Confessions of a Surgeon

By Paul Ruggieri MD, FACS

Confessions of a Surgeon

It has been a little over a month since my book, "Confessions of a Surgeon:  The Good, the Bad, and the Complicated...Life Behind the OR Doors" was published and I have finally had time to think about the unique places it has taken me.   I cannot describe to you what it feels like to be at the end of a very long journey.  I started writing in my head ten years ago and knew someday the words would make it to paper.

I wanted to let the public into my operating room world with a very honest depiction of what I do and how I feel about what I do.  The book is a very blunt depiction of life, death, imperfection, emotional stresses, legal pressures, and human frailties.

I believe , because of our unique day (and night) jobs, everyone one of us physicians has an extraordinary story to tell, a story the public has a right to hear.  Everyone of us has a book buried deep inside our gut (being the general surgeon that I am) that just may need a little coaxing to bring out.

I was not a seasoned writer and had no understanding what it involved to write,publish, or promote a book.  All I knew was I had a story to tell and Julie Silver's Harvard Writing course was something I had to experience.  I had to experience it so much that I attended her course twice before writing my book, once in 2005 and again in 2010.  The first time got me warmed up to write (the timing was just not right).  However, the second time I attended the course, the stars were aligned and it ignited the fire in me.  Her course taught me very usable lessons on how to organize my story, discipline my writing, and instill confidence in my ability to complete what I had set out to accomplish.   Dr. Silver's course was also instrumental in giving me access to top New York City agents and professional writers.  The funny thing was I almost did not attend her course in 2010.  It was a last minute decision and probably the best one (outside of asking my wife to marry me) I have made in a very long time.

Writing my book was not easy and there were many a time when I just stared at my labtop, hoping the keyboards would just move by themselves.  To me, writing anything never came easy.  Remember, I am a general surgeon and if I cannot drain it, remove it, or rearrange it within a few hours I move on to the next one.  Most of us do not have the patience to write almost every night and weekends, one page at a time.  So, when I received my first galley copy in the mail from Penguin Publishing, I got drunk.  No, I am only kidding.  However, I did open up a bottle of single malt I had been saving and toasted everything in sight.  When I finally received my free 50 copies of the finished product,  then I finished the bottle off and got drunk.

The best advice I can give anyone who has a dream is to just go do it.  Do it with honesty and sincerity.  Do it because people need to know what unique lives we lead.  People will never know what is in our heart unless we show, not tell them.

About: Paul Ruggieri MD,FACS is a general surgeon in private practice, writer, stepfather, and a lover of single malt scotch. He writes at http://paulruggieri.com

Submit a guest post and be heard

Traditional Book Publishing is Not Dead

I'm going to a book signing tonight at a local bookstore for one of our new releases Organize Your Mind, Organize Your Life.  

This is a neuroscience book with a coaching approach--not surprisingly written by a psychiatrist and coach team.  It was released as part of book publishing's traditional campaign that begins annually in January, "New Year, New You." 

Organize Your Mind, Organize Your Life has come out of the gate with a bang, and people are quickly snapping up the exisiting copies.  I hear it's going to be standing room only.  The event was announced in advance, and people signed up for seats.  Aren't bookstore events dead?  Mostly, but not completely. 

Why all the buzz about this book?  Two reasons:

1. the BOOK, and
2. the AUTHORS. 

Let's start with the BOOK.

Organize Your Mind, Organize Your Life is a book for smart people about how to do more in less time by first getting your "house" (that would be your brain) in order.  It's the "one-two punch" with first understanding the neuroscience and then having simple but effective tools to implement.  Frankly, it's the book that every CEO should be giving to his or her employees to increase efficiency and productivity.  In book publishing, we call this a great "hook".  Great hooks usually develop when the content is superb and combined with a fascinating concept that is new.  Not surprisingly, people are buzzing about this book (read the early reviews on Amazon).

Now, let's turn to the AUTHORS.

I suspect that these authors, Paul Hammerness, MD (a psychiatrist and researcher at Harvard Medical School) and Margaret Moore (aka Coach Meg who is co-founder of the Institute of Coaching at Harvard Medical School) are a lot like the people that come to FreelanceMD.com.  They are smart and cutting edge and focused on trying to make an impact in their chosen fields — psychiatry and coaching, respectively.  They have a wide network of friends and colleagues who are very supportive of their work.  This is the first book for both of them, and this wide network is helping them to get the word out.  If you happen to know someone who knows these authors — let's call her Mary — at some point in the near future, you'll likely see that Mary has posted something about this book on her Facebook page, tweeted about the book on Twitter, shared info about it on LinkedIn, blogged about it, or at the very least, the good old fashioned way of getting the word out — actually mentioned the book in live conversation.  Mary is one of hundreds of people who are helping them to get the word out.  I'm sure I'll meet some "Mary's" tonight — people who are connected to these authors and will help make up the standing room only crowd.

