Conversations
Season
1
Episode
29
|
Dec 1, 2022
The Fun of Medical Fiction with Shirlene Obuobi, MD
Emily speaks with physician, artist, and author Shirlene Obuobi about fiction as escapism, and the stories behind her debut novel, On Rotation.
0:00/1:34
Conversations
Season
1
Episode
29
|
Dec 1, 2022
The Fun of Medical Fiction with Shirlene Obuobi, MD
Emily speaks with physician, artist, and author Shirlene Obuobi about fiction as escapism, and the stories behind her debut novel, On Rotation.
0:00/1:34
Conversations
Season
1
Episode
29
|
12/1/22
The Fun of Medical Fiction with Shirlene Obuobi, MD
Emily speaks with physician, artist, and author Shirlene Obuobi about fiction as escapism, and the stories behind her debut novel, On Rotation.
0:00/1:34
About Our Guest
Shirlene Obuobi is a Ghanaian-American physician, cartoonist, and author who grew up in Chicago, Illinois; Hot Springs, Arkansas; and The Woodlands, Texas. When she’s not in the hospital (and let’s be honest, even when she’s in it), she can be found drawing comics, writing on her phone, and obsessing over her three cats. She currently lives in Chicago, where she is completing her cardiology fellowship. Her debut novel, On Rotation, has been featured on national outlets such as Teen Vogue, The Washington Post, and Good Morning America.
About The Show
The Nocturnists is an award-winning medical storytelling podcast, hosted by physician Emily Silverman. We feature personal stories from frontline clinicians, conversations with healthcare-related authors, and art-makers. Our mission is to humanize healthcare and foster joy, wonder, and curiosity among clinicians and patients alike.
resources
Credits
About Our Guest
Shirlene Obuobi is a Ghanaian-American physician, cartoonist, and author who grew up in Chicago, Illinois; Hot Springs, Arkansas; and The Woodlands, Texas. When she’s not in the hospital (and let’s be honest, even when she’s in it), she can be found drawing comics, writing on her phone, and obsessing over her three cats. She currently lives in Chicago, where she is completing her cardiology fellowship. Her debut novel, On Rotation, has been featured on national outlets such as Teen Vogue, The Washington Post, and Good Morning America.
About The Show
The Nocturnists is an award-winning medical storytelling podcast, hosted by physician Emily Silverman. We feature personal stories from frontline clinicians, conversations with healthcare-related authors, and art-makers. Our mission is to humanize healthcare and foster joy, wonder, and curiosity among clinicians and patients alike.
resources
Credits
About Our Guest
Shirlene Obuobi is a Ghanaian-American physician, cartoonist, and author who grew up in Chicago, Illinois; Hot Springs, Arkansas; and The Woodlands, Texas. When she’s not in the hospital (and let’s be honest, even when she’s in it), she can be found drawing comics, writing on her phone, and obsessing over her three cats. She currently lives in Chicago, where she is completing her cardiology fellowship. Her debut novel, On Rotation, has been featured on national outlets such as Teen Vogue, The Washington Post, and Good Morning America.
About The Show
The Nocturnists is an award-winning medical storytelling podcast, hosted by physician Emily Silverman. We feature personal stories from frontline clinicians, conversations with healthcare-related authors, and art-makers. Our mission is to humanize healthcare and foster joy, wonder, and curiosity among clinicians and patients alike.
resources
Credits
The Nocturnists is made possible by the California Medical Association, and people like you who have donated through our website and Patreon page.
Transcript
Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.
Emily Silverman
You're listening to The Nocturnists: Conversations. I'm Emily Silverman.
Over the last couple of years, we've had a lot of physician-authors on this podcast. But usually their books are nonfiction books, which cover a certain topic or theme in healthcare. Today's guest is a physician, author of fiction, which I'm so excited about because lately I've been so hungry for physician-authored fiction. And she's here to talk about her debut novel, On Rotation. Her name is Shirlene Obuobi. And she's a Ghanaian American physician, cartoonist and author who grew up in Chicago, Illinois; Hot Springs, Arkansas; and The Woodlands, Texas. When she's not in the hospital, and let's be honest, even when she's in it, she can be found drawing comics, writing on her phone, and obsessing over her three cats.
She currently lives in Chicago where she's completing her cardiology fellowship, and her debut novel, On Rotation, has been featured on national outlets such as Teen Vogue, the Washington Post, and Good Morning America. Shirlene and I had a wonderful conversation in which we explored her creative process, the joys of writing about love, the joys of writing black women, physician characters, her decision making process about how much of the narrative to keep inside the hospital versus outside of it. And finally, what work she is excited to be reading these days. I am just blown away by Shirlene’s energy and creative drive and loved every minute of this conversation, and I hope you do too. But first, here is Shirlene reading an excerpt from her novel, On Rotation.
Shirlene Obuobi
“It had been two and a half months since my last meeting with Dr. Wallace, a short interim for an audience with someone of her station. But Dr. Wallace had a vested interest in my matching into a residency program. As the face of the Diversity and Inclusion Committee, she had fought tooth and nail for every Black student who had walked through the hallowed halls of our medical school over the last fifteen years, and her ability to continue doing so was at least in part contingent on our success in the Match. So when she called for a check-in meeting, I wasn’t entirely surprised. Besides, I had something else I wanted to discuss.
“I saw that you honored peds. Congratulations,” she said. “Peppermint?” she offered, waving toward the latest addition to the disaster of her desk: a clear glass jar of mints.
Remembering Ricky’s declaration that I was a Peppermint Patty, I shook my head.
“Thank you,” I said. Dr. Berber, of all people, had given me a glowing evaluation. Angela is always upbeat and ready to learn, it said. Her fund of knowledge is impressive for a fresh third-year.
“Ob-gyn might be harder,” she said. “But you’ll do fine. Keep this up, and I think we’ll be in the clear for your residency apps. Now. About your project.”
I’d finished the first draft of my DVT prophylaxis literature review weeks ago, and it had been sitting, unaddressed, in my PI’s, Dr. Donoghue’s, email inbox ever since. I told Dr. Wallace as much, and she scowled, crossing her arms.
“That’s not good,” she said. “There are some big conference deadlines coming up. Email him again to check in.” She tapped her chin. “What about another project? Just in case this one falls through. There were a few others on that list that I thought looked promising.”
My hands curled on my knees, and I sat up as straight as possible, meeting Dr. Wallace’s eyes directly. That was the best way to get her attention, I’d learned; be commanding, don’t slouch, avoid self-deprecation. Come prepared with hard data.
“Actually,” I said. “I want to do something else. An . . . original project.”
I told her, then, about the boy in the trauma bay. About his mother, and the assumption of his guilt. About the man from years ago in the Emergency Department (“I wrote about him in my personal statement, actually”). And then, about my idea.
“I want to look into specifically Black patient perspectives on physician-patient communication,” I said. I pulled out a folder from my backpack, removing printed copies of the relevant studies I had found thus far. “There’s a lot of data out there already about how physicians are more likely to undertreat pain in Black patients, and how we’re more likely to miss serious diagnoses. There’s also a lot of data about what factors contribute to patient satisfaction, and what patients think physicians could do better. Some people have looked into medical mistrust in the context of medicine’s role in maintaining racial hierarchies. But . . . there’s this intersection that’s just . . . missing.” I met Dr. Wallace’s stony expression with my own. “I want to address that.”
Dr. Wallace took my papers from me, riffling through them one by one. Then she lowered them onto the desk in front of her.
“You’re very passionate,” she said after a long time. “And driven.”
“But . . .” I filled in for her, quirking an eyebrow.
“But,” she said, “a project like this is risky. For one, you will need IRB* approval, which will slow you down. You might need to find funding for transcription services. You’ll have to collect the data yourself, and code it yourself.” She rubbed her temples. “This isn’t something you can finish in one year, Angela.”
“I know,” I said. “But I think I can make some serious headway—”
“And,” Dr. Wallace added, “it’s a ‘Black’ project.”
Oh. I sat back in my chair, trying to process what I’d just heard. Dr. Wallace leaned back with me, folding her hands on her desk.
“What,” I said finally, trying to hold back the disgust from my voice, “is that supposed to mean?”
“Why are you in my office, instead of, say, Dr. Bauer’s?” Dr. Wallace asked. Her glasses glowed with the reflection from her desktop monitor. “Because we share an experience, right? Because I am able to peek beyond the frosted glass and tell you honestly about the bullshit that is going down on the other side.” She picked up my papers again, and with a firm thud, lined up the sheets before stuffing them back into my folder. “And what I’m saying is that, at this stage in your career, you are better off marketing yourself as a clinical researcher than another Black health disparities one.”
Before, I had been just one of many Black kids with a bad Step score, and now, my attempt at creating original research was just another Black kid looking at health disparities. Even though I knew she was just trying to help me, I felt betrayed. Dr. Wallace had always seemed like a source of unending wisdom, but now I felt like we were out of sync. Like she looked at me and saw only a liability. She reminded me of my parents, summarily destroying my enjoyment of anything that wasn’t directly aligned with her specific vision of my future in medicine.
“I didn’t come to medical school to become a clinical researcher,” I said slowly. “I came to be a doctor.” I stood up, grabbing my folder from her desk. “I’ll email Dr. Donoghue about my DVT prophylaxis review.”
Someone else may have asked me to stop, or even apologized. But not Dr. Wallace. It wasn’t her style to do or say things she thought she could regret. When I walked out of her office, she told me to have a good day, and asked me to please close the door gently behind me.
Whatever. I was tired of being told what I could or couldn’t do. I was Angie fucking Appiah, and no matter what a stupid, outdated test said, I had brains for days. I was going to do whatever I wanted, and I was going to do it well, and when my work was finally done, everyone who tried to hold me back would look upon the spoils of my labor and know that they’d screwed up.”
Emily Silverman
I am sitting here with the wonderful Shirlene Obuobi. Shirlene, thank you so much for being here.
Shirlene Obuobi
Thank you so much for having me.
Emily Silverman
So we just heard that reading and there's so much to talk about, but I'd like to walk it back and hear a little bit about your physician path. You're a cardiology fellow, at University of Chicago. Tell us a bit about the doctor part of your life.
