Backstory

It was during the aftermath of my third chemo infusion—the nausea, the fatigue, the fuzzy thinking—that I began to reminisce about my medical school classmates. Lying in bed, I started that day’s entry in the journal I had kept of my experiences with breast cancer. I wrote about the strong bonds we medical colleagues share, the discipline of our training, the efficiency and beauty of our medical language, and the way we learned to accept hurting people as the first step in helping them through an illness. During my year of cancer, my medical colleagues would ask, “How are you doing?” and I would answer, “This sucks.” They understood completely.

About two pages into the journal entry, I realized it was getting longer than anticipated, so I crawled out of bed and hunted down a legal pad. I kept writing and writing. Then I began revising. The nausea, fatigue, and fuzzy thinking gradually faded (until the next chemo infusion) and I continued revising. Finally I discovered I had composed a personal essay, which I submitted to the “A Piece of My Mind” feature in JAMA, the journal of the American Medical Association. They accepted it right away.

Months later, I ran into a friend who said, “I enjoyed your piece in JAMA. Would you be interested in turning that essay into a memoir?” It took me two seconds to respond, “Sure, why not.” He was working with the University of Michigan Press on a book series focused on medical humanism and thought such a memoir would be an asset to the series. I wrote a book proposal (using an old one of his as a model, since I’d never even seen such a beast), UM Press accepted it, and I spent a year writing. Thus, Inside/Outside was born.