Doctors are Not Immune From Illness

This article originally appeared on Doximity.com, where I was a 2022-2023 Op-Med Fellow.

This is a difficult story for me to tell. It is about facing our humanity and our mortality as physicians. And it’s about the truth that despite our desire to view ourselves as insiders with the keys to the hospital doors, the pact that we have made is one-sided.

There is no covenant with the universe, no deal with the devil that if you save others, you yourself will be saved. I saw my physician father fall victim to this implicit belief after he became ill. I witnessed with sorrow his misplaced trust that he would be treated differently, and his difficulty in disengaging from his identity as a physician.

I’ll start by telling you about my father before his illness. He was a brilliant physician and researcher, an immigrant and outsider who worked his way up to the highest position in his specialty. He taught and inspired generations of medical students, residents, and fellows from around the globe. He was described to me years later by one of his former fellows as “a god.” He saved, mended, and assisted in the conception of countless lives through his innovative therapy and research.

My father was a humble man in many ways. But he refused to submit to becoming a patient, and that’s what was ultimately his undoing.

My father’s family history was riddled with heart disease and early death. His mother died of a heart attack at the age of 45. Most of his siblings died young. But he was a vigorous and proud man, and even when he suffered an unexpected and frightening episode of hypertensive heart failure after returning home from a conference, he refused to see a cardiologist.

I will never know what kept him from seeking help, but I believe that he was afraid of what he might learn. That all the years of work and sacrifice might eventually catch up with him. That he needed someone or something else to become physically whole again. That his health, and thus his independence, might be irretrievably changed. That he, like those he cared for and those he loved, was mortal and vulnerable. Truth be told, he refused to even go to the ER for evaluation. Instead, he sent my mother, a physician herself, out to the pharmacy for a dose of furosemide in the middle of the night. It was she who made the diagnosis, with her stethoscope and blood pressure cuff.

To us, his children, this somehow did not appear inappropriate or unusual. Our parents were true medical do-it-yourselfers. They always seemed to have everything under control, so why should this be any different?

Yet I recognized that something was off. At the time I was a medical student out of state, and during my calls home my dad regularly assured me that his blood pressure was a perfect 120/70 on a low dose of medication. I thought he was misleading me, but there was nothing I could do about it but believe him.

It should have come as no surprise that my father suffered a terrible hypertensive stroke several years later. It was severely disabling, and despite appropriate care, there was no hope of recovery. I will never forget finding him in the radiology department of the hospital, a local facility where no one knew him. Slumped in his wheelchair in a faded hospital gown, he was shivering, weeping, and demoralized.

This was the unraveling of the deal that he believed he had made. No longer the professor, the department chief, the innovator, he was simply the stroke in Room 402. He had gone from a man of the world to a random patient, unacknowledged and unremarkable.

Plaintive pleas for water, request for assistance to the bathroom, and upkeep of simple hygiene were addressed by staff with disinterest, although he received timely care. Instead of being acknowledged as a respected and dignified physician, he felt like an outsider, just another task for the busy staff who had no time or reason to think any more of him.

After my father returned home, there was a brief period of hope and even optimism that things might improve, despite the devastation recorded on his imaging studies. But what little recovery he made was unimpressive and ultimately gave him no freedom or chance of independence.

He had been beloved by his patients and revered by his coworkers, but after the first brief flurry of visitors, the world moved on and he was mostly forgotten. He desperately wanted to return to work, to reclaim his identity, to be of service. He was unable to drive himself, so after much anguished pleading, my mother agreed to take him for a visit to his hospital and research lab. He found himself disoriented, lost, and humiliated, subjected to the well-meaning pity of his former staff.

It was clear to everyone that his days as a physician were over. Only a sole colleague regularly came by to see him for the next seven years of progressive decline that preceded his death.

From my father’s devastating story, I learned several hard but ultimately sustaining truths. These lessons have informed my life and my practice of medicine. I believe they have not only made me a better physician but have allowed me greater freedom to explore and discover the world outside of our profession.

Although I’d like to believe otherwise, the crucial lesson I learned was that being a physician does not provide us with a teflon shield. As physicians, we spend tens of thousands of hours learning our profession, honing our skills, giving up much of our 20s and 30s in service to our calling. Most of the time, we offer this sacrifice willingly, knowing that by doing so we will be worthy of our patients’ and colleagues’ trust. Even after training, the climb never ends. We may lose untold hours of sleep, delay time with family, forgo relationships and other passions. We take on the weight of our patients’ illness, fear, even their anger at the whims of fate.

