One week from Monday I will mark eight years blogging at Pruning Shears. It’s largely been quiet - my numbers have rarely bumped above the hundreds in visits per week. I like to console myself that this is because I write really smart, well reasoned and occasionally polemical essays that don’t fit the successful clickbait models (sensational headlines with quick, breathless and highly partisan takes; inspirational drivel; celebrity sideboob). But the more likely explanation is either a) I’m a terrible writer or b) I write about things that few care to read about.
Which is fine, I’ve only run the site as a hobby and (thankfully) never had to make money off it. I write about what I want, when I want. I don’t have an assignment editor making me cover topics I’m not interested in, and over the years I’ve connected with some really interesting people (including the bloggers at Prairie Weather and First Draft). While it would be nice to have massive traffic, I pretty much have the traffic I’ve earned and I can live with that.
I can afford to do that because I don’t need to make a living off it. Professional writers, on the other hand, need to hustle. They have to publicize their work and compose with one eye on capturing the largest possible audience. They don’t have the luxury I do: of writing only about what interests me, and if no one wants to read it then fuck it. Or of writing “fuck” for that matter.
So I understand that pressure, and I also understand the amateur blogger’s desire to get a big server-busting hit. But I have a hard time wrapping my head around how one can make the leap from that to presenting fiction as fact - particularly when doing so involves confessing to crimes. Alice Goffman appeared to do just that in her new book “On the Run.” She quickly backed off when the issue was raised, yet that just raises more questions. Her statement doesn’t square with her account in the book, so which are we to believe? Will future editions of the book be rewritten to present Hoffman’s new, less dramatic account? And how does she reconcile her radically re-worked version of events with the one in the book? Both of them cannot be true.
A story this week had a similar theme. A doctor with the pseudonym Hope Amantine wrote about1 an absolutely extraordinary event that happened during her residency. Noting her extra care during a heart procedure,
My attending asked, “Why are you being so dainty with your dissection there?” I answered that I wanted to avoid ripping the cava because they’re so much harder to fix.
I take it he interpreted my comment as fear, and decided upon a teaching moment. He took his scissors and incredibly, before my eyes, and with no warning or preparation of any kind, cut a one-inch hole in the cava.
I was stunned. As I tried to process what I just saw, incredulous that he would actually intentionally make a hole in the cava, and as dark blood poured out of the hole, the tide rising steadily in the abdomen, he remarked, “Well, are you just going to stand there or are you going to fix that?”
Now, whatever else you may think about this, it is not presented as fiction. She doubles down on it as fact in the comments too:
it was a different era. Time will tell if we are better or worse off today… I can tell you that since much has changed in the last twenty years, surgical residents today touch instruments much less often, and many report feeling unprepared for the rigors of attendingship when they have finished their training. Their work hours are restricted, their experience likewise, and I have seen more than a few young attendings that can’t operate their way out of a paper bag. They have been trained in a kinder, gentler environment, and that is great as long as every operation goes as planned.
When there is a computer simulation that adequately prepares surgeons for unexpected anatomy, findings, and intraoperative unplanned “events,” I will be the first one to sing Hallelujah. It hasn’t been invented yet - so until that time, you better pray that you never get a hole in a cava. But if you do, you better hope that the person holding the knife can actually fix it in less than the five minutes it will take for you to bleed to death.
When it became clear that this was not just an appalling breach of ethics or a grimly satisfied reflection on how much better things were back in the day (along with mandatory snark about how soft kids today are), but rather a felony assault, the following got tacked on to the end: “Author’s note 7/8/2015: This is a fictional article. No one was harmed, then or ever, in my care or in my presence. I apologize for any remark that may have been misconstrued.” And the author’s personal blog disappeared too.
What’s frustrating is that in both cases the authors already had compelling material to work with. As Michael Hiltzik wrote about Goffman:
Certainly much of “On the Run” rings very true, and there’s no disputing the vigor of its prose and the percipience of much of Goffman’s observation. Authorities’ exploitation of petty infractions to confine minorities in an endless cycle of fines and court dates and police harassment has been documented in many communities, including Ferguson, Mo. No one can follow news reports of police shootings and beatings of black residents of cities across America and doubt that much of what Goffman described does happen as a matter of course in the neighborhood she dubs “6th Street.”
And Janet Stemwedel on Amantine:
Without a doubt, the central question of the original post is an important one. Trainees perfecting their skills can be cautious in a way that frustrates the more-practiced people training them. That caution is amplified, understandably so, when they are perfecting their skills while working on real patients. It is true that real cases they will eventually face outside the training context may be more serious, more complex, more urgent, and that practitioners will need to deploy their techniques more swiftly and confidently.
Which is why it’s so frustrating when things like this happen. Were neither confident enough in the story they were telling to let reality speak for itself? Was there nothing else on the mean streets of Philadelphia that would have made for a dramatic conclusion? Did Amantine have no other tales of god complexes in the operating room that would have seized the reader’s attention? Both authors seem passionate about their subjects. Don’t they realize how severely they cheapen and degrade those subjects by turning in eye-popping reports that get falsified?
I really try not to judge on these things. Sometimes people are under pressures that we can’t know or understand. I’ve certainly done things I’m not proud of, and so far haven’t had any of them held up to the world for comment. I sure don’t know how well I’d handle it if they were. I don’t want to see either writer hounded from public life or drowned in shame. But I don’t want to see them get off without being called to account a little, either. The topics they’re covering are too important for them to get a pass just because their hearts were pure. And in any event, getting it right matters for its own sake.
1. The story has since been deleted from the site. An archived snapshot is still available here. Twitter user Matt Algren made a PDF of the comments here, which I’ve also uploaded along with a plain text version since one of the comments in the PDF appears truncated. Finally, a snapshot of Hope Amantine’s tweets just prior to her account deletion is here.