Thursday, August 25, 2022

Q&A with Larry Atlas




Larry Atlas is the author of the new novel South Eight. He has worked as an actor, playwright, screenwriter, and nurse practitioner, and he lives in upstate New York.


Q: What inspired you to write South Eight, and how did you create your character Dr. Abel Arkin?


A: So, in general terms, the experience of working in a hospital, of being around patients at such crucial moments in their lives, around their families, and around those caring for them, was astonishing, life-changing for me. And this was so in ways that I couldn’t make sense of on many, many levels.


Each of us experiences and organizes the world around us in our own way; for me that way is writing, and so I began. As time went by, my specific interests evolved somewhat. Over perhaps the last half of the book I was increasingly interested in the moral conundrums we face in caring for patients whose lives may actually be diminished even as we provide the very best care.


Arkin’s life and work embody many of the contradictions I was interested in—the control and power exercised by both soldiers and doctors, vs. the uncertainty and randomicity around actual outcomes; the desire and imperative to do good in our work coupled with knowledge that we will frequently, unavoidably do ill; the prestige and security of healthcare work vs the steady increase of burnout among its practitioners.


Q: Without giving anything away, did you know how the novel would end before you started writing it, or did you make many changes along the way?


A: I had only a very general idea about main and secondary story lines when I began; they could have been summarized in a paragraph or two. After that, things just unfolded as I wrote. Specifically—and without giving anything away—I had zero thought of any mystery component when I began writing.


Q: What do you think the novel says about the moral questions surrounding modern medicine?


A: I hope that the book gives readers—both professionals and laypersons—a sense of some of the unintended consequences of the extraordinary advances in medical science over the past 50, 75 years.

Obviously, these have been of profound benefit to many of our patients. But for the elderly and chronically ill, of whom there are millions in this country, these developments have also, often, led to prolonged disability and even suffering.


They have also led us as a society to institutionalize (i.e., in hospitals and nursing homes) a part of life that was previously understood to be natural, and which took place at home among friends and family.


This—the prolongation of disability and suffering among the elderly as a result of medical care provided by healthcare professionals with the best of intentions—has, I believe, created a deep moral distress among many of those professionals.


It is hardly ever discussed; we have no plan for change and are powerless in the face of the contradictions involved—but I suspect it’s this moral distress more than any other factor that underlies much of the burnout we experience in healthcare.


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


A: I hope readers get an in-depth sense of the world of the hospital, of the extraordinary reach of medical science and data, and of some of the issues mentioned in the previous answer.


I also hope they get a sense of the amazing skill and dedication of the people who work in that world, of the emotional costs of doing so, and of the doubts and fears that afflict even the most accomplished professionals. I also hope they enjoy the story in which all that plays a role!


Q: What are you working on now?


A: Well, in addition to continuing to work in healthcare, I am in the initial stages of work on a novel about very early art and language. That’s all I can say about it!


Q: Anything else we should know?


A: I imagine that, at first glance, some readers may see in South Eight a criticism of healthcare, its physicians and other professionals.


They should know that as the book unfolded my admiration for my colleagues—doctors, nurses, techs, everyone—actually only increased. They are laboring under extraordinary burdens, and in the face of some extraordinary unintended consequences such as are mentioned above.


That they nevertheless do in fact labor on is a tribute to their skill and training and compassion and dedication to their patients. I’m proud to have been able to write about them.


--Interview with Deborah Kalb

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