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Life in Emergistan: On Writing Well, Physicians' Edition

Leap, Edwin, MD

doi: 10.1097/01.EEM.0000546135.49051.27
Life in Emergistan

Dr. Leap practices emergency medicine in rural South Carolina, is a member of the board of directors for the South Carolina College of Emergency Physicians and an op-ed columnist for the Greenville News. He is also the author of four books, Life in Emergistan, available at, and Working Knights, Cats Don't Hike, and The Practice Test, all available at, and of a blog, Follow him on Twitter @edwinleap, and read his past columns at



When I first started writing this column in 2000, I thought (and this may be a little arrogant) that I was one of a few physicians writing about medicine the way I did.

It seems to me that the number of physician writers is increasing, and I'm glad to see that. Whether it's a health piece in the local newspaper or a big-deal column in a national publication, it's good for us to be out there. We see a unique (but by no means the only) view of the world, and readers need to hear it.

There are some things to consider, however, for physicians considering this path. I will occasionally see physician-writers complain that their readers are unkind, that someone had an opinion on their work or thesis that was unkind. They will ask other physicians online, who will pile on with how shocked they are at the ignorance or intolerance or whatever of the comment.

It's nice to have that salve applied to our wounded egos, but as one of my editors once said, “You had your turn; now it's theirs.” Readers are entitled to say what they want about what we write. I am humble enough to acknowledge that sometimes they are right. I hadn't thought through the idea. My choice of word or phrase was cliché. Sometimes they are just unkind. That's the lay of the land.

My first instinct, for a long time, was to go full hillbilly and write back in anger. Fortunately, my lovely and wise wife Jan said, “Don't do it.”

“But what they said is stupid!” I retorted.

“I know,” she said calmly. “Let it go.” I ignored her sage advice on a few occasions. It never got anywhere, and it wasted my time. Now if there is a dialogue to be had, it's fine to comment. But always try to bring more light than heat, and don't resort to name-calling or stereotyping. Not everyone who dislikes our work is intolerant, hateful, or backwards. Sometimes they just don't like what we write.

Along the same lines, learn not to care so much about critics. Ernest Hemingway said in Green Hills of Africa that the problem is if we like what people say when they're nice, we'll be too affected when they aren't. Write and move on.

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Credentials Aren't Everything

Next, write honestly. People can smell lies. Write about the things you see and experience in a way that makes readers understand. Don't embellish or try to sound too heroic. When you tell the story well, people will get it.

The column you write is like a chart, passed to the next doctor on shift. (Hopefully a lot more interesting.) Make it readable. As physicians, we often speak only in physician. Unless you're writing only to physicians, readers won't get it. And if you can avoid it, don't write academically. Almost nobody reads academic work. Don't aspire to write like that unless you want your oeuvre read only by your parents and aunts and uncles.

Also, write compassionately. Without very clear explanations, readers don't understand our dark humor either. This is true not only of nonmedical folks but also of many in medicine. Not all physicians have the same lives and experiences. What physicians in emergency medicine joke about can seem terrifying and cruel to others.

To be a good writer, there are a couple other things that are critical. One of them is to write. Not just when there's a deadline or when you are offered an opportunity. Write a lot. A blog is a good way to do this, but a journal works just as well. Another editor used to ask me constantly, “Ed, what are you writing for you?” I do that now. I get it. It makes me better, and makes me experimental in my writing. If you don't like to write, then it will be hard to be a writer. That seems obvious but isn't to everyone.

The other thing is to read. Read a lot. Not just double-blinded, placebo-controlled studies, please. Read novels and short stories. Read columns. And read about writing. Read poetry and classics. And for heaven's sake, read more than politics. Jan and I have been reading the Iliad. Homer is still relevant. Reading makes for good writing.

When you feel ready, submit your work. Look online and find magazines and papers looking for content. If they aren't, write and ask anyway because your credentials as a physician coupled with good content (and that's key) make you a useful asset. You'll be rejected. A lot. But not always. You never know where it will lead you.

Finally, our credentials as physicians don't make us experts in everything, and our stories don't make us good writers. They are only raw material. If you aspire to be a physician-writer, be humble and be willing to learn. That's when you can mix medicine and creativity and create something great.

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