This is a series of Q&As with young and up-and-coming science, health and environmental writers and reporters. They have recently hatched in the Incubators (science writing programs at schools of journalism), have even more recently fledged (graduated), and are now making their mark as wonderful new voices explaining science to the public.
Ilana Yurkiewicz is a second-year medical student at Harvard Medical School. In her spare time, which I would think isn’t too lengthy, she blogs at Scientific American, giving readers an insight into the thoughts of a doctor-in-the-making. She also tackles ethical issues in medicine. Ilana has journalism experience, having worked as a science reporter before enrolling as a med student.
I’m glad to be able to prick Ilana’s brain about her fledgling blogger’s life today on The SA Incubator.
Hello and welcome to The SA Incubator. To start off, why did you get started writing about science?
Thank you for having me. I officially began writing about science in college, but my interest in science communication started earlier while I was doing research in a basic science lab. On a day-to-day basis, through cases where it was done well and cases where it was less than ideal, I saw the importance of effective communication in understanding and interest. From a young age, I was around people who seemed to dichotomize what one could possibly be interested in learning: according to them, there were those who did science and math, and those who did humanities, and they were (supposedly) separate sets of people. Teachers might even ask: are you interested in math and science, or are you interested in writing, social studies, etc.? It’s unfortunate that so many people see science as unnecessarily complicated, often because of how it is presented.
In college I spent a lot of time working on our campus science publication, the Yale Scientific Magazine, which was kind of a university analog to Scientific American. Basically, we aimed to write about research at the school in a way that was interesting and accessible for broad audiences. I began as a staff writer and ultimately worked up to Editor-in-Chief. Editing the magazine was a wonderful experience because I could look beyond individual articles and plan what should be covered overall, trying to seek and capture stories from all disciplines. Physics, chemistry, biology, medicine, mathematics. The intersection of science and ethics. Science and society. After college I wrote about science policy and bioethics for Science Progress. Whether it’s explaining something technical or exploring the ethical sides of science and medicine, I enjoy the process of delving into a topic, trying to approach it thoroughly, and hopefully inspiring discussion.
Many of the topics you tackle on your blog stem from your experiences as a medical student. How challenging is it to convey those views from “the inside?”
One of the biggest challenges is grappling with which stories to tell. In medicine, patients come first. Always. When it comes to writing, officially the competing and overriding interest is patient confidentiality. Perhaps less officially, there’s patient respect; that is, even if a patient gives you permission to write about him or her, there’s something about doing it that feels objectifying. This becomes more complicated considering I always change a few details to protect privacy. It can feel as if I am turning a person’s life into a story; morphing personhood into a character; or using someone to make a larger point about the health care system. Figuring out when and whether to use any particular anecdote is an ongoing challenge.
Apart from the topics that you now cover, how has the medical field influenced your writing?
One influence involves cultivating story ideas for the future. Becoming immersed in clinical training lets you see things that are not written in any book. It gives you exposure to things that might not be discussed openly. There is a wonderful ethics professor at my school named Edward Hundert who has written a lot about the “informal curriculum” of medical school. A substantial transmission of culture happens outside classes and hospital rounds, he says, instead happening over meals or during carpool rides. For me, medical school has meant gradually accumulating content—formally and informally—even if I’m not at a point to write about something just yet. You start to see how things fit together. How different doctors think; how they expect me to think. The mental algorithms medicine relies on. Subtle ethical dilemmas. I think one of the most inspiring things about medicine is how it encompasses so many subjects. It sounds clichéd to say it’s a science and an art, but it really is. In addition, it’s a system of moving parts. Some operate more smoothly than others, and it’s interesting to see how they play out and why. There is excitement in getting a feel for how the system works and jotting notes in mental margins.
Then there are the patients. I have had the privilege of experiencing some powerful, humbling patient encounters. Having the honor to share moments with individuals so honest has inspired me to be more vulnerable in my writing. It has encouraged me to put myself in pieces more and to be less afraid of revealing my emotions.
I’m curious as to how your peers and professors feel about you blogging. Any particular positive or negative reactions?
I think for a lot of young writers with budding careers (especially hierarchical ones), there’s an emphasis on being cautious above all else. There’s a lot of “should I be saying this?” How will a future employer read this? How will this impact my career? Admittedly, there’s something about that mentality that makes me cringe. I wince at the idea of that overwhelming restraint; of living a life of “maybe I shouldn’t.” But there’s a positive side, too. Whenever I write something, I always picture a patient, a colleague, and a superior reading it, and I think that keeps my writing disciplined—in a good way. Instead of being cautious, I try to think in terms of being comprehensive and fair. I think you can provide commentary even on controversial subjects without offending, and that is what I strive to do.
