“The Words” — A brief review

It was because he loved the words more than he loved her.

Those were the words of the Old Man. Those were the words he spoke to the young writer who had plagiarized his own.

In the feature film “The Words,” directed and written by Brian Klugman and Lee Sternthal, the Old Man (Jeremy Irons) is a fictional character; but like many characters in works of fiction, he speaks truth — the truth about himself as the Young Man, so much in love, yet unable to forgive his beloved when he learns she has lost the manuscript of his novel in a Paris railway station.

Decades later, the struggling young writer Rory Jansen (Bradley Cooper) accidentally finds that manuscript.  He covets the words the Old Man has written, so much so that he copies them verbatim and allows them to be published as his own. And for this he also pays the high price of losing the woman he loves.

Finally, in this convoluted drama there is the writer himself — the successful author Clayton Hammond (Dennis Quaid), who reads sections from his latest book “The Words” aloud. Afterwards, a groupie graduate student (Olivia Wilde) finagles her way into his penthouse to attempt to learn the truth about what happened to the Old Man and the plagiarist in his book. When Hammond tells her, she doesn’t buy it. She thinks he’s lying, because no one — not even a fictional character — can continue to live a lie and still sleep at night.

“There is a fine line between fiction and life,” Hammond tells her. “They come close, very close, but they never touch.”

All of the characters that a writer creates come from inside his head. They might be based on persons from real life, but in the end he makes them up; and because they come from the depths of his being, ultimately they are part of him and he is part of them. There is no other way.

And so the words of the fictional book “The Words” were written by Hammond. Hammond made up the Old Man just like he made up the Young Man, just like he made up Rory Jansen. He gave them life; he gave them the words to speak.

But there’s more to it than that, of course; because even Clayton Hammond himself was created by Klugman and Sternthal. Ultimately, they are the ones who drafted the words of the screenplay.

Writers of fiction might love their words to such an extent that they are prepared to sacrifice the greatest loves of their lives for their work.

Hemingway was such a writer; he never forgave his first wife for losing his early manuscripts on a train in Paris. The Young Man in “The Words” never forgives his young wife for doing the same; and when the young writer Rory Jansen opts to plagiarize the Old Man’s words to please himself and his wife, he loses them both.

Writing — or any sort of great art for that matter — can be a sickness, in which the artist sacrifices everything for the work, even the most precious of human relationships.

“We all make choices in life,” the Old Man says. “The hardest part is to live with them. Nobody can help you do that.”

Bradley Cooper and Jeremy Irons in "The Words," Jonathan Wenk/Cbs Films

Bradley Cooper and Jeremy Irons in “The Words,” Jonathan Wenk/Cbs Films

JAAPA’s 25th anniversary poetry contest winners announced

“Why poetry?” you might ask. Why indeed? Of the many venues available to validate the human condition, poetry is perhaps the most poignant. In a poem, we see the pathos of both practitioner and patient laid bare, crystallized before our eyes, whispered under the ebb and flow of our collective breath. Poetry presents the human heart with its joys and sufferings, trials and travails. But what, you might ask, does that have to do with the practice of medicine? more»

Interested readers may access the winning poems in JAAPA’s 25th anniversary poetry competition here. JAAPA is the official journal of the American Academy of Physician Assistants.

Walt Whitman, 1887

Flaubert and Hemingway: Stylists at heart

It took Gustav Flaubert almost four years to complete Madame Bovary. As a writer, he worked tirelessly at his craft, composing numerous drafts of each passage, paring each revision down to its basic elements. In the end he wrote over 4,500 pages.

“A good sentence in prose should be like a good line in poetry,” Flaubert said, “unchangeable, as rhythmic, as sonorous.”

His original drafts are available online at Édition des manuscrits de Madame Bovary de Flaubert. Flaubert believed that the success of the book was entirely dependent upon the style of composition.

“What a bitch of a thing prose is! It’s never finished; there’s always something to redo. Yet I think one can give it the consistency of verse,” Flaubert wrote in a letter to his mistress Louise Colet. He strove to hone a narrative style that was direct, precise and polished “as smooth as marble.”

Flaubert also worked hard to develop his characters through dialogue. In another letter he describes an “episode of six or seven pages without a single reflection or explanation coming from the author (all in direct dialogue).”

As a young writer, Hemingway educated himself in the art of writing by reading the masters: Turgenev, Tolstoy — and Flaubert. He developed his powers of observation in his work as a journalist, gathering facts necessary to flesh out the story. Like his mentor Flaubert, Hemingway’s writing — particularly his early prose — is clear and direct. He uses lengthy stretches of dialogue to develop characters. Hemingway became a meticulous stylist, writing and rewriting passages until the cadence was perfect to his eye and ear.

“I rewrote the ending to Farewell to Arms, the last page of it, thirty-nine times before I was satisfied,” he told George Plimpton in a 1954 interview that appeared in the Paris Review.

And in a letter to Gertrude Stein, Hemingway wrote: “But isn’t writing a hard job, though?”

