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Lisa Sanders, MD / Associate Professor, Yale School of Medicine, New Haven, CT; Clinician Educator, 
Yale Internal Medicine Primary Care Residency, New Haven, CT; Yale New Haven Hospital, St. Raphael’s 
Campus, New Haven, CT; Contributing Writer, New York Times Magazine, New York, NY

Learning Curves

The John P. McGovern Award is named in honor of John P. McGovern and is presented to a member 
or nonmember of AMWA to recognize a preeminent contribution to any of the various modes of 
medical communication. The McGovern Award is presented during AMWA's Medical Writing & 
Communication Conference.

JOHN P. MCGOVERN AWARD ADDRESS

AWARDS

CONFERENCE COVERAGE2020
AMWA

Medical Writing &
Communication
Conference
Dates: TBD
Location: ONLINE

Trends and Opportunities for Medical Communicators

Thank you so much for inviting me to this, the new normal, the 

virtual conference. It’s an incredible honor to be asked to come 

here, to be given this McGovern Prize, and it’s made even more 

meaningful by the fact that it comes from my peers, the people 

who really know how it’s done.

 But to be honest, what I do in my column doesn’t seem 

to me so very different from what I do every day in the exam 

room. I take the complex story of people’s bodies and people’s 

diseases and give it back to them, explain it to them, in the 

words and ideas that I think and hope they’ll understand.

 I think John McGovern understood this. He was a real giant 

in medicine and fully embodied that connection between 

medicine and the humanities. In reviewing the past win-

ners of this award, I see some of my favorite doctors on the 

planet, doctors who were also writers. It means so much to be 

included in this extraordinary crowd.

 I wanted to take a few minutes to talk a little bit about my 

own learning curve and how I learned to write. Real learning is 

never a pretty process. For this talk, I’ve dolled it up as much as 

I can, but it remains a swath cut through a field of failure. But as 

I tell the doctors I train in both medicine and in writing, there’s 

nothing like failure to help you learn something really, really 

well. Writing is no different. It is success carved out of failure.

 In putting these remarks together, I marked my route to 

learning the writing craft with comments that were made to 

me by friends or colleagues that showed me the way. These 

were often off-hand remarks that somehow, for some reason, 

resonated with me. You hear exactly the right thing at exactly 

the right moment and, “click,” it all makes sense. Sometimes it 

can take a long time to understand exactly why.

 Of course, we all have many of these kinds of aphorisms 

or little lines that we tell ourselves, but I’ve picked just a few to 

help me show you what I needed to do, what I needed to hear, 

in order to learn to tell my stories.

 Like many of you, I was an English major in college. But 

real communication, especially communicating with people 

you don’t know, that’s different. And I had to learn it on the job. 

And for me, that job was at ABC’s Good Morning America. Like 

most of the women at ABC, I started as a secretary and slowly 

worked my way up to researcher and finally to producer. My 

very first assignment as a producer was to create pieces with 

the new guy, John Stossel. This was before he took that big right 

turn and left ABC News to go to Fox. This was back when he 

was a consumer reporter. He 

had a job on 20/20. He also 

had a slot on Good Morning 

America.

 Our first story was 

about airbags. We travelled 

to Washington to go to the 

Department of Transportation 

to do a story about this new 

device. That’s how long ago this 

was. The big fear at the time 

was that these airbags would 

go off while you were driving. 

So, we did a demonstration of 

Signposting:
My Learning Curves

1. You know what it looks like.

2. Where are my stories?

3. You can see it in his eyes.

4. Watercooler stories.

5. Once more with feeling!

John Stossel

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that. We did interviews. John did his standup. And then, at the 

end of the shoot, John gave me the tapes and told me to go put 

it together.

 I’m like, I don’t know how to do that. I’ve never done that 

before. He looked at me like I was some kind of moron. He 

said, “You’ve watched TV all of your life, you know how it looks, 

you know how it sounds.” And he sent me on my way. It turned 

out, much to my amazement, he was right. It took me and an 

editor so many more hours than it should have, but we finally 

put together a story that looked very much like stories that you 

see on television. I couldn’t believe it.

 Most of my life, I’d been taught the things I needed to 

know. Suddenly John was telling me I had to figure them out. 

And it was terrifying, but it was also incredibly liberating. To 

know that, whatever it is I needed to know, I could just go learn 

it. Amazing.

 Actually, it was also a little frightening to see that this same 

philosophy existed in medicine. It wasn’t long that I was in 

medicine that I heard the phrase “see one, do one, teach one.” 

You teach yourself; you learn by seeing it once. Fortunately, 

we’ve moved away from all that. Thank God.

