writing – MARY PAN

Writing Through COVID-19

May 6, 2020 No Comments

Like many people lucky enough to have a backyard during this time of pandemic, we’ve spent a lot of time working on the yard, creating space for the kids to run and play and take in the fresh air, get grounded in the earth. I’ve found this essential for myself as well, digging in the previously neglected raised beds, planting flowers and greens in the hope they will grow something new out of this time of desolation. I’m lost when it comes to gardening but, like many things during this season, have tried to embrace anything that offers potential for nourishment.

Usually for me that’s writing, taking pen to paper and letting myself discover what needs to be said. Lately though, I’ve been overwhelmed with ideas—for essays, for poems—but only fragments come out. I’m not sure if it’s the uncertainty of the time, or my life at this moment, or if it’s just there’s too much to write about, too much to process, too much to share. I’ve struggled to find creative space, both physically and emotionally.

Part of the backyard refresh, in addition to the basketball hoop, the dedicated fort-building trees, the shuffling of deck furniture, is a repurposing of a small shed. Cleared out of old bikes, shovels, cracked pots, and campfire wood, the whitewashed space now houses a seafoam writing desk and lilacs blooming at an opportune time. With this space, and the online offerings below, I find I’m emerging from a writing hibernation of sorts, finally having some urge to create.

During this time of pandemic, I’ve found so many generous spaces for writers to connect virtually. I’ve “met” with writers’ groups, both local friends well-known and those from all around the world. One thing I’m grateful for during this time is that many of the classes and gatherings I’ve longed to be a part of are now available via Zoom: Columbia University’s Narrative Medicine program has several offerings a week, Toronto’s Firefly Creative Writing has moved writing sessions online, Stanford’s Medicine and the Muse offers a weekly writing and sharing group that has been encouraging and approachable, Suleika Jaouad’s Isolation Journal email prompts have featured some of my favorite writers and thinkers.

I’m hoping to get back into a regular cadence of Narrative Medicine Monday posts and even Free Write Friday prompts, with a COVID-19 theme. But I’m also letting myself be fluid during this time, resting when I need to (anyone else find they just need naps in the middle of the afternoon no matter what the day holds?) and not demanding so much of myself—that I should be writing more or should be homeschooling in a certain way or should be innovating at work or should be anything other than what I need to be in this moment to move forward.

Here are some resources I’ve found that have provided writing community and encouragement to get pen to paper, finger to keyboard, soul to rest. Some are geared toward healthcare workers, but there are also opportunities for the general public looking for a creative space.

Be gentle with yourself, and those around you. May you find the space for rest and growth and the hope of creating something new.

The Isolation Journals: Author and speaker Suleika Jaouad will send you a daily thought and prompt from an inspiring writer, artist, person of note.

Firefly Creative Writing: Early morning (for us west coasters!) collective writing sessions, a prompt and 20 minutes to write together, to benefit small business rent relief.

Writing Medicine: Saturday morning time for healthcare workers and their families to write and share, led by Writer in Residence Laurel Braitman (who also has a wonderful TED talk on Storytelling and Writing) at Stanford’s Medicine and the Muse program.

Columbia Narrative Medicine: Virtual book club & narrative medicine writing sessions led by faculty and alums of the original program in the traditional style of close reading, discussion, writing, and sharing.

Hugo House Quarantine Write-in: One of many online offerings from this prolific Seattle writing community. Check out their classes, virtual happy hours, and other events too!

Writing

Tin House: On Acceptance, Rejection and Taking My Time

February 17, 2020 No Comments

The Tin House Winter Workshops are held on the Oregon Coast, in the small town of Newport. The quirky Sylvia Beach Hotel is an appropriate literary-themed home base, each room named after a famed author and decorated in the style of their particular genre. I applied to the nonfiction workshop at the last minute, feeling dejected from recent rejections and once again questioning my validity as a writer, as a creator of art. When I saw the instructors for this year’s nonfiction workshop though, I knew I needed to apply.

I’ve admired Esmé Weijun Wang‘s work and, in fact, met her briefly at AWP 2019. I asked her to sign my copy of The Collected Schizophrenias after an awkward non-conversation where I blurted out something about being grateful for her essays. (I am not good around celebrated authors or actors, let me just apologize in advance. Or in retrospect. Sorry, Bradley Cooper.)

