By Lucy Berrington, MS
Ismée Williams, MD
Physicians may grapple with how best to incorporate their own emotions into their clinical practice — how to draw on their feelings in ways that enrich patient care, and their own experiences, rather than compromising either. In acute care situations, emotional connection may feel particularly remote. “You’re running around trying to save as many lives as you can,” says Ismée Williams, MD, a fetal cardiologist. “I wanted to remain objective. Becoming a doctor made me wall off my emotions. If you keep getting your heart broken, you can’t do your job well.”
But Dr. Williams is also an emerging novelist, and this new role forced a shift in her perspective. Water in May, her young adult novel (Amulet, 2017), tells the story of Mari, a pregnant Dominican teen living in the United States whose fetus is diagnosed with Hypoplastic Left Heart Syndrome. “As a writer, I had to take that wall down,” says Dr. Williams, who gave voice to a character inspired by the high schoolers whose fetuses and babies she treated.
Narrative Medicine
Taking down the wall gets to the essence of narrative medicine, which emphasizes a textured, simpatico understanding of patients and their experiences. It’s an interdisciplinary approach to medicine that dovetails with the contemporary priorities of culturally competent and patient-centered care.
David Hellerstein, MD, an essayist and comic novelist who incorporates literary methods into his medical teaching at Columbia University, predicts a boom in physician-writers. On his website, he wrote, “Science is essential to medicine, but it is not all of medicine. And that is why I think we are in for a renaissance of doctor-writers, something that the world has never before seen.”
Physician-writers have always had access to compelling raw material. “Mari’s story had everything: drama, suspense, the character arc. I knew it was unique and that very few would be able to give the story justice,” says Dr. Williams. “I wanted to make the reader experience intense emotion.”
Physicians’ Developmental Arcs
Kirkus Reviews predicts that Mari will challenge readers’ assumptions about teen moms. That prediction speaks to the author’s own developmental arc as a physician — another focus of narrative medicine.
“When I first started, I thought these young mothers were naïve,” says Dr. Williams. “I would see these teenagers, acting silly and clearly happy about being pregnant. Then, all of a sudden, they would grow up. They would have the baby and be back in the hospital for three or four appointments a week, dealing with feeding tubes and oxygen monitors at home. I was incredibly impressed.”
Cultural Connection
Dr. Williams’s story, like her protagonist’s, reaches back to Central America. Her grandfather, Juan Arnao, MD, was an OB/GYN, poet, and political journalist who escaped Cuba. Her mother, Isis Arnao Bartels, MD, was accepted to medical school in the US on her fourth attempt (“They kept telling her to be a nurse”).
Dr. Williams, an MMS member, graduated from Tufts University School of Medicine. She currently practices as a fetal cardiologist at the Children’s Hospital of Montefiore, New York, and is co-PI on the NIH-funded Human Placenta Project at the New York State Psychiatric Institute. She is donating royalties from the book to congenital heart disease research.
