A few years ago, I submitted a short story to a fiction-writing workshop entitled, “The Angels of Watermark.” I have to admit, I was kind of proud of it. It was large and ambitious, dipping in and out of timelines, generous with its lyrical language — all in all a workshop leader’s worst nightmare. “Interesting read,” he wrote in his comments, “but could use more clarity.”
I quickly learned that was one of my professor’s favorite words — a story was useless, he declared, unless it had perfect clarity. Unless it had a beginning, middle and end that made sense. That didn’t confuse.
“You need to give your readers something to hold on to. You can’t trust that they’ll understand, that they’ll go where you want them to go.” He suggested I spend my time on a different work instead of experimenting with something new.
Now, I fundamentally disagree with this philosophy. But to get to how this story relates to the ‘theme’ of this blog, we need to rewind about a week or so. I was again at the hospital when I was assigned an interesting case. As with my last patient, I encountered a slight language barrier with this patient, whom we’ll call SG.
Almost immediately, I could sense this patient was scared. His voice shook as he spoke, as did his hands; I felt like his whole torso would also probably shake if it weren’t so well supported by the bed. It was difficult to make out the first part of his story, in which he was either describing a knife fight or a train accident. I didn’t interrupt him once while he was telling the story. The look of relief on his face as he told it was incredible. It was as though he’d just been waiting for someone to walk through the door so he could tell it, and afterwards he took a couple of deep breaths and lay silent.
The story was fairly implausible. I asked him to repeat it a couple of times, to see if any details changed in his telling, and indeed they did. In every version of the story, however, he was surrounded by folks drinking on the train. He would then gesticulate furiously, trying to paint a picture of the train demolishing a building as it was thrown off its tracks, and then in a different telling, assert that the people around him on the train were out to get him. I sensed the theme of drinking might be a good subject to tackle, and took a seat at the foot of his bed so that, even if we could not understand each other perfectly, at least I could maintain eye contact. A supervising physician sat in a chair a few feet away, interjecting a helpful question here and there to keep the interview going. SG explained that he’d quit drinking years ago, but the shaking of his hands and tongue, the sharp nystagmus we found in both eyes and the pin-pricking sensation he felt all over his body relayed the truth, that in fact he was probably in the midst of alcohol withdrawal.
“I feel safe here,” SG said several times, which served to ramify just how unsafe he felt out there. There was very little I could do for this patient, of course; there’s little I can do for any patient at this stage. But I thought listening to the story, no matter how wild it might be, providing the comfort of the routine physical exam, and being present in the moment by sitting there, at the foot of his bed, might be small and helpful things.
To my surprise, when we exited the room after the interview, the first thing the supervising physician said to me was, “Don’t sit there. On the patient’s bed. If you get permission, it’s all right, but still not preferred. They don’t want you there, and you might be giving them ideas.”
I was taken aback by this statement. After some thinking, I realized he was correct that I probably should have asked the patient for permission. But SG seemed pleased that I was there, and smiled every time I attempted to re-phrase a question in my rusty Spanish. As for “giving [the patient] ideas” — I was immediately reminded of the professor who told me I shouldn’t write complicated stories because my readers might not be able to follow along.
My philosophy is this: I trust my readers, and I believe we should trust our patients, too.
I submitted the complicated, possibly overwrought story to the workshop over my professor’s protestations, and I was rewarded with numerous peer critiques that desired more of the story; more background and details to flesh out the things they didn’t understand, instead of suggestions to cut back or guillotine the story altogether for the sake of clarity.
Next time I see a patient, I might sit in a chair close to them instead of on their bed, but I know I’ll never be comfortable towering over them while asking about the intimate inner-workings of their lives. I trust they’ll know I mean well.