Q&A with Elizabeth L. Silver

Elizabeth L. Silver, photo by David Zaugh

Elizabeth L. Silver is the author of the new book The Tincture of Time: A Memoir of ((Medical) Uncertainty. It focuses on the events surrounding her infant daughter's recovery from a medical emergency. Silver also has written the novel The Execution of Noa P. Singleton, and her work has appeared in a variety of publications, including McSweeney's and The Washington Post. She lives in Los Angeles.

Q: You've said that you wrote this book "to live consciously through the immediate years following Abby's stroke." What impact did writing the book have on you during those years?

A: Initially I started out reading memoirs and quickly realized I had to start looking into history and scientific innovation to understand what I was experiencing, and in turn be present and aware for every element of it. I think it is important to remember all aspects of our lives – the good and the bad – for they make us who we are.

With respect to the research element, I’ve also always been drawn to medicine and history, and putting them together was a task I reveled in. In many ways, writing the book helped me intellectualize some of the trauma. Offsetting the personal narrative with so much of literature and history also helped me navigate the emotional elements of the book when it became difficult to relive.

Q: The book's subtitle focuses on "medical uncertainty." How do you feel you managed the uncertainty surrounding Abby's recovery?

A: Acute, Sub-acute and Chronic are the three stages of disease used by physicians around the world with respect to managing and treating illness and injury.

Shortly after I began writing about uncertainty, I realized that it can also be applied to the subject matter, no matter the severity and no matter the type of illness—be it as large as degenerative neurological disease, cancer diagnosis, or brain injury, or as small as a routine tonsillectomy, appendectomy, or even the flu.

Uncertainty is so nebulous, so difficult to comprehend, that having even a loose semblance of a structured approach was helpful to me.

As a result, writing the book within that paradigm made perfect sense for my own story and also for stories of those I interviewed and researched. By looking at her recovery in this approach, it gave me something to hold onto, a structural guide that didn’t exist.

Q: What do you hope readers take away from your book?

A: I hope that readers will feel a little less alone when dealing with medical situations that may (or may not) encompass uncertainty in medicine. I relied on memoirs so heavily when my daughter was ill and they helped heal me and accompany me through what seemed like a terrifying and isolating time.

If it helps, I hope they also take away the paradigm of the three stages of uncertainty in medicine, if it aids them in navigating their own experiences.

Q: You write, "The Tincture of Time is a mantra for anything that poses the proverbial question, 'What if?'" How did you end up choosing that as the book's title, and what else does it signify for you?

A: The title came from a conversation I had with my husband while we were in the NICCU with our daughter. A physician himself, he mentioned that he sometimes writes, “the tincture of time” at the bottom of some patient notes. I stared at him in shock. Sometimes time is the only cure, the only medicine or treatment to a medical ailment, he continued.

We had a long conversation about this topic. It’s not the cliché that time will heal all wounds, because it may for some and may not for others, but rather time as the only answer for your questions. I realized how specifically that applied to us and then took a step back and saw it as a metaphor for life.

Q: What are you working on now?

A: I had been working on a historical novel for quite some time, spending over a year researching and finding my way into the story.

However in the last few months, a new story settled into my mind and I can’t shake it. As of a few weeks ago, I put down the historical novel (temporarily) and have been finding my way into this new novel and love the process so far.

I’m also working on a few film and TV projects.

Q: Anything else we should know?

A: It’s been an honor chatting with you. Thank you for your interest in this book.

--Interview with Deborah Kalb