In his seminal biography of Hemingway, Carlos Baker describes the writer’s self-laudatory remarks upon finishing The Green Hills of Africa:

A narrative that combined true reporting, the excitements of action, and the quality of real literature was, Ernest thought, a pretty rare thing. First it all had to happen, and second the man to whom it happened had to be equipped to “make it all come true.” This was as hard as “painting a Cezanne,” and Ernest felt that he was “the only bastard right now” who was capable of such an achievement.

Referring to his early experiences as a newspaper reporter, Hemingway said: “On the Star you were forced to learn to write a simple declarative sentence. This is useful to anyone. Newspaper work will not harm a young writer and could help him if he gets out of it in time.”

Writing is difficult, and good writing is even harder to achieve. Even the masters are apt to fall short.

Flaubert alluded to the writer’s attempts to perfect the craft in these lines from the pages of Madame Bovary:

As if the fullness of the soul did not sometimes overflow in the emptiest of metaphors, since none of us can ever express the exact measure of our needs, or our ideas, or our sorrows, and human speech is like a cracked kettle on which we beat our tunes for bears to dance to, when we long to move the stars to pity.

Literary medical weblogs

Dear J.B.,

Your comment on my blog posting The stories we tell came in just as I was re-reading the first chapter of James Joyce’s Ulysses on the front porch.  Previously, I hadn’t run across the Joyce line you quoted about all novelists having only one story, which they tell again and again; but it certainly rings true.  Hemingway said that in crafting a piece of writing he could “cut the scrollwork or ornament out and throw it away and start with the first true simple declarative sentence” he had written. In my book, anyone who takes writing seriously has to start with a desire for truth and the stamina to pursue it, no matter where it might lead.

You also mentioned Dr. Robert Coles.  I too was fortunate to hear Dr. Coles speak two decades ago at a conference on medicine and the humanities.  I recently read Handing One Another Along, a collection of lectures from an undergraduate course which Coles taught at Harvard on literature and social reflection. (The title of the book comes from a line in Walker Percy’s The Moviegoer, one of Coles’ favorites.) Dr. Coles, of course, is an excellent resource for many good works on medicine and literature as well.

Decades ago I got interested in the idea of using story as a vehicle to explore the doctor-patient relationship.  Throughout my medical training (I am a practicing physician assistant) I was appalled at the insensitivity which many clinicians demonstrated in dealing with patients in their time of suffering.  I struggled to understand the source of this coarseness in bedside manner.  Had these clinicians always acted this way, or through years of training had their medical education squelched whatever empathy they might have once had?  Was this perhaps a defense mechanism they had developed over time to shield themselves from the suffering that they witnessed daily in practice?  If so, what could be done about it?  (It certainly wasn’t helping the patient to heal.)  Could empathy be taught, or was it an innate trait possessed by only a minority of individuals who opted for a career in medicine?

As I began to craft narratives of patient encounters, I discovered that the act of writing itself enhanced the way I related to patients.  Somehow writing the story down served to hone an empathetic response.  It also served to help me deal with my own emotions, guilt and grief which I experienced in encounters with patients.  As my perspective developed, I was fortunate to find several like-minded souls in the social ether along the way.  Over the years I worked with other colleagues to create several online sites which continue to function as forums for clinicians and patients alike, Cell2Soul and Dermanities among them.  After reviewing my book Patients Are a Virtue, Dr. Howard Spiro asked me to consider submitting a monthly piece—“Notes from a Healer”— for the Yale Journal for Humanities in Medicine; and I was also invited to write a bimonthly Humane Medicine column for the Journal of the American Academy of Physician Assistants.  I established this weblog to serve as a repository for my writings.

My hope has always been that with ongoing exposure to these sorts of narratives, more and more medical colleagues might come round to recognizing just how intimate and profound the doctor-patient relationship truly is, and come to an understanding that there is much more to the art of healing than just closing a surgical incision, dressing a wound or writing a prescription.  Medical practice is after all the stuff of life; and because literature historically has been an attempt to capture the essence of what it means to be alive, it is small wonder that the two complement each other so beautifully.  As you so aptly put it, medicine and storytelling go hand in hand.

None of us can be all things to all men; but we can certainly make some fumbling attempts to alleviate suffering in the world and bear one another’s burdens as best we can.  As Rilke so aptly put it, perhaps if we learn to love the questions themselves, we can one day live on into the answers.


Last month our editor initiated a rotating blog on the website of our national publication, the Journal of the American Academy of Physician Assistants.  Editorial board members were invited to send in pieces for posting to allow regular readers and subscribers a chance to glimpse the musings of a cross-section of those representing the Physician Assistant profession.

Today my contribution — Front Porch Reflections — has been posted.  Interested readers can access it here.

Over the years it’s been good discipline for me as a writer to generate weekly postings for my WordPress blog: challenging, stimulating and educational too.  One of the beauties of the internet is the ability to link information and ideas across the web.  Articles serving to clarify concepts become instantaneously accessible.  Blog entries can be linked as well.

Here I would like to put forward the concept of the polyblog.  Polyblogs — any number of blogs composed by a single author, or one particular blog with multiple contributors — are becoming ubiquitous across the web.

Like pollywogs in a vernal pool, polyblogs proliferate abundantly.  Some might grow into mature blogs, while others may fall by the wayside and perish — natural selection at work.

The Scottish Artist

I met him at table in the basement of the Masonic Lodge after the morning bird walk at White Pond.  How did he, a Scotsman, come to know the writings of Henry David Thoreau?

Through an obscure reference in a treatise penned by Robert Louis Stevenson, he told me.  “It was actually derogatory in nature,” the Scotsman said.  “Stevenson quoted another author as referring to Thoreau as a scoundrel.  It piqued my interest.  So I set out to learn if it were true.”

The first book he got his hands on was A Week on the Concord and Merrimack Rivers.  After that he read Walden.  By then he knew that Thoreau was no scoundrel.  On the contrary, he found solace in Thoreau’s writing.  “So much of what he wrote resonated with me in my soul,” the Scotsman told me.  “Money and material things aren’t everything.  These days I try, as much as I’m able, to live a simple life.  My needs are few.  Besides,” he said, paraphrasing Thoreau, “a man’s life is rich in proportion to those things that he can afford to live without.”

I asked him what he did for a living.  “Now I’m retired,” he told me, “but I had a career in telecommunications.  When I was a young man, I served in the armed forces as a paratrooper.  I spent some time on deployment in the Middle East—special services,” he said with a wink.  “Afterwards, my wife and I settled in the Wansbeck Valley, ‘dwelling midst woods and waters,’ as our motto says.”

“And how do you spend your days now?” I asked him.

“I rise early and watch the dawn come up over the valley and the river beyond,” he told me.  “I ramble through the woods and fields.  Lately, I’ve done a little column for our local gazette on natural history.  I also paint—birds mostly—working in gouache.  And then there’s my book collection.”

I merely had to wait for the narration.

“I’ve collected over a hundred books dealing with Thoreau alone,” he told me.  “I’ve got several first editions of his works published in Great Britain.  Walter Scott publishers picked him up in the 1880s.  In some of the books the pages weren’t even cut.  I had to go through them with a penknife.  I believe a book should be read, not just put on the shelf.”

And what brought him to Concord year after year?

“Wall, it’s good to rub shoulders with like-minded individuals, you know,” he said.  “And I bring poppies to place at the graves of British soldiers who died in the American War of Independence.  I place two at the graves at Old North Bridge, two in Lincoln, one at Meriam’s Corner and one at the marker by the Colonial Inn in Concord,” he explained.  “The war was really just a family feud.  And these poor lads have been sleepin’ beneath the soil over here so far from home for over two hundred years.  It’s the least I can do for ’em,” he said.

Soldiers of Fortune

While cleaning out my office desk in preparation for an impending move, at the bottom of one drawer, amidst countless pharmaceutical samples, business cards, stray paperclips, staples, rubber bands and pins of all sorts, I found a trove of tiny slips of paper the size of preprinted address labels: fortunes salvaged from luncheons at a local Chinese restaurant.

For several years I ventured out for lunch at Cheng’s Garden once a week. The food was good, the price was right, and it got me out of the office for an hour. At the conclusion of each meal, along with the bill, the waiter would bring one fortune cookie, which I promptly opened and chewed thoughtfully as I read the words on the piece of paper hidden inside. Invariably, I would tuck the fortune into my shirt pocket before rising from the table to make my way to the register to pay the bill. Back at the office I would extract the slip and read it again before tossing it into my desk drawer. My mother (and my wife) can testify that I am a packrat at heart.

I thought of discarding this impromptu collection of fortunes along with myriad other paraphernalia that accumulated over the years—stuff that I had no use for any longer—but then decided to conduct a survey of sorts. I read through the fortunes that had been meted out to me at random to see if I could detect some sort of pattern. I have recorded a number of them below.

Excellence is the difference between what I do and what I am capable of.
Joys are often the shadows cast by sorrows.
Hope is the most precious treasure.
Charity begins at home, and justice begins next door.
The only rose without a thorn is friendship.
A mentor is someone whose hindsight can become your foresight.
He who knows he has enough is rich.
Treasure what you have.
To be eighty years young is more cheerful and hopeful than forty years old.
Good to begin well, better to end well.

Writers of fortunes—those who soldier on, mustering their thoughts in unknown secret offices—must be wise in the sense that they have the uncanny ability to produce universally accepted turns of phrase. Narcissistic at heart, we humans personalize the good that is spoken of us.

But perhaps a greater collective good serves to spur us on to elevate our lives to a higher plane, if only temporarily in our afternoon postprandial somnolence.

That is why, like any good philosophical text, the lowly fortune cookie imparts some small degree of wisdom—at a bargain price.