Meet the emergency physician who writes satire [PODCAST]

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“In the dark radiology reading rooms, only the gentle hum of the computers and the quiet chatter of residents dictating radiology reads break the silence. Among the computers sits Dr. Exner, a senior radiology resident at Hospital Woeisme. He has recently become known for a peculiar habit – he has begun adding Rorschach interpretations into every radiology report he completes.”

Stephanie Benjamin is an emergency physician and can be reached on Twitter @stephbenjaminmd.

She shares her story and discusses her KevinMD article, “Resident adds Rorschach reads to radiology reports.”

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Transcript

Kevin Pho: Welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at KevinMD.com/rate. Subscribe at KevinMD.com/follow. Today on the show, we have Stephanie Benjamin. She’s an emergency physician, and her KevinMD article is titled “Resident adds Rorschach reads to radiology reports.” Stephanie, welcome to the show.

Stephanie Benjamin: Hi, Kevin. Thank you for having me.

Kevin Pho: We’ll get into the article in a little bit. First off, briefly share your story and journey to where you are today.

Stephanie Benjamin: So I’m a physician author. I am board-certified in emergency medicine, and I am fellowship-trained in EMS and disaster medicine, based out of San Diego. I became interested in medicine when I was really young because my brother and one of my sisters actually died from a rare genetic disease called Canavan’s. So I knew from a very young age that I wanted to be a doctor, and I specifically became interested in EMS because I’m from New York, and I was in New York during the 9/11 attacks.

On the writing side of things, I started keeping a journal when I was in first grade, and that is a practice that I have maintained till today. I’ve published one book so far, I’ve won a few writing awards, and I’ve published pretty widely in both medical and mainstream media, ranging from The New York Times to GomerBlog to textbooks and e-courses. A few years ago, I became really into writing satire, which is the type of article I produced for KevinMD.

Kevin Pho: So tell me about your writing. How has that influenced you as a physician professionally?

Stephanie Benjamin: Writing’s always been such a wonderful way for me to debrief and unwind and clarify my thoughts. Historically, I’d always written nonfiction or journaled, so just recording events that had actually happened, which is really therapeutic in its own way. I’ve also enjoyed writing fiction and writing creatively, but it’s entirely made up. What I love about writing satire, and what I’ve found to be really helpful in practice nowadays, especially since COVID, is that satire is this intersection: It’s creative writing, but it’s based on true events.

So what I can do is take in events that have bothered me or made me upset or angry or frustrated, whatever it is. I can deconstruct that event and really tease it apart, pinpoint the issue that really was bothering me, and then rebuild a new narrative around it. It’s become really therapeutic and really powerful to be able to take a negative event and turn it into something that’s a little sarcastic or snarky or funny. I’ve just really enjoyed doing that, so much so that I’ve written over 50 satires since I started writing.

Kevin Pho: So tell me about the role of satire from a physician reader standpoint. You mentioned GomerBlog, which is the satirical website where physicians will write a lot of fantastic satirical pieces. But from a health care professional standpoint, how does reading satire help them?

Stephanie Benjamin: I think it brings some levity to what we do. We see so much, and I can only speak for myself, but I was a frontline physician during COVID, and I did several deployments to COVID field hospitals through the California state disaster team, and it’s just really heavy, and it takes a toll. So to be able to read satire and get a laugh, and to think, “OK, I’m not the only one who has a little bit of dark humor in me,” you can kind of connect with other physicians and see maybe another way to cope with what’s been going on.

Kevin Pho: All right, let’s talk about this particular satirical piece, “Resident adds Rorschach reads to radiology reports.” Tell us the story of how that came to be.

Stephanie Benjamin: The history behind that was based on a patient encounter many years ago, actually back when I was in medical school. I was working in the emergency department and working so hard, and this person came in, and they told me that they knew that they were going to get sick that week because of something they read in their horoscope. I was really fascinated by how adamant they were that their health was being dictated by these astrological events. I wasn’t being judgy of the patient, but they were very dismissive of Western medicine and very insulting: “I had to come in and see money-grubbing, pill-pushing physicians.” And I thought, “Man, I’m just trying to help you. You’re here for my help, and in the same breath, you’re insulting me.”

