GPs with double lives: Authors

GPs are known to be excellent generalists – capable of working in varied specialties, providing teaching and education, and servicing the inner city or remote locations.
 
But the life of a GP can also be taxing. According to the RACGP’s 2022 Health of the Nation report, 61% work less than 40 hours per week, while 73% have experienced feelings of burnout in relation to their role in the past 12 months.
 
With so much expected of GPs in 2022, not to mention the additional burden of a global, once-in-a -century pandemic, it is difficult to imagine practitioners having the time to pursue careers outside of everyday practice.
 
But having a ‘side-hustle’ is becoming an increasingly popular way of avoiding burnout and easing the pressures of full-time clinical work. Two GPs who have done just that by pursuing careers in writing are Dr Joanna Nell – who has written four novels – and Dr Melanie Cheng, the author of two.
 
So, what got them into creative writing?
 
‘I can’t remember a time when I didn’t have the urge to write,’ Dr Cheng told newsGP.
 
‘During primary school and high school, I was always writing my own poems and stories outside of class.
 
‘During the more demanding years of high school and university, however, there was less spare time for such creativity and it kind of fell by the wayside.’
 
Dr Cheng only began writing again once she had completed general practice training, after stumbling across the AMA’s Creative Doctors’ Network led by Dr Tony Chu.
 
‘I went along to one of their meetings and … met lots of doctors from different disciplines supporting and celebrating each other’s artistry,’ she said.
 
‘What struck me was just how happy those doctors seemed, especially when compared to the consultants I’d encountered during my medical training.
 
‘I understood then that creativity would not only be a fun thing to pursue, [but] it could very well protect me from burnout, perhaps even save my life.’
 
Dr Nell told newsGP she has had a similar love of stories for as long as she can remember.
 
‘I taught myself to read before I started school because I was impatient and wanted to escape into fictional worlds,’ she said.
 
‘Being shy and introverted, books were the way I made sense of the world, and the perfect excuse to hide away in the library at recess. The natural progression was wanting to write my own stories.’
 
Her parents bought her a typewriter when she was eight but even though English and creative writing were Dr Nell’s best subjects, no one ever suggested writing as a career.
 
‘As an academically capable, middle-class kid who had fallen in love with the doctor who’d taken my appendix out aged 10, medicine was the obvious choice,’ she said.
 
But while Dr Nell won two awards at medical school for creative writing, she did not start pursuing the interest in earnest until many years later when she had an accident.
 
‘During my first attempt at 10-pin bowling, I managed to do the splits,’ she said.
 
‘The resultant hamstring repair was followed by six weeks of lying flat on my back, and it was during this enforced break from work that I had an epiphany of sorts that culminated in a bucket list of unfulfilled dreams and passions.’
 
Dr Nell enrolled in an online creative writing course and pursued workshops, festivals and other educational resources.
 
‘My first novel was published in 2018 when I was 52, six years after enrolling in that first online course – coincidentally the same length of time it took to complete my medical training,’ she said.
 
The balancing act
Both doctors balance writing with being a GP, in addition to other life factors.
 
‘It’s a constant struggle, especially with the additional pressures of raising a family,’ Dr Cheng said.
 
‘I work part-time in general practice and have one full day off which I try to reserve for writing commitments.
 
‘Other than that, I snatch moments where I can – in the morning as I drink my coffee, over lunch after work, in the evenings while my kids are doing ballet and soccer. Over time, I’ve learnt that you can’t wait for the muse or the perfect conditions to write because they may never arrive.

Dr Joanna Nell was 52 when she first got published and has gone on to write three other novels. (Image: Supplied)
 
‘Instead, you have to find ways of inserting writing into your life, even if this only amounts to a couple of half-hour blocks in the day. Many writers have written whole books in these little fragments of stolen time.’
 
Dr Nell wrote her first novel when she was a full-time working mum.
 
‘I carved out writing time on my afternoon off and at weekends. I was lucky to have a very supportive husband who quickly realised I was a much nicer version of myself when I emerged after a writing session,’ she said.
 
‘After my first novel The Single Ladies of Jacaranda Retirement Village was published, I signed a two-book deal but had to take time off work to fulfill the promotion and publicity obligations and to finish the second book.
 
‘Eventually, I found the perfect balance, joking that I worked two days a week as a GP, and seven days a week as a writer.’
 
A unique part of being a GP – unlike other specialities – is working as a sole traders, which provides the flexibility to swap between jobs, hours and days to accommodate their fluid lives.
 
‘I think it’s much easier to work part-time in general practice than many other specialties, especially during training,’ Dr Cheng said.
 
‘There are also less after-hours and on-call and therefore more predictability. Having said that, I know quite a few specialists, including surgeons, who write books.
 
‘Where there is a will, there is a way.’
 
In Dr Nell’s opinion, medicine itself offers plenty of opportunities for flexible working patterns.
 