From what I remember, the most positive feedback has stemmed from pieces addressing current issues, like Death with Dignity on the Massachusetts ballot, or pieces that resonated as a universal medical student experience, such as how to field medical questions from family and friends. On rare occasion I’ve had a former or current professor tweet or otherwise promote one of my pieces, which has been humbling.
As for negative feedback, I’m afraid I don’t have any juicy stories for you. So far, my biggest critics have been anonymous Internet folks rather than anyone I actually know. Maybe the presumed security of anonymity encourages negativity. Maybe my peers just keep the critical opinions to themselves? The responses from my peers have generally been very supportive, and I am grateful for that.
You were briefly a science journalist before starting your medical course. How was the experience?
I have to start with a plug – I was able to be a science reporter because of a terrific opportunity from the AAAS called the Mass Media Science and Engineering Fellowship. I was assigned to the News & Observer in North Carolina.
A background in journalism prepared me for medicine in sometimes surprising ways. In both worlds, you spend a good amount of time obtaining more information than you need, trying to extract what is relevant, and then piecing it back together in ways that make sense. Preceptors and editors ask for similar things: condensing lots of information into a single story. In the newsroom, that could take the form of reading a bunch of papers, interviewing a bunch of people, and then capturing it all in 600 words or fewer. In medicine, it’s: go into a patient’s room, take a history and do physical exam for an hour and a half, and then present the case in two minutes or less. Figuring out what is relevant is not always easy. It’s as if each patient is a tangled mesh of storylines hiding in the frame of one person, and the diagnosis depends on honing in on the correct one.
My time in the newsroom also made me acutely mindful of the influence a writer wields. Interviewing patients for medical stories, I saw how many turn to the media as a primary source of medical information. As a result, the writer’s rendition rather than the original journal article is often the version that is quoted, emailed, or used as a guide for lifestyle choices. A good adaptation can narrow the gap between public perception and scientific reality. Meanwhile, any miscommunication can have widespread consequences, with long-term effects. Standing at that crossroads made me aware of the importance of being able to communicate medical information to diverse audiences.
How important do you think it is to provide people with a more adequate view of the medical sector (as you do through your blogging)?
Important. Important. I don’t think this applies only to medicine; in general, I wish more people would write on what they’re passionate about. The list of what I read is varied, and it’s always great to find a new blog that covers something I know little about. Sometimes if I am having a good conversation with someone, I think: this person should be writing. A good conversation reaches one person, or maybe a handful. Writing gets to many.
If there’s a divide between doctors and patients, it’s unnecessary. It’s probably based on extrapolating the behaviors of a few to an entire group. I think one downside of too few people writing about a field is that those who do write can unwittingly become seen as representatives they never claimed to be. Once in a while, for example, I’ll read a response to one of my articles along the lines of “oh, is this what medical students today think?” Not exactly. This is what I think, and I am a medical student. Medical students, doctors – name any group and you’ll get a heterogeneous group of individuals with heterogeneous views. I don’t pretend to speak for all medical students, and I don’t wish to speak for all medical students.
There’s a quote I love by Annie Dillard that I found a long time ago through this interview with one of my favorite science fiction writers, Ted Chiang. Dillard said, “Why do you never find anything written about that idiosyncratic thought you advert to, about your fascination with something no one else understands? Because it is up to you. There is something you find interesting, for a reason hard to explain. It is hard to explain because you have never read it on any page; there you begin. You were made and set here to give voice to this, your own astonishment.”
That is a very tall order. But I am trying to give voice to some things that happen to astonish me.
Which story of yours do you like best?
I’ll go with one of my earliest: “What single quality predicts a good doctor?”
What are your plans for the future? Do you intend to continue writing about medicine?
Plans for the immediate future include taking Step 1 of my medical boards (you may have noticed my blog is a on a several month hiatus until I’m past that, sadly), getting on the hospital wards, and figuring out what I want to specialize in. The plan is continuing to learn a little about a lot until I can choose to learn a lot about a little.
I definitely intend to continue writing about medicine. The hope is that the more I become immersed in it, the more things I will have to write about. The pieces I’ve written so far have covered a range of subjects and styles, and I’d love if I could keep it that way. Some make arguments; some are more personal; some just reflect on a topic I find interesting. The ability to mix multiple disciplines like science, humanism, ethics, and policy is what drew me to medicine, and I hope it can come across in my writing, too.
No, thank you!
Previously in this series: