An excerpt from Real Medicine, Unreal Stories: Lessons and Insights from Clinical Practice (Volume 2).

The dinner plates had been cleared and a lazy instrumental playlist drifted through the background. Thad Brigham leaned back in his chair, a satisfied smile crossing his face as he looked at his daughters across the table.

“You two always manage to bring the energy back into this old house,” he said.

Madison, or Maddie as everyone called her, gave a playful smirk. “We’re here for the grand event, remember? Someone’s about to pop.”

Avery, her very pregnant sister, looked up from the jigsaw puzzle she was piecing together on the table. “Gee, thanks for the reminder. Like the watermelon strapped to my stomach wasn’t clue enough.”

Thad chuckled. “Hey, don’t knock it. You’re making this house feel like it’s brimming with life again.”

Maddie glanced at Thad. “So, Dad, what’s this new thriller you’ve been writing? You’ve been cryptic about it for weeks.”

Thad’s eyes twinkled. “I just finished Chapter One last night. Want to hear it?”

Maddie raised an eyebrow. “Are you seriously asking a freshly minted family doc if she wants to read your medical fiction? That’s risky.”

“Oh, come on,” Thad said. “Be gentle. It’s a first draft. Besides, it’s more about inspiration than accuracy.”

He handed over the crisp printed pages. Maddie sighed dramatically but took the stack. Avery continued puzzling, half-listening.

Maddie began reading aloud, her voice steady, eyes narrowing as she skimmed the lines.

“‘The sun hadn’t risen yet when Dr. Flores crept into the alley, her coat pulled tight against the chill. A newborn cried in the shadows, the mother too afraid to come forward. Another border crossing gone wrong.’ Hmm.”

She paused. “Wait. Flores? Isn’t she undocumented herself? How’s she licensed to practice in the U.S.?”

“It’s fiction,” Thad said, raising his hands.

“Yeah, but it doesn’t work that way. You can’t just make up credentialed physicians with… implausible backstories.”

“Why not? It’s not a documentary.”

“Because it loses credibility,” Maddie said, flipping the page. “And… hold up. A 20-year-old med student performing an emergency C-section in a tent? C’mon, Dad.”

Thad chuckled, unfazed. “You think it’s too far-fetched?”

“No. I think it’s bonkers.”

“Well, thanks for the support,” Thad said dryly.

Maddie shook her head but smiled. “I’m not saying don’t write it. Just… maybe a few more journal articles and fact-checks wouldn’t hurt.”

“I do my research,” Thad said. “Besides, much of what I write is about capturing a feeling. Truth isn’t always fact. Emerson said, ‘Fiction reveals truth that reality obscures.'”

Maddie leaned back, crossing her arms. “But what makes you think you can write from the perspective of an undocumented Latina, or a homeless veteran, or someone living with opioid addiction? You’ve never lived those experiences.”

Thad nodded slowly. “Fair question. I can’t live every experience, no. But I’ve spent my life treating patients who have. I’ve listened. Read. Reflected. That counts for something.”

“But it still isn’t you.”

“No, it isn’t. But that doesn’t mean I can’t try to understand. Just like Springsteen.”

Maddie had that deer-in-the-headlight expression. “What does Bruce have to do with this?”

“You remember that concert we went to?”

“Yeah. Giant Stadium. Epic.”

“And remember when he walked into the crowd, picking signs people held up, choosing songs he hadn’t played in years?”

“Thundercrack,” Maddie said, a soft smile forming.

“Yes. That song probably meant something to him back when he wrote it. Seeing that sign pulled him back to that spark. That’s why.”

He pointed to his chest. “This,” he said, tapping his heart, “this is why I write. Same as why I practiced medicine all those years. Same reason you do now. We’re all just trying to keep that spark alive.”

Avery looked up, pausing from her puzzle. “So… basically, you’re saying writing is like medicine—mostly heart, with a little bit of fact checking.”

Thad laughed. “Something like that.”

Just then, Sandy, Thad’s wife, popped her head into the dining room.

“Thad? You quoting musicians again?”

“Only the greats.”

She rolled her eyes fondly. “Well, remember this: Steve Winwood wrote ‘Sometimes I Feel So Uninspired’ when he was with Traffic. That album flopped. Critics hated it.”

Thad grinned. “Thanks, hon. That’s… encouraging.”

“Just keeping you grounded,” she said, disappearing down the hall.

Maddie shook her head, trying to suppress a grin.

Avery whispered, “She always does that.”

The room fell into an easy silence, filled with the sounds of soft music, pages turning, and puzzle pieces clicking.

Thad glanced over at Maddie, who had stopped reading and was now flipping through the pages in quiet contemplation. He looked toward the hallway where Sandy had disappeared.

“You know,” he said, breaking the silence, “your name—Madison—that was inspired, too.”

Maddie looked up, intrigued. “It was?”

Thad nodded, a wistful smile playing on his face. “Your mom and I had just seen the movie Splash—Tom Hanks, Daryl Hannah. The mermaid comes to New York and picks the name ‘Madison’ after seeing a street sign. Madison Avenue.”

Avery glanced up from her puzzle, amused. “Wait, that’s really where her name came from?”

Thad chuckled. “Yep. At the time, it wasn’t even a common name. But something about that scene—a creature from another world trying to find her place in ours—it just stuck with us. As we walked out of the theater, your mom said, ‘If we ever have a daughter, I want to name her Madison.'”

Maddie blinked, caught off guard. “I always thought it was just a pretty name.”

“It is,” Thad said. “But it meant more than that. It reminded us of possibility. Of transformation. The idea that you could take something ordinary—a street sign—and turn it into something beautiful, something meaningful. That’s how inspiration works.”

The room fell quiet again, but this time the silence was thoughtful—weighted with memory, affection, and a shared understanding of what it meant to name something not just for what it is, but for what it could be.

***

Days later, in the birthing suite of the hospital, the walls were sterile and softly humming, the scent of antiseptic and new life thick in the air. Thad stood beside Avery’s bed, eyes red, heart full.

In his arms, he cradled a fragile bundle wrapped in pink.

“Lucy,” he said, barely above a whisper.

Avery, tired but glowing, smiled from the bed.

“She’s beautiful,” Thad said.

“Thanks, Dad.”

He looked down again. “Is she named after anyone?”

Avery hesitated, then shook her head. “Not really.”

Thad raised an eyebrow.

Avery giggled. “OK, maybe kind of. You remember that Paul Simon concert you took me to ten years ago?”

“Of course. One of our best nights.”

“Remember when he suddenly launched into Little Richard’s ‘Lucille’? Out of nowhere?”

Thad laughed. “He said it wasn’t even on the setlist.”

“Yeah,” Avery said. “I remember watching your face light up when he started playing it. You didn’t expect it. He didn’t either, probably. But something in that moment inspired him.”

She looked at him, eyes shimmering. “I thought about that last night. Between contractions. About inspiration. About how it sneaks up on you. And how sometimes, all we really want is to share that spark with the people we love.”

She gestured toward the baby. “So… meet Lucy.”

Thad swallowed hard, holding the baby close. “You remembered.”

“I did.”

A tear rolled down his cheek. “I guess… this is the kind of plot twist even fiction can’t beat.”

“Absolutely,” Avery said. “Inspired, right?”

Thad nodded, smiling through tears. “Inspired.”

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. He is the author of several books on narrative medicine, including Narrative Medicine: New and Selected Essays, and Narrative Rx: A Quick Guide to Narrative Medicine for Students, Residents, and Attendings, available as a free download.