I am doing some research for a book I am writing - more details anon, at least if it gets written, finds favor in the eyes of my agent, and turns into a bound-and-published butterfly. Some of the resources I needed were only available in the stacks of the Johns Hopkins medical library. To their credit, rather than turning the huge, high-ceilinged bibliotemple into yet another office complex, or tearing it down for laboratory space, the librarians - sorry, informationists - asked the users what they wanted. "Let's keep the library," said the users, "but renovate it."

I use the library an awful lot, mostly as a route to borrow resources from other libraries (often on medical themes but just as often on Jewish topics, which probably confuses somebody). Usually, the library brings books directly to my office, which for me is the equivalent of lying on a couch in my toga being fed peeled grapes. The delivery guy is as reliable as the mythical appointed couriers of the Post Office, making it to my office with snow-covered boots and a plastic bag full of library holdings.

Last week, I got an email that a book I had requested was already available, so I would not get it delivered. "See Notes," said the email, and then, on the line below: "See stacks."

Stacks! I had never ventured into the Welch Library stacks. In previous stages of my career and years of school, I had always spent time among the books when I least needed to. I found it a refuge. When everything is supposedly available at your fingertips, sometimes you need to be lured into a space where you find by serendipity, not by search. But here, I have not made the time, or, more likely, not allowed myself the luxury of wasted time.

A friendly staff person showed me the way: "Go down that hallway. Take the elevator." Then she flitted away as if she had divulged a secret to me and was worried she might be found out. The elevator was a rickety thing, a banged-up box set on a shaft: "Be kind to the next user and close the gate AND the door!" The inspection certificate, defying my expectations, was up to date.

I found the book I wanted, but the quiet was an added gift: a surround sound version of that stillness found in a conservatory, a botanic garden, a chapel. I browsed a set of an Italian biology journal: glossy pages, full-color illustrations, the work of generations of scientists I would never know and never read.

The variety was luxuriant, rich, and ignored, a buried garden inside the very walls of biomedicine's fortress. When would the voice of the granting authority find me and cast me out? Where was the flaming sword to guard against intruders?

The security guard smiled on my way out. "Did you find what you needed?"

I nodded, showing her what I could from my brief voyage: a bound book.

Last week I was invited to talk at the DC offices of One Medical Group, which was a healthcare startup back in 2009 when I finished residency (I interviewed with them for a job, as a matter of fact). Now it's a going concern, with branches in San Francisco, New York, and DC -- and, now that I look at their web site, in Chicago, Boston, and LA, as well. One of my friends from residency, Will Kimbrough, is the medical director of the DC office. He is an incredibly smart guy, consummately professional, innately humble, and not afraid to call out bullshit: powerful virtues make for a clinical leader and builder.

Nevertheless, before I knew Will was working there (and, to be honest, maybe for a bit after) I had my assumptions about One Medical Group - because it practices concierge medicine. Concierge medicine is for rich people, I thought. "Thought" is maybe a strong term: it was my assumption, born of ignorance and lack of acquaintance with such a model.

I can't say that I am now intimately acquainted with a concierge model after an afternoon at One Medical Group. But I had a good time giving a short talk to a group of energetic, young doctors who told anecdotes about patients that sound an awful lot like mine. I still wouldn't rely on the concierge system to fix our American health care holes, but it might indeed be a reasonable way of providing care to those that can afford it. And, who knows, maybe the price and quality transparency that have long been a natural, unquestioned characteristic of markets for other goods - cars, groceries - might make its way into the health care market in part through such private companies.

* * *

Sean Looney was a high school friend of mine, a tall guy who was often smiling. Our group of nerds thought we were hot shit (in a quiz-bowl, socially awkward sort of way), but he alone among us seemed to realize that it was worth our while to try and act like normal people, even though we were more academically oriented than others. Or, at least, not to be irremediably dorky.


After getting a liberal arts degree, he went back to medical school and completed a family practice residency in Cheyenne, Wyoming; he told me about an instructor who could tell the caliber of a bullet by the sound it made falling into a metal bedpan. He then practiced medicine in many places across the country, but in these last years in Pikeville (county seat of Pike County, Kentucky), and in Louisville. He got married.

We weren't really in close touch since high school, and I couldn't make it to his wedding. But I did remember the kind of patients he said he took care of in Louisville: alcoholics with schizophrenia. Problems that are not, to be honest, on the pages of the New England Journal too often, and not the subject of fancy clinical trials.

Sean died suddenly last week at the age of 40. His close friends, wife, and family are heartbroken. When I called his mom, I tried to tell her that he is, and was, an inspiration to me.

Sean's sympathy for people was informed by a love of literature. Sean, me, and our mutual friend Jon (who I have known for a long time, even longer than Sean) used to quote El Cid and Spanish romances to each other. He freely cited musicals and I remember he loved opera.

A healing art needs humaneness, a fertile mind and heart, like those Sean had.

* * *

Like concierge medicine, we can't build our entire health care system on the safety net, but we want such humaneness for people of all strata.

I am coming at this question as a reader. There are a lot of health care practitioners and patients who write what can be loosely termed "creative writing on health-related [or medical] topics," which for lack of a better definition (that's near at hand) I will term anything that aims to get at the non-empirical truth of what it means to be sick, or take of those who are. I struggle with one fact: many of these pieces (short stories, articles, poems) are not interesting aesthetically. Let me put this bluntly: when I read them, I am bored.

I am not jerky enough to name which writers or pieces I am talking about, but I do want to outline the conflict I feel when saying this.  On the one hand, the intention is good: the writer wants to illuminate an aspect of the life of a patient (or a provider) which has been overlooked in the empirical literature.

On the other hand, if such a piece is cliched, overwritten, or - most often - leads to a thuddingly obvious conclusion (suffering does not redeem; pain is bad; illness can be isolating; doctors can lack empathy), the intention can be undermined. But can we still take something away from the piece in that case to help inform our understanding of illness?

In other words: are we looking to be impressed as discerning readers, enriched as human beings, or both? Or should I leave my esthetic expectations aside if I want to enter into someone else's world of illness?

Note: This piece has been edited based on comments below and on Facebook. Previously, I had directed this post to "medical humanities" writing, but I was using this term in a narrow and unhelpful way.