Surely the scales must somehow balance out for us in the end, a karmic destiny in this life. That is the deal that I believe my father made.

The truth is that physicians are human, no matter how invincible we may feel. My father’s sad journey taught me that. But if we need any further proof, COVID-19 has shown us that nobody is beyond the reach of sickness and death. I believe that it’s important to live life with that understanding.

To that end, I have made it my mission as a cardiologist to focus on preventive care. Paying attention to our own personal preventive health care is a simple matter of routine checkups and necessary procedures, along with a healthy diet and regular exercise. Addressing the sources of stress and dysfunction in our lives is equally important.

The time to act is now. Even with the best preventive practices, there are no guarantees, but these straightforward measures have the power to extend and improve the quality of the life we have. Waiting until retirement to take preventive care seriously may mean waiting too late. Through my father’s suffering, I was able to appreciate the importance of taking the earliest risk factors seriously. My patients valued my drive and care, even when they didn’t share my concern.

My father’s story also taught me that eventually, most of us will leave the fraternity of medical practice, whether we do so willingly or not. We must take the reins and be the driver of our own lives; otherwise we will one day find ourselves separated and bewildered, without a North Star to follow.

This guiding principle has led me to pursue interests and passions outside of the medical world that have enriched and opened up my life; among other things, I teach yoga and compete as an equestrian athlete. I believe the perspective I gained from my father’s experience also made me a better doctor. For this I am eternally grateful.

I retired from my cardiology practice in 2022 after nearly 35 years in the medical profession. I hope that when I need them, my former colleagues will be there to keep me well and care for me. But nothing is promised. And there is no time to waste.

---

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

As a physician coach, I will work with you to explore what’s possible and create a plan that aligns with your personal values and aspirations. Schedule your exploratory conversation with me by clicking the button below.

How to Get Started as a Medical Writer

An earlier version of this article originally appeared on Doximity.com, where I was an Op-Med Fellow from 2022-2023.

Side gigs are a hot topic for physicians. Some people do it for the extra cash, others want to stretch and learn something new. Some doctors are looking to pivot from clinical medicine entirely and may use a side gig like writing to test the waters.

As a medical writer since 2009 and an author of four books aimed at a lay audience, I have learned a lot about the process, including how to make connections and what it takes to get published in the popular press. But before going any further, let me be clear: Unless you are a celebrity with a powerful platform, you probably aren’t going to get rich off of medical writing. Not even a little.

That’s not meant to discourage you. Writing is a fantastic way to clarify your position, share information, and get in front of a larger audience than you might otherwise find. It’s also a terrific way to deepen your own knowledge base.

Writing can open doors to other opportunities that you may never have considered. And it will introduce you to a world of people, including publishers and other writers, that can expand and challenge your point of view.

In this article, I’ll share my own journey as a medical writer, including my pitfalls and successes. I also offer suggestions that may make your own process easier and more rewarding.

One caveat: When I talk about medical writing here, I am referring to my experience of writing health-focused books and articles for the general public. There are other forms of medical writing, including working within the pharmaceutical industry, working on continuing education, and creating regulatory documents for governmental organizations, that follow a very different set of rules and standards. In some cases, these companies may offer full-time employment.

Like many physicians, I have written for medical journals and presented at innumerable conferences and grand rounds. As a woman in cardiology since the early 1990s, I was enough of an oddity that I was often tapped to give talks and presentations to both professional and lay groups on women and heart disease.

Being comfortable with putting words on paper, and learning to present information in a cohesive, conversational way was an important foundation for my first book, The Smart Woman’s Guide to Heart Health, published in 2009. I’ll be honest. This was not a quick or easy process. It took me several years, carving out 30 minutes here and there to work on my project, but the knowledge I accumulated made me a better physician and communicator.

My book began as a way to address my patients’ questions about diet, supplements, exercise, stress, and other issues that impact cardiovascular health. I realized that fellowship prepared me very well to take care of critically ill patients, and to competently manage preventive care, but I had a very shallow understanding of the impact of diet and lifestyle, and I knew virtually nothing about supplements. These were the questions that my patients kept bringing to me, and I wasn’t comfortable simply addressing their concerns superficially. At the time, the Adkins diet (a precursor to the Paleo and Keto diets) was resurging, so writing critically was a great way to delve into the medical research.

Like most physicians, I depend strongly on evidence-based care. Writing the book was a fantastic way to educate myself, and to become an expert in an area that was crucial not only to cardiovascular health, but to health and well-being in general.

