What I Have Learned As a Writer



I’ve been writing for a long time.

I wrote little ditties on cards to my mother when I was a kid. I wrote papers in school. I wrote essays for contests in high school, and I won a few of them. I wrote an essay for a Fathers Day radio station contest one year and won some cool stuff for my grandfather, including a black recliner that became his smoking and relaxing chair for the next several years. I wrote those crazy idealistic personal statements about how I was going to change the world if I was accepted into medical school. (I guess that one was pretty good too, now that I think about it. I got in, after all.) I’ve written love letters. I’ve written complaints. I’ve written letters that I never sent. I’ve written resignation letters. I’ve written letters telling people goodbye. I’ve written letters to my daughters, trying to impart some tiny piece of knowledge that I felt they needed before they left the nest. I’ve written short stories. I’ve written three unpublished novels. I’ve written hundreds of blog posts. 

I’ve been writing a long time, and I’ve written a lot of stuff. Some of it very, very good. Some of it very, very bad. 

Through it all, I hope I’ve learned some things, some lessons, that I want to share with you. This is not an all-inclusive list by any means. Some things I’ve learned have been very painful and I would not share them here. Some  have been deeply personal and only my very best friends would know about them. That’s okay. The ones I share, I share freely. You may agree or disagree with any of these. That’s your right and your choice. Your writing style, content, thrust and genre may be very different from mine. That, dear reader, is what makes the world go ’round. 


Don’t write deeply personal things about family, even if you are sure that the feelings are your own and yours to share. You will be misunderstood. Your meaning, so clear to you in the creation, will be muddy in the deconstruction by your readers, some of whom will of course be the very family you have written about. I have learned this lesson the hard way. The rifts that come from this kind of writing are hard, sometimes impossible, to repair. 


A corollary to the above? Don’t believe it when your family or close friends tell you that they don’t really care about what you write and that they never read it anyway. They do care and they do read it. Don’t delude yourself on that point. 


The blog posts and essays that you put the most time, effort, blood, sweat, and tears into will get the least amount of attention. 
The posts that you dash off and publish as rickety first drafts, fueled by emotion and angst and passion, will often be your most popular ever. Go figure. 
Most people don’t give a rat’s ass about your likes, opinions or feelings about anything. If you can just acknowledge that as truth, you will be freed up to do some really good writing. Get over yourself and get to writing. 
Write for yourself, nobody else. Write what you would like to read. Somebody else like you will find it and read it too. 
Don’t write to be noticed, published, awarded, praised or famous. Write first because you have something to say. If any of the rest of those things follow, consider yourself lucky and enjoy them. 
Write every single day if you can. Sometimes, need for sleep, work schedules, travel or other obligations get in the way, but make those the exception to your rule. The more you write, the better you get. 
Write at the same time every day. Muses like schedules, and they get pissed if you stand them up. They also hold grudges. 
Arrange your writing environment to help you write. Make it hot enough, cool enough, light enough, shady enough, cluttered enough, sparse enough, colorful or black and white enough to let the ideas flow from your head into your fingers and onto the page or the screen. 
Use excellent tools. I love my big iMac on my simple wooden desk with my harman/kardon speakers and a hot cup of really expensive, really good coffee on the soapstone coaster at my right hand. Are you getting it?
Listen to feedback from people you trust. If they’re professionals, that’s even better.  They will always know more than you do.  That’s the way the world works. Don’t be angry that you can’t know and do everything. Leverage your relationships with the people who will make you smarter, better and stronger. 
Lastly, once you’ve satisfied yourself that you’ve thought about these things long enough for today, write. Then write some more, then write some more. 
Wishing you flashes of insight, moments of clarity, brilliant ideas, and years of creativity to come. 
Photo: One of my trips to the mountaintop trying to figure it all out. Blue Ridge Parkway, North Carolina, USA. 




I love to write.

I have written in journals, in diaries, in Field Notes paper notebooks, in Moleskines, in sumptuous orange French Rhodia notebooks and on sketchpads. I have written two line diary entries and I have written three novels. I have written formal reports, essays and clinic notes. I am writing this blog post. I have done mind-mapping for a project on the large whiteboard in my home office, and I have written lecture outlines on old fashioned blackboards. 

The way I write changes constantly, though the content and themes of my writing, when you get right down to it, don’t vary that much. The fact that I look for the best text editor for me or the paper notebook that fits the hand just so or lies completely flat on the table or the pen that has just the right heft and balance are all parts of the writing process for me that are in constant flux. I may love the flow of a gel ink pen for a few months and then go back to the rough scratchiness of a needle-pointed Hi Tec C that, if not careful, cuts actual grooves in the paper under it. One month, a white-capped Mont Blanc may do it for me, and the next month a green Uniball Signo fits the bill. One year, I may take all my patient notes in a Rhodia web notebook, but come January first the Year of the Clipboard is ushered back in. A Mirado Black Warrior soft lead may find its way out of the cup on my desk and into my hand during those times that I want the maximum connecton between my brain and my hand and the paper under it. 

Why all this muss and fussiness? Why the constant change of paper and pen and pencil and room and board? Why not just pick out a box of clear plastic Bic pens at Staples, grab a yellow legal pad (I have been known to do just that on the front porch at the beach, many years ago) and be done with it?

For me, it’s about the process. It’s about the feel and the flow of the thoughts and the ideas that sometimes come so rapidly that I can’t keep up with them. It’s about having the least amount of friction between brain and publish. It’s about the pursuit of perfection on the page while at the same time arguing with oneself about whether that concept is even valid. 

It’s the fact that even though I try different media and inks and papers and keyboards and fonts and styles, the ideas almost write themselves. 