It's been less than two weeks since Organize Your Mind, Organize Your Life was released, and after just a few days of being "real authors", Margaret Moore and Paul Hammerness can tell you--books are not dead!

"Rookie Mistakes" To Avoid If You Want To Publish A Book

How can you avoid rookie mistakes as a first time physician writer?

The other day I was talking to a colleague about my upcoming publishing course (www.HarvardWriters.com) and mentioned that I need to find a way to tell the doctors who attend how to avoid saying the wrong thing right off the bat to an editor or agent. 

It's easy to do, because what makes sense to say isn't always the right thing.  In fact, it might be exactly the wrong thing--a statement that gets your book idea shot down before you can even describe the concept. 

My colleague suggested that I prepare some slides that are called Rookie Mistakes You Don't Want to Make.  I just may prepare those slides!  There are a lot of things I could put on them.  Here are 4 examples:

1.  Don't ever tell an editor or an agent that you want to write a book about a topic that "has never been done before."  The more unique your idea, the more likely it is to get shot down.  I know that sounds counter-intuitive, but if you think about it from a marketing point of view then you'll realize that editors and agents like what is tried and true.  They think that there's probably a good reason why a book such as the one you are trying to describe hasn't been done.  And, as soon as those words come out of your mouth...they're done listening!

2.  Don't start at the beginning!  A lot of people talk to agents and editors about their book ideas as if they are telling a story with a beginning, middle and end.  These folks don't have the time or patience to sit through that again and again.  Begin with the end -- or at least the middle.  I don't mean to confuse them with a an incomplete example, but rather start with your strongest material.  Think of your first few sentences (whether written or oral) as the headline in a news article.  Very few editors are willing to listen to someone build their story to an exciting climax.  They want the climax first.  What's exciting about it and why should they be interested in it?

3.  Don't tell say that you have never seen a book like yours.  This is a bit of a variation on #1, but it's a little different.  You actually do have to differentiate your idea from other books that have been published already.  This has to do with the competitive book analysis that goes into a proposal.  If your competitive analysis is "I haven't ever seen a book that is quite like the one that I am proposing", that statement will mark you as a genuine rookie.  If you say that you've done your research and searched in the bookstore and online booksellers and there are books that are similar but here's how yours is different, that marks you as a pro. 

4.  Don't say that your friends, colleagues, or especially your family members, like your writing or think you are a good writer or anything that even remotely resembles a comment similar to this.  Even if an editor doesn't actually roll his eyes right then, he's thinking, "Oh, brother..."  Good writers publish.  They don't lead with how much their friends or families love their writing. 

I'll write some "Do's" in upcoming columns.  These are just a few tricky pitfalls that truly doom great books from ever getting published!

If A Surgeon Can Write A Book or Two, So Can You

If I had only one word, I would use “pinball” to describe my transition from academic surgery as an Associate Professor at Dartmouth to what I do now, combining locum tenens general surgery with being a thought leader in physician engagement and optimizing physician-hospital collaboration.

Yet, writing appears to be the common thread in my iterative life journey.  I learned that the words “author” and “authority” have a common root, auctor, (http://dictionary.reference.com/browse/authority)  meaning writer, progenitor, accepted source of information, power, and mastery.

I had a fortunate break that helped me write my first book, Better Communication for Better Care.  In 2003, the head of the California Hospital Association who heard me present results of a consulting project, remarked, “This is the best work in any California community hospital, bar none,” and told the President of the American College of Healthcare Executives (ACHE) to ask me to teach a seminar there.  As a result of the seminar, the acquisition editor of Health Administration Press, the publishing arm of the ACHE, told me that she had a series of 80-page Executive Essentials books and asked me if my seminar material would fit.

When I said yes, she said, “Just because you have published over 40 articles, don’t think of this project as an extended article.  Writing a book is different.”  What I learned from the process is that:

• Writing a book with a publisher requires others’ assistance: people who cannot abide by others advising them re: title, cover design, length, and word-smithing are better off self-publishing
• The focus is on the needs of the target market: unlike a review article, which is a scholarly product, a book published by Health Administration Press must reflect the unmet needs of senior healthcare leaders, guiding them on what strategies and tactics work with physicians, not telling them how ignorant they are because they did not attend medical school
• Once the book is published, the author’s job begins: at Health Administration Press, a marketing department of two oversees the launch of about 100 books in the catalog; it becomes the author’s responsibility to take an active role in marketing the book if s/he wants to publish another book in the future

So, how do you market your book?

