After studying the great books at St. John’s College I dreamed of writing the next great American novel. I enrolled in a graduate program, where my fiction-writing teacher said to write what I knew. At that point I didn’t know much of anything – medical school seemed like the easier option. Twenty years later, I began The End of Healing as a work of narrative non-fiction. When my spouse, who is also my editor, said it was fiction—and suggested I’d better stop because it would take forever—I denied it. I assured her it was creative non-fiction. As usual, she was right. A full year later I admitted it was fiction—and it filled me with terror. I couldn’t write fiction. That had already been determined. But it was a compulsion for me. I wrote nearly daily from 2004 until publication. I wrote and wrote and edited and edited and learned the art of storytelling over a decade because I had to. The End of Healing had to be told. What have I learned about the writing process that might help others who have a story to share?
My initial writing was stream of consciousness, but early on I developed a good story structure. Numerous scenes in my mind were crystal clear from the start, and I had a vague sense of how they might fit into the arc of the bigger story. I began to piece those scenes together and after about six months of serious writing my wife, Sharon, —who had not realized she would serve as my primary editor—insisted I create a detailed outline. I assembled character notes and personality grids to make sure each character was consistent. Eventually, my characters revealed themselves more fully and were ultimately responsible for the arc The End of Healing took.
It helps to write wherever you can and whenever inspiration strikes you, but also to have a regular writing schedule, time, and place. Whenever I get inspired with a perfect phrase I write it down. I’ve scribbled notes in many places – on beaches, balconies, in lectures, in church. My favorite writing place was in the small rooftop study of our apartment in Italy. It looked out over the tiled rooftops of Florence. During the day it could really heat up in there, so my favorite time was in the morning, when a cool breeze blew through the open windows.
Writing fiction is difficult. Early in my writing of The End of Healing I told a good friend and mentor of my deep concern I might never finish the book. I still remember his advice. Just write a little bit every day. Set a schedule. Fit a little writing into each day’s work and in time your effort will add up. I followed his advice. Almost every day for a decade I got up early while the rest of the house was asleep and wrote for at least thirty minutes, but most often for an hour or two. And lo and behold, I discovered that my dear friend—who has since passed on—was right. The writing did add up.
Some people think stories shouldn’t have a point or purpose, or that you shouldn’t write with a purpose in mind. For me that was all wrong. My purpose drove the writing. I wanted to open the eyes, minds, and hearts of readers and encourage them to wake up and see where and how their health is traded for profit. I wanted to help others identify the potential pitfalls of modern medicine, ask the right questions, and effectively advocate for themselves and their families. I wanted to fascinate and empower my readers. I hope that The End of Healing arms them with the understanding they need to pass safely through the maze of modern medicine, take charge of their own health, demand the health care they deserve, and help remake our broken healthcare system. Sometimes, purpose can strengthen a story. No one likes a fable or a myth without a lesson or moral to be learned. Whether authors like to admit it or not, every story has a purpose, a reason for telling. Conscious or unconscious, purpose is there. Even though my protagonist struggles with his identity and seems lost, he is purposeful and determined to find a way to serve his patients.
So in writing, as in life, it helps to have a purpose, a reason for writing. It needs to be a purpose you care deeply about. I was able to write The End of Healing because it grew out of my own experience and was a story I needed to tell. Whether you are writing a PhD dissertation or a poem, great writing begins with careful choice of your subject. Unless you write about something you care about, it won’t resonate and you won’t finish. You will struggle to keep your focus and dedication to the task unless it is something that matters. Look for the story that matters most to you. That’s the story you should aim to share.