Katy Horan: Doctor, Writer, “Modern Love Reject”

Hi All,

Most of my memoir students through the University of Washington’s Professional and Continuing Education department come to writing after having already established themselves in other fields. Katy Horan, who will be attending Wild Mountain Memoir Retreat, exemplifies this trend.  As a college student, Katy dreamed of writing, but turned her attention to medicine. Today, she fits writing classes and writing time into her already busy life as a pulmonary and critical care physician.  Here’s a little bit about how Katy got her new career as a writer started.  Also, a bonus, below the interview you’ll find Katy’s essay, “A Time to Be Born and a Time to Die,” which was published on ModernLoveRejects.com, a wonderful site for the hundreds of essays out there  written for the Times‘ Modern Love column but didn’t quite make the cut. (Modern Love Rejects’ humorous tagline: “All the Love That’s Not Fit to Print”)



Theo Pauline Nestor: How did you get started writing memoir?

Dr. Katy Returns to her Dream to Write


Katy Horan: I went to Duke to be an English major with the dreams of writing novels.  I hated reading the canon and was terrified of the required Milton class and soon dropped out of the English program.  But, I loved my writing class which was called Writing 102 twenty years ago, but would probably be called Narrative Nonfiction.  I wrote about important topics like my sister trying to force me to pluck my eyebrows and the beauty of calloused heels.  My now narrator is totally cracking up at how my then narrator would be so disappointed in me now–sellout with plucked eyebrows and soft pedicures.

I didn’t write much other than morose journal entries and dull medical journal articles for almost 20 years and then while writing an article on nontuberculous mycobacteria, I couldn’t think of a word.  It was almost physically painful to not be able to think of the word (which I can’t recall now, but now it doesn’t hurt).  I thought, there it goes, that’s my brain atrophying.  I mentioned this to one of my patients who gave me an assignment from your class, then encouraged me to take your class.

TPN: Was this Modern Love Rejects piece your first publication?  How did it feel?

KH: My first publication was 17 word poem that was published in a West coast literary journal and I was paid $2.  I still have the check.  It wasn’t worth the gas money to cash it.  Even in 1989, two dollars couldn’t rent you a new release at the video store.

Modern Love Rejects’ acceptance of piece and seeing the piece online was a little surreal.  When I took your class, I told myself, “I’m just doing this because writing had gotten so hard.  Not to publish or anything.”  After I saw it online, all my delusions of grandeur took over and I thought,  “maybe I should write a whole book.”

TPN: What are you working on now?

KH: I writing a piece about getting lost while trail running in the Hill Country in Texas earlier this year.  It’s a little confused about what it wants to be: part of it wants to be about the importance of meditative space, part of it wants to be about how we turn on ourselves and the ones we love when we are stressed.

TPN: What are some of your favorite memoirs?  Favorite writers?

KH: Mary Karr The Liar’s Club:  I haven’t read it for years, but I smile whenever I pass its red cover.  Her narrator was the bravest, baddest, and she was from Texas, which is mainly where I grew up.  It had an amazing sense of place and people, very specific for East Texas.  I never read another book by her–I wanted to keep her frozen in that age, before the drugs, before the sobriety.

Different kind of memoir, but I really loved Patti Smith’s Just Kids Elegeic, an amazing tale of friendship

Dry and Running with Scissors by Augusten Burroughs.
All over but the Shoutin‘ Rick Bragg
I’m Down: Mishna Wolff

In the nonmemoir world, I love John McPhee, and anyone who can write narrative nonfiction about dry science topics well (Laurie Garrett, Gina Kolata before she became obsessed with exercise).  I’m currently seething with jealousy over Sudharta Murkhajee’s Emperor of All Maladies: a Biography of Cancer because he is a great writer and wrote it while working as an oncologist-I’ve go no business complaining about not having enough time.

Thanks for the questions!