Attending my first writing workshop with Tin House and with Esmé was a gift I didn’t realize I needed at this stage of my career. My small cohort of incredible women writers were generous in their feedback and kindness. Their critiques were insightful, their encouragement sincere.

Esmé and the other talented instructors, T Kira Madden and Sophia Shalmiyev, each gave lectures and readings (one of which, I surprised myself by crying through.) Other highlights included the book exchange, dive bar karaoke, participant readings, and moonlit morning runs on the compact coastal beach.

One night we talked about our writing goals for the year and I mentioned my participation in #Rejection100, a group whose purpose is to celebrate the act of trying. Sometimes, I feel too uneducated in the literary world, sometimes I feel too old. Sometimes I feel my voice is too privileged or too uninteresting to have anything of significance to add to the conversation.

T Kira’s lecture, and time with these writers, gave me permission to move beyond my own expectations and the world’s requirements of my work. She challenged us to ask questions of ourselves: What are you writing toward? What are you writing about? How do we reframe our ideas of what “no” means? I like the idea that in nonfiction we are “chasing the question, honoring the unknown.”

Esmé asked us on the last day of the workshop what we’re taking away with us, what we are offering to our fellow participants, from this time on the coast. I said I would take away, and offer, permission. Permission to, as T Kira encouraged, lean into my interests, to listen to my mistakes. Permission to write into the paradox, to take my time. I am impatient and this rushed world fuels this tendency. In writing, in creating, in listening to the story that is tumbling within, I’m learning to take my time, allow rejection to serve as a teacher, not a declaration of who I am. I’ll continue to honor the unknown, and give myself permission to chase the question. Even if I don’t know quite where I’m headed.

Writing

Artist Trust Grants for Artist Projects

October 21, 2019 No Comments

Publishing is rife with rejection. As a physician, I wasn’t prepared for this reality when, several years ago, I began venturing into the writing world, taking classes and submitting pieces with little understanding of the industry or norms, without any concept of what I might expect.

As I’ve delved more seriously into writing, I’ve learned to accept frequent rejections, listen and learn from the talented and established artists and editors around me, and I hope become a better writer myself in the process.

Given how gray my Submittable account usually is (you writers all know what I’m talking about!), I was absolutely thrilled to get the very unexpected and welcome call that my 2019 Artist Trust grant proposal was accepted. Artist Trust supports Washington State artists by encouraging “artists working in all disciplines to enrich community life throughout Washington State.”

My grant will support professional development to further my book manuscript exploring mental illness and identity. This award came at a time when I was questioning my validity and voice as a writer, so this support is not only a financial boost to my project, but also serves as an inoculation against the imposter syndrome lurking within. I am indebted and honored to be a GAP award recipient, especially among such outstanding artists.

I’m so grateful to Artist Trust for the important work they do to amplify and energize Washington State artists, and I’m particularly appreciative of the recognition and encouragement the GAP award provides.

Narrative Medicine

Media & Medicine

October 19, 2019 No Comments

I’m an introvert. I recently took an online Myers-Briggs test a work colleague sent me, and I scored a solid INTJ. This categorization has been stable for me since high school. Though I do enjoy social events and meeting new people, as a true introvert, I find conferences exhausting. Medical or otherwise, the constant introductions, social navigating, and personal storytelling involved can prove daunting.

Last April, I was in Boston at a medical conference and had lunch with a group of women physicians. I struck up a conversation with the woman sitting next to me, trading the standard questions: where we’re from, our medical specialty, our interests. I told her about my passion for writing and narrative medicine and storytelling and physician wellness and bioethics and the humanities and, in turn, heard all about her upcoming book and the wonderful work she was doing in Boston.

A month later she emailed me, saying she had just attended a narrative writing event at her hospital, run by Dr. Suzanne Koven, and that what Dr. Koven was doing seemed very much aligned with my interests and the work I hoped to do in Seattle. Would I like a virtual introduction?

And that, as they say, is history. At least for my work and life. I spent over an hour speaking with Suzanne, learning about her path in both medicine and writing, and how she formed the Literature & Medicine program that has been running for over a decade. I knew I’d like Suzanne immediately when her first words to me were, “Well, let’s discuss our mutual favorite topic: narrative medicine.”