Shirlene Obuobi
So, it starts very early. Like many other medical trainees, I come from a line of doctors. Well, the line is one. And then me. My mom is a neonatologist. We moved to the United States when I was six years old, and she went through residency and then fellowship here, and kind of went through the IMG path (International Medical Grad path). Which meant that, at some point, we were in a really small town in Arkansas, where she was the only pediatrician for, like, 50,000 people. That meant that I ended up growing up in a hospital, basically. A small-town hospital, which is really different from what my hospital here at University of Chicago is like. But I felt like, at a pretty young age, I was immersed in medicine. I was more immersed in the social sides of medicine. Like, that was what I could participate in, as, like, a 10-year old... 11-year old... right? So I would talk to patients after they'd seen my mom, right? Like I put on stickers on books for "Reach Out and Read" for the hospital; I went to the state fair, or, like, the town fair, to man the booth. And so, I kind of developed more of, like, a sense of medicine as service through that experience, and ended up kind of wanting to pursue medicine that way. I always joke that my path to cardiology is hilarious because I resisted it. I went into cardiology, kicking and screaming. But when I went into Internal Medicine, it ended up being the field that I felt most intellectually engaged by. And I also joke that, and I think my entire career thus far can kind of reflect that, I like to do all the things people tell me I can't do. And Cards is a very male-dominated field. I looked at the stats sometime recently: it's 22% of current Fellows are women; 5% are Black. So there's, like, probably ten of us out there who look like me. And I would talk to patients, and they wouldn't necessarily have providers who looked like them. And maybe my "savior complex" was kicking in there, and saying that I can be that person. So now here I am.
Emily Silverman
And, so tell me how you got into writing.
Shirlene Obuobi
Writing is something I've done ever since I was a kid. I actually have my first book that I wrote when I was six. It was called “Lucky the Dog.” I wrote a book that we self-published when I was like 14. It's definitely something that I've used for a long time, to express myself and to, kind of, process my emotions and feelings in the moment.
Emily Silverman
I'm sure you get this question all the time. And I actually also get this question, regarding some of the work that I do, where people are always, like, "How do you find time? How do you find time to do both?" And so, rather than asking you, "How do you find time?"... Like, how do you create the container? Do you go to coffee shops? Do you do it at night, after everyone went to sleep? Where do you creatively thrive?
Shirlene Obuobi
Ooh, I like that question. So I,... this is the truth, by the way... I write on my phone a lot. And I write in every waking moment I can. So, that means that I'm walking, like from one patient room to another, I'm usually writing or I'm thinking about a story. And when I come home, obviously, you know, I have my family. I have my husband. Like, I can't completely disappear. So, I usually try to multi-task wherever I can. If Justin's at a meeting or hanging out with his friends, I'll take that opportunity to write. And on the weekends, I do love me a good coffee shop. I do like escaping, because I have a cat who will prevent me from working at all, at all costs. And so, kind of, going to a different space is typically good for me.
Emily Silverman
I love this: writing on the phone in these interstitial moments of life. And I just have to probe a little bit deeper on that. Like, is it something simple, like an image or a line of dialogue? Is it something that you draw from your day to day experience? Or is it, like, you imagine something and you want to capture it before it escapes? Are you writing linearly? Or is it just moments? How do you pull from the Universe into your phone like that?
Shirlene Obuobi
I'm typically writing linearly. I would say that a lot of the work that goes to actually structuring my stories happens in my head, and not necessarily on paper. And so, I mentioned that I write to process. But I also do it to escape. That's one of the reasons why, On Rotation, although I always hesitate to call it a romance, it has a strong love story. Because what is more fun to escape into than love, when you're surrounded by tragedy? I wrote most of On Rotation during the pandemic. I had started it forever ago. I put it down; put it in a box for, like, two years, and then pulled it back up again as a way to produce my own dopamine, basically. And so, in that same way, I do a lot of the plotting in my head, I talk to my friends about my story ideas. (Those are my writing friends, or just close friends who have come to become my writing friends.) And I write linearly. So I have a Google Doc with my novels on it. And I just...I go.
Emily Silverman
That's amazing. I was watching an interview with you on "Good Morning America". And I think you said, "I don't actually talk that much about my writing. And I joke that my husband didn't know that I wrote until I landed an agent." And so I was curious about that part of it, like the public/private or is it something that you prefer to keep private? And how does that play out?
Shirlene Obuobi
I find it difficult to share my writing. And I think it comes from two places. Back then, one of the places was that I felt like I hadn't yet really been validated as a writer. And I have a lot of, or maybe had,... I'm working on it... a lot of "impostor syndrome" in a lot of areas of my life, and I didn't quite yet feel like saying, "I'm a writer". Right? I didn't feel like I had a right to say that for a long time. And so, I never really loudly claimed it, until I had a reason to because I felt like I had industry validation. I had gotten a literary agent, which is incredibly difficult to do. So yeah, even even Justin... I think he did know, but he jokes all the time. He's, like, "I didn't know you wrote." I just never brought it up.
Emily Silverman
So this is a novel about a young physician. Her name is Angela; we call her Angie. And, for you as a young doctor, I'm wondering how did you navigate the tension between autobiography and fiction? Like, how much of yourself is in Angie? How much of Angie did you just create out of thin air? And, did you find it difficult to be in that in-between space, or what was that like?
Shirlene Obuobi
You know, when I was creating Angie, I wanted to create, almost, the typical West African girl in medicine, like typical Ghanaian girl. Even her name is kind of like a "Sarah Jones" in the Ghanian community. If you look up Angela Appiah on Facebook, for example, you're gonna get, like, a thousand different ones. And her features are very common for Ghanaian-American or Ghanaian women as well. Like, she's, like, a mid-sized, curvy, dark-skinned. She has short, natural foresee hair. She's a beautiful woman who has a lot of features that are not necessarily celebrated in America, and she also is very intelligent and accomplished. And, I gave her experiences that were very common to her identities, which means that they weren't necessarily all my experiences. They weren't experiences that were exclusive to me. But they were ones that I had found occurred frequently amongst Black women in medicine. I wanted to give some validity to those experiences. They can feel very lonely until you meet other people who've had them. And so, it's one of the most gratifying aspects, honestly, about On Rotation. I say it in my dedication, like, who this book is really for, like who I wrote it for. But it's really for the girls who don't get to see their experiences represented often in fiction. And when people reach out, back to me, and tell me that, oh, my gosh, I thought I was alone in this, or I thought that this was just me, and I thought all my friends tell me that I'm making it up, or I'm imagining it. That is really, really gratifying for me, because it means I accomplished what I set out to do with it.
Emily Silverman
One thing that struck me about the book is how much of it takes place outside the hospital. So, there's a lot of physician memoirs out there, less physician novels. The one that comes to mind from the 60s, I think, or the 70s, is House of God, which was written by a white man, obviously a very different book, and that one is almost entirely in the hospital. And so this, I just loved how we were at the Beyonce concert; we were in her parents' house; we were in all sorts of places in the garden. And so, talk a little bit about that. Did you have to make an intentional choice that you wanted to have the center of gravity of the story actually not be in the hospital?
Shirlene Obuobi
I really did, because Angie is a third year medical student. And I did that very intentionally, because I feel like third-year is when you kind of grow up as a physician, or as a physician-in-training, and so much of what makes that year so transformative isn't actually what happens within the hospital walls. Like, there's a lot that happens within the hospital walls that is very impactful. But a lot of it is learning how to all of a sudden balance your relationships, when you go from having a lot of control over your time in your pre-clinical years, to having basically no control of your time. It's managing how you're perceived. It's making these huge decisions about what you want to do with the rest of your life. And those are all, I think, elements of a typical coming-of-age story. I also wanted non-physicians to be able to see physicians as people a little bit more. I think that when we look at lots of media where the main character is in medicine...I say Gray's, because everybody knows Gray's, right? But almost all of the shows take place in the hospital, and they make it very much seem as though most of the drama in peoples' lives is coming from the hospital. And a lot of it is. Right. But we're whole people outside of it, who fall in love, and make mistakes, and have to figure out who they are, the same way as everybody else. And I wanted to kind of strip away this idea of who we were supposed to be, with a story.
Emily Silverman
Tell me about the decision to make it a love story. Because you do have these moments where your heart is fluttering, and you almost are falling in love right alongside Angie. Talk more about Angie and Ricky, and what was it like to drop into that relationship?
Shirlene Obuobi
Yeah, I fought for this book to be a love story. And people don't always appreciate how few love stories there are for women who look like me. Where we get to be the main character, and where we get to be loved, receive love, or even navigate love. Right? I also thought that, you know, it was really important for the love story to feel real and to feel messy and to invoke a lot of the complicated feelings that can come, when you are dating in a skin like mine. It's very interesting, actually. People are very torn, in general, about the love story, I think, people who empathize really strongly with Angie. So, a lot of the people who I wrote this book for actually don't love Ricky, and a lot of the reasons why they don't is because I very intentionally made him play and have his own issues be almost indirect opposition to Angie's. And those are things that a lot of us are very insecure and scared of. And so Angie's whole journey is overcoming a lot of fear around romantic love. And, I think if anyone feels really similarly to her, it's a hard love story to stomach, if you haven't had those feelings. The other group of people are like: Ricky's perfect, what's wrong with her? And so, I just wanted to write a love story that felt true to this experience, you know, dating as a millennial, when you are you a high-powered Black woman who doesn't fit beauty standards, but yet is beautiful. Like, what does that look like? What does that look like when you're used to being sexualized? What does it look like when you're used to being loved, but outside of the light? What does that feel like when you have parental pressures around who you're supposed to be with? I wanted to kind of explore all of those complexities in a love story. And it requires you to really get a reader invested in a love story, or even a writer, like, who's writing the love story. And it really required me to do a lot of digging into each of the characters to figure out what their motivations were, what their histories were, to make them fall in love in the first place, and then eventually actually come together.
Emily Silverman
I'm holding back from spoilers. But she also has, Angie, a best friend, Nia, and that relationship, in some ways is just as tumultuous as her relationship with Ricky. And I imagine that's so relatable to anyone in the medical profession who is getting immersed in this culture and in this world, and it really places strain on these existing relationships. So, talk a bit about Nia and how it was writing that part of the story.
Shirlene Obuobi
So for everyone who hasn't read, Nia is Angie's best friend. They have been friends since high school; they moved in together for medical school, while Nia kind of figures her own life out. And, it was so important for me to show a female platonic friendship in this story, because I feel like, in your early 20s especially, those can often be the strongest relationship. At least, they were for me. Like, my relationship with my girls were some of the most formative relationships in my life. And, around that time, as well, I think people's priorities sometimes start to shift. People get partners; they get jobs and careers that start to pull them away from their friendships and make it harder to maintain them. And that transition can be painful, and, as you said, just as tumultuous as a romantic relationship. So, I really, really wanted to show that. It was also important to me that Nia be queer as well, so that I could show a little bit of the dynamics of the friendship and how that could affect issues that they end up having. But also, because I wanted to have that representation in the book as well. A lot of my friends are queer, and don't get to see themselves written as much more than stereotypes in these books.
