All the Other Small Devotions
In my first year as an obstetrician-gynecologist, I cultivated a habit of documenting everything that happened outside the hospital and almost nothing that happened within it. A day off resulted in photographs of everything I ate, drank, and otherwise experienced, through the lens of my mobile device. A weekend became a montage—a vacation, a deluge. Perhaps I worried that I would forget all my hours spent not working. The illusion was as much for others as it was for me.
When I started residency, the bare necessities—sleep, exercise, regular meals, any meals—became hot commodities. Perhaps it was simpler for me than it was for others. I had no child, no partner, and no pet. After killing five potted basils in rapid succession, I had no one to care for but myself. I was determined to become an expert in self-care.
Self-care, I later realized, was nothing more than a proxy for self-love.
It started with a series of tiny sacrifices. One of my co-residents never filled out evaluations. Another outsourced a variety of household tasks. A third neglected cataloging her surgical cases until the final week of the academic year. After all, we had already sacrificed the big things. Chisel by chisel, we carved out a space for all the other small devotions.
What were mine? I never cooked. Cooking had been ruined for me years ago, when I started medical school and quickly realized that what had previously been a joy had now become a chore. In my first year as a resident physician, I came home night after night and assembled a salad. A few evenings a week, I dined out or ordered in. I took an Uber to work instead of using public transit. I let my plants die.
On the first day of orientation, my program director asked me and my co-residents to each name our hobbies. I said, “Writing”—and nothing else. A small silence ensued before the following person spoke. In a panic, I realized that while I had answered in the singular, everyone else conjured multiples. But writing for me was just that—the one true devotion. I could hardly yoke it to a series of less beloved things.
The first step to self-love was to discover other things I loved.
“Hobby” is an English word I never entirely grasped. What did I do in my leisure, for pleasure? As a child, everything I did seemed to serve a higher purpose. My love for music was co-opted into violin lessons with the goal of participating and (hopefully) winning competitions in order to be admitted to an elite university. My love for oratory translated to becoming captain of the speech and debate team. Writing was an endeavor my loved ones saw limited value in and actively discouraged me from pursuing. Therefore, it became entirely my own.
After listening to everyone else’s hobbies—cooking, baking, running, spinning, gardening, singing, any and all gerunds that comprise modern human joy—I was convinced that I needed another. But trying, as an adult, to discover new activities seemed inauthentic, like a belated rebranding of a startup doomed to flop. I tried anyway. In my handful of empty hours, I walked all over Boston. I sought out wine tastings and coffee cuppings. I went dancing with friends. I went dancing alone. As much as my vacation schedule would allow, I explored the rest of the world.
I learned to close my eyes and move in a sea of strangers. I sang aloud for the first time in years. I made pasta in Florence and believed, for a moment, that maybe I could love cooking again. A few weeks later, I bought a pasta machine and was relieved to discover that I had not forgotten everything. A month after that, I invited a friend to my apartment so that we could cook together.
During that time, I had not written one thing.
The hardest part of my first year of residency—beyond the relentless chirping of my beeper and the Sisyphean scut list and the sheer terror of performing my first (and second, and third) Cesarean section; beyond the thunderous silence of being alone in a room with a body that had moments before breathed her last, listening for a heart that will never thud, feeling for a pulse as her hands are already, impossibly, colder than ice; even more than opening my eyes, morning after miserable morning, in the darkest dark without seeing for days the color of the sky, or the countless birthdays, reunions, dinners, and all the other vacancies big and small, a never-ending litany of absence, a forever accumulating pile of emotional debt never to be repaid—the hardest part was the feeling of urgency bordering on panic that never quite left me, long after I had gone home for the night only to awaken, in the small hours of the morning, and do it all again.
At first, I thought this urgency was the physical and emotional embodiment of learning to be a doctor. Then I thought it was the fear that in learning to be a doctor, I was forgetting how to be a human. Perhaps it was neither. As abruptly as it came on, so subtly it regressed, day by day and moment by moment, until I woke up on an unseasonably warm Saturday in April and felt, for the first time in a long time, free.
