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.
Shara Yurkiewicz is currently training to become a doctor at Harvard Medical School. In spite of her busy schedule, she also pens wonderful prose on her blog, This May Hurt a Bit, part of the PLoS blog network. Her writings offer a window into the life of a medical student and also show us the rarely-seen “human face” of medicine. Before beginning medical school, Shara worked at the Los Angeles Times as an AAAS Mass Media Fellow and at Discover.
I recently met Shara at the ScienceOnline 2012 conference earlier this year and found her to be a very amiable person indeed. I am really pleased that she agreed to answer some questions about her budding writing career here at The SA Incubator.
Hello and welcome to The SA Incubator. How and when did you get started writing about science?
It’s an honor to be interviewed. I began writing in high school, and I began doing science research in high school, but it didn’t dawn on me to combine the two until college. I joined the Yale Scientific Magazine--a quarterly publication that reported on research at the university--on a whim during my freshman year. The Features section appealed to me immediately, because that offered the most creative freedom in both subject matter and writing style. My first piece investigated some of the most egregious inaccuracies and stereotypes that the Yale Scientific Magazine propagated during the early 20th century. I began pitching ideas that I thought would resonate with the magazine’s readership, and when I became editor of the Features section my ideas got rejected a lot less often! I never dropped my involvement with creative writing or science as separate spheres. I found that becoming stronger in both was gratifying in its own right but also enhanced my ability to intertwine the two.
In your blog, you tend to write about your personal experiences as a medical student. And many times, you grapple with some heavy issues. How challenging is that?
I think the biggest challenge of writing as a medical student is the balance between confidentiality and honesty. Using the first person perspective opens up comments not only on your writing but on who you are as a person and the decisions you make. There are a lot of audiences you have to answer to when you write about patients: your colleagues, your institution, your profession, your current patients, your future patients, and the public in general. Patients may be curious to know what surgeons talk about during a procedure, for example, but sharing that would be a massive breach of professional etiquette. During the first few days of medical school, I asked the higher-ups at Harvard for advice about boundaries in writing. Admitting it was a gray area that made heavy use of common sense, one of my advisers told me, "People aren't going to trust you enough to talk to you if they think you'll have no restraint in writing what they say. The classroom would no longer be a safe place."
Similarly, sometimes you meet a patient with an extraordinary story that you wish you could share, but it is simply too challenging to anonymize the details without losing the message. I personally adhere to the strictest form of confidentiality: the patient should not be able to recognize himself. To do this, sometimes I change identifying details (gender, age, location, when the event took place, or particular disease) or use a conglomeration of patients instead of just one. However, this brings up another issue: even though you have a disclaimer mentioning your changes, your story is now partly fictional and the reader doesn’t know which part. It becomes a representation of your perception rather than reality. You sacrifice honesty for confidentiality.
In addition, there is a sense of overarching honesty, the kind that transcends a single story. If I only write when I’m feeling pleased with myself, that doesn’t accurately reflect the range of emotions that comes with this journey. I try to write when something strikes me, usually soon after the event. The downside of this approach is that at the time of writing I lack significant hindsight. However, I’m hoping that recording things as they are in the moment will help me find common threads later and explore specific themes in-depth and with greater retrospection.
You were in science journalism before opting to go to medical school. What was your experience as a science journalist?
I knew since college that I wanted to be a doctor, so I went into science journalism with that in mind. My main goal was to learn the process by which the public gets its science information, so that I could better relate to and communicate with future patients.
There were definitely the glamorous, “I can’t believe I’m doing this” moments--riding in a NASA airplane up and down the California coast at 1000 feet to record air and water measurements comes to mind, for example. But what really amazed me when I worked at the Los Angeles Times was the ease with which I gained access to some of the most brilliant thinkers in their fields. I could speak with scientists for hours and ask whatever questions I wanted about their work. What other field lets you get consistent one-on-one discussion with people so personally invested in making sure you understand what they do?
The fast pace of working at a daily newspaper was intimidating because it was hard for me to “let go” of my pieces in time for deadline. I was used to research writing, which takes months to gather and source. Condensing that into hours left me terrified that I was going to have gaping accuracy holes and misinform the entire Greater Los Angeles Area. But I think working on a timeline like that was beneficial and more realistically reflected what I will eventually have to get used to in medicine.
Has your current training as a doctor helped you in your writing?