Emily Silverman
So I loved the experience of walking through Angie's, journey and getting an inside look into what it feels like to being a Black woman in medicine. Obviously I'm white. I don't have that experience. and I just thought it was so powerful. And the scene that you just read between Angie and one of her mentors, I believe a senior professor, a black woman, Dr. Wallace, and we have, this way in which they are really connected and bonded, but on the other hand, we have Dr. Wallace, kind of steering her into a certain direction, in trying to support her, but there's obviously some conflict there. So, talk about,those aspects of the story and how you thought about weaving those in. Because that, to me just made this narrative so fresh. It was just something that I hadn't, read before.
Shirlene Obuobi
I think that, in a lot of ways, I hadn't seen the minority tax (although people are coming up with different terms for it now) really represented, when we talk about medicine. It was important for me to talk about the extra weights that a lot of Black people in medicine feel. So one example is mentorship. We're expected to really apply mentorship to the future generations. We're recruited in part with that expectation - that not only will we be studying for boards, studying for exams, and do well on our rotations - that we'll also be bringing the next generation after us. There's also the fact that how well we do affects whether future Black students get to be brought in. We don't really ever get to be our own people, with our own set of interests. And, we reflect upon people who come before and after us. And that can be a really heavy weight. Knowing that: "Look, if you under-perform, people will use this as evidence that Black people under-perform", rather than just saying, "Okay, you, in particular, are struggling." Which, obviously, doesn't make it easy to perform well, all the time. Right? And the added aspect, too, that she brings up about health disparities. It is very natural for someone who comes from a population that is underserved to want to go into medicine in order to serve that population. Like I said, when we talked about why I went into cardiology, like, a not insignificant part of the reason why I chose cardiology was because there wasn't anybody who looked like me in the field, and cardiovascular disease is, like, still the number one killer of people. And I think that's inappropriate. And so, if that's one of my motivators, it's going to be something that motivates a lot of other Black people who decided to go into medicine. And to have that fairly uniformly de-prioritized, and kind of thought of as "lesser than", is really unfortunate. And it kind of adds, in a lot of ways, to the systemic aspects of racism in medicine. And our selection processes, and how we think of our students and trainees, ...right?... if you don't value what a group of people is more likely to honestly be invested in. Dr. Wallace is a good person. But she's also a person who has had to make her own way; she's had to force her way through by doing exactly what is expected of her and exactly what is respected. And even though she respects Angie's idea... It's not the she thinks that it's worthless... She knows that the other people, the ones who are behind the frosted glass, aren't going to, and that that might damage her career in the future. Obviously, this has some parallels to my journey, right? I am a creative, as are you, I believe. And a lot of what I'm doing with my cartoons, and my writing, weren't valued by the larger medical community. And I had to do things like get on "Good Morning America" and publish a book under HarperCollins, to get any kind of acknowledgement of the potential impact, for anyone to really see its value. And I wanted that aspect to be, like, in there. That all of these things - that they have clear value. I don't think anyone is reading this thinking that Angie's project is actually frivolous, or a bad idea, I'm sure, from a patient perspective. They're, like, yeah, like, I want to know: Like, what are physician-patient communication practices like when they're talking to Black patients? What do black patients think about this? I think it's a good question to ask. It's just not one that people in the medical field will promote, or hire, or recruit you for.
Emily Silverman
As I was reading it, I was like: Wait, I want to read that paper! I was like, Wait, this is a novel, but that paper has to exist! And I'm sure there are some versions of it that do exist, but I was, like, maybe there can be a sequel where it's, like, Angie's paper. So, I'm curious, tell me about the response that you've received to this. So, it came out in June of 2022. It's been out there now, a few months. Do you get messages from physicians, medical students, people outside of medicine? What kind of response have you had?
Shirlene Obuobi
So, the messages that come come in different categories. I got quite a number of, like, incredibly touching messages, typically from Black women, immigrant women, in medicine, who feel like they've been seen for the first time. And, sometimes they'll send me voice notes; sometimes they'll send me, like, an essay. And it just really validates this whole journey. Every time I receive one like this,... I actually made a video a while back to really chronicle them. But of course, I wrote from a perspective that isn't often read, with the hope that people would be able to empathize. But not everyone has great practice in empathy. And, so I also sometimes get, like, kind of tone-deaf messages, or people tag me and things, where I'm like, "Oh, dear...". So, there's an aspect I don't enjoy as much, which is that I feel like the micro-aggressions, that I probably wouldn't receive as much on a daily basis, now kind of come in the form of a deluge, that is thankfully dying down as my release date gets more distant. But that was definitely something that was harder to deal with, which is when I felt like, wow, I've spelled out this experience on a page, and people are still kind of refusing to accept it, because it doesn't line up with what they've experienced. Or like the kind of,... the people who say, as you said, On Rotation doesn't take place in a hospital, right? Or it does, but that's about 50/50 for where she is, and not everybody likes that. Not everybody likes the fact that there's a bunch of other stuff going on. They're like: "No, we just want them to kiss!"
Emily Silverman
That's funny. I thought it was gonna be the opposite. I thought you were gonna have haters writing that it should all be in the hospital. But, no, you have people who want it to get steamier, I imagine.
Shirlene Obuobi
Oh yes! Yeah, I mean, I have those too. I have a lot of people who are like: "I wanted her to be, like, a fully fledged doctor. I didn't want her to be a medical student," and I'm kind of, like, you know, the inside cover says she's a medical student. So, I don't know that I can help you with that. But I also get people who are like, "Why are they boning?"
Emily Silverman
Tell me... Is there an author right now, or a book, or an artist, that is really speaking to you? What are you reading these days?
Shirlene Obuobi
Oh, I have a best writer friend. But I always say that I was her fan before we were friends. Actually I have two; I'll give two. So, one of them... her name is Riss Neilson. I am obsessed with Riss' writing. Her first book is Deep in Providence, and it came out in May, and it's technically YA, but it's very readable for an adult audience. And it follows three girls after their best friend dies in a car crash, and uses a lot of elements of, kind of, Filipino magical realism, to take these girls who are having these very human raw experiences, and adds an element of magic to it. I love that book so much. And because I'm a writer now TM, I get access to early reads. And so I have read her second book already, You're Not Supposed to be in the Dark, and it's also delicious. I also,... I'm a huge R.F. Kuang fan. Something I tell people all the time is that I wrote a book that is sometimes categorized as romance; it's really more of a coming-of-age Women's Fiction, but I read a lot of Sci-fi, and Fantasy. And R.F. Kuang just had a book that came out ...I think it was end of August... called Babel. And, oh my god, it is incredible. It takes into account, like, British colonialism. It's kind of like a reimagining of British colonialism in the 1800s, using linguistics as, like, a magical tool. It's also like the most intelligent book I've ever read. So I'm obsessed with Babel. I bought like a limited edition version of it; that's how obsessed I am.
Emily Silverman
So, our audience is mostly healthcare workers. And often it's healthcare workers who have a little bit of a creative side, or a creative bent. So as we close, I'm wondering, do you have any advice or messages for people listening? People who maybe want to start writing or creating? Or, maybe even if not, just trying to kind of find their their path in medicine? What would you like to share with them?
Shirlene Obuobi
So, I will start by addressing my young ones. So potentially the medical students, the trainees, the people who still have more rungs to climb. And this is not very romantic advice. What it is, is: Play the game; we are not yet at the place where this kind of stuff is necessarily valued. And there are only 24 hours in the day. So I wouldn't abandon.... obviously I didn't,.... I would not abandon your creative side. A lot of us came to medicine, in part because of our love for narratives. And we wrote about the music that we like to play and create, and the books we read and write, and the poetry we do. And that's what got us in in the first place: that diversity of interests. And then we're kind of asked to abandon that at some point. And I'm not saying you should go along with abandoning that. I think more of us would be better doctors if we held on to the things that we were passionate about outside of medicine. But I am saying that to get to the next step, you gotta play the game a little bit, which means that you gotta relinquish a little bit of that time to the things you're told you have to do. For everybody else, honestly, I find that creating art is one of the more human things we can do. It helps me process my interactions with patients and people. That can often be hard interactions; they're fraught with emotion. They're usually happening when we're exhausted and busy. And, I think that if you have a creative streak, taking some time to move some of those emotions into your creative side can be hugely impactful, and it has been for me. Not to be off all your dreams, but at least don't leave them at the door, like.
Emily Silverman
I have been speaking to Dr. Shirlene Obuobi about her novel called On Rotation, and it's such a fun read. Highly recommend you pick it up. Shirlene is also a budding cardiologist, I guess we could say. Is a cardiologist?
Shirlene Obuobi
Yes, budding... budding.
Emily Silverman
...at the University of Chicago and I cannot wait to see what you do next. Thank you so much for being here, Shirlene.
Shirlene Obuobi
Thank you so much, Emily. This was great.
Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.
Emily Silverman
You're listening to The Nocturnists: Conversations. I'm Emily Silverman.
Over the last couple of years, we've had a lot of physician-authors on this podcast. But usually their books are nonfiction books, which cover a certain topic or theme in healthcare. Today's guest is a physician, author of fiction, which I'm so excited about because lately I've been so hungry for physician-authored fiction. And she's here to talk about her debut novel, On Rotation. Her name is Shirlene Obuobi. And she's a Ghanaian American physician, cartoonist and author who grew up in Chicago, Illinois; Hot Springs, Arkansas; and The Woodlands, Texas. When she's not in the hospital, and let's be honest, even when she's in it, she can be found drawing comics, writing on her phone, and obsessing over her three cats.
She currently lives in Chicago where she's completing her cardiology fellowship, and her debut novel, On Rotation, has been featured on national outlets such as Teen Vogue, the Washington Post, and Good Morning America. Shirlene and I had a wonderful conversation in which we explored her creative process, the joys of writing about love, the joys of writing black women, physician characters, her decision making process about how much of the narrative to keep inside the hospital versus outside of it. And finally, what work she is excited to be reading these days. I am just blown away by Shirlene’s energy and creative drive and loved every minute of this conversation, and I hope you do too. But first, here is Shirlene reading an excerpt from her novel, On Rotation.
