Physician Writing: Broken Justice

By Kenneth C. Edelin, MD

The Secret to writing: Remove your “stuff” from its boxes and lay it all out.

It took me 30 years to write my book; Broken Justice. A True Story of Race, Sex and Revenge in a Boston Courtroom recounts my criminal trial in Boston on a charge of manslaughter in the death of a fetus during a legal abortion.

I was the chief resident in Obstetrics and Gynecology at Boston City Hospital and in October 1973 I performed an abortion on a 17 year old high school senior, at the request of both the young girl and her mother. The abortion took place nearly 10 months after the Supreme Court, in its decision in Roe v. Wade, struck down all restrictive abortion laws. In spite of this I was indicted by a secret Grand Jury and went to trial for manslaughter. At the end of the six-week trial I was found guilty, but a year and a half later the verdict was overturned by the Supreme Judicial Court of Massachusetts. They entered their own verdict of “not guilty”.

I knew that someday I would write a book about this experience so I collected and saved every document, note, memo, legal brief, letter, news clipping and the entire printed transcript of the six weeks of the trial. I packed all of this “stuff” in boxes and they moved with me every time I moved.

My first attempt to write my book was immediately after the trial with a professional writer – a “ghost” writer – but our styles and personalities didn’t mesh and that relationship ended after several months.
Ten years passed during which time I was appointed Chairman of the Department of Ob/Gyn at BU School of Medicine. I was due a sabbatical and decided I would use it to write my book. At the end of the six month sabbatical I had an outline for my book and a few chapters. With the help of Gloria Steinem I got my proposal in front of an editor at Little Brown. She liked it, but the editorial board turned it down. I was crushed, so I packed-up my “stuff”, and put it back on a shelf in the basement. 

In the years that followed I would occasionally write a paragraph, page or chapter. More often than not I would get “stuck”, close the box of “stuff” I had opened, and stopped writing.

Six years ago, I decided I was going to try writing one more time. I was nearing retirement and didn’t want this unfinished project hanging over my head during my retirement years. I was either going to complete my book now or give up the dream forever.

I started out by trying to understand how other writers started and finished their books. I read every book I could find about writing. I subscribed to writers’ magazines. I explored writing web sites. I even attended a writers’ conference for physicians. I learned, not only about the craft of writing, but also about the business of writing and publishing.  (I’ll describe this in a later blog).

In a spare bedroom I setup my workspace, opened up my boxes of “stuff”, and laid it all out chronologically on a large table. As I read through it all memories were jogged, details were remembered, emotions were dredged-up and gaps were filled-in. This 30 year old story came alive. I began to write. I wrote about my residency and about the patients I had taken care of – especially that 17 year old girl. I re-read and re-wrote the transcript of the trail and tried to transform it from a dull, bland collection of questions, answers and rulings by the judge, to a living, exciting, dramatic document while being faithful to the meanings of the words.

Simultaneously, I had to explore how I was going to get my book published. I learned that, first, I needed an agent and she or he would find a publisher for my book. I sent more than 50 Query Letters to agents describing my book. I received a rash of rejection letters and a few that wanted more information. In the end I couldn’t find an agent to represent me. I then investigated how to self-publish my book and chose a company to help me do that. (I’ll write about self-publishing in an upcoming post.)

In the summer of 2007 I self-published my book Broken Justice. A True Story of Race, Sex and Revenge in a Boston Courtroom. It was an amazing and satisfying accomplishment. My book received very positive reviews in several major publications and I was invited to speak in bookstores and other venues around the country. The experience has been everything I wanted it to be and more. You can read more about my book and its reviews by going to www.brokenjustice.com

About: Kenneth C. Edelin, M.D. is Emeritus Professor of Obstetrics and Gynecology at Boston University where he was Chairman of the Department for eleven years.

Submit a guest post and be heard.

Physician Excuses For Not Making Your Ideas Happen

If you're a physician that wants the freedom to control your career and lifestyle, you're going to have to act.

Here are the most common excuses that physicians give for why they can't actually take control of their career and lifestyle and actually do what they want. (You'll also notice that it's the same list that everyone else has.)

It's quite a list and there are plenty of pegs for most physicians to hang their hats on and, indeed, most docs will never have real control or freedom. But, as the wise man once said, the world needs ditch-diggers too.

If you're risk-adverse and choose security over opportunity every time, here's your list courtesy of 99%:

1. I DON’T HAVE ENOUGH TIME.
Extra time, like money, rarely just materializes out of thin air. We have to work for it. If “finding creative time” is a struggle for you, consider getting proactive about carving it out, and doing the most important work first.