‘For instance, having achieved my childhood dream of becoming a writer, I was able to juggle two careers by working shifts at a hospital medical centre and during the pandemic, in a COVID vaccination clinic,’ she said.
 
‘General practice has always been seen as an easy option for doctors who want to work part-time compared to other specialities. I think this is a misnomer, since the continuity of care required in traditional general practice often makes this difficult to achieve in reality.’
 
An issue for many doctors, Dr Nell says, is that they view medicine as a vocation rather than a job.
 
‘To take time away to write feels frivolous, and as a working parent, selfish. But to deny ourselves a creative outlet is way more damaging in the long run,’ she said.
 
‘I meet a lot of aspiring writers who say they don’t have time to write or dream of giving up their day job to become a writer. Writers write, whatever, wherever [including] sitting in carparks, lunchrooms, the kids’ swimming lessons or at the kitchen table before the rest of the family wake up.
 
‘But succeeding as a writer needs commitment and that starts by giving yourself permission to prioritise something non-family-related and non-medical in your life.’
 
And while writing and practising medicine may seem like worlds away, there are also similarities between the two professions.
 
‘At the heart of both are stories,’ Dr Nell said. ‘For centuries, doctors have been formulating case histories.
 
‘The job of a GP is essentially to construct a narrative based on what our patients tell us, and what they don’t. We listen to their words and observe their actions. We ask questions to understand their backstory and uncover their emotional wounds.
 
‘We start with a problem and it is our job to find a satisfactory conclusion, if not always a “happy ever after”.
 
‘Writers do the same with their characters. Even the consultation itself is analogous to a scene in a novel – each visit or encounter contributing another vital piece of the overall story arc.’
 
Dr Nell also points to other doctors who wrote, including Somerset Maugham, Anton Chekhov and AJ Cronin.
 
‘It is no wonder, therefore, that so many famous writers have also been doctors. Also, both doctors and writers are, to a degree, driven by a sense of social injustice,’ she said.
 
‘I have set novels in retirement villages and nursing homes. One of my books is told from the point of view of a character with dementia. As an author I am privileged to have a platform from which to highlight the crisis in aged care and the broader issue of ageism in society.’
 
For Dr Cheng, listening to peoples’ stories is a principal aspect of a doctor’s capability.
 
‘There is of course a whole discipline – narrative medicine – devoted to this,’ she said.
 
‘But the other common feature of the two is that of empathy and trying to understand the world from the position of someone whose lived experience is far removed from your own.’

Dr Melanie Cheng says patients have been ‘extremely supportive’ of her writing.
 
Meanwhile, a unique part of being a published author and having a book is that people can read it, including patients.
 
‘A few of my patients have read my books, and an enthusiastic group even filled the front row at my first book launch,’ Dr Nell said.
 
‘To begin with I found this clash of my two worlds very awkward and confronting, fearing it would damage my professionalism.
 
‘My experience has been the opposite ... [and] I wonder if by reading my books, my patients come to understand me a little more and find me more approachable as a result.’
 
Some of Dr Cheng’s patients have also read her books.
 
‘So far, it’s been a positive experience, if a little awkward,’ she said.
 
‘They’ve generally been extremely supportive – I’ve even had one or two bring their copies into the clinic for me to sign.’
 
Writing as therapy
Less than half of all respondents to the 2022 Health of the Nation survey felt that they had a good work–life balance, continuing a downward that this year culminated in the rate dipping below 50% for the first time since the survey began.
 
So what, if any, respite does writing provide from being a GP?
 
‘I think the two can be quite complementary,’ Dr Cheng said.
 
‘In writing about some of the more challenging and complex situations I’ve encountered in general practice, I’ve developed a greater understanding for my patients.
 
‘In general practice, as with most jobs, there are days when you feel frustrated and out of control, and creative writing can be a great counterpoint to this, particularly in fiction where you can quite literally take the story in any direction you wish.’
 
And with burnout becoming increasingly commonplace, Dr Nell says it is clear that GPs are often far better at looking after their patients than themselves.
 
‘What draws us to general practice – empathy, compassion, humanity – can also leave us diminished, and if we’re not careful, burned out,’ she said.
 
‘All doctors need an emotional outlet, and a surprising number of doctors have a creative passion, whether it is music, art or writing. There is a very healthy community of published doctor–writers in Australia, many of whom are GPs.
 
‘Personally, writing helps me to process my emotional response to what is a very demanding job, to unpack my psychological baggage at the end of each day, and particularly through fiction, rewrite the narrative of countless situations in which I’ve felt a helpless bystander as nature wreaks havoc on the patients we care about.
 
‘Whether it is a few notes jotted in a diary, a short story or a full-length novel, writing is therapy. And highly addictive.’
 
This article is the first in a series about GPs with parallel careers. Anyone interested in telling their story is encouraged to contact filip.vukasin@racgp.org.au
 
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