08 December 2008
A Journey of Revisions
Maggie Leffler
Choosing a career is hard. Choosing two careers must be harder. But this essayist writes that choosing to be both a novelist and a physician was the only choice that seemed right.
Dr. Maggie Leffler is a physician, practicing family medicine in Pittsburgh, Pennsylvania. Her first novel, The Diagnosis of Love, was published in 2007. Her second novel, The Goodbye Cousins, will be released in June 2009.
I have a distinct memory of Career Day at my elementary school: the nine-year-old, pig-tailed me raising a hand and volunteering that I wanted to be a doctor and a writer. My dream was met with more disbelief than that of the boy who hoped to play baseball for the Baltimore Orioles [a professional team].
My mother and father were physicians, my grandmother was a novelist, and at an early age I’d been inspired to do both. Later on, after the death of my parents, I realized the two professions were linked by my own looming mortality. I wanted to save myself and my loved ones by acquiring medical knowledge, but I also wanted to write something that would live longer than I would. In time, I just hoped to reach people while I had the chance. This was the most powerful motivation calling me to medicine and is probably the most powerful motivation that compels me to write.
From the time I learned to read, I loved to put my own words on paper, forming my own small truths into a story. As an elementary school student, I started writing with what I called “The Big Five” short stories, modeled after a less-dysfunctional version of my family. In middle school, I moved on to Judy Blume-inspired novellas; in high school, I wrote a screenplay; and the year after I graduated from the University of Delaware, I finished my first unpublished novel. I cannot remember a time in my life when I wasn’t writing.
Medicine, on the other hand, was a conscious decision that presented me with two large obstacles: science and standardized tests. The former — including chemistry, physics, and organic chemistry — did not come easily to me. The latter — including Medical College Achievement Tests [MCATs] — actually induced panic attacks and palm-sweating so profuse that, in the days before computerized board exams, I found it hard to even hold a pencil. Despite this, I pressed on through the required “weed-out” courses, through 16 weeks of summer school hell, and through MCAT review classes. In the fall of my senior year of college, I applied to medical school.
Backpacking through Austria that spring, I used a youth hostel pay phone to call home, only to learn that I’d been rejected from the 27 medical schools where I had applied. Maybe I’d focused too much on American literature during college; maybe I hadn’t appeared scientific enough.
Somehow, my mother spun the grim facts into an opportunity: “Now is your chance to really dream. What would you do if you could do anything?” she asked over miles of telephone wire. “I want to write books that people will read and re-read,” I said. I was really thinking, “I would be a doctor.”
It was time to get my first “serious job”: at the University of Maryland doing bench work in a windowless lab that I secretly called “The Dungeon.” Under the direction of my principal investigator, I performed lab techniques — measuring the micrometers traveled by proteins separated by a gel, all the while feeling as if I were measuring the minutes of my own life. During the downtime, as we waited for reagents to boil or timers to go off, I was busy writing. Soon, the principal investigator gave up asking me about medical school and instead just asked about my novel, which I took as a sign of double failure. After all, I’d sent out even more query letters to literary agents than applications to medical school. None of the agents were interested in reading my manuscript, much less representing me. It seemed possible that I could spend my life writing words that no one would read and pursuing a profession that no one wanted me to enter.
Six months later, on a cold January day, I got on a plane for the island of Grenada to start at St. George’s University, an off-shore medical school that dared to let me in, and — equally astonishing — that I had dared to attend. Life in a developing world country was a time of discovery, the most important one: that I was smart, something I’d been doubting in the months since I received my undergraduate degree. At St. George’s, I got the idea for a new book, which I finished before graduation. During my family practice residency in Pittsburgh, I rewrote the novel — and then rewrote it again once I got out in private practice. The year that my son was born, The Diagnosis of Love, was picked up for publication.
These years in the hospital have taught me that writing and medicine are not so very different. Every day, patients privilege me with rambling stories, which I sift through for the important points, constrained by my job to sacrifice the details I love for the ones that really matter to the story of their condition. I’m honored to be the necessary ghost editor for their histories.
It has been a journey of revisions — both in my own stories and in my personal expectations: I never planned on leaving the country to become a doctor, but it did give me something to write about. And in the medical profession, as in writing, revisions of thought and ideas never end. Each day, choices are made: What outdated concepts can I let go of; what can I keep? Medicine is about refinement of an elusive ideal; in writing, there is always another draft.
I have become what I wanted to be when I grew up, but I am still becoming.
