revising & revising

Four women in my Wednesday evening non-fiction workshop graciously agreed to be my beta-readers and look over my manuscript during a two week break, following suggestions outlined by our leader, Carol Henderson. What Carol stressed, among other things, was not to get bogged down with spelling and formatting but look for flow, bumps and where you fall asleep. How does the narrator come across? Make a note where things are not clear.

The four women are talented writers. Their stories deep, interesting and well told. I consider myself lucky to have willing and skilled readers. Their feedback, positive and negative, can only improve my book. They have heard my stories, isolated, standing alone, without any connection to what had happened before or followed next. Now for the first time they would have the whole picture of my creation.

Stein On Writing
Stein On Writing

The “corrected” manuscripts (Sol Stein, Stein on Writing, says corrections are better done on hard copy.) sat for a couple of days before I ventured to look at them. I had already cleaned my office, cleared my desk and now isolated myself for a day to read.

Had I thought my readers would unanimously tell me that my book was so wonderful that no changes were needed, I would have been delusional. But honestly, I didn’t expect that. I was ready, so I thought, to honor the suggestions. What I wasn’t ready for was the strong agreement among their observations.

With tunnel vision, I had selected stories about patients I had cared for that had “haunted” me over the years—unforgettable because they were complicated and sad. I wanted to show what we nurse practitioners were up against. As an observant professional, I described the sights, smells and  “nasty images” so well that my readers felt, at times, overwhelmed. Plus, I appeared “too clinical.” Could there be less intense patient interactions wedged between the mayhem? Where was my softer, feeling side, they asked? Where indeed?

After the initial shock of realizing I had many more painful hours at my keyboard—writing for me is slow and tedious—adding inner reflections and lightening up, I wondered how much my long-standing role as the professional nurse for over forty years played in this evaluation.

I can see one of my older patients, a short, slight man, sitting on the edge of the examination table. As I monitor his high blood pressure I observe a suspicious discoloration around his left eye. He admits his granddaughter had hit him. He adamantly refuses any interference. I don’t remember my exact response except I’m sure it culminated with a stoic nod of my head.

stature with tearAfter long years of stuffing my emotions in my lab coat pocket, I’m usually surprised by the visceral reaction I have when I resurrect these tales. How much deeper do I need to go to allow the sentiment that I didn’t know I was withholding flow from my vignettes?  How strong are the barriers I constructed to dampen my own despair when I couldn’t correct a problem and will I be able to shatter them after all these years?

While I have always encouraged my fellow nurses to write their stories, I wonder how common it is for us to deny the deep connections we forge with our patients and the influence they have on our psychological well-being? Maybe this is why so many of us resist documenting what we do?

Or slant the telling with cold, clinical facts?

By Marianna Crane

After a long career in nursing--I was one of the first certified gerontological nurse practitioners--I am now a writer. My writings center around patients I have had over the years that continue to haunt my memory unless I record their stories. In addition, I write about growing older, confronting ageism, creativity and food. My memoir, "Stories from the Tenth Floor Clinic: A Nurse Practitioner Remembers" is available where ever books are sold.


  1. Getting feedback–always good, always enlightening. But I understand the dilemma. As nurses, we are educated to look for the cold clinical facts, and it’s understood that the empathy is there: it shows in the way we touch the patient, take time to listen, look into their eyes, and give reassuring words.

    So naturally, since we take the empathy part for granted, the part that’s going on in our heart, we won’t think to put that part on paper. Not the either negative or positive reactions we may have.

    Like a fiction writer friend of mine said to me, I don’t know why you don’t see it on the page, I knew it was there, I saw it in my head. But, yes, I had to say, If I don’t see it on the page, I don’t know that.

    Best wishes. You are almost there! And you are indeed fortunate to have insightful and helpful readers.


  2. Reblogged this on Nursing Stories and commented:

    This seems this like a good time to revisit an earlier post as I start on my second book, which will be about various home visits I have made over the years. It originally appeared on April 7, 2013.

    Recording sad, depressing, and unpleasant experiences is challenging. They are often the stories we nurses would rather block from memory. I empathize with nurses who choose not to write while, at the same time, I encourage them to do so. Motivation varies from writer to writer, and composing my stories grants me an absolution of sorts. Revealing my reactions to clinical situations will be challenging. But then who said writing is easy?


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