My goal as a writer is to create a story that will leave the reader feeling intense emotion. This is something that as a pediatric cardiologist, a heart doctor for children, I experience every day. Evaluating the hearts of fetuses with ultrasound, making sure all the parts are there and in the correct location, is technically and intellectually challenging.
I, like Dr. Love, one of my characters in Water In May, always draw pictures when I’m talking to parents about their baby’s heart problem. The insides of my white coat pockets are marked by the red, blue and purple crayons I carry around with me. I am a very visual person. Sketching the heart helps me. I assume it helps the parents too. The hand-drawn images also slow down my words and give the family time to absorb what I say. Walking parents through what a normal heart looks like, showing them how their fetus’s heart differs and what we plan to do after birth is what I love about what I do. The challenge is to tailor the explanation so each individual can understand, regardless of culture, language and education level. Because every family is different.
I mention in my acknowledgments for Water In May a doctor I met in medical school. He gave me my first and best example of how to deliver bad news. It so happened he was a pediatric cardiologist. The patient was a two-week old infant referred to the clinic for a murmur. Many newborns have murmurs. Most often the murmur is insignificant and the heart is normal. Not so with this one little one who ended up having the same type of heart defect that Jimmy Kimmel’s son has. The doctor had to tell the baby’s mother that her son needed a heart surgery or he would die.
The pediatric cardiologist brought the mother and baby to a separate room that had a couch, two chairs and a coffee table. Even though the doctor was in extreme pain–he needed a root canal but didn’t have time to go to the dentist because he had a long list of patients to see that day–he got down on his knees on the floor, the coffee table between them, so he would be at eye level with the mother. He took her hand and said he was so sorry to have to tell her this. Her eyes teared up. She clutched her sleeping newborn to her, even before the doctor told her what the problem was. The mother had come alone. The father was at work. Their other child had been left home with a grandparent. The mother, understandably, was a wreck. It was Friday afternoon. The waiting room was full. But the cardiologist stayed with that mother, holding her hand, until she was calm enough to understand the instructions he gave her. When the baby’s father showed up hours later, thanks to city traffic, the doctor repeated everything for the two of them, slowly and carefully. It was the most perfect example of the doctor-patient interaction I had seen to that point. It made me want to be like that pediatric cardiologist, even before I had decided I wanted to take care of children with heart defects. I wanted to be a doctor who could help a family like he had.
In some ways writing Water In May was similar. As the writer, I was tending to the emotions of the reader, who would likely be experiencing for the first time, through my main character, Mari, the shock, the denial, the grief of being told your beloved baby is sick and needs a high-risk surgery to survive. I want the reader to feel that. To empathize for the families affected by congenital heart disease. So yes, my work as a fetal cardiologist very much influenced my writing.
Working up in NYC’s Washington Heights, I took care of a lot of Dominican patients. My mother was born in Cuba and my abuelos helped raise my brother and me. Cuba and the Dominican Republic share a language and some aspects of the Caribbean island Latino culture are the same. I like to think that my background helped me relate to my Dominican patients. But I know many amazing doctors who are able to connect to their patients across cultural and language barriers. I do think the close connection I feel to my Dominican patients informed my writing. Not to mention I was comfortable with Dominican slang which is quite distinct – even from Cuban slang. All of this contributed to the creation of Mari as a full character who was real to me and who often dictated what she was going to do next, at times overriding my outline. Mari’s determination is one of the aspects I love most about her and that I hope you love about her, too.