So that encounter was the basis of the article, and I thought, wouldn’t it be funnier if a physician began to use this subjective interpretation of medical data to come up with diagnoses or prognosticate their patients’ health based on their own personal interpretations of what they’re seeing? That’s very subjective.

Kevin Pho: Now, for those of you who get a chance to read it, just talk a little about that story in the satire.

Stephanie Benjamin: So the radiology resident starts to look at the CT scans and MRI scans of his patients as if they’re inkblot tests. He looks at these images, and he starts to read his own interpretation. So he looks and sees, “Oh, it looks like there’s a dragon in this woman’s brain. Clearly, she’s very fiery and at high risk for medical noncompliance.” He really just goes off on these fantastical interpretations to come up with diagnoses for his patients, and some of them are interpreted as being correct, and the article explores a bit about how this actually applies to his patients.

Kevin Pho: So you say you’ve written over 50 satirical pieces, I’m sure drawn from your observations and experiences. So take us into the writing process. How do you write one of these satirical pieces? Take us through it step by step.

Stephanie Benjamin: It can be a little daunting to be staring at a blank page, so I do have a structure that guides me. All of my satires take place in a fictional teaching hospital that I created called Hospital Woeisme, so there’s the same group of residents and medical students and attendings that are running around the hospital. They’re all standalone pieces, but the characters do interact with each other. So all of my satires have that structure.

Then, in terms of the contents, my job and the news provide an endless source of inspiration. But typically, the inspiration is going to be when I get home from a shift, or if I’ve just seen something on the news, and it’s weighing on me for whatever reason. It’s something that’s made me upset, it’s something that I keep mulling over, something that I really need to process. And I think, “OK, how can I look at this? I can journal about it, or can I tease it apart and make it into something funny or more palatable? And can I put it in Hospital Woeisme and make it into something that I find acceptable?”

Kevin Pho: So it’s like the Hospital Woeisme universe, right? So you have the whole collection of characters that kind of form that common thread through all your pieces. How long does it take you to write one?

Stephanie Benjamin: It takes me a couple of hours to sit down and really write it out. That being said, it takes me a couple of hours to write a specific piece, but I do have a file that is just full of ideas and possible headlines for various satirical pieces.

Kevin Pho: Do you ever get responses from patients who take your satirical pieces the wrong way and take offense to some of the humor? Tell me some of the feedback that you get to some of your pieces.

Stephanie Benjamin: I think one of the other nice things about satire is when it’s done right, it’s so far removed from the actual event that no patient would ever know that they were the inspiration for that piece. Partially, it’s to protect the patient, and partially, it’s just because I really want to reframe and rebuild the whole story. It’s never to poke fun at the patient. It’s always the situation, or how the situation made me feel. So it’s really, from my perspective, a coping mechanism and never meant to ever be insulting towards the patient. That being said, I don’t think I’ve specifically had any patients that know that I’m a writer. I don’t know if that would change how they interact with me.

Kevin Pho: How about your colleagues? Do they ever know about your writing hobby, and in general, what’s their reaction?

Stephanie Benjamin: My colleagues are incredibly supportive. I do tend to post when I publish new articles, and I’ve gotten a ton of really nice feedback. One of the best things is building a community of physician writers and people I can reach out to. I’ve been really lucky that by writing and connecting with other writers, I have a fabulous mentor who’s a physician author, and he’s provided so much guidance in terms of how to write and edit and publish. So I’ve had some really positive experiences.

Kevin Pho: How about those physicians who are interested in incorporating more writing into their professional careers? You mentioned that you have written not only for GomerBlog but also for mainstream media publications as well, The New York Times, and of course, that’s a fantastic way for physicians to elevate their voices and really have that platform where they can share their story. So what kind of tips and advice do you have for physicians who want to incorporate more writing but are just starting out and don’t know where to turn?

