What’s the Story #33

This is Creative Nonfiction‘s third issue devoted to health care. The first, issue no. 11, A View from the Divide, dealt generally with science, biology, and psychology. It is still in print and has been repeatedly acknowledged by critics and teachers for the fine writing it contains.

Then, issue no. 21 featured writers who had something significant to say about the need for change in the health care system, especially in the area of patient-professional contact and treatment. The title said it all: Rage and Reconciliation: Inspiring a Health Care Revolution. The essays we collected vividly identified the need for change and inspired, if not revolution, then a significant and proactive movement to fix up a system that was out of sync with both the people who work within it and those whom it serves.

Our issues usually remain in print for a long time, but Rage and Reconciliation sold out. We resolved to republish and so approached editors at Southern Methodist University Press, which was, at the time, launching a new series in Medical Humanities, edited by Thomas Mayo. We added new essays and a CD of material recorded at the public forum, and SMU republished our issue as a book that available now in stores across the United States. In a review, the Journal of the American Medical Association concluded: “The essays in Rage and Reconciliation are not so much indignant rants as thought-provoking analyses grounded in persuasive evidence that the practical medical problems affecting us all can be rectified only after they have been recognized.”

Now, with this issue, also supported by the Jewish Healthcare Foundation, we are confronting the health care crisis in an even more vigorous literary assault. 

Silence Kills, as Jill Drumm’s compelling essay explains, was actually an initiative of an organizational-performance consulting company, VitalSmarts, which released a report called Silence Kills: The Seven Crucial Conversations for Healthcare in 2005. It soundly concluded that communication breakdown is at the root of most medical errors.

Karen Wolk Feinstein, president of the JHF, and her staff were so impressed with the Silence Kills study and so pleased with circulation and the impact of Rage & Reconciliation that they approached Creative Nonfiction to see if we could inspire writers and health care professionals to address the “silence kills” theme using the vivid storytelling techniques for which creative nonfiction is known. This special issue is the result of our collaboration. Feinstein has provided a foreword to Silence Kills, and the introduction is written by Dr. Abraham Verghese, the founding director of the Center for Medical Humanities and Ethics and the author of two powerful memoirs about his experiences as a physician.

Three of the writers in this collection—Paul Austin, Merilee D. Karr, and Helena Studer—are physicians or former physicians, but a variety of viewpoints is represented in these pages, with essays written by patients and also by patients’ and physicians’ family members. What they share is a frustration with a system that hinders communication and, in many cases, leads to unnecessary suffering.

Karr’s essay, “Missing,” about the experience of being sued for medical malpractice, has been awarded $1,000 prize for best essay. Three other writers won $500 prizes for their work: Tamara Dean, for “Saving My Breath”; Pamela Skjolsvik, for “You Have the Right to Remain Silent”; and Grace Talusan, for “Foreign Bodies.”

Ordinarily, creative nonfiction as a genre is inspired by inner feelings and softer (although not necessarily less important) subjects having to do with nature, rural or urban life, and personal survival. Less literary topics are expected to be the province of journalism. We do not accept this premise, that detailed reporting and artful writing are incompatible, which is flawed, and in many respects, elitist. We believe that art and literature not only document change but can also inspire and facilitate it. We would not publish this issue or any of the essays in Silence Kills without believing that our work will fulfill the promise in the issue’s subtitle—that speaking out in a dramatic way, with courage and compassion, will save lives and help people to connect and communicate. In choosing the subjects we confront, creative nonfiction writers and editors must listen to our hearts and to our consciences, for the silence of injustice is deafening.


Like Rage & Reconciliation, Silence Kills is being published as a book in SMU Press’s Medical Humanities series; you will be able to find the book in stores around the country, and you will notice it contains two essays not included here because of space constraints.

As for the issue, you’ll notice that we’ve added a new section, “Keeping It Real,” with three new columns that will become regular parts of upcoming issues. “Spotlight On…” will profile an emerging writer in the field. In “Ask an Editor,” we’ll chat with a nonfiction editor about trends in publishing and bring you insider tips about the business of writing. “Notes on Craft” will offer a focused look at an element of crafting creative nonfiction.


Finally, if you haven’t been to the Creative Nonfiction Web site (www.creativenonfiction.org) lately, I’d like to invite you to stop by and visit us. We’ve recently unveiled an updated look, complete with new content and a more user-friendly store. You can browse our extensive selection of back issues and books, leave reviews of our products, and learn more about upcoming Creative Nonfiction events and programs. Plus, if you subscribe to our free e-mail newsletter, we’ll keep you updated about upcoming issues, calls for submissions, news about our authors and editors, and more.

About the Author

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Lee Gutkind

Lee Gutkind is the author and editor of more than thirty books, including You Can’t Make This Stuff Up: The Complete Guide to Writing Creative Nonfiction–from Memoir to Literary Journalism and Everything in Between, Almost Human: Making Robots Think, The Best Seat in Baseball: But You Have to Stand, Forever Fat: Essays by the Godfather, and the award-winning, Many Sleepless Nights: The World of Organ Transplantation.

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