Writing By Hand

I had never held one before. It was a thoughtful gift from my wife, a fountain pen and a leather-bound journal to commemorate finishing my Master’s degree. It was a large black pen with bronze accents and a two-tone nib. I inked it and was hooked. Since that first day the pen has never been dry. The original journal sits on my shelf and another is half full. I’ve used the pen for notes, outlines, and more. The feeling of a fountain pen gliding across a page is unique.

Before the fountain pen I was an avid user of rollerball pens. I still use them on the go. Cheap, easy to start if you leave the cap off, and enjoyable to use. I’m a student that makes compressed notes and does so by hand. Over the years I moved to rollerballs since they required less pressure and thus cause less cramping.  I still pick up a pack of Pilot G2s every once in a while. Fountain pens required even less pressure, however, they do need higher quality paper. There is something about writing or drawing the key points that aids in consolidation of my learning. Until recently my writing was primarily making compressed notes, to-do lists and journaling. I would think of interesting projects, but they would come and go, rarely captured on a page.

I had a few essays I was proud of in undergrad and high school, but all were rather standard fair. I started this blog late in my application cycle to medicine and initially it was more a collection of tips and experiences.

The move to more creative writing came in my first year of medical school. I became interested in the history of medicine after nearly fainting during placement of an intraosseous needle (link). I also had memorable interactions with patients and began to write capture their essence while preserving patient privacy. A change occurred following time in a rural family medicine clinic at the end of the year. We did week-long placements and at their conclusion had to present to the class about our experiences. My presentation came together as a set of short stories. These stories included: Pain in the Butt Friends about removing a pencil tip from a teenager’s buttock, Right Chart? about a pregnancy test nearly ordered on an 80 year-old gentleman, and The Crying Doctor (link) about priorities. Telling that final story people listened, it struck a chord. A few weeks later a medical narrative contest was closing and I decided to write the story down and share it.

In the spring of the same year I befriended a physician that previously led Western’s Medical Humanities program. I sent him an early draft of my story and he provided feedback along with encouraging me to continue writing. Over the last two years he has become something of a writing mentor. We speak regularly and his feedback on my work has been invaluable. This fall I am doing a month long elective with him.

That summer a friend recruited me to write on a knowledge translation blog. I had received positive feedback on my writing in high school and beyond, so I thought my skills were reasonable. I was wrong. Simply writing an introduction took numerous revisions and this helped me realize how underdeveloped I was as a writer. This prompted my reading of Keys to Great Writing and The Elements of Style as a means to begin improving my writing skills.

Over time I met others interested in the medical humanities and have enjoyed exploring their work. I’ve also found some success in publishing my pieces and continued to work on my craft. Writing and other projects have been great creative outlets throughout medical school.

With practice I started to gain confidence in my writing. I continue to work on my craft. Some of this work occurred last summer (link) and involved reading over a dozen books on writing from the basics of composition to structuring a novel. This work is ongoing, more reading and practice are needed. I often return to the notes I made while reading and plan to add to them over time.

In terms of a process, I have a basic one. Aside from this process I make note of upcoming writing competitions and publication opportunities in the medical humanities. Having a goal or a deadline can help with motivation.

The hardest step to describe is the first one; I’m not really sure where my ideas come from. John Cleese (link) gave an excellent lecture about creativity; I don’t have a full explanation. Also, if something really catches me I often jump from 1 to 5. Except for writing and formatting, most is by hand.

  1. Ideas – Can come at any time and in many forms. Some are develop from experiences with patients or a quote; others come while falling asleep or walking. Ideas are also easy to forget, especially when you are busy, so I always have some means of capturing them. Usually this is a pocketbook and a pen, my regular ones are below, quite standard fair. Sometimes I use my phone, or grab some scrap paper. Simply put, I get them down somewhere.
  2. Compile – Collect the notes from various sources regularly. Each update is dated and the ideas labelled as an article, narrative, art or research. Often in the process of collection of ideas new connections or themes become apparent.
  3. Curate – Choose those of interest to give more thought and research. Those that are worth working on I transfer into a second journal. This journal holds ideas for projects, pieces of writing and art that I’m actively working on. Some in the end are duds and that is fine.
  4. Expand – An outline or rough of the piece highlighting key words and phrases. Often between having the idea and expanding it I’ve run across some new information, a quote or a new facet and add them during this step. If at this point I have a clear picture of the piece then I add a possible title, message, themes, audience, and target for posting or publication.
  5. Write – The transition to a computer. I have tried many different applications, but in the end most things find their way to Word for final formatting and editing. At this point I often deviate from the outline or rough as it doesn’t sound right, ideas merge, or something new grows while typing. I don’t consider the previous work a waste, I’m sure I wouldn’t have had the new insight without putting in time during the previous steps. The first draft usually comes out in a single session, often <1000 words.
  6. Edit – Once again by hand. Unless it is something short and silly I print it out go through it line by line. No special instrument for editing, but I usually avoid fountain pens as my printer paper feathers and bleeds.
  7. Revise – Make changes. Give it another full read. Let it sit if there is time.
  8. Edit – Again.
  9. Revise – And Again
  10. Finalize – Move to Word for final formatting. Some things I post on here, others I submit elsewhere. Some are for fun or are part of larger projects, so they sit archived or for further development.


FullSizeRenderClairefontaine & Leuchtturm1917 pocketbooks, Pilot G2 & Uniball Vision Needle

FullSizeRender-1Wörther Compact, Visconti Homo Sapiens & Pilot Justus 95


Nanami Paper Seven Seas Journals


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