• The Internet is a great equalizer: you can build buzz for your book even before it is published through blogging; I use WordPress because it combines seamlessly with my website (http://healthcarecollaboration.com/blog/)
• LinkedIn (http://www.linkedin.com/in/kencohn) is a great way to connect with fellow healthcare professionals; it also can provide links to your latest blog posts
• I maintain a Facebook page for each of my books, (http://www.facebook.com/pages/Better-Communication-for-Better-Care/98165231327), (http://www.facebook.com/pages/Collaborate-for-Success/114669573209)
• I customize my email signature; my Hotmail account, which has my widest distribution, displays: Author of Better Communication for Better Care: Mastering Physician-Administrator Collaboration (2005) and Collaborate for Success! Breakthrough Strategies for Engaging Physicians, Nurses, and Hospital Executives (2006) http://healthcarecollaboration.com/books

My mentor Sam Horn, taught me, “Ink it when you think it.”  I keep a pad of paper and a pen in my pocket, and on my bedroom nightstand for those moments when a thought comes to me.  Others use the record button of their smart phones to capture ideas.  For me, writing has been a wonderful journey that has expanded my knowledge base and circle of friends and colleagues and that has led to speaking and consulting invitations in 40 states, England, Sweden, Italy, and China.

I hope that your writing journey is equally rewarding and that you will keep me posted on your progress by writing me at ken.cohn@healthcarecollaboration.com

Physician Poetry

By Dr. Jon Wolston

“Bitch is... we’re all close.”

When I heard a patient speak those words years ago, something happened to me that I still don’t fully understand. I felt like I had just been bestowed a gift in that moment, a gift that had to somehow remain unspoken about between us, but that nevertheless deserved to be acknowledged more widely somehow and eventually recognized publicly in some sense.

My outpatient practice began to take on an added dimension of “word mining” so to speak. The enduring value of certain words in and of themselves seemed to blossom overnight, yet the nature of their power remained mysterious to me. I couldn’t deny the potency of this experience, but I was still at a loss as to how to account for it except that it reflected some aspect of an intimate moment.

Eventually I learned about the tradition of “found poetry” and began to write what I heard in poetic format. I looked into poetry therapy as an adjunctive treatment modality, because I could sense its transformational heft. The National Association for Poetry Therapy is a wonderful organization, highly recommended, but it still wasn’t quite what I was after. Meanwhile, the poems continued to appear. Would they continue to emerge or would they mysteriously wane, like so many of the other things we hold precious? In a way I had difficulty claiming sole authorship. It seemed like the intimate moment was the author and I the transcriber.

Fortunately, I signed up for Dr. Julie Silver’s course in 2007, which was a godsend. Here were established authors of all stripes with tales to tell, professionals from all facets of the publishing world, and bemused newbies opening to the power of words. Julie helped me accept that I was evolving into a physician-writer and that I had good company among other emerging practitioners of this art. I’ve enjoyed keeping in touch with many of the participants since. One lasting understanding that I gained was that any book you see reflects the work of many different individuals, not just the author. Maybe this is a lesson of particular value to physicians.

Soon I began to attend all the poetry readings I could muster in my hometown, dragging friends along whenever possible. I met some inspiring poets, particularly on the nearby Brown campus, and corresponded with those who struck a chord and were kind enough to respond to me. I joined the writing group at the venerable Providence Athenaeum, an invaluable source of support and former hangout of Edgar Allen Poe. I started compiling first email lists and later blogs to send out poems for critique. Readings came by invitation. My favorite is probably the Super Bowl halftime reading my son Chris requested. You had to be there.

With the help of my good friend and publisher Bill Connell, I put together a manuscript of a poetry collection, “Paradise Root-stock,” printed in April 2008 . Bill’s advice was, “Publish when you feel like you have a certain ‘body of work’ that you’d like to represent.” In this collection I look to capture the sense of awe I still feel about where this all came from. The process still mystifies me. The title comes from a Galway Kinnell poem called “The Stone Table.” He names the most common apple-tree cultivar in New England as emblematic of his tenacity in the face of our notoriously tough growing conditions.  The title also alludes to what is probably my favorite poem in the collection, called “Nor’easter”:

     Poems are windfall
     of the orchards of my soul. . .
     some bruised some glowing,

     all with secret seeds
     ready to be swallowed up
     when God is hungry.

In hindsight, my friend the historian Dr. Doug McVicar was also a big help in getting PR-S into print. He issued a “dare” in 2007 to see which one of us would publish first! I think physicians thrive on healthy competition. If you’re feeling a little stuck with your writing, consider old-fashioned dares.