2. I’M AFRAID OF FAILURE.
If we really push ourselves, we will fail more than we’ll succeed. But that’s how we gain experience, how we learn, how we grow. The greater failure is to never risk failure at all. Choreographer Twyla Tharp: “If you do only what you know and do it very, very well, chances are that you won’t fail. You’ll just stagnate, and your work will get less and less interesting, and that’s failure by erosion.” 

3. I’M NOT INSPIRED.
Inspiration comes from action, not the other way around. Our friends at Red Lemon Club shared this insightful tidbit from leadership guru John C. Maxwell: “"The whole idea of motivation is a trap. Forget motivation. Just do it. Exercise, lose weight, test your blood sugar, or whatever. Do it without motivation. And then, guess what? After you start doing the thing, that’s when the motivation comes and makes it easy for you to keep on doing it."

4. I NEED TO FIND BALANCE IN MY WORK AND HOME LIFE. 
Living a full, balanced life is a wonderful goal. But does that mean doing less work and having more leisure time at home, or doing better work and feeling more fulfilled? Seasoned non-conformist and entrepreneur Chris Guillebeau makes the case for better work and bigger dreams, arguing that balanced people don’t change the world.

5. I CAN’T OVERCOME MY INERTIA.
Getting started can be hard. Once you’re sitting still, once you’re in your comfort zone, the easiest thing to do is just stay there. As serial entrepreneur Andy Swan has written, one of the most common mistakes when we’re just beginning a project is to “set lofty goals from a resting start.” With images of fame and success dancing in our heads, we set the bar too high, fail to make the grade, and quit because we’re discouraged. Instead, build momentum by starting with small, achievable goals, and work from there.

6. IT’S NOT ORIGINAL ENOUGH.
Originality is immaterial. Filmmaker Jim Jarmusch puts it like this: “Nothing is original. Steal from anywhere that resonates with inspiration or fuels your imagination… Select only things to steal from that speak directly to your soul. If you do this, your work (and theft) will be authentic. Authenticity is invaluable; originality is non-existent… Remember what Jean-Luc Godard said, ‘It’s not where you take things from – it’s where you take them to.’” 

7. I’M AFRAID OF THE COMPETITION.
If someone else is doing something similar that needn’t be a reason to give up. In fact, it’s a great reason to get more excited. As Seth Godin has said, competition validates your idea by creating a category. It also lights a fire under your ass. 

8. I GOT MY EXPECTATIONS TOO HIGH JUST THINKING ABOUT IT…
It’s easy to get high on the idea of executing your idea. You daydream about how great it will be, the recognition and acclaim that will inevitably follow its launch. You build it up so much that the reality of actually executing the idea starts to seem unappealing. Ze Frank calls these un-executed ideas “brain crack” – it’s a dangerous addiction. 

9. IT’S NOT THE RIGHT MOMENT TO DO IT.
Occasionally, this excuse has the merit of actually being valid. Twitter creator Jack Dorsey had the idea for the service back in 2000. Unfortunately, the technology that would help Twitter thrive wasn’t in place yet. But how did he recognize this? Dorsey did a small-scale implementation of the idea that flopped. Even though it failed then, the exercise crystallized the idea in his mind, and Dorsey was able to revive it later when the timing was right. 

10. I HAVE TO PLAN EVERYTHING FIRST.
At this year’s 99% Conference, author and entrepreneur Frans Johansson argued that humans are very bad at predicting which ideas are going to be a success. Thus, nearly every major breakthrough innovation has been preceded by a string of failed or misguided executions. The moral of the story? Spend more time doing, and less time planning.

11. THE PRODUCTION IS TAKING TOO LONG.
Nobody ever said creative execution was sexy. In fact, it’s grueling. Author Junot Diaz battled writers block for 5 years before finishing his Pulitzer Prize-winning novel. Inventor James Dyson built over 5,000 prototypes before he found the right design for his vacuum. And the list goes on. We must find joy in the process of execution, not just the end product.

12. MY IDEA ISN’T POLISHED ENOUGH YET.
Charles Darwin spent 20 years developing his theory of natural selection, and planned to eventually publish his research in a multi-volume tome. But in 1858, he received a letter from the naturalist Alfred Russel Wallace essentially summarizing the theory he’d been cultivating over decades. Darwin scrapped his plans for a tome and quickly published his now-famous abstract, On the Origin of Species. Without Wallace nipping at his heels, though, how long might Darwin have gone on perfecting his world-changing theory? Sometimes it’s best to launch a project before it’s “perfect.” 