Content, content, content. The fortunate thing about writing about medicine is that the public seems to have an inherent interest in reading about it. Everyone deals with doctors, everyone has at least a bit of knowledge about doctors, and everyone has an opinion about doctors. Doctors are disproportionately portrayed in films, television, and novels, which is particularly impressive considering most of the writers aren’t in the field.
However, there’s a caveat to this. Writing is a combination of content and form. Patients’ stories alone can more than adequately suffice for content, and it can be tempting to use them as a crutch in lieu of developing your own thoughts and prose. My favorite physician writers use patients to enhance but not carry their stories. They use patients to segue into bigger ideas about research, clinical practice, policy, or personal growth. And they still write beautifully.
More science writers and communicators are embracing social media to promulgate science to the public. And slowly, the health sector is also joining: live-tweeting surgeries, posting surgery photos on Pinterest. What are your views about the health sector trying to connect more directly with the public?
I think the health sector trying to connect more directly with the public is a good thing. However, I cringe at the examples you give. I’m going to define “social media” as social networking sites like Facebook, Twitter, Pinterest, and Tumblr. Outside of major public figures who write, I think these sites are overhyped as ways to connect with the public. They are fairly self-selective, and as a result there is a significant echo chamber effect. I’ve found networking quite useful for finding support within my professional community (medicine and writing) but not outside it.
In addition, social media represents an extraordinary tool for making narcissism public. (Believe me, I’m by no means immune to this.) I would ask a person who is live-tweeting a surgery who exactly he or she is trying to reach and why. I’ve only had two weeks of third year gynecological surgery under my belt, admittedly. But I don’t even understand the logistics behind something like live-tweeting. Everyone in the operating room is focused on the patient on the table. Surgeons, anesthesiologists, nurses, and techs anticipate each other’s moves, some people are sterile and the rest are at least gloved, and there is often a lot of non-verbal communication. It’s a huge detriment to patient care to disattach yourself from that process--physically and emotionally--for something as trivial as tweeting or taking photos. In that moment, your obligation is to the patient alone, not the public.
I think a fruitful way of connecting with the public, at least for now, is through more traditional avenues, like articles in the mainstream media or blog posts on a reliable site or from a reliable author. These are more thoughtful, have a point, and are read by people outside of the providers’ circles.
Going back to your blog, your writings remind me of Atul Gawande’s writings which also show readers the “human face” of medicine. So, I’m wondering who your role models are and whether Gawande is one of them.
When I was applying to medical school, almost every interviewer asked me if I wanted to be the next Atul Gawande (talk about a loaded question!). And yes, I do obsessively reread his works and try to dissect what makes his writing so powerful. He currently works at the Harvard School of Public Health, and he was kind enough to make the time to meet with me and share some advice about medical writing. I recently found out it’s so cliched to want to be like him that there’s even a term for it: Atul Gawannabe.
One of my favorite books is Pauline Chen’s Final Exam, which made me cry more times than I’d like to admit. I feel like Richard Selzer is so pivotal to the field of medical humanities that it’s almost hubris to say he’s my role model as well. I’ve heard him speak in person, and his casual speech is so beautiful it sounds edited! Oliver Sacks is a big part of the reason why I’m considering neurology as a specialty. Michelle Au makes me simultaneously think and laugh, and I love her accessible style. And then there are the usual suspects like Abraham Verghese, Jerome Groopman, and Perri Klass. Michael Crichton is a bit different from the rest since he writes science fiction. I enjoy most of his works, but A Case of Need is the medical novel that really stands out in my mind.
Which story of yours do you like best?
I’m going to cheat and pick two: an article on anatomy for the Los Angeles Times and a post on the intimacy of medical school that’s going to be in The Best Science Writing Online 2012. I’m incredibly thankful for these opportunities.
What are your plans for the future? Do you intend to continue writing about science?
Well, the major plan is to figure out what type of medicine I want to practice for the rest of my life. Third and fourth year rotations in various specialties will help determine that. I absolutely intend to continue writing, though in what form is anyone’s guess. Can I dream big? Books, articles, and columns. I don’t feel complete without that outlet and connection to other people. More than anything, I want readers to feel something they haven’t felt before, or become engaged with an idea that they haven’t considered before. I think I subscribe to a Walt Disney quotation a bit more than the stereotypical science writer: “I’d rather entertain and hope that people learn, than teach and hope that people are entertained.”
Previously in this series: