The physician and writer spoke to KSJ fellows about the ethical challenges of writing his third book, which offers a look behind the scenes of a clinical drug trial.
When bestselling author and physician Matt McCarthy first told his editor at Random House that he wanted to write a book about antibiotics, he was shot down. “Hasn’t that been done?” he recalls his editor saying.
But, as McCarthy told his audience at a KSJ seminar last week, the rejection forced him to think more deeply about the story he wanted to tell. After all, his editor was right: Stories about antibiotic resistance had been done time and time again. Searching for a fresh angle, McCarthy went back to the drawing board and revisited an old strategy of his, asking himself, “What is the thing that I uniquely have access to?”
Then it clicked. He had realized that most stories about antibiotic resistance were broad overviews, told “from 30,000 feet” but missing a crucial detail: people. “That’s the thing I have access to,” said McCarthy, a physician at New York Presbyterian hospital in New York and an assistant professor at Weill Cornell Medical School. “These patients who are being infected.”
McCarthy said the revelation planted the seed for his third book, “Superbugs: The Race to Stop an Epidemic,” which chronicles his experience conducting clinical trials of an antibiotic designed to target drug-resistant microbes. The book is an up-close and personal narrative that frequently takes the reader right into the room with McCarthy and his patients. Right after conversations, McCarthy recalled, “I would walk out of the room and type them up.”
During the seminar, KSJ fellow and healthcare reporter Tony Leys asked whether writing about patients has ever put McCarthy in a touchy situation, “when you’re talking to this patient and part of you is saying, ‘Oh boy, this is a good story.’”
McCarthy said the ethical dilemmas were challenging — he had to change patients’ names and a wide range of their identifying qualities to protect patient privacy, for instance — but he also said he didn’t have time to think about his book while in the room with his patients.
“I have so many patients that I see and so much clinical responsibility, that I can’t have that on the forefront of my mind,” he said. He explained that he’s never intentionally tried to dig something out of a patient for the sake of a story, though occasionally “they offer up something.”
Another ethical dilemma McCarthy faced was writing about his colleagues. He wanted to be truthful, but he didn’t want to write a book that would offend his coworkers. “The biggest challenge for me up front was writing about Tom Walsh,” McCarthy said, referring to his mentor of almost ten years, who he described in the book as “thin and pale, like a potato chip.” McCarthy recalled reading nearly the entire manuscript aloud to Walsh, to give him an opportunity to provide feedback — but not the chance to markup pages with edits.
Despite all those challenges, McCarthy told the fellows he felt it was important for “Superbugs” to feel personal. He said a book about drug-resistant microbes could easily end up being a bummer — after all, superbugs are predicted to be the number one cause of death in the year 2050. But he wanted the book to also feel hopeful and exciting, “and the way for it to suffuse those thoughts into a very serious topic is to have a human connection.”
Noting that such narrative writing is rare among the doctors and researchers he’s encountered, KSJ fellow Richard Fisher asked McCarthy whether he’s always written in that style or if he had to learn along the way.
“No, they’re all like this,” McCarthy responded. “I want you to be in the room, I want to grab whoever I’m writing about, and bring them right into your face, so that you can feel everything that’s happening right there.”
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