A beginning

welcome; some background; the idea(s)

Hello to all! Welcome to my first ever newsletter. I’m happy you’re here and hope you’ll sign up to follow along and to help me figure out what this space will be. In the meantime, some background below on the journey that has brought me here …

Photo by RetroSupply on Unsplash

Then.

Twenty-one years ago, in 2003, when I was a student in the MFA program at Columbia, I answered a call to go up to the medical center to teach a fiction writing course to medical students as part of a burgeoning program called “narrative medicine.” I was eager for teaching experience, as Columbia offered none as a matter of course.

I had spent a lot of time in healthcare settings before I arrived uptown to teach that day, primarily as a family member. Ten years before that, in November of 1993, my father died of a brain tumor after six months of illness, and then six months after that, in June of 1994, my youngest brother Ben, then 21, died of the same disease. In those months I had spent many hours in hospitals, in waiting rooms and cafeterias and sick rooms shared with strangers, many days in the ICU when my brother was in a coma, many days in a hospice center when my father was close to death. This was also all just a handful of years after my oldest brother, nine years older than me, suffered a psychotic break, ushering in an era of visits with my parents to mental hospitals and halfway houses. I had always felt *profoundly* different from the people who buzzed around us in those healthcare settings, wearing scrubs and white coats and sometimes paper caps that covered their hair. I resented them, for some unclear reason, those people who were supposedly trying to help, but who had not found a way to help. I will never forget the rage I felt when a social worker approached me once in the waiting room of the ICU, asking if I needed to talk. Those people were on that side of the line, my family and I were on the other. What I knew about, what I felt, what I did with what was happening, all those things had nothing to do with those people.

Ten years later, in that first fiction workshop with that first batch of medical students, I did with them what I had always experienced myself in writing workshops: we read short stories, they wrote and shared short pieces of writing with one another. I was amazed that they did what I told them to do, that I had skills that they didn’t have. I remember one exercise, where I asked them to write a single scene ten different ways - a woman gets on a bus, for example - and to think about inhabiting perspectives that were challenging for them. “What if you wrote from the POV of the lamppost nearby,” I said, and I still remember the looks I received to that suggestion.

It was thrilling, to think that I had anything to offer to the world of medicine, a world I had been so alienated from. Later that year, I taught another workshop, this time to fourth-year students, who were spending a month immersed in humanities work as they applied to their residencies. This class was more intense - we met more often and the students wrote more - and this time I added a new element and asked the students, at the end of the month, to write a fictional piece involving a true patient experience. On the last day of class they shared these, and they spoke about what the exercise had done for them. One student, who had written about a patient encounter that had deeply disturbed her — the patient’s family had dismissed and abused her — wrote her way into the imagined perspective of the patient as well as that of the patient’s family members. She knew that what she wrote was an invention, she said, but something about the process of that inventing had shifted the experience for her. Another student wrote a piece imagining a patient in a hospital bed as a fish, dragged out of his natural environment, unable to breathe. All of the students agreed that the imaginative work had been transformative for them, allowing them to shift elements of their experiences inside of them, giving them back a sense of authority that they so often felt they lacked in medical school.

What I was witnessing was something I had never been taught in school while studying to be a writer. There had never been any conversation, in all those years, about what the writing did for us on a deeper level, about what powers it might hold for those who didn’t desire to pursue the work professionally or with an eye toward publication. Those first workshops, and subsequent ones, helped me to see something that I had not necessarily thought about before — that there is something about the practice of writing, the work of it, that can be useful for anyone. I knew, of course, what writing had done for me in those years after my father and my brother died, when the grief was deep inside me but I couldn’t let it out, not wanting to add to my mother’s burden, not knowing how to express what felt too large for words. My oldest brother was then living at home, psychotic as ever, my mother too overwhelmed and the system too broken for any other possible situations. I can see now that I was in a kind of survival mode, all other systems shut down. If I put my grief or my trauma anywhere in that time, and for years afterward, it was only in small bursts of words.

When I eventually wrote my first novel, The Cure for Grief, ten years after we buried my father and Ben, the process of turning my family’s story into fiction - giving it form - was transformative for me. I was writing the book at the same time as I was experiencing those first workshops with the medical students, but at the time I didn’t connect the different work in my mind. Now I see the activities as intrinsically connected. In both places I was developing what became, as I entered the world of Narrative Medicine as it is specifically practiced at Columbia (I pursued and was eventually hired into the program, and have been working in and around it ever since), my own particular lens on the work. That lens was and is specifically grounded in what creative work can do for us psychologically, and in relation with others. Over twenty years later, it is still the primary way I see and practice the work.

Now.

My mother died in December of 2023, from dementia, after seven years of illness. As happens for many in the wake of a loss of this magnitude, the ground has shifted beneath me. Everything is different, even all the things that are the same. I have begun to wonder about how I might use the teaching I’ve been doing all these years in other ways and in different directions. Wondering about new workshops to offer, new training programs to put together, new people to reach in new ways.

I am also moving through grief again, but this time I am an adult, and the process is entirely different. Now I am able to observe the process, able to question it, attribute elements to it, and I am also able to look back at that young person whose experience was so different all those years ago. I am able now to understand better what was happening to me when I was a teenager, as I buried myself deep. I am also now curious about the process, curious to read, to study, to learn, unafraid to think about death and grief because it does not, now, threaten to swallow me entirely as it did then. I have just completed a grief educator program, which has helped to underscore for me how much I already know.

All of this brings me to why I am starting this newsletter.

In the months since my mother died, I have been trying to synthesize all the work I have done with the emotional work I am doing now; I have been thinking, as I move through my own grief process, about the ways that creative work has and has not changed for me over the years, about all that I have witnessed and experienced in the teaching that I have done, and about whether and how creative work is or can be of use —for me, for others — in grief. This is not new territory for me but I have been immersed in it with new energy. I have been reading widely — books about creativity, books about grief work and psychology, books about death and the (possible) afterlife. And I have been wondering about what to do with all that I’m learning — a new novel? New courses? A new life?

I’ve decided to open up a space here that I hope might be useful, not only for me but (dare I hope!) for others — a space where I might explore these questions, about creativity, about grief, about medicine, about spirituality and death and all manner of other unanswerable questions. It’s an experiment, as everything feels like it is these days, but I hope I might find other people who are interested in coming with me on the journey. I also hope that some tangible things might come out of this — writing workshops and perhaps also grief workshops and book groups and hopefully some things not yet seen. Stay tuned for all of this.

I hope that this can be a conversation among like-minded people, concerned with questions that are unfortunately not commonly asked, and often not even answerable. Please do respond and keep in touch with me - also if you have suggestions for questions to explore or books to read, I am all ears.

Thank you, in advance, for joining me.

Photo by Jess Bailey on Unsplash

---