Under Suzanne’s guidance, I went on to establish a Literature & Medicine program at my own institution in Seattle, and she has since become Massachusetts General Hospital’s first Writer-in-Residence.

So when I heard that she and Neal Baer were starting a Media & Medicine course at Harvard, looking at how we can use storytelling to address pressing public health issues, I knew I wanted to be involved.

This past week, the inaugural Media & Medicine class met together in Boston for five days of lectures and networking, community and conversation. With a cohort of 50 people from all over the world, there was rich discussion and consideration of how we can use journalism and podcasting, op-eds and plays to address issues in healthcare.

I was impressed with the many innovative ideas, including implementing design thinking to tackle complex healthcare problems, weaving public health education into television and plays, and using solutions journalism to show that “better is possible” to enact change. Keynote speaker Dr. Leana Wen urged us to start with our authentic selves and stick with the voice we know. We collectively wrote op-ed pitches, practiced playback theater techniques, critiqued podcasts, and turned partner stories into playdough and pipe cleaner art.

I met an impressive group of healthcare professionals from all over the world, eager to expand on work in public health, mental health, health disparities, physician wellness, and chronic disease. We learned from each other, advised each other, helped with networking solutions and built our own community of advocates for storytelling and listening, which we’ll continue to grow over the next six months as we work on specific public health projects.

I had so many rich conversations, and heard from experts in media and storytelling. I’m leaving Boston invigorated and exhausted. I can’t wait to work on my own project, focusing on mental illness, and support and champion the work of my fellow colleagues. Although taxing for introverts like me, I’m so glad I had that conversation, shared my story with the women physicians I met at that conference back in 2018. It speaks to the power of personal connection, of telling our stories with vulnerability and hope, and this, I think, is what the Media & Medicine program is all about.

Narrative Medicine

Narrative Medicine Monday: Jamaica Kincaid’s “Girl” and the Challenge of Growing Up in Medical Training

October 7, 2019 No Comments

I first read Jamaica Kincaid’s “Girl” as part of a generative writing workshop during a summer writing residency. Our small group gathered folding chairs around long tables set up in an old barn near the Stillaguamish River in rural Washington. I was taken with each of the readings poets Jane Wong and Claudia Castro Luna had us read, but “Girl” struck me most, with its unusual punctuation, jarring directness, and call to re-examine the lessons we receive.

Emergency physician and writer Dr. Naomi Rosenberg explains in a recent JAMA article how Jamaica Kincaid’s “Girl” resonates in a very different environment–with new physicians in a narrative medicine workshop.

Rosenberg comments on the unexpected “striking similarity” these physicians have to Kincaid’s young girl, joining “a system that demands they quickly learn the skills of their craft, the rules of survival, and the values they will fight for all while navigating their instinctive psychological responses to illness, injury, healing, injustice, and grief.”

Rosenberg and the “burgeoning narrative medicine department” at her urban hospital have used “Girl” in the residency didactic curriculum, medical school electives, and writing workshops for all health care system employees with a goal to “constantly explore ways to help physicians, nurses, staff, and students ‘develop attention.'”

She describes how when they ask the residents to read “Girl,” intially they are met with resistance. How could this lyrical prose about coming of age in an island culture relate to healthcare professionals who “treat gunshot and stab wounds, deliver babies, diagnose cancer, unclog dying hearts for a living?” And yet, the new physicians quickly make the connection: “‘It reminds me of residency,’ one obstetrics-gynecology resident tells us, ‘a million instructions and things to do. It’s all over the place, and rapid fire.'”

At the end of the session a simple writing prompt is given, “metabolizing their own experiences and taking a moment to string words together—something young physicians today rarely, if ever, get a chance to do.” The result is surprising: “an exploration of hierarchy, medical education, and the silent curriculum of growing up.”

I wrote about my own experience at Columbia’s Narrative Medicine workshop, where we did a similar exercise and I again encountered Kincaid’s “Girl.” I love Rosenberg’s use of this piece to help new physicians still finishing their training grapple with the accelerated nature of a medical residency, the growth and expectations that come with modern medicine. It also was interesting to learn that Rosenberg herself used “Girl” as inspiration for her own wrenching New York Times essay, “How to Tell a Mother Her Child Is Dead” which I wrote about here and is one of my own favorite pieces to use for reflection and discussion among healthcare professionals.