Four of the poems in PR-S were selected by the Poetry Society of New Hampshire for inclusion in their 2010 Poets’ Guide:More Places, More Poets. In doing promotion, I found that smaller independent bookstores love to have you read for them to help draw business. They are also more likely to be interested in stocking your poetry book afterwards than a chain or large bookstore would. Two of my all-time favorite bookstores: http://www.lexingtonbooksandco.com in Virginia and http://www.bayswaterbooks.com in New Hampshire. Both these wonderful venues allow an intimacy to develop, on account of their size, that is distinctive, and particularly conducive to poetry readings.

For physicians interested in developing as writers, Dr. Julie Silver’s Harvard course is invaluable and highly recommended.

About: Dr. Jon Wolston is a psychiatrist who transitioned to retirement by finding unexpected pleasure and meaning in writing poetry and publishing it, both in print (“Paradise Root-stock” 2008) and online at http://jonwolston.wordpress.com.

Submit a guest post and be heard.

What is it Like to Have Your Book Reviewed by the New York Times?

It's an exciting day when your book is finally released, and you read about it in the New York Times.  Sure, the review could be bad, but if you are on a roll and things are really going your way, then it will be a good one!

I asked psychologist Joe Nowinski what it was like when his new book, Saying Goodbye: How Families Can Find Renewal Through Loss was featured in the New York Times.  Joe said, "Having our book review appear in both the online and print editions of the New York Times is a landmark experience for me."  He went on to say that becoming a blogger for the Huffington Post—a result of publishing Saying Goodbye—is also a "dream come true." 

Joe co-wrote Saying Goodbye with another psychologist (and colleague of mine at Harvard Medical School), Barbara Okun.  He says, "There is no doubt that Barbara Okun and I poured our hearts and soulds into Saying Goodbye, but this kind of response is incredibly rewarding for our efforts."

When I mentor physician-writers, I always encourage them to write about things that are really meaningful to them.  After all, hopefully you'll be interviewed extensively on the topic, and it's always best if you really are passionate about it.  Joe and Barbara wrote about what they coined "new grief."  The kind of grief that ensues when people with terminal diagnoses have months or even years to live, because medical science is getting better and better.

Joe told me, "The need to come up with a new paradigm for understanding how grief has changed has immense and direct application to my clinical work."  Interestingly, he has found that the principles in new grief are helpful in other situations such as divorce.

A book review in the New York Times is a wonderful announcement to the world about a subject that you feel passionately about.  A rare and wonderful accomplishment and a day to savor forever!

Physician: 11 Reasons to Write Your Book in 2011

If you're a physician considering writing your first book, here are 11 reasons to go for it.

As a physician, maybe you’ve already written a book for a technical/medical audience, but when you write for a lay audience at a national level, here are some ideas of what your book can do for you:

1. Increase Your Influence: after publishing The Favorite Child with Prometheus Books, Dr. Ellen Weber Libby appeared on the CBS Early Show and became a blogger for The Huffington Post and Psychology Today. Her first Huffington post article got 273 comments. If you want to reach a national audience with your message, a book is one of your most potent tools.

2. Add Fuel to Your Entrepreneurial Engine: Whatever your enterprise, your book can bring in your ideal clients or customers.

3. Double or Triple Your Speaking Income: No question that most speakers get paid more (and get higher profile speaking gigs) when they become published authors.

4. Retire from Your Day Job: If you’re still working your “day job” and looking for a way to move into your new career more quickly, consider this: Pat Hastings retired from her job as a substance abuse counselor nine months after publishing her first book, Simply a Woman of Faith, and launched her career as a speaker, retreat leader and life coach. What’s your dream?

5. Get that PR: I’ve had many an expert tell me they couldn’t get on TV until they became a published author. Your book makes it much easier to get coverage (especially at the national level).

6. A Boost for High End Sales: One of my clients, Evana Maggiore, says that a $25 book sale off the internet often results in someone devouring her book, Fashion Feng Shui: The Power of Dressing with Intention, in one sitting and then registering for a $3,000 seminar. What could your book do for you?

7. Meet Interesting People: When I became a published author, I met stimulating and inspiring authors, speakers, TV and radio hosts and others. Becoming an author will expand your circle and your world—leading to personal growth and the expansion of your own ideas and enterprises.

8. Be Known as the Expert You Are (and not just by your colleagues): If you want to be seen as a top expert in your field and reach beyond your colleagues, write a book! (Your competition probably is…).

9. New Experiences:  Exciting opportunities will show up in your life as people read your book and want to connect or partner with you—things you may not have even dreamed of.

10. Tax write-offs: Ask your accountant: You may be able to write off expenses that are related to your book (travel, research, classes that inform your book, etc.).

11. The Feel Good Factor: Writing a book provides a powerful sense of accomplishment. According to a New York Times article, it’s on 80% of people’s bucket lists. Most people never make it happen. Think of how you’ll feel when you hold your published book in your hands.