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UP CLOSE AND PERSONAL WITH JOHN H. MENKES, MD: PEDIATRIC NEUROLOGIST, NOVELIST, AND PLAYWRIGHT

Antoline, Dawn

CAREERS PLUS

Although John H. Menkes, MD, writes fictional novels and plays, his writing bears the mark of his life experiences. His first published novel, the thriller The Angry Puppet Syndrome (Demos Publishing 1999), features a doctor who takes on his fellow physicians and a pharmaceutical company in order to find the truth about a mysterious disease, a tale that he based on his experiences with a vaccine-induced encephalopathy case. His second novel, After the Tempest (Fithian Press 2003), addresses his experiences fleeing the impending Holocaust in Austria with his family in the late 1930s. The book follows two young lovers – a Jewish girl who flees Austria for America and a Nazi soldier who participates in the events at Auschwitz – and the progression of their love before, during, and after the war.

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Among his literary influences, Dr. Menkes lists Anton Chekhov as his “idol and guiding light.” He noted that Chekhov juggled literary and medical careers and “had a doctor in practically every play.” Dr. Menkes has also published several plays, four of which have been produced in California theaters. Like his novels, his plays address a wide range of topics, from Lady Macbeth Gets a Divorce, a comic retelling of Shakespeare's original, to The Last Inquisitor, about a Nazi commander facing his final losing battle of World War II.

Currently Professor Emeritus of Neurology and Pediatrics at the University of California-Los Angeles (UCLA), he was the first to describe Menkes disease in 1962, which is caused by incorrect copper metabolism and affects predominantly male infants.

Dr. Menkes earned his MD from Johns Hopkins University in 1952 and later became Head of the Division of Pediatric Neurology there before taking his position at UCLA. While at UCLA, he also became Director of Pediatric Neurology at Cedars-Sinai Medical Center. He is currently preparing the seventh edition of his textbook, Child Neurology (Lippincott Williams & Wilkins), which covers all diseases affecting the developing nervous system.

Before starting his medical rounds for the day, Dr. Menkes talked with Neurology Today about the challenges of juggling a medical career and writing.

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WHAT INSPIRED YOU TO START WRITING?

I started about 20 or 25 years ago. I had always wanted to write, to be creative in some form or another, and never quite felt satisfied with science. The creativity of science is so contingent on the facts you obtain in the laboratory or clinic. You cannot – in fact you must not – use the creative imagination, because you are in deep trouble if you do.

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DON'T YOU HAVE TO BE CREATIVE TO COME UP WITH AN IDEA FOR INVESTIGATION?

Yes, of course one has to be creative to come up with ideas. But then in science, ideas are a dime a dozen; what is hard is the work that is necessary to back up these ideas. Many times, the necessary experiments cannot be performed, or when they are performed, the answers do not support the idea.

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HOW DID YOU CHOOSE PEDIATRIC NEUROLOGY?

I started out in child psychiatry, and I had started my psychiatric residency at Johns Hopkins, when two things happened. A year or so before I had published a paper on maple syrup urine disease. One of the great pediatric neurologists, Dr. Frank Ford, who wrote a textbook that is still very useful in pediatric neurology, called me up to his office one day and said, “Tell me more about this maple syrup disease.” So I told him about it, and he said, “What are you doing now?” I said, “I am in psychiatry,” and he said, “You are wasting your time in psychiatry, you should go into neurology.”

In addition to that, I was drafted. This was during the Korean War and they needed physicians. I was doing some psychiatry while I was in the Air Force, and I was impatient with it. What always bothered me about psychiatry was its total unpredictability. For the average psychiatric patient there is no prognosis, and intervention moves so slowly that it is not for someone like myself, who basically is impatient. Therefore I was not happy with psychiatry, and I went into neurology.

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HOW DO YOU BALANCE WRITING AND MEDICAL AND ACADEMIC DUTIES?

I use the right and the left hemispheres of my brain. I try to set some time aside for writing. Often it is when I wake up in the middle of the night, at two or three in the morning. You just organize your time.

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DO YOU APPROACH FICTION DIFFERENTLY THAN SCHOLARLY WRITING?

No, the mental effort is really the same. With the scholarly writing, you are bound by the facts and the data, but the concentration necessary, the rewriting and making sure it is clear, is all the same.

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WHAT VALUE DOES WRITING NARRATIVE HAVE IN TREATING PATIENTS?

I think I write a better history, probably. I can write a clearer, more concise history.

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DO YOUR PATIENTS INFLUENCE YOUR WRITING?

I am not like Oliver Sacks; I have to set up a dividing line. Oliver Sacks can see a patient with a bizarre neurological syndrome and write a story about it. William Carlos Williams also did that. They have been able to use their patients as material for their fiction, but I have not been able to get inspiration from my interchanges with patients. I think I must use a different part of the brain when I go to the clinic than when I write.