As Rosenberg recognizes, literature has a way of “again and again, deepen[ing] our inspection and understanding of the internal and external worlds.”

Writing Prompt: Take a cue from Rosenberg’s exercise and respond to “Girl” by writing instructions on how to be a healthcare professional (nurse, physician, pharmacist, etc.) Alternatively, write instructions on how to be a patient, or a patient’s parent or partner or child. Write for 10 minutes.

Motherhood, Writing

Writing Motherhood

September 15, 2019 No Comments

What a privilege to be part of this Hugo House panel on Writing Motherhood last month. I was blown away by each of the readings from these talented mama writers, and particularly excited to meet poet Amber Flame. I first saw her at a Seattle Lit Crawl (coming up again October 24th!) reading work inspired by Whitney Houston. Carla Sameth read from her wonderful memoir in essays, “One Day on the Gold Line,” and my dear writer friend and talented teacher Anne Liu Kellor read a new poem. Samantha Updegrave served as host, shared a striking essay, and guided the panel discussion following the readings. The gathering was even a highlighted event by The Seattle Review of Books.

I enjoyed the chance to discuss how and why we write about motherhood, as well as how motherhood has influenced our writing and the writing life. For me, I came to writing as a serious vocation only after I became a mother, so motherhood tends to infuse and influence much of my work. Though I write about much more than motherhood, the fact that I am a mother is so central to my identity, just like being multiracial, or a physician, or growing up and living in the Pacific Northwest are all integral components to the lens through which I create art. I’m grateful I had a chance to discuss motherhood and writing with these extraordinary women and hope to continue this important conversation.

Ramblings

Paris

June 30, 2019 No Comments

Bonjour! I’ve been remiss with posting lately due to travels. I went to Paris in early June for both work and pleasure. It had been a decade since I’d visited the City of Lights, and, despite several stressful setbacks (beware that Airbnb, even if reserved months in advance, can cancel within days of your scheduled arrival!), Paris did not disappoint.

I have a special affinity for the city, as it was the first place I traveled internationally. I took French in high school and went there as an exchange student, living with a host family for just a couple of weeks. It was the first time I’d been anywhere predominantly non-English speaking and my host family was attentive, warm and forgiving. My time in Paris was a gentle nudge out of my American suburban bubble. More drastic shifts in my world perspective would come later, but I always think of Paris fondly as my start to a love of travel. And, of course, it’s Paris! The richness of art, architecture, food, parks, history…. I’ve been back to Paris once each decade since and this, by far, was my favorite trip.

I had initially planned to attend a writing retreat right before my medical conference, but as the retreat was canceled, I instead had several days completely to myself in Paris before my husband arrived and my conference started. As a working mom with three little ones, solitary time in this magical city was bliss. I strolled the narrow streets, stepped into cafes and hidden parks. I hit my favorite Musée d’Orsay and Rodin and sat in quirky bookshops sipping espresso and writing in my notebook. I even had a chance to read a poem during a multilingual open mic night.

The summer institute I attended was also exceptional, an annual meeting of the minds hosted by the CHCI Health and Medical Humanities Network. This organization is a “hub for health and medical humanities research and collaboration” and this year’s theme, “Health Beyond Borders,” brought together experts in both narrative medicine and global health, each particular interests of mine.

Several talks I particularly enjoyed were:

A keynote by Ghada Hatem-Gantzer about her incredible work with women and girls who have suffered violence.

I connected with Shana Feibel on #somedocs prior to the summer institute when I stumbled across her post about presenting in Paris. Dr. Feibel spoke about a topic that resonates with me: “Bridging the borders between Psychiatry and other Medical Specialities: A Case for the Medical Humanities.” I hope to continue to learn from her work in this area.

Sneha Mantri from Duke is a neurologist with her Master’s in Narrative Medicine and gave a fascinating presentation about border crossing and modern medicine as it relates to Mohsin Hamid’s novel Exit West. I also learned Dr. Mantri was in the same narrative medicine class at Columbia as Stephanie Cooper, who I’ve gotten to know well through the Seattle chapter of the Northwest Narrative Medicine Collaborative. It’s a small, connected world!

Columbia’s Danielle Spencer presented innovative work on the idea of lived retrospective diagnosis, or metagnosis. I’m looking forward to her book on this topic, forthcoming in 2020.

