When Medicine Meets Fiction

The first week of my pediatrics residency at Columbia University Medical Center, I was assigned to care for a twelve-year-old boy with leukemia. I’ll call him TJ. He had been in the hospital for 126 days after his third bone-marrow transplant. Since he was severely immunocompromised, TJ was in a room where all visitors had to don gowns, gloves, and masks. The interns rotated every four weeks, which meant I was probably the 30th resident assigned to him—and he was understandably resentful and distrusting of new medical personnel. Determined to win him over, I told him jokes day after the day. I kept at it, even though he crossed his arms and refused to look at me. At the end of our third week together, I recited the poem “Lazy Jane” by Shel Silverstein. It earned me a smirk. More importantly, it led to a conversation that wasn’t about bowel movements or rashes. We talked about books.

I arrived home elated. When my boyfriend asked how I wanted to spend my first full weekend off, I told him we were going to the bookstore. TJ had been in and out of school much of his childhood and had never read poetry. I was a brand-new intern whose skills consisted of reporting vital signs and patient symptoms. There was little I could do to help my patient medically. But this was something I could fix.

Monday morning, I tucked a gift-wrapped Where the Sidewalk Ends in my bag. On my way to the hospital, I imagined TJ giggling at the poems. I could see him smile. I stepped off the elevator and into the residents’ workroom to scan the white board that had the service list. TJ’s name wasn’t on it. The on-call intern, bleary-eyed and in wrinkled scrubs, delivered the news: TJ had passed away the night before.

At that moment I built a wall, the emotional divider all physicians erect to some degree or another to allow us to survive the tragedies we witness. After that day, I never cried at work. I rarely cried at home.

Over the years, I became a pediatric cardiology attending at an academic medical center, a NIH-funded researcher, and a mother. While pregnant with my third child and on bedrest, I picked up a book unrelated to medicine for the first time in over a decade, a young-adult book about a girl falling in love, and then losing that love. Swept into the story, I cried. That novel broke through my wall. It made me want to write something similar, a book that would cause readers to experience intense emotion.

It took four years of writing, rewriting, and editing, and learning about the publishing world before I began what would become my debut novel, Water in May. I drew from my clinical experience in fetal cardiology. Imagine being told your baby has only half a heart and might not survive. The main character is based on the young women I cared for while working in Washington Heights, New York: women who fought for their babies, teens who grew into mothers. Readers have told me my book deeply affected them. And if I can educate and spread awareness of the most common birth defect while moving my reader emotionally, even better.

I still see patients. I still rely on my wall to help me through difficult cases. But I also have my writing. And I have the books of others—the power of literature—for times when I want the wall to come down.

The daughter of a Cuban immigrant, Ismée Williams is a pediatric cardiologist who trained and practiced at Columbia University Medical Center for 15 years. She currently sees patients at Montefiore Hospital and lives in New York with her husband, three daughters, and a labradoodle.

This article originally appeared in Tufts Medicine.