Q&A with Physician-Author Dr. Matt McCarthy

Dr. Matt McCarthy is an assistant professor of medicine at Weill Cornell Medical College and an assistant attending physician at New York-Presbyterian Hospital. He graduated from Harvard Medical School and went on to complete his internal medicine residency at Columbia University Medical Center. Before that, Dr. McCarthy graduated from Yale University with a degree in molecular biophysics and biochemistry, and then spent a year in Minor League Baseball. He wrote about his stint in baseball in Odd Man Out: A Year on the Mound with a Minor League Misfit. The Real Doctor Will See You Shortly: A Physician’s First Year is his most recent book, and details the trials and tribulations of internship year. Dr. McCarthy has published in USA Today, Sports Illustrated, The Atlantic, Slate, Reuters, Deadspin, and Stat. I sat down with Dr. McCarthy at an Upper East Side café to pick his brain. This interview has been edited and condensed:
Can you tell us more about yourself and your career path?
I went to Yale for undergrad and was a molecular biophysics and biochemistry major, and thought that I was going to be a basic scientist. I can remember being in a really good lab where I was working with an MD/PhD student and I remember saying, “I want to run a lab someday. I want to be like our PI [principal investigator].” And this MD/PhD student said, “You know, not everyone gets to be a PI. It’s really hard to make it. You should think about going to medical school.” [Laughs] That really got into my head that if I was good at research, I could still do it if I went to medical school. So I fulfilled all the premed requirements, ended up going to med school at Harvard, did research there in basic science, went into internal medicine and did my residency at Columbia, and all the while planned on being a basic scientist. Then I went on to do an infectious disease fellowship at Cornell and after my first clinical year, I went to work in a lab. And I realized that I didn’t quite have the passion to be a basic scientist. I liked it, but while I was there, I started writing. That’s where I sort of lost interest in being a basic scientist and became a physician-writer.
It seems like you have a lot of really diverse interests. How do you manage to juggle that or even incorporate writing into your career as a physician?
When I was a medical student, I went and saw a talk by Atul Gawande after Complications had come out a year or two earlier. Afterwards, I went up to him and I said, “How did you even decide to become an endocrine surgeon? Like, why the parathyroid? Why was that your life?” I said it in a nice way, but I said “How does somebody end up in that?” And he said, “Well, that’s the career that allows me to write.”
The career I’ve chosen gives me a schedule that allows me to write. I typically will see patients for 28 straight days or 14 straight days. And then I have that same amount of time off. So during that, say, 14 straight days, I don’t do any writing. I can occasionally do some interviews with people for some journalistic stuff, but I’m not really able to sit down and write. Then when I’m off, I’ll have 14 straight days off, but I can wake up and spend nine hours writing.
Why the interest in sports and medicine?
I used to play baseball and I know people at Sports Illustrated, so it was a nice connection. The people I’m friends with from college are a large rag tag group of ex-athletes. And so I was often just up on sports in a way that say, during residency, I wasn’t up on popular music or political science or politics. But sports I always kind of kept aware of and so it was a natural thing for me to write about because I had experience there. I kind of knew the landscape of what was happening, and I had this medical expertise that most sports writers don’t have. I mean, how many physicians write about sports? …There’s a lot more physicians who write about policy or some other area so I went where there was an opportunity.
You also played baseball for a while after college and before you went to medical school, is that right?
I played at Yale for four years and then I played in the Minors for a year.
What’s one of the most important lessons you’ve learned from baseball that you’ve been able to translate to your daily life, either as a writer or as a doctor?
The reason is that you’re going to be a good doctor because you’re a team player, you’re going to be good working with others. What I think often about is that the people who struggle in medicine often aren’t good members of a team. And, you know, there’s so much teamwork.
When I look at medical students or people who are applying to medical school, I like to see some evidence that you play well with others. And it doesn’t have to be sports, but it can be some way you worked in a group dynamic and done well. Could be working in a lab. Any group dynamic you have demonstrated you’re at least not bad in that group, is a good sign.
In addition to sports, you do quite a bit of memoir writing.
Yes, so I’ve written two memoirs. The first one was about playing baseball so the book was about my one year in the Minors where my whole life my dream was to get to do this, to get to play professional baseball. And then I showed up and I wasn’t very good. And I was kind of coming to the realization that this thing you dream about and that you want so badly, you’re just not really cut out for it. And then what? What do you do next?
The other memoir that came out in April [2015] is about my first year as a doctor. It’s kind of the opposite book because I hadn’t really thought about being a doctor for much of my life and then I showed up and I desperately wanted to do this and I wanted to be good at it. And again, similar to baseball, I wasn’t particularly good at it when I got there. But I eventually kind of figured it out. And so the book is kind of looking at how you stumble through your intern year.
And I think it’s really fascinating that you touch on not being good at things because most of the time, whenever you’re trying something new, you’re not good at it initially.
