Seven Doctors Project: Physicians Take on Creative Writing

Maggie Maize

Disclosures

September 28, 2021

It's springtime in 2008 in Omaha, Nebraska. Author and professor Steve Langan has spent years in public health administration and injection safety, watching doctors give their all to help people. He's seen the need for imagination in their lives, the need for self-expression. And he keeps coming back to the question, "Who is there to help the physician in need?"

This winding path eventually leads Langan back to his creative writing roots and his realization that "the physician cohort is an underserved one." So he decides to plant new seeds around the University of Nebraska Medical Center, seeds for a workshop and community place for mid-career physicians willing to claim job burnout or dissatisfaction. It's a taboo topic, yet seven doctors walk through the classroom door anyway, marking the beginning of the Seven Doctors Project.

The project is as rigorous as a graduate-level creative writing course, beginning with skill-building — form, character, plot, figurative language. Participants bring plenty of life experiences: encountering people on their worst day, living by the words "do no harm," being tethered to pagers, going home to families that have no clue what type of day they've had. But they have to start channeling it into a poem, a piece of fiction, and creative nonfiction, all within the first 3 weeks of the 9-week session.

Since the workshop's inception, Langan has captained 17 sessions, which translates to over 200 participants. Some of the doctors have had to bide their time until their busy schedules allowed for a weekly meeting, time to write, and the optional casual coffee shop meet-ups. Things get weird, deep, and vulnerable as members learn to nourish and care for their writing.

Figure 1. Healthcare workers during a workshop in 2015.

Using Prose to Recapture the Past

Surgical oncologist William Lydiatt, MD, joined the Seven Doctors Project because he heard good things from a colleague who participated and wanted a new way to communicate. He learned that creative writing, particularly prose, helps him capture and relive moments. "I tend to forget the past," Lydiatt says. "So for me, it's a lot of fun to go back and read something I've written. It brings me immediately back into the same sense of whatever it is — the mood, the thought." And he sees it as something to pass on to his children like a fable, a family history.

Lydiatt compares his own writing approach to surgery. "In surgery, you're making lots of decisions with respect to where to make a cut, or what thing to clamp, or where to move in the operation," Lydiatt says. "I spend most of the operation avoiding drama. I try to keep things as low-key, as calm, as risk-averse as possible." In the workshop, the mentors and other members encouraged him to write clearly and honestly, without "couching things in analytical prose as opposed to expressive prose."

Langan helps teach physicians to step into associative and impulsive thinking through an exercise called "abstraction to image." Langan calls out a series of abstract words, such as coldness, success, joy, vanity, prudence. The participants jot down what they see in their minds, write two-line poems using concrete imagery, and read them aloud. "We're just flooding that room with imagery and surprise, not necessarily with sense," Langan says. During that exercise, they leave behind traditional meanings. "It makes a different kind of sense," he adds.

Another go-to exercise is a nonfiction prompt entitled "Nobody knows this but me…" As if murmuring secrets into a friend's ear, the writers arrange some of the strange observations they've mined from life — facts about the early history of liver transplants, how people talk hours into a double shift, how their original poem feels tucked into their lab coat pocket. Some even share intimate fears that they haven't expressed to anyone but themselves.

Lydiatt came away from the Seven Doctors Project with a new communication skill set (one that already included humor) and applies it to his teaching and everyday self-expression. Currently, he's putting what he's learned into practice and crafting his first book.

Permission to Make Mistakes

Lydia Kang, MD, an internist, writer, and early workshop participant, had one published essay when she first joined the workshop before hitting a wall of rejections. When she heard about the project, she saw it as an opportunity to write another essay, intending to publish it in the Journal of the American Medical Association.

Kang had "a lot of hang-ups" about entering this unfamiliar creative culture. "I was so afraid of what people were going to think about my writing," she says. Shedding the expert coat and assuming the role of a student again can be both humbling and challenging. Rather than being afraid of failure, Kang suggests people lean into the learning environment. Things got easier for her when she adopted that mentality. "Finally, I was like, 'Well, teach me,'" she says. "'I will try to get better. I will try to do this better. '" Kang says the mentors' supportive yet constructive feedback "opened a lot of doors for me."

Kang wasn't alone in her trepidation of not living up to expectations. In fact, Langan says that's the most common fear he's heard from the physicians he's taught — fear of making a mistake on the job. At Seven Doctors Project, mistakes are all in a day's work. "That's the best part of writing," Langan says. "We're going to guide you. You don't have to be in charge. You're going to make mistakes. It's okay. Disappointment is going to be part of it. And that's okay, too."

In 2009, shortly after Kang joined the Seven Doctors Project and started writing novels, she also picked up blogging. At first, she wrote about writing but then realized she could help her online community with medical questions they might have to make their own fictional tales more accurate.

These "fictional medical consultations" might look like someone saying that their character needs a head injury but also needs to be able to run shortly afterward. Kang would suggest plausible injuries the writer could inflict. These scenarios helped bridge her patient-care world and creative writing world. "Once I allowed them to flow into each other, I had a lot more peace," Kang says.

Kang has gone on to publish several books, ranging from young adult to historical fiction to nonfiction, including "Quackery: A Brief History of the Worst Ways to Cure Everything," which she co-authored with journalist Nate Pedersen. She's even returned as a mentor for Seven Doctors Project.

'The Therapeutic Value of the Writing Experience'

The project's more recent students featured 15 participants and four mentors who helped guide folks through detailed revisions. Jennifer Larsen, MD, Vice Chancellor for Research at the University of Nebraska Medical Center, says, "In our small groups, I'd share just about anything." But at the end-of-session public reading, she felt vulnerable in a new way. Larsen says that sharing poetry feels "a lot more personal" than the public speaking she does for her job. "You gear your poem to the circumstance," Larsen says. "Write for your audience." It's hard to be completely vulnerable around strangers.

To read a piece Larsen worked on during a Seven Doctors Project reunion, click here.

"I didn't believe in the therapeutic value of the writing experience," Langan says. "Then I watched it happen." The most satisfying response Langan receives, though, is from participants' co-workers and spouses saying, "I don't know what you're doing with him, but he seems a lot happier."

Like everyone else, the Seven Doctors Project is trying to adapt to the pandemic. They were 2 weeks into their most recent session when the world shut down. They left the local nonprofit they were affiliated with and ventured out on Zoom to finish that session. Now, they're looking for a way to relaunch, perhaps on a larger scale.

The impact of the Seven Doctors Project extends beyond just its participants. Larsen has taken the lessons she's learned in practicing vulnerability in her poetry and offered them to grieving colleagues, emphasizing the necessity of writing down their thoughts, working through the emotions. "I think it is important for everyone — in whatever job they do, particularly in medicine — to be able to get your head away from the trials and tribulations,'' Larsen says. "It's been incredibly important to me to pass this knowledge on to others."

Meditation by Jennifer Larsen

The boots marched
over old and new snow
ice frosted by light
their cadence regular
predictable
stamping out order
on a disordered life
their clear objective
to erase and replace
uncertainty and anxiety
with peace
a meditation in movement
uninterrupted for once
by any human requests
contemplating only the sea of white
aching for contrast
to improve insight about the terrain ahead
knowing jagged peaks and pits
still lurk beneath unseen
but for now
the rhythm remained
unbroken
and the thoughts remained
unspoken

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