Wow! Both of these stories are quite powerful and memorable! “Number 72,” really speaks of that distance that doctors create with their patients. Can you tell us a bit about the inspiration for this story?

Meg, thank you for your kind words. I wrote this story after my father died from stage 4 sinus cancer. During the 18 months between diagnosis and death, we worked with many health care providers, including several of the best specialists in the country. Now, all blurs, and I can’t recall the exact event that sparked this story–the nurses and aides who never bathed him during a week-long hospital stay? The clinical trial coordinator who did not return calls? The physician who did not sign the papers necessary for hospice after terminating him from the clinical trial? But what I do remember is the clinical sterility that surrounded those visits, especially the day the physician discharged my father from the clinical trial. Number 72 erupted from the stage of grief fueled by anger at the medical mishaps, indignities, and apathy heaved upon him at one of the nation’s premier comprehensive cancer centers.

This is not to say my father did not encounter wonderful, caring providers–he did, especially the hospice workers who helped us care for him at the end. As you know, hospice is hard work, important and healing work. I wish my father’s physician and nurses understood the importance of palliative care. Unfortunately, my father’s experience was not unusual--our health care system has replaced care and compassion with technology and efficiency. This angers me and, as a health professional, shames me.


I love that you come back to that moment where humanity overpowers the sterile thoughts of the doctor even if it only peeks through her racing thoughts. In fact, both stories deliver a hopeful message, so beautifully rendered. Anything you’d like to say about this?

With this story, I wanted to get into the doctor’s head and figure out the ‘why’ around the emotional distance. Because of my day job, I understand the pressures riddling academic medicine—bringing in grants, enrolling patients, publishing promising results, navigating the conflicts of interest and perverse incentives. Furthermore, the high degree of specialization in medicine reduces patients to specific parts or systems; the clinical trial overlay further deconstructs patients to numbers, to data points. Indeed, I don’t remember the clinical trial physician ever asking how my father felt emotionally or spiritually, only how he felt on measurable items–pain, swelling, tumor growth, pus.

But, students enter medicine to save people, not to help them die, and they receive little training, if any, in palliative care. This despite the reality that for many practices – oncology, cardiovascular, HIV/AIDS, liver and renal disease – patients present on a trajectory towards death. I suppose protective mechanisms, including emotional distance, must kick in for the physician to do her work.

I want to have hope for medicine and its practitioners. In the end, I let Number 72’s doctor remember his first name. In earlier drafts I did not, but the passage of time and diminution of anger bled into something akin to acceptance, or maybe forgiveness; I wanted to impart this small  grace.

Although these two stories share the same event, I had not considered they shared a theme until you mentioned it. So thank you. But I guess they do–navigating the tenuous balance between intimacy and distance. Caring for a dying person if difficult, whether you are paid to care for that person or whether you love that person. We humans are funny, always protecting our tender hearts.

When a doctor terminates his patient from a clinical trial, it is the beginning of the end--and the end comes like a train in a tunnel. You count the ‘lasts’ – the last time he eats, the last time he shares a glass of wine, the last time he sleeps in his bed beside his wife. The last time he plays cribbage with your son. You do not realize when you leave the hospital on that dreary afternoon he will never be outside again, he will never feel wind or rain or sun against his skin. You do not comprehend he will stop speaking or eating or kissing because the tumor engorges his throat. I had no idea, but if I had, I would have wheeled my father up and down the bricked sidewalks of Chapel Hill, rain or no. I would have taken back roads home, damn the time and traffic, windows down, wind pummeling. I would have lingered. But I didn’t, and I regret that.

Lots of eclectic and wondrous stuff, mostly “contemporary American writers” because that’s the focus of the class I’m taking (in my Master’s program in creative writing at Hopkins). In particular, Tobias Wolff’s collection of shorts Back in the World awes me. He writes spare, every word necessary and appropriate, every sentence loaded with yin-yang tension. He writes about those small pivotal moments that we often don’t notice until later. Before bed, I indulge in Amy Hempel, Goddess of the Perfect Sentence and almost as good as a bit of dark chocolate.

A poem I circle back to is The Glass by Sharon Olds. She has a way of transforming something quite horrible–a glass filled with phlegm–into an object of beauty. This poem, about her father’s death from throat cancer, haunts me and makes me realize how much more I have to learn about word choice, syntax, and circling and expanding on the fault lines of my stories and poems.

The last excellent novel I read was Revolutionary Road by Richard Yates. Wow. What a devastating snapshot of marriage and suburban life in the 1950s, and still applicable. I miss reading novels. I can’t wait until the semester break and I can plunge into the pile of books waiting by my bed–Atwood, Marquez, Waters, and a little treasure by Tuite!

Everyone. Call me a sponge. I am fascinated in the containers of stories, how novels unreel. Early on, Audrey Niffenegger and Julia Glass influenced me because of the unusual structures employed in their novels. I’m deconstructing Olive Kitteridge to understand how Strout put her stories and characters together (and apart) as I wrestle with my own linked stories project. Charles Baxter is my constant touchstone. I worship The Feast of Love and everything else he writes—poetry, short stories, novels. His words inspire me to think or feel at a transcendent level. One of my prize possessions is a hand-written story postcard signed by him that hangs over my desk.

I feel fallow now, for the first time in five years. It is an uncomfortable feeling to not have a big project hustling me up every morning. Life, school, work, finishing up novel edits–all have distracted and exhausted me from substantive writing (or even insubstantial writing, like my blog). Mostly, I am reworking older pieces and mustering energy to market my completed novel. A second novel marinates in a drawer and will likely rest there for a while - it is a tough piece of meat. But characters from The Minister’s Wife, the working title for the linked-stories, whisper to me at odd moments. I hope this means my subconscious is percolating, preparing for another obsessive plunge.  

Meg, thank you for hosting me and my work at Connotation Press. I love what you do here for writers and artists, and admire your words tremendously.