I'm a great believer in geography being destiny.
My desire to be a physician had a lot to do with that sense of medicine as a ministry of healing, not just a science. And not even just a science and an art, but also a calling, also a ministry.
Rituals, anthropologists will tell us, are about transformation. The rituals we use for marriage, baptism or inaugurating a president are as elaborate as they are because we associate the ritual with a major life passage, the crossing of a critical threshold, or in other words, with transformation.
I've never bought this idea of taking a therapeutic distance. If I see a student or house staff cry, I take great faith in that. That's a great person; they're going to be a great doctor.
I think we learn from medicine everywhere that it is, at its heart, a human endeavor, requiring good science but also a limitless curiosity and interest in your fellow human being, and that the physician-patient relationship is key; all else follows from it.
Literature is a beautiful way of keeping the imagination alive, of visiting worlds you would never have time to in your day-to-day life. It keeps you abreast of a wider spectrum of human activities.
Patients know in a heartbeat if they're getting a clumsy exam.
I still find the best way to understand a hospitalized patient whose care I am taking over is not by staring at the computer screen but by going to see the patient; it's only at the bedside that I can figure out what is important.
The flip side of suicide is that it leaves a lingering question in the minds of the people who survived. It's like a cancer that's metastasized. The suicide is the cancer and the metastasis is all these people saying, Why? Why? Why?
You can't show up at the bedside and then turn on your skills. You have to keep your game sharp all the time.
I was taking care of people my age who were dying. The constant feeling, hearing from them, was that life is transient and can end very quickly, so don't postpone your dreams.
Medicine, you see, is my first love; whether I write fiction or nonfiction, and even when it has nothing to do with medicine, it's still about medicine. After all, what is medicine but life plus? So I write about life.
What we need in medical schools is not to teach empathy, as much as to preserve it - the process of learning huge volumes of information about disease, of learning a specialized language, can ironically make one lose sight of the patient one came to serve; empathy can be replaced by cynicism.
When I use the word 'healing,' by that I mean that every disease has a physical element that we're very good at handling, but there's always a sense of the violation. 'Why me?' 'Why is my leg broken on the ski trip and not anyone else's?' And I think that medicine has done a terrible job of addressing that spiritual violation.
Though I am fascinated by knowledge, I am even more fascinated by wisdom.
There is that lovely feeling of one reader telling another, 'You must read this.' I've always wanted to write a book like that, with the sense that you are contributing to the discourse in middle America, a discourse that begins at a book club in a living room, but then spreads. That is meaningful to me.
My sense is that the wonderful technology that we have to visualize the inside of the body often leaves physicians feeling that the exam is a waste of time and so they may shortchange the ritual.
Certainly when I got to medical school, I had role models of the kind of physicians I wanted to be. I had an uncle who, looking back, was probably not the most-educated physician around, but he carried it off so well.
There's something universal about illness... Whether you like it, at some level all patients are saying, 'Daddy, Mommy, help me, tell me it's going to be alright.'
When you have a natural genetic tan developed over centuries and many generations, the idea of soaking up rays by the pool has never made sense.