 If John Stossel taught me that I already knew what televi-

sion looked like and sounded like, it was another correspon-

dent, Maria Hinojosa, who introduced me to the idea that the 

media I made also needed to reflect who I was. I knew Maria 

when we were both lowly producers at the CBS Morning News 

in the late 1980s.

 She was young and smart and far more cosmopolitan than 

I was. And while I was focused on mastering the art of telling 

the usual kind of TV news story, Maria chafed at those con-

straints. She wasn’t interested in mastering that kind of story. 

She wasn’t even interested in telling that kind of story. She had 

her own story she wanted to tell.

 She was from California. Her family was from Mexico, and 

she knew that there were stories from her world that weren’t 

being told. And Maria thought—and time has certainly proved 

her right—that these stories needed to be told.

 “Where are your stories?” she asked me then. I admired 

her tremendously but thought that was a crazy question. The 

media wasn’t there for us to use to tell our stories, it was for 

us to use to tell their stories. The stories of the old white guys, 

although I’m sure I didn’t see it that way then. These were the 

stories of the news. Those stories. And Maria was not interested 

in telling those stories. She left CBS after a year or so to carve 

her own way forward, but it was those conversations we had in 

the hallways of CBS News that stayed with me.

 Finally, I wondered, where are my stories? It took me a long 

time, years, really, before I really found the stories I wanted to 

tell. It wasn’t until I left TV news and went to medical school. 

It was there that I found the stories I wanted to tell. I wanted 

to share how very cool it was to be a physician, to hear patient 

stories, to help them answer the question that brought them to 

my office: “Doctor, what’s wrong with me?” But, as I found out, 

I still had to learn how to tell those stories.

 To learn that, I needed a coach. Atul Gawande said in an 

essay a couple of years ago that everyone needs a coach, and I 

think he’s right. Or at least I needed a coach. And this was my 

coach: my husband, Jack Hitt. He’s a writer and radio personal-

ity, and he’s an extraordinary storyteller.

       I learned a lot about telling stories just watching him do it. 

Seeing him figure out the beats and watching him adapt a story 

to fit his audience, their mood and interest. But I learned the 

most about telling my stories from his eyes.

 We started off in life together as 2 journalists. Me in TV, him 

in print. And we would come together at the end of the day and 

talk about what we saw, what we did. When I went to medical 

school, it seemed natural to me to have the same kind of shar-

ing. Plus, what I was seeing was so powerful, so important, so 

amazing, that I couldn’t wait to tell him all about it, and he’s a 

great listener.

 But sometimes as I told this new kind of story, I could 

see he wasn’t really listening. I’d start a story and somewhere 

along the line, I’d see that I’d lost him. It was something in his 

eyes. His eyes would provide immediate feedback about what 

worked and what didn’t work—real-time, honest feedback. 

Way more honest than he’d ever be verbally. I could see imme-

diately when his attention wandered, and I could see how to 

tweak that story to get it back.

 I didn’t tell him about this for years. I didn’t want to ruin it. 

He still doesn’t believe me, but it’s true. And I still rely on his 

eyes when I have a story that I’m not sure exactly how to tell.

 Not surprisingly, he’s who I really write for. When I teach 

writing, I tell my students that they need to keep their audience 

in mind. That they need to have a picture of who it is they’re 



      AMWA Journal / V36 N1 / 2021 / amwa.org    13

writing for. I used to say that the person I had in my mind, that 

my audience, was an 11-year-old boy. Someone who was inter-

ested, curious, but didn’t know anything.

 It’s only recently that I realized that the real reader I was 

writing for is my husband, who is really an 11-year-old boy  

in disguise. That’s him in the foreground and him age 11 on  

the left.

 It turns out who you write for in your head is incredibly 

important. It helps you find the right voice, the right words, 

how to pitch the right ideas. And when you write for the  

wrong guy, when it’s the wrong person in your head, well, all 

bets are off.

 I used to write for the wrong guy. Alone at my desk, I could 

feel the disapproval of this old guy, this old doctor in my mind, 

I could feel him breathing down my back. I couldn’t help it. I 

wanted to please this guy. I wanted to write for the approval of 

the doctors who told me these stories, and the doctors I saw 

in the hallways and in the conference rooms of the hospital. 

These are the folks, the doctors, the scientists who taught me. 

These are the people I respect and admire. But they are not  

my audience.

 They already know this stuff. It doesn’t make any sense 

to write for these guys. Yet it’s sometimes hard to remember. 

Coming to med school in middle age, I had a terrible case of 

imposter syndrome. And because of that, I used to worry that 

doctors would think I didn’t understand medicine if I described 

it in language that anyone could understand.