13. I NEED TO DO MARKET RESEARCH.
If you think about real, game-changing inventions and discoveries – the electric lightbulb, the double helix of DNA, the airplane – almost none of them had the support of the masses in the early days. Being a visionary means being able to see what other people can’t even imagine. That’s why companies like Apple don’t do market research. 

14. I HAVE YOUNG CHILDREN.
This excuse reminded us of a great piece from writer Rebecca Cantrell, who struggled with the impact her newborn had on her writing. Though initially she lost her will to work as she focused on child-rearing, Cantrell found – in watching her son’s willingness to experiment and fail and never give up – that the experience actually inspired her and improved her writing practice. 

15. I’VE GOT TO PAY THE BILLS.
Here's the big one for most physicians. Going with the status quo, we tend to give high priority to things like wealth and stability. And once we have them, it’s extremely difficult to imagine life without them. (To wit: “The three most harmful addictions are heroin, carbohydrates, and a monthly salary.”) But should these things come at the expense of pursuing big, bold ideas? Paying the bills won’t necessarily earn you a legacy.

The enjoyment of control and freedom isn't something that's ever going to be handed to you. You'll have to earn it through action.

The 24/7 Baby Doctor

By Victoria McEvoy, M.D.

Losing the Contest but Winning the “War”

Dr. Julie Silver’s annual writing course (www.HarvardWriters.com) had me at “hello.”

Rarely do I enjoy sitting through a conference, but I was transfixed with the nuts and bolts presented about how to get a book published for all the physician-writers. The course was packed. The participants were invited to enter a contest: offer a title and a brief synopsis of the book that you would like to write. The winner gets to meet with an agent and discuss the process. I lost.

However, several months later I was contacted by a member of the Harvard Medical Book Publishing Division who had seen my entry and was intrigued. With a little encouragement I was off and running on a multi-year odyssey to write a compelling book proposal that a real publisher would actually want to underwrite. There were lots of starts and stops—the usual discouragement and shock at the amount of time this project was consuming with no obvious reward in sight. And this was just the proposal; I could only imagine what the actual book writing would entail, should I ever get to that part.

We finally reached the “fish or cut bait” point. Dr. Silver said that I needed to partner with a professional writer who knew how to write a proposal that would pass muster. Enter Florence Isaacs, a New York writer who became my alter ego for the better part of a year. Once she pulled me over the finish line, we got an agent, found a publisher, and in May 2010 my book was published—The 24/7 Baby Doctor: a Harvard Pediatrician Answers All Your Questions From Birth to One Year. The book really does exist, and people have paid real money to purchase it—what a thrill! More importantly, new parents and grandmothers have told me how helpful the book has been to them.

The journey was long, painful, and hard but worth every minute. With the help of many knowledgeable journeymen and women along the way, we now have a book that sits on bookshelves in retail outlets, hospital gift shops, and homes of new parents. You can order it on Amazon.com where the author page completes the story.

Victoria McEvoy, M.D. is an Assistant in Pediatrics at Harvard Medical School and Chief of Pediatrics at Massachusetts General West Medical Group in Waltham, MA. She is a former columnist for The Boston Globe and has written for numerous publications including The New York Times.

How To Become An Author On Freelance MD

Freelance MD’s primary goal is to deliver quality information to physicians who want to gain freedom and control of their careers and lifestyle.

Of course, this information comes form our contributing authors who are willing to share their time and effort to provide access to the best information and experitise around lifestye, income and career for physicians.

Writing takes time. Closely examining the latest developments takes its time as well. If you're a thought leader with information to share and want to make it available to our readers as one of our writers, we welcome your participation and help!

Of course, you don't need to become a "Contributing Writer" for Freelance MD. You can interact with the community—Including our writers—by leaving comments or using our community forums. You can also write and submit a guest post and have it appear in the main blog and all of our RSS feeds.

But this post is for those who may consider becoming part of the team. Here's a pretty simple FAQ that walks throught some of the common questions about our contributing team. Let's get on with it.

Click to read more ...

Google Tech Support For Parents (And Physicians)

If you're looking to get out of the tech support role this Christmas, Google has a site for you.

Christmas is going to have more technology gadgets than ever, and they're all going to be connected and web enabled. If you've been handing the tech support for your parents since the VCR needed to be connected, you're days of wine and roses are here.