Stephanie Benjamin: So I have a couple of points to that. One, and the most important thing, is there’s no shortcut to becoming a better writer, so you just have to start writing. You can’t wait until, “Oh, when I’m a good enough writer, I’ll start writing.” You really just need to get going, and it can be a little daunting, which is why I like to have a structure and some guidelines when I write, but just getting started and jumping in. So writing a lot, reading a lot, will also help improve one’s writing. And having a really good mentor and someone to help guide you through that process of publication, because it can be pretty daunting when you’re trying to get things published.

And then the last two things would be having a thick skin, because more pieces will be rejected for publication than will be published, so just keep going, keep at it. And then the other piece, which I found out when I was doing my job search, is that depending on where you work, if you produce writing, if you’re publishing pieces, the company that you work for may feel that the intellectual property is their own. So you really want to know what your contract says and make sure that whatever you’re producing, you’re in charge of, and that your organization isn’t going to claim ownership over the work that you produced.

Kevin Pho: Now, at KevinMD, I get a lot of physician-written pieces that come from public relations firms. So what’s the role of hiring some type of external firm to make that connection between you and whatever mainstream media publication? Is there a role for some type of external public relations firm to do that?

Stephanie Benjamin: There are a lot of different options for publishing. For me personally, I like to publish on my website and maintain all control over what I write. Involving professional publishers, or someone who’s going to help with publicity, can be very helpful. Just know what you’re getting into, and know: What cut are they going to take of the profits? Are they going to have the final say over the editing, over the title? Are they going to be dictating what content you’re producing? So it can definitely be helpful, but just be wary that you might be giving up some of your independence over what you produce.

Kevin Pho: And just to give a sense of the time commitment that you spend writing and being successful in publishing your pieces, in general, in a typical week, how much would you spend doing clinical medicine versus writing?

Stephanie Benjamin: So I work full time, so that is 40 hours a week. I’m a night shifter, and I write really whenever I can, because if I waited for an uninterrupted block of time, I would never get anything done. So I write first thing in the morning when I wake up, or at night when I wake up if I’m going into a shift. Usually, that’s journaling and just trying to clear my mind. I try, when I’m being really productive, to produce one satire a week, which I think ended up being about once every other week, because I have about 50 for the last two years. And then really just taking the opportunity whenever I can.

The new thing I started doing was dictating my writing so that I can be hands-free. That’s also provided a lot of opportunity for me to write when I’m doing other things, such as commuting to work. I can turn on my microphone and just talk out loud and record my thoughts on my way to work, and that provides a lot of extra time that I didn’t even realize I had before to get my writing done.

Kevin Pho: And for those physicians interested in learning more about writing or improving their writing, what kind of resources can you recommend?

Stephanie Benjamin: There are so many resources out there that are really wonderful. There are creative writing resources, journaling resources, and ones that are specific for physician authors. So there is the American Medical Writers Association. There are medical writing conferences that are out there. There are websites, some free and some that you pay to join, that post opportunities for freelance writers. And then there are always just old-fashioned job searches if you’re looking for freelance jobs outside of mainstream medical positions. There are all sorts of writing contests and other opportunities that people can apply for, and usually you need to include some writing samples. So just have that ready and know what you want to write, so that you can just keep an eye out for any opportunities that can arise.

Kevin Pho: We’re talking to Stephanie Benjamin. She’s an emergency physician, and we’re talking about her writing career and her KevinMD article, “Resident adds Rorschach reads to radiology reports.” Stephanie, tell us about some take-home messages that you want to leave with the KevinMD audience.

Stephanie Benjamin: I would say writing is so incredibly powerful, whether it’s writing satire or journaling. It gives you ownership over events that have happened in your life and allows you to reframe narratives. I would go so far as to say it decreases burnout, at least in my case. I think that’s true. So I would recommend to all the listeners that they give writing a try, and they might be surprised at the positive impact that it has on their life.

Kevin Pho: Stephanie, thank you so much for sharing your story, time, and insight, and thanks again for being on the show.

Stephanie Benjamin: Thank you so much, Kevin.

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