I show up every morning at the same time, in the same place. I set my coffee cup down after that first satisfying, life-giving, brain-jolting swig. I wait. My muse is always there. Sometimes she is loud and boisterous and excited and won’t stop talking until my fingers start flying, and not even then. Sometimes, she whispers so sweetly to me, so softly and earnestly and so physically close to my ear that I can feel the kiss of her warm breath on my skin. She rarely takes no for an answer. Oh, I’ve tried to ignore her. She is having none of that. She does not care if the hand is on the keyboard or the Mirado or the silver Tornado. 

She will allow me my fun, my change-up. 

Then, she will demand that I get down to business.

What will we do together? What ideas will float to the top?

Out of mental health, and sometimes out of madness, comes creativity. 

What will you create today?

Is This Mike On?

Good morning, my faithful readers. Except of course for you overachievers in Australia, who always insist on reading me tomorrow, almost. Have another glass of wine for me, would you? I’ll catch up with you after the long Monday shift is over.

This week, Dr. Mike Sevilla decided to hang up his podcasting mic, his blogging tools, his Twitter creds, and his Facebook presence, all in one fell swoop. Find out more about Mike the man, and why he decided to take this drastic action, at his website.

Now, I have known Mike for some time on Twitter primarily, where we will sometimes comment back and forth about issues of the day or one of his podcasts or one of my blog posts. We’ve never been close, personally close, as I have come to be with other friends in social media. That said, there has always been that connection, usually unspoken, with another doctor who wants to make a difference by what he thinks, says and does online and over the air waves.

Mike started out in this social media space as many doctors have, anonymously. He began to use his real name just a short time back. Now, I can’t speak for Mike and exactly why he decided to bow out and regroup. He has already said a little about this, and he will say more if and when he decides the time is right to do that. I can, however, speak for myself. Oh, yeah. You know I can.

If you’re not in this game, not ever or not yet, you need to understand some things.

If you’re a writer, you have to write. It’s a compulsion. For me, it’s the first thing I want to check off my ToDo app list for the day after making coffee. I write to think out loud. I write to teach. I write to share feelings. I write to celebrate. I write to mourn loss. I write to dream. I write to chastise. I write to lose myself and escape the grinding, wrenching, painful day-to-day stuff of life. I write to exercise a part of my brain that gets little use in my real job. I write because I have been a writer since I was a little kid, since I won that first essay contest medal in school or that first D.A.R. speech competition and realized that if I wrote it, if I said it, somebody would pay attention to it. I write because I’m a a writer.

If you’re a doctor, a good doctor, you want to share. You want to teach. You want to put out there what you know, thinking that you can reach just one more person and bring insight to just one more soul who needs it. It’s about ego, of course it is, because you wouldn’t or couldn’t do it without a healthy one, but that’s not all.

It’s about being needed, being relevant. It’s about knowing that what you do makes a difference in this world. You can share by talking to one patient at a time. That’s perfectly fine. You can write columns for your local paper. You can give speeches about a new surgical procedure at the Lions Club. That’s fine. You can do a podcast like Mike did and reach many more people on a regular schedule.

The point is, you want to be heard, and you find the best way, the way that fits, for you. Facebook and Twitter and other social media platforms have made it easier than ever to instantly share things, says things and advertise things that we think, process and create. Blogging platforms like Blogger and WordPress have made it possible for anyone to publish anything. Much of it is good. Some of it is bad. Some of it is terrible. Goes with the territory.

So, this is all touchy-feely and kittens and unicorn tears and sparkles, right?


If you put yourself out there, if you speak and blog and write and tweet and post and podcast and comment, other things will happen. Trust me on this. I have several well-worn T-shirts.

You will be misunderstood. The thing that you created that you thought was magical and insightful and full of deep hidden meaning for all of mankind? Well, I hate to tell you this, Skippy, but people don’t read your stuff in a vacuum. They BTOB (bring their own baggage) and it colors not only everything that they do but everything that you do. They will take what you hammered out and interpret it with tea leaves, hammer it out on their own anvils, and make it their own. It will be a shadow of itself by the end of the day, after a few hundred hits and a few dozen comments. If you can’t stand the heat…

You will be praised. This is intoxicating and makes you keep coming back for more. Oh, come on, go with me here. Do you think I would keep writing solely for myself if I thought none of you ever read me? If I thought nobody out there cared what I said? I might as well just do a diary entry every morning and be done with it. I need you. I want to hear from you. I cherish your comments, both on the blog and on Twitter and on Facebook, and dare I say this, in real life by the use of something called the phone! I learn a tremendous amount from you, my readers and friends. You may not want to believe that. You may not want to believe that social media and what goes on in this space is real. It is. It’s true.

You will be vilified. If you’re at the top of your game, if you put yourself out there as somebody who knows something about something, somebody else is going to shoot you down, or at least try to. It’s human nature. We’re a jealous bunch. We’re vindictive. We’re snarky. We love to see people succeed, but we love seeing them trip up and stumble even more. If you join the game, be prepared to be shot at. It’s happened to me. It’ll happen to you. It’s not fun. Sometimes it’s downright painful.

I sincerely hope that Mike will decide to come back to the social space, even if it’s in a radical new way. I hope he works through whatever it was that caused him to take this time out. I hope most of all that this does not deter other doctors from joining the conversation.

As you can tell if you’ve read any of my stuff over the last seven years, I am passionate about what I do. The system I work in, health care and the mental health part of it, is badly broken. I flail around in it every day doing he best I can to take care of my patients. I also think about it and write about it and I want to make a difference in how this care is being provided. I want to call attention to some things that I think are not right. I want these things to change. I want to play a part in changing them.

I’m a doctor because I care about people.

I write because I’m a writer.

I’m willing to put myself out there on both counts and deal with whatever comes my way.