Emergency Medicine physician Craig Spencer gave a moving keynote presentation about his work with Medecins Sans Frontieres and specifically the migrant crisis in the Mediterranean.

I returned from Paris rejuvenated and energized on many fronts. C’est magnifique.

Narrative Medicine

Narrative Medicine Monday: Hospital Writing Workshop

May 27, 2019 No Comments

Poet and physician Rafael Campo describes the magic that can occur in a “Hospital Writing Workshop.” Campo starts the poem at the end of his clinical workday, “arriving late, my clinic having run / past 6 again.” Campo is teaching a workshop for “students who are patients.” He notes the distinction that “for them, this isn’t academic, it’s / reality.” These are patients with cancer, with HIV, and Campo is guiding them through poetry and writing exercises to search for healing and respond in a unique way to their disease and suffering.

Campo outlines his lesson, asking the students to “describe / an object right in front of them.” Each interprets their own way, to much poignancy. One student “writes about death, / her death, as if by just imagining / the softness of its skin … she might tame it.” In the end, this poem is about the power of poetry and art for both the patient and the medical provider. It’s about how something as simple as a writing workshop can cause us to pause, “take / a good, long breath” and move through suffering to a kind of healing, to a kind of hope.

Writing

AWP 2019 Recap

April 1, 2019 No Comments

My first AWP conference was everything I thought it would be: overwhelming, inspiring, and engaging. At times I felt like hiding in a small dark room by myself, at others I was torn by all the panels and gatherings happening simultaneously, wishing I could somehow replicate myself so I could be in all places at once. I met and interacted with admired authors, poets, editors and other emerging writers. I left Portland exhausted and elated.

As an emerging writer who hasn’t had formal training, I didn’t have the same MFA reunion or tribe that other writer friends enjoyed, but I did benefit from a new cohort I now belong to: the AWP Writer to Writer Program. Diane Zinna runs this mentorship program, now in its tenth session, with contagious enthusiasm. I was able to meet Diane and my mentor in person at AWP, as well as other Writer to Writer alumni.

The panels I attended were varied and largely helpful. I learned about writing and teaching flash nonfiction, the perils and pitfalls of writing about real people, writing through trauma, managing parenthood and the writing life, and so much more. I was able to hear Cheryl Strayed and Colson Whitehead speak about the writing life and their craft and hear my own mentor Emily Maloney and writing friends Anne Liu Kellor and Natalie Singer share their work.

I applied for a Tin House intensive workshop on writing the very short essay with Melissa Febos, and and was thrilled to be accepted. An afternoon writing offsite with courageous and creative women was a highlight.

photo credit: India Downes-Le Guin

One of the biggest joys, and hurdles for me, of the week was sharing my own work at a paired reading. I read an essay that has not been shared publicly before and holds particular emotional weight. It was freeing to release this work out into the world and I’m grateful it was well received.

Writers are, by and large, a forgiving and authentic crowd. Though many, like me, are introverts, I was impressed that the feeling of holding space for each other infused the conference. I moved out of my own comfortable cocoon of anonymity by walking the book fair, approaching editors of presses and journals I admire, striking up a conversation with unsuspecting poet Jane Wong as I was walked by the Hedgebrook table (hopefully in a decidedly uncreepy way), and doing a public reading myself.

I tweeted some favorite quotes from the event, but wanted to share these pearls here as well:

“Be willing to dig through the layers of artifice to get to the deeper truth.” – Cheryl Strayed

“What is the purpose of art? To suggest potential realities or states of mind that would not otherwise suggest themselves.” -Richard Froude (a fellow physician!)

Jessica Wilbanks shares she learned “to trust my subconscious more than my intellect” during her writing process.

“Trust that isn’t absolute isn’t trust at all.” – Alison Kinney

“Living a trauma is living a trauma. Writing a trauma is a reconsideration, an attempt to capture yourself in the reconsideration.” – Alison Kinney

“The purpose of art is to lay bare the questions that have been hidden by the answers.” – James Baldwin

“I’ve learned that writing a book will not make you whole.” – Colson Whitehead

“It is a joy to be hidden and disaster not to be found.” – D.W. Winnicott

“Telling this story was worth more than my comfort.” – Melissa Febos

“Real people are more than the worst or best things they’ve done. Craft requires we honor a person’s complexity.” – Lacy M. Johnson

“Be rigorous ethically and in craft before you put your work out in the world. [When writing about real people] scrutinize your own intentions.” – Melissa Febos

So much of writing feels like a solitary pursuit, laced with overwhelming rejection. But, like I’ve experienced in medicine and motherhood and many other aspects of my life, finding a tribe, a cohort of passionate individuals to help support each other and share in community, is invaluable. Thanks, AWP 2019, for providing that space.