Google staffers (Googlers) have drafted a site that teaches the most technology-challenged among us how to take a screenshot, set up an autoresponder for your email, send large files or make a phone call with your computer.

If you're smart, you may just use this on the rest of your more tech-challenged family members and staff.

Freelance MD's Kiva Lending Group For Third World Entrepreneurs

Freelance MD's Kiva lending group for micro-loans to Third World entrepreneurs.

Kiva, a non-profit website that allows you to lend as little as $25 to a specific low-income entrepreneur across the globe. You choose who to lend to—whether a baker in Afghanistan, a goat herder in Uganda, a farmer in Peru, a restaurateur in Cambodia, or a tailor in Iraq—and as they repay the loan, you get your money back. Here's the Kiva about page.

I've been a member of for a while now. In fact, my daughtter and I started her micro-loan fund a few years ago. Since she started with $100, Maddy's lent to 33 different entrepreneurs and groups around the world and her fund is $500 or so. She re-invests the money with new entrepreneurs as the loans are repaid.

We've created a lending team for Freelance MD members.

Once you're a part of the team, you can choose to have a future loan on Kiva "count" towards our team's impact. The loan is still yours, you choose who you loan to and repayments still come to you—but you can also choose to have the loan show up in our team's collective portfolio.

If you'd like to join our lending team we'd love to have you. We'd love it even more if you were to blog/post/tweet/invite your friends. For $25 you can help change someone's life.

Physician Outsourcing: Technology Will Flatten The Medical World?

Medical outsourcing is going to become standard practice for specialties that don't require high-touch patient interaction; Radiology is one such example.

Here's a story from Canada that shows how this will start, but it will become much more prevalant as 'local' or 'regional' outsourcing.

When an Ontario man fell off a ladder and struck his head recently, the life-saving medical treatment he received included a surprising assist from halfway around the world.

The radiologist who read his brain scan, diagnosing a potentially lethal blood clot, was based in India, part of an unusual new twist on the overseas outsourcing trend.

A six-month-old arrangement between the Indian "teleradiology" company and an unnamed Canadian imaging centre is one of the first examples in this country of foreign medical outsourcing, a development that has professional groups and medical regulators here worried.

MRI, CT scan and X-ray images taken in Ontario and converted to digital format are zapped to the subcontinent over the Internet and interpreted by Canadian-trained Indian radiologists, who then report back on their findings.

A spokesman for Telediagnosys, based in the Western Indian city of Pune, said the service his firm offers is cheaper and faster than what is provided by overworked local specialists.

"Their earlier radiologist used to take at least 48 hours to give the reports and charged more than us," Dr. Ashish Dhawad, chief operating officer of Telediagnosys, said in an e-mail interview. His company turns around non-emergency work for the Ontario imaging centre within 12 hours.

Professional associations and regulators, however, question whether the quality of work would match that of a radiologist closer to hand, and ask whether disciplinary action would be possible against the offshore doctors if something went wrong.

"Imaging studies are not to be downplayed and treated as a commodity like a pound of butter or sack of wheat," said Dr. David Vickar, an Edmonton radiologist. "This is a consultation we are doing; it is not a laboratory test."

Meanwhile, as Canada continues to grapple with a severe physician shortage, observers speculate that foreign medical outsourcing could eventually expand to include other services, including pathology -- analysis of human tissue -- and even remote-control surgery.

In a paper just published in the journal Healthcare Quarterly, Sally Bean, a bio-ethicist at the University of Toronto, predicts that a lack of doctors and new technology will lead to a bigger role for health care outsourcing.

She suggests, though, that standards be developed to ensure privacy and quality are safeguarded and legal liability issues are addressed.

"It's a matter of how well it's done," Ms. Bean said. "If it's regulated and we're taking quality and safety and liability concerns seriously, then it could be a good thing."

Dr. Dhawad said his company has two radiologists who were trained in Canada and are certified in the specialty by the Royal College of Physicians and Surgeons. The firm has done mostly non-emergency work for a diagnostic-imaging centre in Ontario for the past six months.

All commercial markets, and medicine is a commercial marketplace, push for maximum efficiency. The fact that physicians will be impacted by this won't prevent it from happening and tired arguments that it's not in the best interest of patients are false on their face. While there will be much hand-wringing, gnashing of teeth, lawsuits and stories in the press of outsourcing gone wrong, it is in the best interest of the marketplace AND the patient population at large.

The fact that technology solutions are more efficient, more reliable, and scalable mean that this is an inevitability. It also means that it's an opportunity for physicians who embrace it.