Pauline W. Chen: A Surgeon's Reflections

The more things change

I went home this weekend, back to the town where I grew up. There have been lots of changes in the last 30 years. The town post office has become a CVS drugstore. My mother’s favorite hair salon has been transformed into a Knights of Columbus hall. And there is now a fancy exit ramp off the main highway just outside the center of town; it cuts through the hills and curves right into the road to my father’s old office.

But in many ways, the town hasn’t changed much. Tobacco fields still sprawl across the landscape. The pizzeria that belonged to the family of a middle school classmate remains open for business. And the town theatre where I had my first date still shows movies, though I’m guessing the price of admission is no longer 99 cents.

I went home this past Saturday to speak to some current students at my high school and to give a reading at the town library. I thought it would be fun to do a hometown reading, but when I stood up in front of the nearly 200 people who had come to hear me speak, I began to get choked up. “I have a hard enough time keeping it together when I read from the book,” I told them. “But now you all have me tearing up even before I have begun.”

Reading aloud from the book, even in front of crowds, is hard for me. When I was proofreading the manuscript, I sometimes had to stop and put the book aside for a few minutes before I could continue. Nearly every time I read aloud, the narratives of my past come alive once again in my mind.

I was worried about this before I started touring, anxious that these “lapses” might prove embarrassing and unprofessional or that they might just make people in the audience uncomfortable. After all, it is one thing to feel the past deeply in the privacy of your office. It’s another thing to do it in front of people who have made the effort to come hear you speak.

So far, I have been able to make it through most public readings, but there have been a few times when my voice has begun to crack. It happened in Philadelphia and it nearly did so once more at my hometown reading.

But what has amazed me is that people are okay with it. And I have this feeling when looking out to the group assembled that these people are comforting me. Their faces are filled with sympathy – empathy – and those expressions of compassion help me find my voice once more.

The hometown audience this past Saturday was no different. Except that when I looked out, I saw the faces of my high school and middle school teachers, my friends from as far back as grade school, and old family friends. And the looks on their faces on Saturday – of sympathy and of pride – helped me to collect myself and begin.

So when I left my hometown that night, I thought about these people who had been such a part of my youth. I thought of my teachers, my school buddies, and my family’s friends. I thought about how their early belief in me gave me the support and strength to find out who I was and what I could do. 

Things have not really changed much from 30 years ago.

Anxiety

When The Virginia Quarterly Review and the New York Times Sunday Magazine published excerpts of my book in December, I was thrilled. I am a huge fan of both magazines, so I knew it would be exciting to see my work on their pages.

What I did not expect was to feel naked. I had not really thought about it before, but events in my life – moments that up until then I had hardly shared with a soul – were suddenly out there in print.

As a doctor, I have always tried to be open with my patients. As a writer, I have tried to be the same way. I want to be as honest as possible because I believe that is how writers should relate to their readers, just as I believe doctors should do the same with their patients.

The difference is that a writer is alone much of the time. And because of that solitude, I sometimes forgot that people I did not know would one day know parts of my life more intimately than my closest friends.

So, in December, when excerpts of my book were suddenly out there, I got kind of anxious. I had put my heart into Final Exam and there it was. On those pages. For all to read.

But I have lost that anxiety recently. This past week, people I have met through this blog and on the radio have been as open with their stories as I have been with any of my writing. They have shared their own experiences, some of them painfully difficult. And their willingness to do so has left me speechless.

Tomorrow I begin my discussion/reading events. I speak at Hevesi Jewish Heritage Library in Queens, NY at 1:00 p.m. and at Borders at 576 2nd Avenue in Manhattan at 7:00 p.m.

I go to Washington D.C. on Wednesday (1/17) and will speak at Politics & Prose at 7:00 p.m. Philadelphia follows on Thursday (1/18) with a reading at UPenn Bookstore at 7 p.m.

I am no longer anxious about having put my heart out there for all to read. The people I have met recently have changed that.

Instead, now I hope I will have the opportunity to thank you in person for inspiring me.

He got it!

I am lucky to have great publicist. Over the last few months, she’s become a friend, one who manages not only to do an amazing job but also to give me good recipes (most recently, her mother’s Chocolate S’more Pie). And good news.

A few days ago, she told me that there was a rumor in her office that The New York Times was going to publish a review of Final Exam, perhaps even on January 10, the day after the book’s official publication date.

“WOW,” was my response.

To which she said, “We’re not sure, but they come online the night before, so you can check the website compulsively.”

Check the website compulsively? I thought. Is this what writers do?

I have to admit here that I am an inveterate book review reader. Maybe addicted is a better adjective. Some people are obsessed about the sports pages of a newspaper; I go for the book review pages and hoard them, a habit that has resulted in piles of papers on top of and around my desk.

Book reviews and I have a long history. They were one of my greatest sources of comfort during surgical training. One of my favorite things to do as an intern on the few days I had off was to take the book review section of the paper and a cup of tea, then spend a couple of hours reading about all the books I had no time to read. The best reviews taught me something – history, ideas, or whatever the topic of the new book of that week was – and I loved feeling as if I had been there with the book’s author, as if I had been transported to the author’s, and the book’s, world for a few minutes. For an exhausted intern, it was the very best tonic.

So yesterday night, I found myself drawn to the computer. At 6:55, I told my husband I was going to check online. “Don’t check now,” he said. “It’s not even time yet. Let’s start eating dinner.”

He was right. There was no review.

At 7:05, I left the dinner table to check again, but there was no review

At 7:30, after most of dinner was done, I went back. And it was there. It was online. Final Exam’s review.

I’ve never done this reading a review before and I certainly never expected to have this kind of reaction. But by the time I got to the end of the piece, I was in tears. Of course, a lot of it was because the reviewer liked my book and because he wrote so well. But some of it was because he understood exactly what I was trying to say. He transported me back for a few minutes to my book’s world.

So I had to cry. Because he got it.

And so did my publicist. She sent me an email at 7:19 pm. “Congratulations,” she wrote, “you have just received a rave review from The New York Times.”

It's all about the stories

A few months ago, soon after I finished the last draft of Final Exam: A Surgeon's Reflections on Mortality, my literary agent suggested I start a blog. “It would be a great way for people to keep up with you while you’re on book tour,” she said.

She must have sensed my apprehension because she then quickly added, “I'll bet you are going to hear a lot of great stories.”

Her uncanny intuition and general brilliance aside, my literary agent knows me well. I’ve always loved stories – non-fiction, fiction, long, and short – but it’s the ones involving real people that really draw me in. That’s why I studied anthropology in college, and that’s one of the reasons I like doctoring so much. Everything in medicine is a story, from the patient’s description of an illness to the daily progress notes doctors scribble in patient charts. Even operations have their own narrative arc, beginning with the scalpel against skin and ending with the skin staples or stitches.

So here I am. I’m starting a blog.

Over the course of the book tour and perhaps beyond, I hope to tell you stories - my own and, with their permission, those of people I meet along the way. I’ve also included a comments function with the hope that you will leave your thoughts. Perhaps some of you may even share a story or two.

I'd love that. Because for me, as my literary agent will tell you, it's all about the stories.