Narrative Medicine

Narrative Medicine Monday: Burnout in Healthcare

March 11, 2019 No Comments

I’ve wanted to attend Columbia’s Narrative Medicine workshops for years. Life finally aligned to make that possible this past weekend as I joined professionals from different disciplines gathered to address “Burnout in Health Care: The Need for Narrative.” As a wellness champion for my physician group, this year’s topic was particularly pertinent to my work and practice.

The conference consisted of lectures from leaders in the field of narrative medicine alternating with small group breakout sessions. I was fortunate enough to have Dr. Rita Charon, who inaugurated the field of narrative medicine, facilitate two of my group’s sessions, which consisted of close reading and reflective writing and sharing. This format allows for in depth discussion with medical and humanities professionals, as well as time for introspection about how best to expand on learned concepts and practices when we return home.

Several takeaways for me:

Narrative can be used to address many issues in healthcare, burnout among them. I’ve been facilitating a Literature & Medicine program for my own physician group, and have taught narrative medicine small group sessions to resident physicians, but am inspired to do more of this work to expand the reach to medical professionals and patients. Dr. Charon encouraged us to disseminate the skills deepened through the humanities, that these are what’s missing from a health care system that has become depersonalized. Skills learned through narrative medicine can improve team cohesion, address moral injury and bias.

Writer Nellie Herman offered Viktor Frankel’s words: the primary force of an individual is to find meaning in life. Herman showed us how writing can help us find that meaning, giving shape to our experiences, our memories. Harnessing creativity can be particularly important for those of us who experience moral injury because “when we write, we externalize what is inside us.” Through writing and sharing, we’re making a commitment to something, a raw, less mediated version of events. Through this vulnerability we connect to others; though difficult, that’s what makes it valuable.

Dr. Kelley Skeff approaches burnout and narrative from a physician educator’s perspective. It is not lost on anyone who has been a medical resident or trained them that “we have trained people to take care of patients, even if it kills them. We have trained people to keep quiet.” Skeff offers us this quote from Richard Gunderman: “Professional burnout is the sum total of hundreds and thousands of tiny betrayals of purpose, each one so minute that it hardly attracts notice.” He implores us to combat the code of silence and ask ourselves and each other: What’s distressing you?

Maura Spiegel contends that “narrative language can proliferate meaning.” Spiegel used film clips to show how we can gain access to our own experience. In watching a film, we’re not called upon to respond, but we are often running our own parallel stories along with the movie. Spiegel showed clips from the movies “Moonlight,” “Ikiru,” and “Philadelphia,” and the documentary “The Waiting Room.” In that final clip we saw a young doctor run a code in the Emergency Room where a teenage boy dies. He then is tasked with telling the family the devastating news. He seeks out support from his colleagues on how to do this. Spiegel notes a quote from Jonathan Shay: “Recovery happens only in community.”

I was bolstered to hear about he the work of Craig Irvine and Dr. Deepu Gowda, who discussed how to create a culture for narrative work, both in academic institutions and in clinics. Dr. Gowda explored using narrative medicine sessions with the entire medical team (including nursing staff, administrators, physicians) and found improved teamwork, collaboration, and communication. Both suggested building a team of people interested in narrative work, be they art historians, philosophers, writers, physicians, or psychologists.

More than anything, this workshop churned up ideas and inspired methods that could be used at my own workplace to use narrative work to address burnout. I came away encouraged and connected to colleagues who are interested in the same questions and in addressing the daunting problem we face in our current health care system. Ultimately, we want to “allow voices to be heard, and address suffering, not only of patients but also of medical providers.” This work is challenging, but necessary. As Tavis Apramian noted in the final lecture of the conference, “the meaning that we draw from other people is the reason to keep going.” That it is. I hope to continue learning about this important work and am grateful for the faculty at Columbia who inspire tributaries (or rhizomes!) of narrative and creativity throughout the medical world.

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