What do famous authors Anton Chekhov, Michael Crichton, Robin Cook, Khaled Hosseini and Sir Arthur Conan Doyle have in common? Answer: all had another profession apart from their writing: the practice of medicine.
As some of my readers know, I have a two-pronged career of writing and medicine as well. On the face of it, there wouldn’t seem to be a logical connection: long hours at the hospital or clinic don’t seem that conducive to sitting down to write fiction. Or is it because of that fact that a doctor feels compelled to write? What makes him or her do it?
Russian author Anton Chekhov (January 1860 – July 1904), considered one of the greatest short-story writers in the history of world literature, practiced medicine through most of his medical career. He had a marvelous quote that captures the uniquely split allegiance to medicine and writing: ”Medicine is my lawful wife”, he once said, “and literature is my mistress.” In other words, I spend passionate times with my writing, but in the end I always return to the staid world of medicine. A Wikipedia source states: Chekhov’s work as a doctor…enriched his writing [my bolding] by bringing him into intimate contact with all sections of Russian society. A dedicated and caring physician, he worked himself to exhaustion up to the time of his death from tuberculosis.
Moving to more modern times, Michael Crichton was born in Chicago, Illinois, October 23, 1942 and died of cancer in Los Angeles, November 4, 2008. A brilliant physician and scientist, he graduated summa cum laude from Harvard College and received his MD from Harvard Medical School. His first bestseller, The Andromeda Strain, was published while he was still in medical school, a feat I could never have pulled off even if I’d tried. Later, Crichton went into writing full time. His books have been translated into at least 38 languages, and he won an Emmy, a Peabody and Writers Guild of America Award for the top TV series ER. His novels were of the techno-thriller genre, with sometimes alarming scenarios in which technological and scientific achievements go haywire as a result of human failings. I would speculate that the technological aspects of his stories stemmed from the fund of knowledge gained more from his experiences at the Jonas Salk Institute for Biological Studies than his work as a physician, but his website states that Crichton based ER on his own experiences as a young doctor.
Robin Cook, born in May 1940, is best known for combining medical writing with the thriller genre. Dr. Cook grew up in Queens, New York, and was a graduate of Columbia University School of Medicine. He writes medical thrillers that uniquely combine technological advances in biomedical science with ensuing ethical problems. That may sound a little dry, but Cook does it in a way that keeps you glued to the page. His 1977 bestseller Coma, was made into a highly successful and visually stunning film directed by none other than Michael Crichton. Cook has been quoted as saying, “I joke that if my books stop selling, I can always fall back on brain surgery. But I am still very interested in it. If I had to do it over again, I would still study medicine. I think of myself more as a doctor who writes, rather than a writer who happens to be a doctor.” [My italics.]
Khaled Hosseini, who once worked at HealthCare Partners, the same medical group to which I belong, was born in Kabul, Afghanistan. Khaled practiced medicine until about 18 months after the release of the phenomenal worldwide bestselling novel The Kite Runner. It became a movie of the same name in December 2007. His second novel A Thousand Splendid Suns, was also a huge success, and the movie version will be released on a TBA date.
I left Sir Arthur Conan Doyle as the pièce de résistance because he is the creator of probably the most famous fictional detective in the world, Sherlock Holmes. Doyle, a Scotsman, studied medicine from 1876 to 1881 at the University of Edinburgh. While studying, he began writing short stories. In 1882 he joined a former classmate as his partner at a medical practice in Plymouth, but apparently their relationship ran into problems and Conan Doyle left to set up an independent practice. Legend has it that business was slow and while he was sitting around waiting for patients to show up (which never seems to happen to me) he began writing stories again.
The observation and deductive powers of Sherlock Holmes are said to be based on Conan Doyle’s former university teacher, Dr. Joseph Bell, who emphasized to his students the importance of deducing aspects of a patient and his or her life merely by observing his or her appearance and physical features. Much of that is very clever, but to me, Conan Doyle’s magic is his facility for creating atmospheric, transporting scenes. Images of Holmes and his companion Watson in a horse-drawn cab clattering down dark, wet London streets at breakneck speed in pursuit of a villain, or the sinister setting of The Adventure of the Speckled Band have remained in my mind as vividly as a movie since the time I first read Conan Doyle as a child. Describing a setting in a way that the reader feels completely immersed is important for me in my writing, and some of that no doubt comes from my admiration of Conan Doyle. He was also one of the masters of the locked room mystery in which it seems impossible that the murderer could have gotten to his victim inside a room because the door was solidly locked and there was no sign of forced entry.
So what does make a doctor want to write? There’s much pop psychology here to offer: the need to escape the stress of busy medical practice is one example – but then remember Conan Doyle wasn’t that busy when he began writing. In fact he was probably bored out of his mind waiting for patients to show up.
In certain cases like Chekhov’s, as noted above, the places his medical practice took him and the people he met almost certainly enriched his writing, and in Cook’s and Crichton’s cases, biomedical knowledge was fodder for their books. So maybe doctors have a desire to create a fictional world out of their reality material. Which still leaves us with, why?
Certainly there’s an interesting parallel between solving a mystery and diagnosing a medical case. (In fact they are often one and the same on medical shows like House - at least what I know about it. I’m unable to watch such programs, which are mostly excruciating to me. But I digress.) When the doctor first meets a patient with an illness, s/he first has to be alert to the patient’s appearance and demeanor (remember what Joseph Bell taught his students?) That’s like a detective quietly observing the crime scene – if s/he can start developing an idea of likely suspects this early on, that’s good. The doctor can do the same thing. The patient says her back hurts and she thinks the cause is a kidney infection, but the doctor notes a UPS insignia on her shirt and knows it’s more likely she has a back sprain from lifting heavy packages.
As the patient talks about her illness or disorder, the doctor is picking up clues, but as in a crime scene, sometimes the clues are hard to come by. Just as the detective probes deeper by carrying out searches, talking to likely suspects and witnesses and so on, the doctor goes down a path of physical exams, lab tests and/or imaging studies that will rule out suspect illnesses and (hopefully) rule in the culprit, i.e. the true cause of the patient’s disorder. Along the way, both the doctor and the detective might encounter red herrings and initially make the wrong diagnosis/arrest the wrong man or woman.
As much as making a clever diagnosis is gratifying, the process of reaching it is not as much fun as developing a plot in a Darko Dawson mystery. The former is an anxiety-provoking reality: a patient’s life might be on the line. The latter is well, just fun.