Freedom had its bittersweet moments, too. When I was not working, I was often overcome by an immense inertia. Everything was precious and fleeting. I lay in bed underneath my blankets and watched askance as the sun spread its rays across my bedroom ceiling. I lit candles and blew them out. I ignored phone calls. I bought myself cut flowers from the grocery store. The mere existence of those flowers meant to me that they were doomed. All they had left to offer was beauty. The same is true, I suppose, of every living thing, but I cannot abandon the fallacy. This I do believe—that to practice medicine happily, one must either hope the tide will turn or find truth beneath the waves.
How do you describe this crazy thing that has happened to you, that has entirely consumed you, while you are still caught in the current, when the simple act of speaking feels like gasping for air?
I carry within me the angst of every artist who feels urgently the need to create but simply cannot.
When I decided to go to medical school, I underestimated the rift that would ensue between the part of me who was a writer and the part of me who wanted to be a doctor. I managed to write only one substantial work in four years, among a smattering of tiny, inconsequential, musings. Atul Gawande wrote his first book, Complications, during an intensive surgical residency and fellowship. On a good day, I can scarcely put together a thousand words.
Even worse, I hardly read. Rather, I hardly read anything that moved me. I still believe that every good writer must first be a good reader. I became a terrible one. I made my way through Gray’s Anatomy for Students, perused various board examination textbooks, nibbled at Te Linde’s Operative Gynecology, all the while craving literature. Unlike many of my friends, I cannot read bit by bit, a few pages here and there, in the quiet moments before falling asleep. Perhaps it was a vestige of my years as an English major. Literature, for me, could only be savored if it was urgently and utterly consumed. I had neither the time nor energy for anything of the sort. I almost exclusively read and wrote during my vacations. Every time I did, it felt like a return to my other life. Sometimes I came back more lost than when I left.
In my first year, I nearly stopped writing. It took several months before I finally tried again. Medicine became part and parcel of who I was, so much so that a colleague remarked that it was hard to imagine me doing anything else. But a piece of me will always be adrift, caught between two worlds. My former classmates published in literary journals, became editors, had books forthcoming. I had traded pen for scalpel, words for wounds. I asked myself if it was enough.
In college, I took a class called Writing About Oneself. At our first meeting, I learned a metaphor that I still carry with me: the David. It came from an unattributed quote regarding Michelangelo’s famous statue. “How do you carve a statue of David? You start with a block of marble and remove everything that isn’t David.” David represented the heart of an essay, poem, or story—the meaning beneath it all. I remember telling my classmate while reviewing one of my essays, that I was struggling to find my David hidden within the marble. I cannot remember what he said in return, but I like to think that, whatever it was, it brought me here.
I saw Michelangelo’s David for the first time at the Galleria dell’Accademia in Florence, the same day I learned to make pasta. It was, for lack of better expression, larger than life. I wanted to take a photo with the caption, “Look! Finally found David.” But the truth is, I am struggling still.
I believe that every writer who writes about herself carries a second, deeper angst. While interviewing for residency, I read Benjamin Hedin’s essay on the late William Gass. Gass believed that “the charge of a writer… was not to relate a world but to create one.” Therefore, writing about oneself is the art of creating oneself. When you hit a snag, find yourself caught between iterations of a sentence, are unable to move on and cannot make sense of it all, you are in danger of self-destruction. The page is as alluring as it is deadly, a mirrored sea with no shore, a lucency in a universe already beginning to dim.
Still, we chisel away. That, I suppose, is a form of love—not what we wrote but simply that we tried.
Not long after returning from Italy, I purchased another basil plant. It sits on the windowsill and watches the sun pass by. I have, impressively, remembered to water it just before leaving for work every morning. It has finally outlasted its predecessors, and I am cautiously optimistic. I want to add it to my salads. I want to make pesto. That will require me to pluck the majority of its leaves—a feat the Internet has advised against—which will lead to its death. This reminds me that the destruction of one thing lends itself to the creation of another, only itself to be destroyed, a circle that never ends.
What I love about writing is that words on a page will always remain, even when both writer and reader have moved on. In his novel, Cutting For Stone, Abraham Verghese creates a historic Ethiopia in which “among the poor, marriage consists simply of writing two names on a piece of paper.” Today, we still consider a marriage certificate—along with birth, death, and divorce certificates—a vital record. Words not only communicate the vow but embody it. Writing, therefore, is not a process but a promise. To be a writer is to work relentlessly to keep one’s art alive—to water, nourish, and love it for just long enough in the hopes that, one day, it takes on a life of its own.