Shirlene Obuobi
“It had been two and a half months since my last meeting with Dr. Wallace, a short interim for an audience with someone of her station. But Dr. Wallace had a vested interest in my matching into a residency program. As the face of the Diversity and Inclusion Committee, she had fought tooth and nail for every Black student who had walked through the hallowed halls of our medical school over the last fifteen years, and her ability to continue doing so was at least in part contingent on our success in the Match. So when she called for a check-in meeting, I wasn’t entirely surprised. Besides, I had something else I wanted to discuss.
“I saw that you honored peds. Congratulations,” she said. “Peppermint?” she offered, waving toward the latest addition to the disaster of her desk: a clear glass jar of mints.
Remembering Ricky’s declaration that I was a Peppermint Patty, I shook my head.
“Thank you,” I said. Dr. Berber, of all people, had given me a glowing evaluation. Angela is always upbeat and ready to learn, it said. Her fund of knowledge is impressive for a fresh third-year.
“Ob-gyn might be harder,” she said. “But you’ll do fine. Keep this up, and I think we’ll be in the clear for your residency apps. Now. About your project.”
I’d finished the first draft of my DVT prophylaxis literature review weeks ago, and it had been sitting, unaddressed, in my PI’s, Dr. Donoghue’s, email inbox ever since. I told Dr. Wallace as much, and she scowled, crossing her arms.
“That’s not good,” she said. “There are some big conference deadlines coming up. Email him again to check in.” She tapped her chin. “What about another project? Just in case this one falls through. There were a few others on that list that I thought looked promising.”
My hands curled on my knees, and I sat up as straight as possible, meeting Dr. Wallace’s eyes directly. That was the best way to get her attention, I’d learned; be commanding, don’t slouch, avoid self-deprecation. Come prepared with hard data.
“Actually,” I said. “I want to do something else. An . . . original project.”
I told her, then, about the boy in the trauma bay. About his mother, and the assumption of his guilt. About the man from years ago in the Emergency Department (“I wrote about him in my personal statement, actually”). And then, about my idea.
“I want to look into specifically Black patient perspectives on physician-patient communication,” I said. I pulled out a folder from my backpack, removing printed copies of the relevant studies I had found thus far. “There’s a lot of data out there already about how physicians are more likely to undertreat pain in Black patients, and how we’re more likely to miss serious diagnoses. There’s also a lot of data about what factors contribute to patient satisfaction, and what patients think physicians could do better. Some people have looked into medical mistrust in the context of medicine’s role in maintaining racial hierarchies. But . . . there’s this intersection that’s just . . . missing.” I met Dr. Wallace’s stony expression with my own. “I want to address that.”
Dr. Wallace took my papers from me, riffling through them one by one. Then she lowered them onto the desk in front of her.
“You’re very passionate,” she said after a long time. “And driven.”
“But . . .” I filled in for her, quirking an eyebrow.
“But,” she said, “a project like this is risky. For one, you will need IRB* approval, which will slow you down. You might need to find funding for transcription services. You’ll have to collect the data yourself, and code it yourself.” She rubbed her temples. “This isn’t something you can finish in one year, Angela.”
“I know,” I said. “But I think I can make some serious headway—”
“And,” Dr. Wallace added, “it’s a ‘Black’ project.”
Oh. I sat back in my chair, trying to process what I’d just heard. Dr. Wallace leaned back with me, folding her hands on her desk.
“What,” I said finally, trying to hold back the disgust from my voice, “is that supposed to mean?”
“Why are you in my office, instead of, say, Dr. Bauer’s?” Dr. Wallace asked. Her glasses glowed with the reflection from her desktop monitor. “Because we share an experience, right? Because I am able to peek beyond the frosted glass and tell you honestly about the bullshit that is going down on the other side.” She picked up my papers again, and with a firm thud, lined up the sheets before stuffing them back into my folder. “And what I’m saying is that, at this stage in your career, you are better off marketing yourself as a clinical researcher than another Black health disparities one.”
Before, I had been just one of many Black kids with a bad Step score, and now, my attempt at creating original research was just another Black kid looking at health disparities. Even though I knew she was just trying to help me, I felt betrayed. Dr. Wallace had always seemed like a source of unending wisdom, but now I felt like we were out of sync. Like she looked at me and saw only a liability. She reminded me of my parents, summarily destroying my enjoyment of anything that wasn’t directly aligned with her specific vision of my future in medicine.
“I didn’t come to medical school to become a clinical researcher,” I said slowly. “I came to be a doctor.” I stood up, grabbing my folder from her desk. “I’ll email Dr. Donoghue about my DVT prophylaxis review.”
Someone else may have asked me to stop, or even apologized. But not Dr. Wallace. It wasn’t her style to do or say things she thought she could regret. When I walked out of her office, she told me to have a good day, and asked me to please close the door gently behind me.
Whatever. I was tired of being told what I could or couldn’t do. I was Angie fucking Appiah, and no matter what a stupid, outdated test said, I had brains for days. I was going to do whatever I wanted, and I was going to do it well, and when my work was finally done, everyone who tried to hold me back would look upon the spoils of my labor and know that they’d screwed up.”
Emily Silverman
I am sitting here with the wonderful Shirlene Obuobi. Shirlene, thank you so much for being here.
Shirlene Obuobi
Thank you so much for having me.
Emily Silverman
So we just heard that reading and there's so much to talk about, but I'd like to walk it back and hear a little bit about your physician path. You're a cardiology fellow, at University of Chicago. Tell us a bit about the doctor part of your life.
Shirlene Obuobi
So, it starts very early. Like many other medical trainees, I come from a line of doctors. Well, the line is one. And then me. My mom is a neonatologist. We moved to the United States when I was six years old, and she went through residency and then fellowship here, and kind of went through the IMG path (International Medical Grad path). Which meant that, at some point, we were in a really small town in Arkansas, where she was the only pediatrician for, like, 50,000 people. That meant that I ended up growing up in a hospital, basically. A small-town hospital, which is really different from what my hospital here at University of Chicago is like. But I felt like, at a pretty young age, I was immersed in medicine. I was more immersed in the social sides of medicine. Like, that was what I could participate in, as, like, a 10-year old... 11-year old... right? So I would talk to patients after they'd seen my mom, right? Like I put on stickers on books for "Reach Out and Read" for the hospital; I went to the state fair, or, like, the town fair, to man the booth. And so, I kind of developed more of, like, a sense of medicine as service through that experience, and ended up kind of wanting to pursue medicine that way. I always joke that my path to cardiology is hilarious because I resisted it. I went into cardiology, kicking and screaming. But when I went into Internal Medicine, it ended up being the field that I felt most intellectually engaged by. And I also joke that, and I think my entire career thus far can kind of reflect that, I like to do all the things people tell me I can't do. And Cards is a very male-dominated field. I looked at the stats sometime recently: it's 22% of current Fellows are women; 5% are Black. So there's, like, probably ten of us out there who look like me. And I would talk to patients, and they wouldn't necessarily have providers who looked like them. And maybe my "savior complex" was kicking in there, and saying that I can be that person. So now here I am.
Emily Silverman
And, so tell me how you got into writing.
Shirlene Obuobi
Writing is something I've done ever since I was a kid. I actually have my first book that I wrote when I was six. It was called “Lucky the Dog.” I wrote a book that we self-published when I was like 14. It's definitely something that I've used for a long time, to express myself and to, kind of, process my emotions and feelings in the moment.
Emily Silverman
I'm sure you get this question all the time. And I actually also get this question, regarding some of the work that I do, where people are always, like, "How do you find time? How do you find time to do both?" And so, rather than asking you, "How do you find time?"... Like, how do you create the container? Do you go to coffee shops? Do you do it at night, after everyone went to sleep? Where do you creatively thrive?
Shirlene Obuobi
Ooh, I like that question. So I,... this is the truth, by the way... I write on my phone a lot. And I write in every waking moment I can. So, that means that I'm walking, like from one patient room to another, I'm usually writing or I'm thinking about a story. And when I come home, obviously, you know, I have my family. I have my husband. Like, I can't completely disappear. So, I usually try to multi-task wherever I can. If Justin's at a meeting or hanging out with his friends, I'll take that opportunity to write. And on the weekends, I do love me a good coffee shop. I do like escaping, because I have a cat who will prevent me from working at all, at all costs. And so, kind of, going to a different space is typically good for me.
Emily Silverman
I love this: writing on the phone in these interstitial moments of life. And I just have to probe a little bit deeper on that. Like, is it something simple, like an image or a line of dialogue? Is it something that you draw from your day to day experience? Or is it, like, you imagine something and you want to capture it before it escapes? Are you writing linearly? Or is it just moments? How do you pull from the Universe into your phone like that?
Shirlene Obuobi
I'm typically writing linearly. I would say that a lot of the work that goes to actually structuring my stories happens in my head, and not necessarily on paper. And so, I mentioned that I write to process. But I also do it to escape. That's one of the reasons why, On Rotation, although I always hesitate to call it a romance, it has a strong love story. Because what is more fun to escape into than love, when you're surrounded by tragedy? I wrote most of On Rotation during the pandemic. I had started it forever ago. I put it down; put it in a box for, like, two years, and then pulled it back up again as a way to produce my own dopamine, basically. And so, in that same way, I do a lot of the plotting in my head, I talk to my friends about my story ideas. (Those are my writing friends, or just close friends who have come to become my writing friends.) And I write linearly. So I have a Google Doc with my novels on it. And I just...I go.
Emily Silverman
That's amazing. I was watching an interview with you on "Good Morning America". And I think you said, "I don't actually talk that much about my writing. And I joke that my husband didn't know that I wrote until I landed an agent." And so I was curious about that part of it, like the public/private or is it something that you prefer to keep private? And how does that play out?
Shirlene Obuobi
I find it difficult to share my writing. And I think it comes from two places. Back then, one of the places was that I felt like I hadn't yet really been validated as a writer. And I have a lot of, or maybe had,... I'm working on it... a lot of "impostor syndrome" in a lot of areas of my life, and I didn't quite yet feel like saying, "I'm a writer". Right? I didn't feel like I had a right to say that for a long time. And so, I never really loudly claimed it, until I had a reason to because I felt like I had industry validation. I had gotten a literary agent, which is incredibly difficult to do. So yeah, even even Justin... I think he did know, but he jokes all the time. He's, like, "I didn't know you wrote." I just never brought it up.
Emily Silverman
So this is a novel about a young physician. Her name is Angela; we call her Angie. And, for you as a young doctor, I'm wondering how did you navigate the tension between autobiography and fiction? Like, how much of yourself is in Angie? How much of Angie did you just create out of thin air? And, did you find it difficult to be in that in-between space, or what was that like?
Shirlene Obuobi
You know, when I was creating Angie, I wanted to create, almost, the typical West African girl in medicine, like typical Ghanaian girl. Even her name is kind of like a "Sarah Jones" in the Ghanian community. If you look up Angela Appiah on Facebook, for example, you're gonna get, like, a thousand different ones. And her features are very common for Ghanaian-American or Ghanaian women as well. Like, she's, like, a mid-sized, curvy, dark-skinned. She has short, natural foresee hair. She's a beautiful woman who has a lot of features that are not necessarily celebrated in America, and she also is very intelligent and accomplished. And, I gave her experiences that were very common to her identities, which means that they weren't necessarily all my experiences. They weren't experiences that were exclusive to me. But they were ones that I had found occurred frequently amongst Black women in medicine. I wanted to give some validity to those experiences. They can feel very lonely until you meet other people who've had them. And so, it's one of the most gratifying aspects, honestly, about On Rotation. I say it in my dedication, like, who this book is really for, like who I wrote it for. But it's really for the girls who don't get to see their experiences represented often in fiction. And when people reach out, back to me, and tell me that, oh, my gosh, I thought I was alone in this, or I thought that this was just me, and I thought all my friends tell me that I'm making it up, or I'm imagining it. That is really, really gratifying for me, because it means I accomplished what I set out to do with it.
Emily Silverman
One thing that struck me about the book is how much of it takes place outside the hospital. So, there's a lot of physician memoirs out there, less physician novels. The one that comes to mind from the 60s, I think, or the 70s, is House of God, which was written by a white man, obviously a very different book, and that one is almost entirely in the hospital. And so this, I just loved how we were at the Beyonce concert; we were in her parents' house; we were in all sorts of places in the garden. And so, talk a little bit about that. Did you have to make an intentional choice that you wanted to have the center of gravity of the story actually not be in the hospital?
Shirlene Obuobi
I really did, because Angie is a third year medical student. And I did that very intentionally, because I feel like third-year is when you kind of grow up as a physician, or as a physician-in-training, and so much of what makes that year so transformative isn't actually what happens within the hospital walls. Like, there's a lot that happens within the hospital walls that is very impactful. But a lot of it is learning how to all of a sudden balance your relationships, when you go from having a lot of control over your time in your pre-clinical years, to having basically no control of your time. It's managing how you're perceived. It's making these huge decisions about what you want to do with the rest of your life. And those are all, I think, elements of a typical coming-of-age story. I also wanted non-physicians to be able to see physicians as people a little bit more. I think that when we look at lots of media where the main character is in medicine...I say Gray's, because everybody knows Gray's, right? But almost all of the shows take place in the hospital, and they make it very much seem as though most of the drama in peoples' lives is coming from the hospital. And a lot of it is. Right. But we're whole people outside of it, who fall in love, and make mistakes, and have to figure out who they are, the same way as everybody else. And I wanted to kind of strip away this idea of who we were supposed to be, with a story.
Emily Silverman
Tell me about the decision to make it a love story. Because you do have these moments where your heart is fluttering, and you almost are falling in love right alongside Angie. Talk more about Angie and Ricky, and what was it like to drop into that relationship?
Shirlene Obuobi
Yeah, I fought for this book to be a love story. And people don't always appreciate how few love stories there are for women who look like me. Where we get to be the main character, and where we get to be loved, receive love, or even navigate love. Right? I also thought that, you know, it was really important for the love story to feel real and to feel messy and to invoke a lot of the complicated feelings that can come, when you are dating in a skin like mine. It's very interesting, actually. People are very torn, in general, about the love story, I think, people who empathize really strongly with Angie. So, a lot of the people who I wrote this book for actually don't love Ricky, and a lot of the reasons why they don't is because I very intentionally made him play and have his own issues be almost indirect opposition to Angie's. And those are things that a lot of us are very insecure and scared of. And so Angie's whole journey is overcoming a lot of fear around romantic love. And, I think if anyone feels really similarly to her, it's a hard love story to stomach, if you haven't had those feelings. The other group of people are like: Ricky's perfect, what's wrong with her? And so, I just wanted to write a love story that felt true to this experience, you know, dating as a millennial, when you are you a high-powered Black woman who doesn't fit beauty standards, but yet is beautiful. Like, what does that look like? What does that look like when you're used to being sexualized? What does it look like when you're used to being loved, but outside of the light? What does that feel like when you have parental pressures around who you're supposed to be with? I wanted to kind of explore all of those complexities in a love story. And it requires you to really get a reader invested in a love story, or even a writer, like, who's writing the love story. And it really required me to do a lot of digging into each of the characters to figure out what their motivations were, what their histories were, to make them fall in love in the first place, and then eventually actually come together.
Emily Silverman
I'm holding back from spoilers. But she also has, Angie, a best friend, Nia, and that relationship, in some ways is just as tumultuous as her relationship with Ricky. And I imagine that's so relatable to anyone in the medical profession who is getting immersed in this culture and in this world, and it really places strain on these existing relationships. So, talk a bit about Nia and how it was writing that part of the story.
Shirlene Obuobi
So for everyone who hasn't read, Nia is Angie's best friend. They have been friends since high school; they moved in together for medical school, while Nia kind of figures her own life out. And, it was so important for me to show a female platonic friendship in this story, because I feel like, in your early 20s especially, those can often be the strongest relationship. At least, they were for me. Like, my relationship with my girls were some of the most formative relationships in my life. And, around that time, as well, I think people's priorities sometimes start to shift. People get partners; they get jobs and careers that start to pull them away from their friendships and make it harder to maintain them. And that transition can be painful, and, as you said, just as tumultuous as a romantic relationship. So, I really, really wanted to show that. It was also important to me that Nia be queer as well, so that I could show a little bit of the dynamics of the friendship and how that could affect issues that they end up having. But also, because I wanted to have that representation in the book as well. A lot of my friends are queer, and don't get to see themselves written as much more than stereotypes in these books.
Emily Silverman
So I loved the experience of walking through Angie's, journey and getting an inside look into what it feels like to being a Black woman in medicine. Obviously I'm white. I don't have that experience. and I just thought it was so powerful. And the scene that you just read between Angie and one of her mentors, I believe a senior professor, a black woman, Dr. Wallace, and we have, this way in which they are really connected and bonded, but on the other hand, we have Dr. Wallace, kind of steering her into a certain direction, in trying to support her, but there's obviously some conflict there. So, talk about,those aspects of the story and how you thought about weaving those in. Because that, to me just made this narrative so fresh. It was just something that I hadn't, read before.
Shirlene Obuobi
I think that, in a lot of ways, I hadn't seen the minority tax (although people are coming up with different terms for it now) really represented, when we talk about medicine. It was important for me to talk about the extra weights that a lot of Black people in medicine feel. So one example is mentorship. We're expected to really apply mentorship to the future generations. We're recruited in part with that expectation - that not only will we be studying for boards, studying for exams, and do well on our rotations - that we'll also be bringing the next generation after us. There's also the fact that how well we do affects whether future Black students get to be brought in. We don't really ever get to be our own people, with our own set of interests. And, we reflect upon people who come before and after us. And that can be a really heavy weight. Knowing that: "Look, if you under-perform, people will use this as evidence that Black people under-perform", rather than just saying, "Okay, you, in particular, are struggling." Which, obviously, doesn't make it easy to perform well, all the time. Right? And the added aspect, too, that she brings up about health disparities. It is very natural for someone who comes from a population that is underserved to want to go into medicine in order to serve that population. Like I said, when we talked about why I went into cardiology, like, a not insignificant part of the reason why I chose cardiology was because there wasn't anybody who looked like me in the field, and cardiovascular disease is, like, still the number one killer of people. And I think that's inappropriate. And so, if that's one of my motivators, it's going to be something that motivates a lot of other Black people who decided to go into medicine. And to have that fairly uniformly de-prioritized, and kind of thought of as "lesser than", is really unfortunate. And it kind of adds, in a lot of ways, to the systemic aspects of racism in medicine. And our selection processes, and how we think of our students and trainees, ...right?... if you don't value what a group of people is more likely to honestly be invested in. Dr. Wallace is a good person. But she's also a person who has had to make her own way; she's had to force her way through by doing exactly what is expected of her and exactly what is respected. And even though she respects Angie's idea... It's not the she thinks that it's worthless... She knows that the other people, the ones who are behind the frosted glass, aren't going to, and that that might damage her career in the future. Obviously, this has some parallels to my journey, right? I am a creative, as are you, I believe. And a lot of what I'm doing with my cartoons, and my writing, weren't valued by the larger medical community. And I had to do things like get on "Good Morning America" and publish a book under HarperCollins, to get any kind of acknowledgement of the potential impact, for anyone to really see its value. And I wanted that aspect to be, like, in there. That all of these things - that they have clear value. I don't think anyone is reading this thinking that Angie's project is actually frivolous, or a bad idea, I'm sure, from a patient perspective. They're, like, yeah, like, I want to know: Like, what are physician-patient communication practices like when they're talking to Black patients? What do black patients think about this? I think it's a good question to ask. It's just not one that people in the medical field will promote, or hire, or recruit you for.
Emily Silverman
As I was reading it, I was like: Wait, I want to read that paper! I was like, Wait, this is a novel, but that paper has to exist! And I'm sure there are some versions of it that do exist, but I was, like, maybe there can be a sequel where it's, like, Angie's paper. So, I'm curious, tell me about the response that you've received to this. So, it came out in June of 2022. It's been out there now, a few months. Do you get messages from physicians, medical students, people outside of medicine? What kind of response have you had?