A Time to Be Born and a Time to Die

by Katy Horan

Infertile is an arid word. It is so dry, that my mouth becomes parched and I choke on the phrase, “I am infertile.” I prefer childless. It sounds breezier, like a summer sleeveless dress, rather than a straightjacket. In the true vernacular of infertility, I should say my husband, Dan, and I are infertile, but every month that passes without pregnancy is like a gigantic foam finger, jabbing at me, “You, you, you.” Shame on you, I tell myself, this is your punishment for over-indulging in coffee, work and wine.

After greater than one year of childlessness, I lobbied Dan to pursue fertility treatments. Dan was more than happy to keep trying “the natural way.” He grimaced at the idea of stimulating my body to produce double-digit eggs, sucking the eggs out of my body, injecting his sperm into my eggs in a laboratory, and then shoving the resultant embryos back inside me. He’d cringe and shake his head, and say, “It’s just not natural.”

“It’s not natural to wait until you’re almost forty to have kids,” I would bark back. As a physician, I understood our barriers to pregnancy and believed we would find our baby salvation in reproductive technology. Of course, I have great faith in medical technology; I work in the critical care unit where we prescribe drips and ventilators to save our dying patients. The French call our specialty “réanimation.” We are puppeteers; our tubes and intravenous lines are the threads that bring life to our crumpled, dying patients. I believe in medical technology, most of the time.

In a whirlwind of negotiation that left Dan’s head spinning, we agreed to pursue a single cycle of in vitro fertilization. With the glory of medical technology reigning, it should have gone perfectly. But, it didn’t.

I hung up the phone after receiving the phone call that we weren’t pregnant. I had taken the news well, I thought, better than my nurse, Melinda, who had responded to my meek, “It’s okay,” with her growling, “It’s not okay. Not at all.”

I folded over like rag doll. “Why, God?” I whispered to the carpet, “Why won’t you let me get pregnant?” In that moment, I had a new target for my blaming, foam finger.

I’m not certain who was more surprised by the question: Me or God. God for His part had every right to wonder who the hell I was, berating Him. In the best of times, I am a lapsed Catholic. At worst, I am a half-hearted agnostic calling out from every foxhole. Yet, I hadn’t asked God for His help with our childlessness, though I knew others who had.

A patient of mine, six weeks post-partum with an asthma flare, confided in me about her divine intervention. She had an air of purity, her bangs laid straight across her forehead like the hood of a nun’s wimple. She was Asian and had a habit of looking directly into my eyes, then quickly at her gentle hands, folded in her lap. These staccato moments of intense connection were unnerving, as if all my agony of childlessness was exposed, and suddenly I was the broken and she was the healer.

“What’s his name?” I asked, to hide the kernel of babylust that always threatened to pop whenever I met a new mother my age.

“Samuel.” Her soft brown eyes met mine, and we both smiled broadly.

My heart jumped for this little boy with such a big name. “I love it! Why Samuel?”

She laughed, a light sound, like butterfly wings. “We went on a pilgrimage to Medjugorje because we wanted a third child, but I could not seem to have one.” The laugh evaporated from her lips as she refolded her hands and stared at her wedding band.

I struggled to imagine her, hiking through the Bosnian thicket to a bleached white statue of Mary.

“I prayed at the foot of the Blessed Mother Mary for hours,” she recalled, her head bowed as if in prayer, “Until an angel came to me, and told me that I would be blessed with a child and that I should name him Samuel.”

Angels do not figure often into my daily work. Reams of paperwork, buzzing pagers, and the delivery of bad news occur every day of the week, but angels are rare. A chill ran down my neck and I believed her because I knew that she believed. Medically, she probably hallucinated from dehydration and the venous pooling from kneeling on the concrete carpet, but in her piety, a vision came to her, and nine months later, so did baby Samuel.

A month later, I found a lumpy envelope on my office desk. On the envelope was a blessing of the Mother Mary of Medjugorje, and in the center was a heart with my name. The beads of what only could only be a rosary tumbled like pachinko balls within the sealed envelope. My patient had left me a talisman for my childless journey. She must have smelled the musky scent of childlessness pouring out of me, seen a flash of the abyss of self-loathing within me and recognized it as her own.

