Writing has never come easily for me. My parents had to be called in to my third grade classroom, because I refused to put words to paper. There are reasons -- as most people who know me can imagine, I need structure, and my hippy school didn't really teach grammar. Even more difficult to me was semantics -- having ideas that were of supreme importance but being unable to grasp how to convey these ideas in words. It's still very much a struggle for me.
I knew, about one year ago, that I needed to go back to blogging. There's good evidence that medical professionals who write in at least a semi-structured manner have a higher level of empathy, decreased depression, and in general, are better at self-criticism and self-improvement. It makes sense -- medicine has the illusion of a solitary pursuit. One of my favorite medical concepts is "causitry" -- using a case to determine principles, especially in ethics. The connotation is that the case is used instead of a rational derivation of principles. The parallel, I think, is key to how physicians view themselves. We think of ourselves as cases, without connection to others moving around us. Some of this is the structure of medical training, which is systematically designed to innure the medical student to illness, suffering of physical and emotional varieties and, ultimately, death. On the one hand, training as part of a team is emphasized more in medicine than anywhere else I have been exposed to; on the other, close friendships among coworkers are rare and self-exclusion from the patients and global culture is an unspoken expectation. Discussing ones own emotions is a social taboo -- although technically encouraged, the "unwritten curriculum" mandates disparaging all such conversations. One's difficulties and mistakes are an even more unforgiveable conversation -- allowed among other healthcare professionals; but there is a stigma to sharing the lack of perfection in medicine as a whole with the lay personnel. I remember the conversation that made me leave Oberlin Hillel -- "you can discuss problems with Israel, but only with Jews." So, there's one excuse not to write. But, in the end, it requires buying in to all of the problems that I see in medicine -- that is the sort of physician that it is easy to be, but not the sort of physician that it is good to be. I struggle every day to be the sort of doctor to share decision making with my patients, to avoid paternalism, not to glorify medicine or exaggerate the science behind my decisions. Being open is a requirement for trust, and ultimately, being open with myself is an obligation that I have both to my self and to my patients.
I still hate writing. I'm a very verbal thinker -- if I can't think of the word for something, or I can't phrase it correctly, I very literally can't think it. At the same time, I'm not a linear thinker -- I will frequently formulate thoughts from the same starting point and go different directions and then return to the starting point and go somewhere else -- trying to mold these thoughts into words that must go marching on in the same direction, leaving the other vetors of thought to the wayside frustrates me. It makes me feel flattened. I feel shallow -- the thoughts that mean so much in my head mean so very little on paper. I write this in a google doc page, reassuring myself that if I hate these words, I need never publish them. (I will because I will force myself -- I know that if I don't, I will only be making it harder for myself to blog next time and I have committed myself to writing.)
I can't remember where I was going with this, other than to commit myself to writing and to explain why it is so damn difficult for me and to commit myself to write on a regular basis.