Shirlene Obuobi
So, the messages that come come in different categories. I got quite a number of, like, incredibly touching messages, typically from Black women, immigrant women, in medicine, who feel like they've been seen for the first time. And, sometimes they'll send me voice notes; sometimes they'll send me, like, an essay. And it just really validates this whole journey. Every time I receive one like this,... I actually made a video a while back to really chronicle them. But of course, I wrote from a perspective that isn't often read, with the hope that people would be able to empathize. But not everyone has great practice in empathy. And, so I also sometimes get, like, kind of tone-deaf messages, or people tag me and things, where I'm like, "Oh, dear...". So, there's an aspect I don't enjoy as much, which is that I feel like the micro-aggressions, that I probably wouldn't receive as much on a daily basis, now kind of come in the form of a deluge, that is thankfully dying down as my release date gets more distant. But that was definitely something that was harder to deal with, which is when I felt like, wow, I've spelled out this experience on a page, and people are still kind of refusing to accept it, because it doesn't line up with what they've experienced. Or like the kind of,... the people who say, as you said, On Rotation doesn't take place in a hospital, right? Or it does, but that's about 50/50 for where she is, and not everybody likes that. Not everybody likes the fact that there's a bunch of other stuff going on. They're like: "No, we just want them to kiss!"
Emily Silverman
That's funny. I thought it was gonna be the opposite. I thought you were gonna have haters writing that it should all be in the hospital. But, no, you have people who want it to get steamier, I imagine.
Shirlene Obuobi
Oh yes! Yeah, I mean, I have those too. I have a lot of people who are like: "I wanted her to be, like, a fully fledged doctor. I didn't want her to be a medical student," and I'm kind of, like, you know, the inside cover says she's a medical student. So, I don't know that I can help you with that. But I also get people who are like, "Why are they boning?"
Emily Silverman
Tell me... Is there an author right now, or a book, or an artist, that is really speaking to you? What are you reading these days?
Shirlene Obuobi
Oh, I have a best writer friend. But I always say that I was her fan before we were friends. Actually I have two; I'll give two. So, one of them... her name is Riss Neilson. I am obsessed with Riss' writing. Her first book is Deep in Providence, and it came out in May, and it's technically YA, but it's very readable for an adult audience. And it follows three girls after their best friend dies in a car crash, and uses a lot of elements of, kind of, Filipino magical realism, to take these girls who are having these very human raw experiences, and adds an element of magic to it. I love that book so much. And because I'm a writer now TM, I get access to early reads. And so I have read her second book already, You're Not Supposed to be in the Dark, and it's also delicious. I also,... I'm a huge R.F. Kuang fan. Something I tell people all the time is that I wrote a book that is sometimes categorized as romance; it's really more of a coming-of-age Women's Fiction, but I read a lot of Sci-fi, and Fantasy. And R.F. Kuang just had a book that came out ...I think it was end of August... called Babel. And, oh my god, it is incredible. It takes into account, like, British colonialism. It's kind of like a reimagining of British colonialism in the 1800s, using linguistics as, like, a magical tool. It's also like the most intelligent book I've ever read. So I'm obsessed with Babel. I bought like a limited edition version of it; that's how obsessed I am.
Emily Silverman
So, our audience is mostly healthcare workers. And often it's healthcare workers who have a little bit of a creative side, or a creative bent. So as we close, I'm wondering, do you have any advice or messages for people listening? People who maybe want to start writing or creating? Or, maybe even if not, just trying to kind of find their their path in medicine? What would you like to share with them?
Shirlene Obuobi
So, I will start by addressing my young ones. So potentially the medical students, the trainees, the people who still have more rungs to climb. And this is not very romantic advice. What it is, is: Play the game; we are not yet at the place where this kind of stuff is necessarily valued. And there are only 24 hours in the day. So I wouldn't abandon.... obviously I didn't,.... I would not abandon your creative side. A lot of us came to medicine, in part because of our love for narratives. And we wrote about the music that we like to play and create, and the books we read and write, and the poetry we do. And that's what got us in in the first place: that diversity of interests. And then we're kind of asked to abandon that at some point. And I'm not saying you should go along with abandoning that. I think more of us would be better doctors if we held on to the things that we were passionate about outside of medicine. But I am saying that to get to the next step, you gotta play the game a little bit, which means that you gotta relinquish a little bit of that time to the things you're told you have to do. For everybody else, honestly, I find that creating art is one of the more human things we can do. It helps me process my interactions with patients and people. That can often be hard interactions; they're fraught with emotion. They're usually happening when we're exhausted and busy. And, I think that if you have a creative streak, taking some time to move some of those emotions into your creative side can be hugely impactful, and it has been for me. Not to be off all your dreams, but at least don't leave them at the door, like.
Emily Silverman
I have been speaking to Dr. Shirlene Obuobi about her novel called On Rotation, and it's such a fun read. Highly recommend you pick it up. Shirlene is also a budding cardiologist, I guess we could say. Is a cardiologist?
Shirlene Obuobi
Yes, budding... budding.
Emily Silverman
...at the University of Chicago and I cannot wait to see what you do next. Thank you so much for being here, Shirlene.
Shirlene Obuobi
Thank you so much, Emily. This was great.
Transcript
Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.
Emily Silverman
You're listening to The Nocturnists: Conversations. I'm Emily Silverman.
Over the last couple of years, we've had a lot of physician-authors on this podcast. But usually their books are nonfiction books, which cover a certain topic or theme in healthcare. Today's guest is a physician, author of fiction, which I'm so excited about because lately I've been so hungry for physician-authored fiction. And she's here to talk about her debut novel, On Rotation. Her name is Shirlene Obuobi. And she's a Ghanaian American physician, cartoonist and author who grew up in Chicago, Illinois; Hot Springs, Arkansas; and The Woodlands, Texas. When she's not in the hospital, and let's be honest, even when she's in it, she can be found drawing comics, writing on her phone, and obsessing over her three cats.
She currently lives in Chicago where she's completing her cardiology fellowship, and her debut novel, On Rotation, has been featured on national outlets such as Teen Vogue, the Washington Post, and Good Morning America. Shirlene and I had a wonderful conversation in which we explored her creative process, the joys of writing about love, the joys of writing black women, physician characters, her decision making process about how much of the narrative to keep inside the hospital versus outside of it. And finally, what work she is excited to be reading these days. I am just blown away by Shirlene’s energy and creative drive and loved every minute of this conversation, and I hope you do too. But first, here is Shirlene reading an excerpt from her novel, On Rotation.
Shirlene Obuobi
“It had been two and a half months since my last meeting with Dr. Wallace, a short interim for an audience with someone of her station. But Dr. Wallace had a vested interest in my matching into a residency program. As the face of the Diversity and Inclusion Committee, she had fought tooth and nail for every Black student who had walked through the hallowed halls of our medical school over the last fifteen years, and her ability to continue doing so was at least in part contingent on our success in the Match. So when she called for a check-in meeting, I wasn’t entirely surprised. Besides, I had something else I wanted to discuss.
“I saw that you honored peds. Congratulations,” she said. “Peppermint?” she offered, waving toward the latest addition to the disaster of her desk: a clear glass jar of mints.
Remembering Ricky’s declaration that I was a Peppermint Patty, I shook my head.
“Thank you,” I said. Dr. Berber, of all people, had given me a glowing evaluation. Angela is always upbeat and ready to learn, it said. Her fund of knowledge is impressive for a fresh third-year.
“Ob-gyn might be harder,” she said. “But you’ll do fine. Keep this up, and I think we’ll be in the clear for your residency apps. Now. About your project.”
I’d finished the first draft of my DVT prophylaxis literature review weeks ago, and it had been sitting, unaddressed, in my PI’s, Dr. Donoghue’s, email inbox ever since. I told Dr. Wallace as much, and she scowled, crossing her arms.
“That’s not good,” she said. “There are some big conference deadlines coming up. Email him again to check in.” She tapped her chin. “What about another project? Just in case this one falls through. There were a few others on that list that I thought looked promising.”
My hands curled on my knees, and I sat up as straight as possible, meeting Dr. Wallace’s eyes directly. That was the best way to get her attention, I’d learned; be commanding, don’t slouch, avoid self-deprecation. Come prepared with hard data.
“Actually,” I said. “I want to do something else. An . . . original project.”
I told her, then, about the boy in the trauma bay. About his mother, and the assumption of his guilt. About the man from years ago in the Emergency Department (“I wrote about him in my personal statement, actually”). And then, about my idea.
“I want to look into specifically Black patient perspectives on physician-patient communication,” I said. I pulled out a folder from my backpack, removing printed copies of the relevant studies I had found thus far. “There’s a lot of data out there already about how physicians are more likely to undertreat pain in Black patients, and how we’re more likely to miss serious diagnoses. There’s also a lot of data about what factors contribute to patient satisfaction, and what patients think physicians could do better. Some people have looked into medical mistrust in the context of medicine’s role in maintaining racial hierarchies. But . . . there’s this intersection that’s just . . . missing.” I met Dr. Wallace’s stony expression with my own. “I want to address that.”
Dr. Wallace took my papers from me, riffling through them one by one. Then she lowered them onto the desk in front of her.
“You’re very passionate,” she said after a long time. “And driven.”
“But . . .” I filled in for her, quirking an eyebrow.
“But,” she said, “a project like this is risky. For one, you will need IRB* approval, which will slow you down. You might need to find funding for transcription services. You’ll have to collect the data yourself, and code it yourself.” She rubbed her temples. “This isn’t something you can finish in one year, Angela.”
“I know,” I said. “But I think I can make some serious headway—”
“And,” Dr. Wallace added, “it’s a ‘Black’ project.”
Oh. I sat back in my chair, trying to process what I’d just heard. Dr. Wallace leaned back with me, folding her hands on her desk.
“What,” I said finally, trying to hold back the disgust from my voice, “is that supposed to mean?”
“Why are you in my office, instead of, say, Dr. Bauer’s?” Dr. Wallace asked. Her glasses glowed with the reflection from her desktop monitor. “Because we share an experience, right? Because I am able to peek beyond the frosted glass and tell you honestly about the bullshit that is going down on the other side.” She picked up my papers again, and with a firm thud, lined up the sheets before stuffing them back into my folder. “And what I’m saying is that, at this stage in your career, you are better off marketing yourself as a clinical researcher than another Black health disparities one.”
Before, I had been just one of many Black kids with a bad Step score, and now, my attempt at creating original research was just another Black kid looking at health disparities. Even though I knew she was just trying to help me, I felt betrayed. Dr. Wallace had always seemed like a source of unending wisdom, but now I felt like we were out of sync. Like she looked at me and saw only a liability. She reminded me of my parents, summarily destroying my enjoyment of anything that wasn’t directly aligned with her specific vision of my future in medicine.
“I didn’t come to medical school to become a clinical researcher,” I said slowly. “I came to be a doctor.” I stood up, grabbing my folder from her desk. “I’ll email Dr. Donoghue about my DVT prophylaxis review.”