Without my own baby Samuel to incubate after our failed cycle of in vitro fertilization, I limped through my next rotation in the ICU. One evening, I was called to the bedside of a man dying of cancer. After asking his wife and family what he valued and enjoyed, his wife told me that the most important thing to him was to see his current, failing chemotherapy kill the cancer. I explained that we could bring him to the intensive care unit, put him in a medical coma, and attach him to a breathing machine, but we couldn’t change that he was dying.

“So, we can do all these interventions, but to what end?” I let the question hang between us for a moment. The only sound in the room was the patient’s raspy breathing. He sucked each breath as if he was surfacing from deep under water. His brother-in-law cleared his throat, but didn’t say anything.

The patient’s hunger for air made me uncomfortable and I looked back at his wife. “We cannot fix the cause of his dying–his cancer,” I explained, “But we can give medicines, like morphine, to help ease his breathing.”

“Morphine is euthanasia,” she snapped at me. “I’ve put down dogs before.”

I was already angry with her before she accused me of attempting to euthanize her husband. I was angry that she thought it was appropriate to maintain her dying husband on a mechanical ventilator for one month, praying that his failing $10,000/day chemotherapy would begin to work. I was angry that the oncologist who had created this false optimism was safely ensconced at home with his two, pony-tailed daughters while I was alone and childless in the hospital. I was angry that my husband and I had failed to get pregnant again, and wondered if all this time I spent with the dying was leeching into me, poisoning any chance at living.

A smog of distress from this anger encircled me for weeks and I let its haze feed the mournful hunger left behind from our failed in vitro fertilization. Why would people so certain in their beliefs about their God be so afraid of dying? How can we become so fixated on our greed for life that we’ll take brutal steps to satiate it? When I searched my sacred medical texts for the answer, I was surprised to find biblical verses wrapped in the statistics of dying. There is a time to be born and a time to die. Ecclesiastes 3:2

Those twelve words summed up the twin battles within me. At work, I see people who are so desperate to hold onto life, so convinced that there is an antidote to their poison, that they are in constant search for next therapy that will make them whole. They embrace technology and our presumed wizardry as we wash their blood with dialysis and give air to their lungs with our bellows. I now recognize that the smog of distress encircled me, not because I didn’t understand my patient’s wife’s zealousness, but because I recognized it in my own monomaniacal drive to have a baby.

At home, I am doggedly chasing the end of my childbearing years down the technological rabbit hole, and dragging my husband with me, blind to his fears or how this journey is changing us.

I think of my talisman, the enveloped rosary, blessed in Medjugorje, stuffed in my bedside drawer. My husband has a vague idea of its existence; I’m not certain whom he would prefer to disinvite from our private babymaking lives: fertility enhancing technology or an unseen God. Unlike Dan, I have no problem kneeling at the altar of reproductive technology to feed my insatiable hunger for a child. But, even in my exuberant baby greed, I am not ready to unseal the envelope, drape the rosary across my fingers, and murmur my Hail Marys.

I don’t understand my reluctance to ask God for help when I find it so easy to blame him for our failures. I don’t understand why I’d rather embrace technology than God, when at work, I beg my patients to do the opposite.

Despite our available technology and prayers, we all have to die, and some of us will never give birth. I am coming into acceptance that we may or may not have children. Dan and I have set limits on what more we will do in our attempts to have children, and, since setting limits on our babymaking, the world of opportunity appears much wider. Several weeks ago, I held the baby of a college student whom I mentor and I realized that I could bond and love a baby who was not of my flesh. And, when the babylust bubbles up inside me, I temper it by singing The Byrds, “Turn, Turn, Turn” with its lyrics borrowed from Ecclesiates. “A time to be born, a time to die…I swear it’s not too late.”

2 responses to “Katy Horan: Doctor, Writer, “Modern Love Reject”

  1. LOVED it! That was such a heartfelt, emotionally charged piece, Katy! I found myself relating to many aspects of your story. Thank you for sharing. Looking forward to meeting you at the retreat.

  2. Vivid writing, unexpected contrasts, deeply personal. I was pulled into the desire and problem and was relieved at the narrator’s acceptance/hope. This is a writer to watch.

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