say a lot, that I’ve written about in my newsletter, a phrase that gives me comfort every time: If you like where you are, you gotta be OK with what got you there. I said that if a fairy godmother came down and said I could go back in time and have a great high school experience instead of a horrifying one, I’d say no.

I’ve gotten too much good writing from bad things.

Before the retreat, we were all at a writing conference, the wonderful Hippocamp Creative Nonfiction Conference. During the conference, I was approached a couple of times by writers with a deep, dark confession. They’d been “Anna March victims.” March—not her real name, as we all eventually found out in this wonderful LA Times article detailing the scam—recruited writers to pay her large sums of money up front, then didn’t deliver the promised editing, coaching or, as she put it, “book midwifery.” The scam kept going because the victims were ashamed to say they’d been taken advantage of, or worried that March’s literary might (as it was perceived during her grifting period) would crush them.

I feel for these writers. It’s a shitty situation to be in, to discover that your instincts were wrong, or that you’d overridden some perfectly good instincts to hand a couple thousand dollars to a con artist. I feel for their wasted money, their wasted time, their wounds from asking themselves “How could I have been that dumb?” or “Was it me? Was I just not good enough?”

But you don’t have to get conned to feel wounded. Did you get your money’s worth at your last conference? Finish your book in that pricy writing workshop? See a payoff yet from all that time on social media?

The problem with this line of thinking is seeing writing as a race with a finish line, or a game with a prize, instead of a process. There is no “done.” There is no amount of money and time you can invest that guarantees a payoff. Many MFA grads never publish. Many great books get remaindered. Great writers, including my teachers and mentors, finish books, then putter around the garden and the internet wondering, will I ever write again? Great human beings get conned, dumped, wounded physically and spiritually.

It’s not you.

And it’s not a waste.

That horrible realization you’ve been scammed is one day going to be either material, or a thing you survived.  A thing that proves you can survive. That bad relationship is teaching you what you don’t want in the next partner, or how you can be a better partner (marriage #2, right here!). The failed book is proof you wrote a whole book—and you can do it again. The debilitating illness is a chance to pace yourself, to value small moments more than showy accomplishments that later feel hollow. All these things suck, and you are legitimately entitled to be angry, sad, and/or defiant about them. Feelings are facts, too. But these catastrophes and misspent time and futile efforts are also the pieces you have to work with. The fragments you will take up, sand off the edges, and shape into your story and your life.

You may not yet be thriving, but survival alone is proof you’re on the way there. You may not yet be publishing, but you have a lot to write about, a story to share. The gift of memoir is telling our readers they aren’t alone. You’re not the only one who feels like this. Experiencing the tragedy of waste builds empathy and allows us to embody our readers’ experiences, often in a way they cannot themselves process or put into words.

That’s our job. To study our craft and learn to use the best words we can to share the things that happened, the things our readers are suffering alone. To have the courage to step out of the shadows and say, me, too.

Bernstein made a song out of broken dreams, a good song, a song that’s lasted.

What will you do with your pieces?

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Allison K Williams is Brevity‘s Social Media Editor. She has one spot left to finish your book in Italy in October. Get references 🙂 

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