Someone else may have asked me to stop, or even apologized. But not Dr. Wallace. It wasn’t her style to do or say things she thought she could regret. When I walked out of her office, she told me to have a good day, and asked me to please close the door gently behind me.
Whatever. I was tired of being told what I could or couldn’t do. I was Angie fucking Appiah, and no matter what a stupid, outdated test said, I had brains for days. I was going to do whatever I wanted, and I was going to do it well, and when my work was finally done, everyone who tried to hold me back would look upon the spoils of my labor and know that they’d screwed up.”
Emily Silverman
I am sitting here with the wonderful Shirlene Obuobi. Shirlene, thank you so much for being here.
Shirlene Obuobi
Thank you so much for having me.
Emily Silverman
So we just heard that reading and there's so much to talk about, but I'd like to walk it back and hear a little bit about your physician path. You're a cardiology fellow, at University of Chicago. Tell us a bit about the doctor part of your life.
Shirlene Obuobi
So, it starts very early. Like many other medical trainees, I come from a line of doctors. Well, the line is one. And then me. My mom is a neonatologist. We moved to the United States when I was six years old, and she went through residency and then fellowship here, and kind of went through the IMG path (International Medical Grad path). Which meant that, at some point, we were in a really small town in Arkansas, where she was the only pediatrician for, like, 50,000 people. That meant that I ended up growing up in a hospital, basically. A small-town hospital, which is really different from what my hospital here at University of Chicago is like. But I felt like, at a pretty young age, I was immersed in medicine. I was more immersed in the social sides of medicine. Like, that was what I could participate in, as, like, a 10-year old... 11-year old... right? So I would talk to patients after they'd seen my mom, right? Like I put on stickers on books for "Reach Out and Read" for the hospital; I went to the state fair, or, like, the town fair, to man the booth. And so, I kind of developed more of, like, a sense of medicine as service through that experience, and ended up kind of wanting to pursue medicine that way. I always joke that my path to cardiology is hilarious because I resisted it. I went into cardiology, kicking and screaming. But when I went into Internal Medicine, it ended up being the field that I felt most intellectually engaged by. And I also joke that, and I think my entire career thus far can kind of reflect that, I like to do all the things people tell me I can't do. And Cards is a very male-dominated field. I looked at the stats sometime recently: it's 22% of current Fellows are women; 5% are Black. So there's, like, probably ten of us out there who look like me. And I would talk to patients, and they wouldn't necessarily have providers who looked like them. And maybe my "savior complex" was kicking in there, and saying that I can be that person. So now here I am.
Emily Silverman
And, so tell me how you got into writing.
Shirlene Obuobi
Writing is something I've done ever since I was a kid. I actually have my first book that I wrote when I was six. It was called “Lucky the Dog.” I wrote a book that we self-published when I was like 14. It's definitely something that I've used for a long time, to express myself and to, kind of, process my emotions and feelings in the moment.
Emily Silverman
I'm sure you get this question all the time. And I actually also get this question, regarding some of the work that I do, where people are always, like, "How do you find time? How do you find time to do both?" And so, rather than asking you, "How do you find time?"... Like, how do you create the container? Do you go to coffee shops? Do you do it at night, after everyone went to sleep? Where do you creatively thrive?
Shirlene Obuobi
Ooh, I like that question. So I,... this is the truth, by the way... I write on my phone a lot. And I write in every waking moment I can. So, that means that I'm walking, like from one patient room to another, I'm usually writing or I'm thinking about a story. And when I come home, obviously, you know, I have my family. I have my husband. Like, I can't completely disappear. So, I usually try to multi-task wherever I can. If Justin's at a meeting or hanging out with his friends, I'll take that opportunity to write. And on the weekends, I do love me a good coffee shop. I do like escaping, because I have a cat who will prevent me from working at all, at all costs. And so, kind of, going to a different space is typically good for me.
Emily Silverman
I love this: writing on the phone in these interstitial moments of life. And I just have to probe a little bit deeper on that. Like, is it something simple, like an image or a line of dialogue? Is it something that you draw from your day to day experience? Or is it, like, you imagine something and you want to capture it before it escapes? Are you writing linearly? Or is it just moments? How do you pull from the Universe into your phone like that?
Shirlene Obuobi
I'm typically writing linearly. I would say that a lot of the work that goes to actually structuring my stories happens in my head, and not necessarily on paper. And so, I mentioned that I write to process. But I also do it to escape. That's one of the reasons why, On Rotation, although I always hesitate to call it a romance, it has a strong love story. Because what is more fun to escape into than love, when you're surrounded by tragedy? I wrote most of On Rotation during the pandemic. I had started it forever ago. I put it down; put it in a box for, like, two years, and then pulled it back up again as a way to produce my own dopamine, basically. And so, in that same way, I do a lot of the plotting in my head, I talk to my friends about my story ideas. (Those are my writing friends, or just close friends who have come to become my writing friends.) And I write linearly. So I have a Google Doc with my novels on it. And I just...I go.
Emily Silverman
That's amazing. I was watching an interview with you on "Good Morning America". And I think you said, "I don't actually talk that much about my writing. And I joke that my husband didn't know that I wrote until I landed an agent." And so I was curious about that part of it, like the public/private or is it something that you prefer to keep private? And how does that play out?
Shirlene Obuobi
I find it difficult to share my writing. And I think it comes from two places. Back then, one of the places was that I felt like I hadn't yet really been validated as a writer. And I have a lot of, or maybe had,... I'm working on it... a lot of "impostor syndrome" in a lot of areas of my life, and I didn't quite yet feel like saying, "I'm a writer". Right? I didn't feel like I had a right to say that for a long time. And so, I never really loudly claimed it, until I had a reason to because I felt like I had industry validation. I had gotten a literary agent, which is incredibly difficult to do. So yeah, even even Justin... I think he did know, but he jokes all the time. He's, like, "I didn't know you wrote." I just never brought it up.
Emily Silverman
So this is a novel about a young physician. Her name is Angela; we call her Angie. And, for you as a young doctor, I'm wondering how did you navigate the tension between autobiography and fiction? Like, how much of yourself is in Angie? How much of Angie did you just create out of thin air? And, did you find it difficult to be in that in-between space, or what was that like?
Shirlene Obuobi
You know, when I was creating Angie, I wanted to create, almost, the typical West African girl in medicine, like typical Ghanaian girl. Even her name is kind of like a "Sarah Jones" in the Ghanian community. If you look up Angela Appiah on Facebook, for example, you're gonna get, like, a thousand different ones. And her features are very common for Ghanaian-American or Ghanaian women as well. Like, she's, like, a mid-sized, curvy, dark-skinned. She has short, natural foresee hair. She's a beautiful woman who has a lot of features that are not necessarily celebrated in America, and she also is very intelligent and accomplished. And, I gave her experiences that were very common to her identities, which means that they weren't necessarily all my experiences. They weren't experiences that were exclusive to me. But they were ones that I had found occurred frequently amongst Black women in medicine. I wanted to give some validity to those experiences. They can feel very lonely until you meet other people who've had them. And so, it's one of the most gratifying aspects, honestly, about On Rotation. I say it in my dedication, like, who this book is really for, like who I wrote it for. But it's really for the girls who don't get to see their experiences represented often in fiction. And when people reach out, back to me, and tell me that, oh, my gosh, I thought I was alone in this, or I thought that this was just me, and I thought all my friends tell me that I'm making it up, or I'm imagining it. That is really, really gratifying for me, because it means I accomplished what I set out to do with it.
Emily Silverman
One thing that struck me about the book is how much of it takes place outside the hospital. So, there's a lot of physician memoirs out there, less physician novels. The one that comes to mind from the 60s, I think, or the 70s, is House of God, which was written by a white man, obviously a very different book, and that one is almost entirely in the hospital. And so this, I just loved how we were at the Beyonce concert; we were in her parents' house; we were in all sorts of places in the garden. And so, talk a little bit about that. Did you have to make an intentional choice that you wanted to have the center of gravity of the story actually not be in the hospital?
Shirlene Obuobi
I really did, because Angie is a third year medical student. And I did that very intentionally, because I feel like third-year is when you kind of grow up as a physician, or as a physician-in-training, and so much of what makes that year so transformative isn't actually what happens within the hospital walls. Like, there's a lot that happens within the hospital walls that is very impactful. But a lot of it is learning how to all of a sudden balance your relationships, when you go from having a lot of control over your time in your pre-clinical years, to having basically no control of your time. It's managing how you're perceived. It's making these huge decisions about what you want to do with the rest of your life. And those are all, I think, elements of a typical coming-of-age story. I also wanted non-physicians to be able to see physicians as people a little bit more. I think that when we look at lots of media where the main character is in medicine...I say Gray's, because everybody knows Gray's, right? But almost all of the shows take place in the hospital, and they make it very much seem as though most of the drama in peoples' lives is coming from the hospital. And a lot of it is. Right. But we're whole people outside of it, who fall in love, and make mistakes, and have to figure out who they are, the same way as everybody else. And I wanted to kind of strip away this idea of who we were supposed to be, with a story.
Emily Silverman
Tell me about the decision to make it a love story. Because you do have these moments where your heart is fluttering, and you almost are falling in love right alongside Angie. Talk more about Angie and Ricky, and what was it like to drop into that relationship?
Shirlene Obuobi
Yeah, I fought for this book to be a love story. And people don't always appreciate how few love stories there are for women who look like me. Where we get to be the main character, and where we get to be loved, receive love, or even navigate love. Right? I also thought that, you know, it was really important for the love story to feel real and to feel messy and to invoke a lot of the complicated feelings that can come, when you are dating in a skin like mine. It's very interesting, actually. People are very torn, in general, about the love story, I think, people who empathize really strongly with Angie. So, a lot of the people who I wrote this book for actually don't love Ricky, and a lot of the reasons why they don't is because I very intentionally made him play and have his own issues be almost indirect opposition to Angie's. And those are things that a lot of us are very insecure and scared of. And so Angie's whole journey is overcoming a lot of fear around romantic love. And, I think if anyone feels really similarly to her, it's a hard love story to stomach, if you haven't had those feelings. The other group of people are like: Ricky's perfect, what's wrong with her? And so, I just wanted to write a love story that felt true to this experience, you know, dating as a millennial, when you are you a high-powered Black woman who doesn't fit beauty standards, but yet is beautiful. Like, what does that look like? What does that look like when you're used to being sexualized? What does it look like when you're used to being loved, but outside of the light? What does that feel like when you have parental pressures around who you're supposed to be with? I wanted to kind of explore all of those complexities in a love story. And it requires you to really get a reader invested in a love story, or even a writer, like, who's writing the love story. And it really required me to do a lot of digging into each of the characters to figure out what their motivations were, what their histories were, to make them fall in love in the first place, and then eventually actually come together.