The title of your book, about being a real doctor, what does a real doctor mean to you?
Well, I’ll tell you a little about the book. My editor was over at my apartment three years ago for a celebratory dinner because he had edited a book on Malcolm X that won the Pulitzer Prize. And after dinner, he said “You should write a book about medicine.” And I said, “Nah.” Well he said, “Why not?” I said, “I don’t know.” The next day I went for a walk with my wife, who’s also a physician – she’s on faculty at Columbia. And I said, “Why don’t we really connect with most medical books?” And we started talking about it. It’s because it doesn’t feel real to us, doesn’t feel genuine. When doctors show up on day one, they’re not particularly good. They don’t really know what they’re doing. They don’t even know where the bathroom is, right? So I started thinking about what it is I don’t like about reading doctor books. And I wanted to convey this feeling that – just how insecure and difficult it can be to be an intern.
The thing that’s been most remarkable to me is talking to attending physicians who say, “I read your book and I feel like that’s me still. I still don’t feel like a real doctor. I’m a cardiologist, but I don’t know which antibiotics to use. I’m a hepatologist and I don’t know what diuretic to use.” All of these people still feel like imposters in some way. I say in the book that anyone in the hospital could make another person look foolish if they really wanted to. There’s a lot of insecurity in medicine and I think that my book is kind of touching on just how insecure we all feel. That there are patients where we don’t have answers for them and we don’t know what to say. And just how difficult that is.
I wanted my book to be something for people who are struggling could read and say, he went through the same crap as I went through and he got through it. And I love my job now. I’m thrilled with the career I’ve chosen. And how did he get to a place where he went from being so low, so frustrated, and thinking about leaving medicine to being really happy with his job? That was the theme of the book. It’s from connecting with my patients and colleagues, and just finding this meaning that we’re all in it together. It’s brutal. It’s really hard. But it’s also amazing and, you know, to really cherish and internalize those good moments.
And I mean you do touch on a lot of ethical issues as well. What’s the biggest ethical challenge that you’ve had in your writing?
Unquestionably, the biggest ethical issue is writing about your own patients. There’s one main character in my book and I’m still in touch with him. So it was very easy for me to text this person and say, “Hey, I want to write about your life.” You know, I’ve done public appearances with this person. But that was something that weighed very heavily on me. I can tell you that for each patient in the book, you try to reach out to those people.
There are some ethicists who would say you should never write about one of your patients unless you have written consent. And there’s another group of people who think that’s preposterous because stories need to be told and especially if you’re a journalist, sometimes you can’t get consent. That doesn’t mean you bury the story.
What’s the best piece of advice that you’d give to trainees who are interested in incorporating writing into their career?
I just came back from UCSF [University of California – San Francisco] where I gave a talk based on this. The reason I give this talk is because there’s unprecedented interest in writing from physicians. The way that I started thinking about this was two years ago I was in a talk at Cornell where very prominent administrators stood up and pointed out all the terrible things that are happening in medicine, from the decrease in funding to the work hour restrictions – all these things that are cramping our style essentially. And the last slide was him saying we all need to speak up more, we need to stick up for ourselves. And then it was like, thank you, thank you for having me here. Goodbye. And he didn’t give anybody any tools for speaking up.
What I think would really be powerful… is to have an army of really good writers who are covering these issues for The Atlantic, for Slate, for Gawker, for any media outlet you can think of, [so] that when the GOP debate turns to vaccines and autism, it’s not just one science journalist responding to that, but it’s an army of physicians in all of these places which can drown out the nonsense.
And so the advice I have – there’s a way to pitch stories [and] you need to be succinct, no more than three paragraphs. You need to explain who you are and why you’re uniquely positioned to write the piece that you want to write. You have to also tailor it to the site that you’re writing for, that you’re pitching it to. You don’t do a generic pitch to everyone. My editor for Slate would say, “Tell me how this works for Slate and not for the New York Times magazine.” Or what is it about your readership that will be unique? That’s a skill; it’s not something that is inherently obvious to people.
Any other last words or messages that you want to convey?
This is an unprecedented time for interest in medical writers and there are websites popping up all the time. If you’re interested in writing, what I would say is there are two approaches. One is to aim high and to shoot for the stars with the top publications in the world. The other is to just get yourself out there with some of these blogs and just start writing. Because then you can amass a body of work [and] you can start building your way up. If you look at the stuff I’ve done, I use them to build on each other going from Deadspin to The Atlantic to Slate, Sports Illustrated, in a way that I couldn’t have predicted. But by just getting a foot in the door, you build a body of work that you can then show to other editors and then they can potentially work with you to do more writing.
Christy Duan is an award-winning writer, editor of in-House magazine, fourth-year medical student at Albert Einstein College of Medicine, and budding psychiatrist.