However, it was not a money-making enterprise. The book was published by an independent publisher that required that I pay up front for the services, which included an editor. The publisher also offered marketing services, which I naively bought into. Though I was happy with the book and reviews, and my patients and practice loved it, I never made back the money that I put into it.

Two years later, I decided to take a shot at getting a contract with a traditional publishing house. This time, I received an advance, and the book, Best Practices for a Healthy Heart: How to Stop Heart Disease Before or After it Starts, was published in 2011. That was also the time that my practice was acquired by a large healthcare organization.

I learned belatedly that due to the strict bylaws of the organization, I could not effectively publicize or promote my work. That was important because most publishers rely on (and may even contractually require) their authors to market their books through multiple platforms.

Nevertheless, having now created a body of work as a medical writer, in 2014 I was asked to co-author The DASH Diet for Dummies with two well-known dietitians who were happy to do promotional work. That book is now in its second edition and sells dozens of copies per week.

Had I never sat down and started writing, my financial bottom line would probably not be much different, but writing has given me so many other interesting opportunities.

Writing made me a better educator for patients and trainees, teaching me to communicate more concisely and clearly. It brought many people into my practice, which benefited me, my partners, and my organization.

I’ve written and presented for a number of organizations and websites, receiving modest but still meaningful compensation for my work. I am recognized as an expert in my field. And writing has given me a platform and a way to connect with people from all over the world.

So, how can you get started as a medical writer?

I recommend starting small, testing the waters, to discover if writing is something that feels right to you. From there, you can always move up. Here are some practical ideas to spark your imagination:

Create a brief series of handouts for your patients.

For example, perhaps you’re frustrated with the lack of educational resources that you can offer your patients. You have an idea of creating a handout, but you don’t know where to start or how to get it done. Maybe you think someone else would do a better job, and you don’t want to look amateurish, so you just let it slide. Meanwhile, you’re spending extra time trying to get your ideas across to patients in the limited minutes you have in the office schedule.

It’s easy to feel a bit overwhelmed when tackling a writing project for the first time. Keep in mind that it doesn’t have to be complicated or detailed. A few salient bullet points may be all you need. Start by setting aside a little time to make a simple outline and work from there. You’ll provide something of real value to your patients, and you’ll ultimately create more time to focus on patient care.

Start a blog.

You don’t have to write a book to get your ideas out there. Simply choose a topic you’re interested in, tell a brief story around it, and provide information that you know your patients, family, or friends want to know. Write as if you’re having a conversation, and then stop after a few hundred words.

There are all sorts of options for free or low-cost websites on the internet. It’s great to be consistent, but don’t beat yourself up if you can’t do this regularly. Once a month is a good way to start.

Reach out to a wider audience.

Once you’ve written a few pieces and have your bearings, consider reaching out to your local newspaper to share one of your posts or offer your services. You can also offer your expertise to services like Connectively, where journalists are often looking for quotes.

Consider writing brief pieces to post on LinkedIn under your own account. This can be especially useful if you are able to discuss new research or health conditions that appeal to a broad audience.

Consumer health magazines or online resources may also be interested in your work. Check their websites for submission details. I found my current writing gig with GoodRx.com on a physician job board, and have been writing for them consistently since 2021. I love working with the editors and improving my work. And it’s great to be able to share my knowledge and insight with a wide public audience.

Consider an e-book.

Self-publishing is a much bigger industry than it was just a few years ago. The downside is that you will need to pay for an editor to review and help you refine your work. Or you can enlist a colleague or trusted friend to proof-read and make suggestions.

Find a publisher.

Writing a book is not for the faint of heart. The hours you put into it may never be compensated. But there is nothing like the feeling of your own book in your hands. If you are really intent on working with a traditional publisher, you will need a literary agent. Resources such as Publisher’s Marketplace and Writer’s Digest can help you drill down your options.

Conclusion

You probably won’t get rich as a medical writer, and you may not even make minimum wage when all is said and done. But you will enrich your experience as a physician, become a better communicator, and create opportunities you may not have even considered. Writing can be a path to lifelong learning, and patients and other physicians will appreciate your expertise. Not to mention, you’ll meet a wide range of people whose paths you may not ever have crossed otherwise.

DISCLAIMER: As an Amazon Associate I may earn from qualifying purchases, which means that if you click on one of the product links, I’ll receive a small commission. This helps support the website, for which I am grateful! Please do your own research before making any important decisions.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you. And if you’re interested in learning more about my coaching program, you can schedule an introductory meeting by clicking the link below.