Emily Silverman
I'm holding back from spoilers. But she also has, Angie, a best friend, Nia, and that relationship, in some ways is just as tumultuous as her relationship with Ricky. And I imagine that's so relatable to anyone in the medical profession who is getting immersed in this culture and in this world, and it really places strain on these existing relationships. So, talk a bit about Nia and how it was writing that part of the story.
Shirlene Obuobi
So for everyone who hasn't read, Nia is Angie's best friend. They have been friends since high school; they moved in together for medical school, while Nia kind of figures her own life out. And, it was so important for me to show a female platonic friendship in this story, because I feel like, in your early 20s especially, those can often be the strongest relationship. At least, they were for me. Like, my relationship with my girls were some of the most formative relationships in my life. And, around that time, as well, I think people's priorities sometimes start to shift. People get partners; they get jobs and careers that start to pull them away from their friendships and make it harder to maintain them. And that transition can be painful, and, as you said, just as tumultuous as a romantic relationship. So, I really, really wanted to show that. It was also important to me that Nia be queer as well, so that I could show a little bit of the dynamics of the friendship and how that could affect issues that they end up having. But also, because I wanted to have that representation in the book as well. A lot of my friends are queer, and don't get to see themselves written as much more than stereotypes in these books.
Emily Silverman
So I loved the experience of walking through Angie's, journey and getting an inside look into what it feels like to being a Black woman in medicine. Obviously I'm white. I don't have that experience. and I just thought it was so powerful. And the scene that you just read between Angie and one of her mentors, I believe a senior professor, a black woman, Dr. Wallace, and we have, this way in which they are really connected and bonded, but on the other hand, we have Dr. Wallace, kind of steering her into a certain direction, in trying to support her, but there's obviously some conflict there. So, talk about,those aspects of the story and how you thought about weaving those in. Because that, to me just made this narrative so fresh. It was just something that I hadn't, read before.
Shirlene Obuobi
I think that, in a lot of ways, I hadn't seen the minority tax (although people are coming up with different terms for it now) really represented, when we talk about medicine. It was important for me to talk about the extra weights that a lot of Black people in medicine feel. So one example is mentorship. We're expected to really apply mentorship to the future generations. We're recruited in part with that expectation - that not only will we be studying for boards, studying for exams, and do well on our rotations - that we'll also be bringing the next generation after us. There's also the fact that how well we do affects whether future Black students get to be brought in. We don't really ever get to be our own people, with our own set of interests. And, we reflect upon people who come before and after us. And that can be a really heavy weight. Knowing that: "Look, if you under-perform, people will use this as evidence that Black people under-perform", rather than just saying, "Okay, you, in particular, are struggling." Which, obviously, doesn't make it easy to perform well, all the time. Right? And the added aspect, too, that she brings up about health disparities. It is very natural for someone who comes from a population that is underserved to want to go into medicine in order to serve that population. Like I said, when we talked about why I went into cardiology, like, a not insignificant part of the reason why I chose cardiology was because there wasn't anybody who looked like me in the field, and cardiovascular disease is, like, still the number one killer of people. And I think that's inappropriate. And so, if that's one of my motivators, it's going to be something that motivates a lot of other Black people who decided to go into medicine. And to have that fairly uniformly de-prioritized, and kind of thought of as "lesser than", is really unfortunate. And it kind of adds, in a lot of ways, to the systemic aspects of racism in medicine. And our selection processes, and how we think of our students and trainees, ...right?... if you don't value what a group of people is more likely to honestly be invested in. Dr. Wallace is a good person. But she's also a person who has had to make her own way; she's had to force her way through by doing exactly what is expected of her and exactly what is respected. And even though she respects Angie's idea... It's not the she thinks that it's worthless... She knows that the other people, the ones who are behind the frosted glass, aren't going to, and that that might damage her career in the future. Obviously, this has some parallels to my journey, right? I am a creative, as are you, I believe. And a lot of what I'm doing with my cartoons, and my writing, weren't valued by the larger medical community. And I had to do things like get on "Good Morning America" and publish a book under HarperCollins, to get any kind of acknowledgement of the potential impact, for anyone to really see its value. And I wanted that aspect to be, like, in there. That all of these things - that they have clear value. I don't think anyone is reading this thinking that Angie's project is actually frivolous, or a bad idea, I'm sure, from a patient perspective. They're, like, yeah, like, I want to know: Like, what are physician-patient communication practices like when they're talking to Black patients? What do black patients think about this? I think it's a good question to ask. It's just not one that people in the medical field will promote, or hire, or recruit you for.
Emily Silverman
As I was reading it, I was like: Wait, I want to read that paper! I was like, Wait, this is a novel, but that paper has to exist! And I'm sure there are some versions of it that do exist, but I was, like, maybe there can be a sequel where it's, like, Angie's paper. So, I'm curious, tell me about the response that you've received to this. So, it came out in June of 2022. It's been out there now, a few months. Do you get messages from physicians, medical students, people outside of medicine? What kind of response have you had?
Shirlene Obuobi
So, the messages that come come in different categories. I got quite a number of, like, incredibly touching messages, typically from Black women, immigrant women, in medicine, who feel like they've been seen for the first time. And, sometimes they'll send me voice notes; sometimes they'll send me, like, an essay. And it just really validates this whole journey. Every time I receive one like this,... I actually made a video a while back to really chronicle them. But of course, I wrote from a perspective that isn't often read, with the hope that people would be able to empathize. But not everyone has great practice in empathy. And, so I also sometimes get, like, kind of tone-deaf messages, or people tag me and things, where I'm like, "Oh, dear...". So, there's an aspect I don't enjoy as much, which is that I feel like the micro-aggressions, that I probably wouldn't receive as much on a daily basis, now kind of come in the form of a deluge, that is thankfully dying down as my release date gets more distant. But that was definitely something that was harder to deal with, which is when I felt like, wow, I've spelled out this experience on a page, and people are still kind of refusing to accept it, because it doesn't line up with what they've experienced. Or like the kind of,... the people who say, as you said, On Rotation doesn't take place in a hospital, right? Or it does, but that's about 50/50 for where she is, and not everybody likes that. Not everybody likes the fact that there's a bunch of other stuff going on. They're like: "No, we just want them to kiss!"
Emily Silverman
That's funny. I thought it was gonna be the opposite. I thought you were gonna have haters writing that it should all be in the hospital. But, no, you have people who want it to get steamier, I imagine.
Shirlene Obuobi
Oh yes! Yeah, I mean, I have those too. I have a lot of people who are like: "I wanted her to be, like, a fully fledged doctor. I didn't want her to be a medical student," and I'm kind of, like, you know, the inside cover says she's a medical student. So, I don't know that I can help you with that. But I also get people who are like, "Why are they boning?"
Emily Silverman
Tell me... Is there an author right now, or a book, or an artist, that is really speaking to you? What are you reading these days?
Shirlene Obuobi
Oh, I have a best writer friend. But I always say that I was her fan before we were friends. Actually I have two; I'll give two. So, one of them... her name is Riss Neilson. I am obsessed with Riss' writing. Her first book is Deep in Providence, and it came out in May, and it's technically YA, but it's very readable for an adult audience. And it follows three girls after their best friend dies in a car crash, and uses a lot of elements of, kind of, Filipino magical realism, to take these girls who are having these very human raw experiences, and adds an element of magic to it. I love that book so much. And because I'm a writer now TM, I get access to early reads. And so I have read her second book already, You're Not Supposed to be in the Dark, and it's also delicious. I also,... I'm a huge R.F. Kuang fan. Something I tell people all the time is that I wrote a book that is sometimes categorized as romance; it's really more of a coming-of-age Women's Fiction, but I read a lot of Sci-fi, and Fantasy. And R.F. Kuang just had a book that came out ...I think it was end of August... called Babel. And, oh my god, it is incredible. It takes into account, like, British colonialism. It's kind of like a reimagining of British colonialism in the 1800s, using linguistics as, like, a magical tool. It's also like the most intelligent book I've ever read. So I'm obsessed with Babel. I bought like a limited edition version of it; that's how obsessed I am.
Emily Silverman
So, our audience is mostly healthcare workers. And often it's healthcare workers who have a little bit of a creative side, or a creative bent. So as we close, I'm wondering, do you have any advice or messages for people listening? People who maybe want to start writing or creating? Or, maybe even if not, just trying to kind of find their their path in medicine? What would you like to share with them?
Shirlene Obuobi
So, I will start by addressing my young ones. So potentially the medical students, the trainees, the people who still have more rungs to climb. And this is not very romantic advice. What it is, is: Play the game; we are not yet at the place where this kind of stuff is necessarily valued. And there are only 24 hours in the day. So I wouldn't abandon.... obviously I didn't,.... I would not abandon your creative side. A lot of us came to medicine, in part because of our love for narratives. And we wrote about the music that we like to play and create, and the books we read and write, and the poetry we do. And that's what got us in in the first place: that diversity of interests. And then we're kind of asked to abandon that at some point. And I'm not saying you should go along with abandoning that. I think more of us would be better doctors if we held on to the things that we were passionate about outside of medicine. But I am saying that to get to the next step, you gotta play the game a little bit, which means that you gotta relinquish a little bit of that time to the things you're told you have to do. For everybody else, honestly, I find that creating art is one of the more human things we can do. It helps me process my interactions with patients and people. That can often be hard interactions; they're fraught with emotion. They're usually happening when we're exhausted and busy. And, I think that if you have a creative streak, taking some time to move some of those emotions into your creative side can be hugely impactful, and it has been for me. Not to be off all your dreams, but at least don't leave them at the door, like.
Emily Silverman
I have been speaking to Dr. Shirlene Obuobi about her novel called On Rotation, and it's such a fun read. Highly recommend you pick it up. Shirlene is also a budding cardiologist, I guess we could say. Is a cardiologist?
Shirlene Obuobi
Yes, budding... budding.
Emily Silverman
...at the University of Chicago and I cannot wait to see what you do next. Thank you so much for being here, Shirlene.
Shirlene Obuobi
Thank you so much, Emily. This was great.
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