Conversation with Walter M. Robinson

Walter M. Robinson is a writer and physician. Originally from Nashville, Tennessee, Walter now lives in Massachusetts. His collection of essays, What Cannot Be Undone—True Stories of a Life in Medicine, won the River Teeth Book Prize for 2020 and was published by University of New Mexico Press. Walter has been a fellow at MacDowell and Yaddo and was a PEN-New England “New Discovery in Non-Fiction.”

What Cannot Be Undone relates stories from a lifetime of professional experience, primarily working with cystic fibrosis patients. That experience expertly shows the complexity of cystic fibrosis, of the body in general, and of the inner workings of the mind and soul of a medical professional. Among the many aspects of Walter’s work, I admire how he is able to break down complicated medical information so that I, as a lay person, am able to understand it. Walter also served as a medical/hospital ethicist, and the ethical questions—about why and how a person is treated—are some of my favorite parts of these essays.

Walter and I first met as students in the Bennington Writing Seminars, and now we work together as editors at EastOver Press and Cutleaf. Walter agreed to answer some questions about What Cannot Be Undone as well as about the writing and publishing process. Come back tomorrow for a writing exercise inspired by Walter’s work in non-fiction.

DL: The full title of your book is What Cannot Be Undone: True Stories of a Life in Medicine, and yet, you explain in the book’s foreword that you’ve relied on an imperfect memory to write these essays. Can you talk about the challenge of relying on memory in nonfiction, some of the workarounds, and what added measures you took to protect the privacy of patients?

WR: Everything in the book is just as I remember it, but I acknowledge in the foreword that others might remember these events differently than I do. Everyone’s memory is imperfect because we only notice fragments of any event while it is happening, and as time passes, the act of remembering brings some things into sharper focus while others fade away. This is the fallible nature of human memory.

I chose the term “true stories” because these essays are not case reports or journalistic accounts, but nor are they fiction. I wrote them in a style that tries to give life to my experience as a doctor rather than simply recounting a clinical case. Medical case reports never use the first person, but I use it in some of these essays to accentuate that the story is about my perspective. In other essays I use the third person to remove myself somewhat as a character, while in still others I use third person to emphasize how I see myself in the past as a very different person. None of these approaches are typical in medical reports, so it seemed like the term “true stories” was the best fit.

I changed the identifying details of patients and families because I didn’t want my version of events to crowd out the families’ or patients’ versions. I was just one doctor among many, and I was often present at a very difficult part of their lives. I hope the story they live with now is not about me but about their loved one.

One way a nonfiction writer can address natural flaws of memory is to acknowledge in the essay that his version of events is not necessarily the only accurate account, as I did in “Nurse Clappy Gets His.” Another way is to take care not to re-configure the story to make himself look smarter, wiser, or kinder than he was in the moment. I hope I succeeded in that. As I wrote in the foreword, I am “no hero, no wizard, no saint.”  

DL: At the time we met, your goal was to find a way to write about your experiences as a doctor, particularly one who worked with cystic fibrosis patients. So it seems like What Cannot Be Undone is the successful answer to that pursuit. Is this book exactly as you imagined it?

WR: I didn’t call myself a writer when I started at Bennington, though I had written scores of academic papers. I had finished about 60% of what I called a “social history” of cystic fibrosis. It was overly academic and unbearably dull. I knew it, and anyone who tried to read it knew it. Thank goodness my teacher at Bennington, Susan Cheever, told me at our very first meeting, “Walter, this is terrible, just start over.” I will forever be grateful to her for that advice because it saved me from trying to rescue something that wasn’t worth the effort.

And while I started over, I followed the Bennington method: Read one hundred books to write one. Pay close attention to the work of others. Read the work of the past in order to make the work of the present. Gather up the tools of art to see if they fit your own work. What a gift those reading lists have been to me!

By the time I finished I had some idea of what I was doing, and I’ve just kept at it. So I’d say this book is the descendent of that early draft, but they have very little in common. Or at least I hope so.

DL: The essays in What Cannot Be Undone describe traumatic events, particularly for the patients whose lives you write about. But what has always been clear to me in reading your work is that you as a medical professional have carried much of that traumatic history with you. Do you have advice for writers writing about their own trauma?

WR: I think of my work as a doctor as meaningful, moving, difficult, exhausting, and completely absorbing. Yes, it was sometimes heartbreaking, but sometimes it was joyful. I loved being a doctor most of the time, even though I worked mostly with patients with life-limiting illnesses. I admit that I am a person who concentrates more than most on the tragic aspects of human life, and many of the stories in this book end with the death of a patient because being at the bedside of these patients may be the most meaningful work I have ever done.

In the most personal essays in the book, “The Necessary Monster” and “White Coat, Black Habit,” I write about my work in a way that most doctors keep private. I try to bear witness to my uncertainty about my value as a doctor and a human.

I think anyone trying to write about difficult experiences should be as honest as they can but also hold things in reserve. Not every part of a life should be open to public view.

DL: In my recent conversation with Lauren Davis, she said that it took her about five years and 48 rejections before she found a publisher for her first full-length collection of poems. How long did it take you to write and shape these essays? What was the submission and publication process like for What Cannot Be Undone?

WR: I worked on these essays much longer than I work on essays now because I was learning how to write while I was writing this book. I revised all of them over and over and started over with a blank page many times. I’ve gotten much faster over the years, especially in knowing what is not working and starting over.

Once I had enough essays for a book, I submitted the manuscript to an agent and was floored when she said “yes.” I thought it would be smooth sailing from then on, but eighteen months later most of the publishers had not replied. I thanked the agent for her time, and I gave up.

But then two friends from Bennington—one of them you––told me about contests for manuscripts run by journals, and so I submitted it to as many contests as I could find.  A year later, I had gotten form rejections from every single contest. I thanked my two friends, and I gave up, again.

I told myself, “This is no tragedy. You learned so much by writing these essays. This is your second career, and you started in your late fifties. What did you expect? Time to move on to something else.”

As is so often the case, I was wrong again. I thought I had gotten rejections from every contest, but one day I got a call from an unknown number. I didn’t pick up; surely it was those people who are so worried about my warranty expiring, right? But no, the voicemail was from the very kind editor at River Teeth, telling me I had won their Literary Nonfiction Prize. I smiled so hard the rest of that day my face hurt.

After winning the Prize, the publication process was a breeze. The folks at University of New Mexico Press have been delightful and kind to a first-time author. I didn’t count the number of rejections, but I wrote the first very rough draft of one of the essays, “Nurse Clappy Gets His,” in July 2012, and the book came out in February 2022. So it took about ten years.

DL: What are you working on now?

WR: I have been working on two projects. One is another essay collection about medicine and medical ethics tentatively titled “Deciding the Fate of Others.” The other is a more speculative book about the lives my ancestors did not lead so that I might be here to write a book. 

DL: Are there any opportunities coming up for readers to meet you or study with you via zoom or in person? (workshops, readings, interviews, AWP?)

WR: I’ll be at AWP with EastOver Press and Cutleaf, so please stop by our booth and say hello if you’d like to talk about the book. And I am happy to try to arrange readings or other interviews or talks about the book, over Zoom or in person. Contact me at words (at) wmrobinson (dot) com.

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My next post will feature a writing exercise inspired by one of Walter M. Robinson’s essays in What Cannot Be Undone—True Stories of a Life in Medicine.