Who Really Has the Authority to Write About the Pandemic?
Selina Mahmood on Making Space for Contradictions in Medicine
It recently came to my attention, on the heels of a New York Times review of my book A Pandemic in Residence: Essays from a Detroit Hospital, that a resident friend had declared I had “no authority to write a book with ‘pandemic’ on the cover.”
I am a neurology resident who worked on a COVID floor for a while—and I had already been hesitant to use the word “pandemic” in the title of my essay collection, so the comment hit a nerve (pun intended). My hesitancy came from a similar place as my decision not to add “Dr.” to my byline, even though I discussed it with my publisher. This was not meant to be a medical treatise.
At first mention of the collection, I’ll usually point out that it originally had a different title—The Case of the Missing Feather—or say something about a work that was put together during the pandemic rather than one that focuses on the pandemic as a narrative. The problem is that, normally, I’m making that defense to people who don’t need to hear it. Any reader who has actually make it to the book’s opening page where I quote Momtaza Mehri—“Let’s live in digression. We have no other choices”—has already put aside the skepticism about its author possibly being an opportunistic neurologist-writer.
Still, some people will see the word “pandemic” on a title by a neurologist, instead of an infectious disease doctor, and balk. The skepticism is not ill founded; people in health care, “in-betweeners” from all different spheres and specialties, are using the pandemic for publicity and clickbait, for everything from research to articles to social media posts. Influencers from the medical field have posted about it to increase traffic and followers. The sheer amount of research related to the virus was enough to drive memes of physicians drowning under all of it. Anything with the word “COVID” in it was likely to garner more attention both inside and outside the medical field. I had voiced this fear to my publisher and was reminded that the point of writing is, essentially, to communicate; whether fortunately or unfortunately, the “pandemic” title did more to bring my essay collection together as an arc than the former Case of the Missing Feather.
The change in title also clarified my intended audience: people who enjoy creative writing, whether they are inside or outside the world of medicine. The essential content is framed by the time and place in the title. There are those who look at the frame and can’t see beyond that—modernists in the making, if I am to consider that position kindly. There are others who see the title and think it is going to be a clear first-hand narrative account of working with COVID patients—but that is not my place and I definitely cannot claim that authority.
Who has the power to use, or a claim on, the word “pandemic”? Presumably, it would be those of Dr. Anthony Fauci’s rank, or, in other direction, people completely outside of the medical world: artists documenting an isolated world, Zadie Smith essaying deserted aisles, comedians bringing sense back to a world inaner than usual. Who, then, is excluded from this ring of power? In this line of thinking, the answer would be the people in between: physicians who are not specialized in infectious disease, physical therapists, speech therapists, et cetera. We’re in the strange position of being both within and without. Our in-betweenness excludes an authentic claim to pandemic—a claim I didn’t even intend to make.
The assignation of authority, those who are deemed to have power over certain words and subjects, is an assignation intended to be questioned and broken by those who are excluded. In this case, it is the power to utilize the word “pandemic” as a neurologist. This work was also a way for me to take ownership of the non-verbal through the verbal. The power to find (or shape) reality. My only authority, then, is in translating my mostly paralinguistic stories into the written word. For those who have been in discussion with me about my work, whether at book signings or the people who have interviewed me—it has been humbling and moving to talk to people who see their own reality in my words.Writing about the pandemic was my attempt at making a space to address the contradictions of working in medicine.
In one of my undergrad English lectures years ago, a student asked if we were not over-interpreting writing and giving extravagant meanings that writers hadn’t intended. I realized during book interviews that intention is often hidden and can be discovered in retrospective conversation. At least part of the reason literary analysis is so profound is that we unearth layers of meaning and intention long after the author is no longer alive—and I think those layers have a valid source that merits the curious space between discovery and creation.
Furthermore, writing about the pandemic was my attempt at making a space to address the contradictions of working in medicine. How do you reconcile yourself with a profession that claims to help humanity, but whose practitioners are also very visibly, audibly, and clearly pursuing said profession for money and status? How do you reconcile the selfless with the selfish? I was recently discussing this moral dilemma with an Australian friend. She asked me if I was proud of everything I’d accomplished. I told her how pride in my profession makes me feel sick for its ridiculousness; she reminded me that there is such a thing as healthy pride and that I can’t live the rest of my profession resentful of selfishness and arrogance.
That conversation moved me from a place of closed bitterness to open bitterness and then open gentleness and warmed gentleness to hope. It was this wordy evolution (in addition to help from certain substances) that had the Beats running around talking their way to oblivion. The power of automatic writing comes from this contradiction. This is one, if not the foremost, reason I love free associative writing. It opens the space through disassociation for interactive engagement and creative discovery for both the writer and reader. I practiced automatic writing for years prior to this collection. The utilization of disassociation in automatic writing is a powerful maneuver in moving from the subjective to the objective. You literally become a vessel for the words.
Communication, the back and forth, the inherent reflection, pulls something out and around and together and connects and weaves and make things okay. Carl Jung said, “Whatever happens in your life is not reality, but rather your interpretation of it.” Interpretation, or really just the stories we tell ourselves, is the key to letting things go. Reality arises from the knowledge of unending stories. You don’t even really have to change the story. You just have to become aware of it. Freedom follows from the simple awareness of a story’s existence.
I’ve often reapproached my free associative writing exercises hours later, only to be surprised that I had written them. This reduces a sense of vanity and shame—the two are two sides of the same coin. If you don’t own words, you can’t really be either proud or ashamed of them. I think this distance is a necessary precursor to writing pretty words. When words come through you instead of from you there is the chance that they might end up beautiful and profound. To distance myself from this writing, I read around ten different essay collections and returned to my work each time to see how it changed my perspective. I recorded myself reading my essays and listening back to them and edited the parts that didn’t work. I re-read my work hundreds of times to make sure it didn’t feel too much like “me”—and if it did, I would question why that was and whether it was something that needed to be edited out. I wanted someone who knew me to read this work and think, “Oh, that’s Selina’s voice,” and vice versa. At the same time, I wanted it to be a voice distant from an immediate sense of emotionality.
I am happy to say I achieved my goal in being able to read my own work without cringing and actually being pleasantly surprised, but I didn’t anticipate the feeling of alienation that would also necessarily come from “good” free associative work. No one owns reality, right? The great part is that I have become a reader of my own work, and I think that, at least, is part of my answer to the student who asked that question in my undergrad English class all those years ago.
Selina Mahmood’s A Pandemic in Residence: Essays from a Detroit Hospital is available now via Belt Publishing.