In the first months after I got here, I asked myself when I would be able to say “I come from Baltimore.” Then I realized that’s a stupid question. A city doesn’t require the participation of any given person. That is its promise of freedom and alienation: you can move to a city and be completely anonymous. Baltimore doesn’t care whether I’m from it or not.
The real question is: have I really gotten to know Baltimore yet? Do I feel a part? Living here means confronting huge daily diifferences. Black and white, rich and poor live starkly opposed lives in this city, and since I have always lived a life of comparative privilege it becomes a responsibility to place myself, somehow, within the entire city of Baltimore, not just the thin strip of rich white suburbs I live and commute in.
It’s hard to meet different kinds of people. You have to talk to strangers, which I’m not comfortable doing. But there are two things I love which have helped me overcome, if only in small measure, my city-dweller’s inertia which keeps me an individual in an atomized society. One is writing. The other is medicine. The two – especially in Baltimore – reinforce each other.
I work as a doctor in the gleaming city on a hill that is the Johns Hopkins medical campus. Hopkins has had its difficulties relating to the community, and only in past decades come to realize its responsibility and interrelatedness with it. I practice general internal medicine: in other words, I treat sick and healthy adults of all sorts: all colors, sizes, ages, shapes, and incomes.
As an ordinary person, I am impatient, preferring the constrained dimensions of poetry to the sprawling indulgence of a novel. “Yeah, get to the point,” I tend to mutter to myself when someone treats me to a tale. As a doctor, not through any alchemy but by dint of education, sustained practice, and proffesional aspirations, I listen more. I take down stories. I write down patients’ tales of suffering, anguish, success, heartbreak, and courage nearly every day – without any attention to literary artifice or style.
Unfortunately, I can’t tell these stories to anybody. This is a good thing, I think, this confidentiality. But it does compartmentalize. Over here is my comfortable, privileged rich-white existence, the one lived by 25% of Baltimoreans, more or less. And over there is the existence of many more Baltimoreans who are different from me in various ways. I can’t tell their stories in all their painful exactitude outside of work. Recently, many medical centers have started “allowing” patients to see their own medical notes, but none in Baltimore that I know of – and at Hopkins that is definitely not the case.
What I can do, though, is make up stories about people like them that I can share with the wider public, or at least with whoever wants to read them. Thus, without any concrete plan in this regard, I have been trying to write short stories ever since I came to Baltimore. I’m just starting out so I’m not very good at it. Learning how to put characters through their paces feels a lot like learning the lessons I have perhaps more completely internalized, in the past decade or so, as a parent of young kids: you can try to bodily move them from place to place, strenuously indicating that they should PUT ON THEIR SHOES and GET INTO THE CAR, but sometimes characters – like kids – have to be let alone to do what they want.
These stories that I’m trying to write and the narratives I record in the medical chart have a lot in common. They are meant to be read. They have a point: In the medical record, Chekhov’s adage about the gun hanging on the wall is all the more fitting. If someone comes to the doctor with chest pain, the doctor better proffer an explanation, by the end of the note, why she thinks the pain is there. Medical notes, like stories, can’t be loose, baggy, or meandering. They must hold the reader.
And both the medical note and the created story must understand the other human being, through acknowledging their concrete yet unknowable specificity. As a doctor I might not know what it is like to have many relatives in jail, others with mental illness, and still others with substance use problems. But I know what pain is like. When a patient comes to me with pain, I can try and heal it despite my ignorance of their inner life.
As a writer, I can no more divine someone’s psychic struggles than I can as a doctor. But I can try and externalize those struggles in a plausible way through showing what they do, what happens to them, what they say and how they react. I don’t aspire to any measure of healing through my still-inexpert prose stylings. But I do hope to inhabit this city of inequities more fully, and become another in the long line of Baltimore writers: if not through my stories, then at least through my medical notes in the privacy of the exam room.