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ARE YOUR NOVELS BASEDON FACT?

People say that every novel is fictionalized autobiography. My first novel dealt with the experiences I had with pertussis vaccine encephalopathy, the whole business with the drug companies and the lawyers being involved. While in Washington for a hearing, I was talking with the lady who runs the national vaccine advisory council, and told her about my experiences. She advised me to write them up, and I said, “How can I write this, I would get sued by everybody.” We started talking and I said, “You know, I could turn this into fiction and nobody would know.” So I did. The facts are all there, I just changed them around.

And, of course, After the Tempest is utterly autobiographical. The novel came about when I started to think about what would have happened to me if I had been the same person, but born a Christian. How would I have responded to Hitler and the war? One of the two main characters [the Nazi soldier] is just me, answering these questions and responding to the events of World War II.

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WHERE DO YOU GET YOUR IDEAS?

Something happens or I may read something in the paper. The novel I am working on now was inspired by seeing a production of the opera Turandot. The opera, as written by Puccini, does not have an ending, and several composers have set out to write the ending, based on Puccini's handwritten sketches. The ending I heard was new, very good, and written by one of the foremost Italian composers, Luciano Berio. I felt it was totally unsatisfactory. I thought, “Why didn't Puccini finish the opera?” The answer that is usually given is that he died from cancer of the larynx before he had time to do so. I said, “No, that is not really true.” My novel is about why Puccini did not finish the opera. I will have to do a tremendous amount of historical research, but it still is fiction.

I am, of course, totally shaped by the events of World War II and the Holocaust. I lost my home, my family, and my language as a result of these events. Naturally these losses changed my outlook on life.

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PLEASE DESCRIBE WHAT IT WAS LIKE TO LEAVE AUSTRIA AT THE BEGINNING OF THE HOLOCAUST.

This was just before the war started, and my family was trying to get out of Vienna desperately. Of course, everybody thought of going to America, but America didn't want us. We had to look elsewhere. Fortunately, as fate had it, my father was taking English lessons – because we were all learning English – from an Irish lady in Vienna. She had a boyfriend who was exiled from Ireland to Vienna; I think he was involved in the Irish Republican Army. He told my father that, for a suitable donation to his cause, he would arrange to get us to Ireland. My father of course had no hesitation and gave a large donation, and very promptly we were called by the Irish consul. He said, “We have a visa for you,” and off we went to Ireland. I was in Dublin for one or two years. They were always looking for Irishmen to come to America, and my family came to California. I was 11 years old.

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HAVE YOU EVER RETURNED TO AUSTRIA?

Yes. This is really the core of my book, After the Tempest, trying to restart my life there. I was envious and very angry at the same time of the people who had not had their lives disrupted, or lost their homes and language. But I have been back several times.

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DOES GOING BACK TO AUSTRIA RESOLVE THAT ANGER, AND HAVE YOU USED THAT IN YOUR BOOK?

No it does not, and I have used the mixed feelings that I experience whenever I return as one of the topics of my novel.

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WHAT IS MOST DIFFICULT ABOUT PUBLISHING A NOVEL?

It is not as hard to write a novel as it is to get it published and publicized. You are faced with a Catch 22: If you have not published a successful novel, no good agent will take you, and unless you have a good agent, you are not going to have a successful, well publicized novel. You have to somehow get through the back door to one of them or the other. That is the hardest part, I think. It is not creative; it is just a matter of pushing and pushing and pushing.

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HOW DID YOU BREAK THROUGH AND GET PUBLISHED?

A quiet persistence. I kept sending my manuscript out, and sending it out, and sending it out. One day, if you do it long enough, you luck out.

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IS WRITING A PLAY DIFFERENT THAN A NOVEL?

There is one basic difference between writing a novel and writing a play. Writing a novel is a very solitary experience, whereas writing a play and getting it produced is gregarious. The writer gets to meet people: actors, actresses, directors. Although at times the experience can be exasperating and aggravating, it often is quite a lot of fun.

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WHAT ADVICE WOULD YOU GIVE TO NEUROLOGISTS WHO WANT TO WRITE?

Organize your time, and don't wait for inspiration. Rather, make writing a daily habit, like reading the paper in the morning. Sit in front of a computer whenever the time is best. Block off an hour, if you can find it.

I will tell anyone who wants to write that there is no way you can wait for inspiration. That doesn't work. Chances are if you sit in front of the computer or in front of a sheet of paper and ponder about your writing, something will happen. That is how writing gets done. I know that I am not the only one who has said that; many successful writers have said the same thing. It is fine if you are one of those poets where you have a flash of insight come to you and you write down this tremendous poem, but for the average creative writer, you just have to sit there, and if you do so often enough with enough consistency, something will happen.

© 2003 American Academy of Neurology