Robert Oldshue

When Robert Oldshue, MD, MFA, was on a date with the woman who would become his wife, there was something he needed to confess up front, he told her. She went pale.

“I like to write,” he said. To his relief, she eagerly asked to see his work.

More than 20 years later, creative writing remains a passion for Oldshue, now a primary care physician at Southern Jamaica Plain Health Center. Like medicine, writing has become his practice – one that earned him the 2016 Iowa Short Fiction Award earlier this year for his short story collection, November Storm. As part of the award – among the most prestigious in the literary world – the collection was released as a book in October.

Oldshue recently spoke with BWH Bulletin about being a physician and an author.

Why do you write?

RO: I teach at Harvard Medical School, and one of the things I talk to the students about is the difference between empathy and sympathy. Empathy is something you do as a matter of discipline. It means that I try to understand what you might be experiencing as you go through a physical exam or are in a cardiac unit.

Sympathy is related, but it’s different. Sympathy is what you feel for your friend: ‘Oh my God, you’re having heart surgery. I’m so sad.’ Sympathy can inform empathy, but it is not appropriate for me, as a doctor, to be weeping when doing a procedure that might be frightening to a patient. What I’m doing when I’m writing is that part of medicine you can’t do in the office. I’m really trying to tap into sympathy.

How did you get into creative writing?

RO: I traveled after college, before I decided to be a physician. I kept a journal and got into the habit of writing every day. I had daydreams about becoming a professional writer and found out that doesn’t happen very often, so I fell into medicine but kept writing. A very big part of why I kept going was encouragement from my wife.

How has your background in medicine influenced your writing?

RO: One of the things I learned very quickly was that the mental processes for writing fiction and medical diagnosis are opposites. In creative writing, they always tell you to add more detail. What was he wearing? What temperature was it? What did it smell like? It’s the potent details; the generalities don’t help you. Whereas in medicine, if a guy shows up to the emergency room wearing a clown suit, carrying a shopping bag with a chicken in it, those details don’t matter as much. You’ve got to answer broader questions: Is he bipolar? Is he a college kid playing a prank? You focus more on generalities.

You also spend a lot of time understanding the difference between activity and action. There’s a lot of activity in the ICU, but the action – meaning things that have an emotional impact – usually happens in the family room.

How do you make time to write?

RO: I take Monday and Friday mornings away from the clinic, and I write on weekends. Also, a lot of writing is thinking things like, ‘Why did she say that?’ You can decide that standing in line at the grocery store. If you’re truly committed to your characters, it’s all mixed in with your day-to-day activities.