 After 18 years of writing my column, I mostly know that 

even doctors appreciate clarity and simplicity. And yet,  

even knowing this, there are times when this old guy still 

haunts me.

 There are 2 guys who started my career at the New York 

Times Magazine. Of course, neither one of them is there any-

more. One is Paul Tough. He’s a remarkable writer. A fantastic 

writer—writes about education—but 20 years ago, he was a 

new editor at the New York Times Magazine and had been given 

the job of coming up with some-

thing new for the front of the book.

 I had just completed my 

training and taken the job on the 

faculty at the program where I 

trained at Yale when Paul called 

me and a bunch of other doctors. 

He asked one question: “What 

can doctors write?” Oh, I had an 

immediate answer. It was a story 

I’d been fascinated by since half-

way through med school. Doctors 

like me, internists, we write the story every day. It’s a story 

about a patient who comes in with a problem and asks for help 

in figuring out what’s going on and how it can be fixed.

 It’s a mystery story. A detective story. The challenge of fig-

uring out these mysteries is a big part of why we become doc-

tors in the first place. So that was the story I pitched to Paul. 

He didn’t believe me. And why should he? It was one of the 

best kept secrets in medicine. I went to med school after cov-

ering medicine for years. I thought I understood how medi-

cine works. But I didn’t know this. I didn’t know that any single 

symptom could have any number of causes. And I didn’t know 

that the big challenge for doctors was figuring that out. They 

don’t tell you that.

 Doctors, at least the ones I’d seen on TV, and had inter-

viewed as a journalist, they all seemed so confident, so  

certain. And the science they talked about seemed so solid. 

I was amazed when I first saw what an uncertain practice it 

all was. I didn’t know this. No one knew this back then. Of 

course, the secret is out now. It was the subtext of a show 

based on my column. Well, my column crossed with the work 

of one of my earliest heroes, Sherlock Holmes. The show was 

House M.D.

 It’s easy to see now that the story that doctors write,

called an “H&P” or “history and physical,” is structured a lot

like an episode of House or vice versa. The H&P starts with the 

chief complaint, the lead, really. Or, if it were an episode of 

House, it would be the cold open. Something dramatic hap-

pens to the patient. Then you get a little context. What hap-

pened right before the drama? This is called the history of the 

presenting illness. Then you get a little backstory about the 

patient, him or herself.

 In medicine, it’s the past medical history and the physical 

exam. In House, undoubtedly one of the team would probably 

just break into the patient’s home. And then, there’s the inves-

tigation. In medicine, it’s often blood testing or imaging. And 

finally, there’s an answer. A diagnosis. To me, it was as clear as 

day. I sent Paul medical journals that offer these little mysteries 

as both education and entertainment.

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 Journals like The New England Journal of Medicine, Mayo 

Clinic Proceedings, The Journal of the American Medical 

Association—this is what doctors do for fun, I explained. It took 

a while for the magazine to believe me. Such a long while, that 

by the time it was all okayed, I had a different editor,  

Dan Zalewski, and he gave me the best single best piece of 

advice I ever got about choosing a story. He said, “Write the 

stories that doctors would tell each other at the water cooler.” 

Snap. Got it. Done.

 There’s one more editor who lent me a line I want to 

share with you. Her name is Catherine Saint Louis. She was 

my first long-term editor at the New York Times Magazine. Of 

course, like Dan, like Paul, she’s long gone. She’s gone to a new 

medium, podcasting. So maybe, in retrospect, I shouldn’t be 

surprised that she should suggest I read my stories out loud 

before I turn them in.

 That was huge. Out loud, the long wandering sentences 

leave you gasping, quite literally, and the clunky metaphors 

declare themselves as soon as they leave your lips. I have to say,

after years of this practice, I don’t really know what I’ve written 

until I hear it from my own lips.

 Thank you for the opportunity to share these stories and 

to honor a few of the many people who have helped me along 

the way. I know that all of us have these stories, and I’m glad to 

be able to share a few of mine. And I want to thank you for this 

wonderful honor and for including my name in the roster of all 

of the wonderful doctor–writers you’ve honored in the past.

 I wish I could be there. I wish we could all be there. But, we 

can’t. At least not now. But, enjoy the rest of your conference 

despite all that. It won’t last forever.

 Thank you.

Acknowledgment
I thank Austin Ulrich, PharmD, Freelance Medical Writer 
(ulrichmedicalwriting.com) for his help in bringing the tran-
script to the page.

Author declaration and disclosures: The author notes no commercial 
associations that may pose a conflict of interest in relation to this article.

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