The Angst of the First-time Author

Pencil erasing an "error"This was a difficult summer. It was the first summer of my new persona as a writer. Outwardly it appears to have been luxuriously loaded with visits and weekend trips. Inwardly it was littered with insecurities, frustrations, and the angst of authorship.

Having explored the world during my Gap Year and having dipped my toe into the world of health care reform during my post Gap Year, I found that I remain passionate about the ineffective excesses of the American Medical Industrial Complex (see previous blog posts here and here and here).

One factoid that became known to me recently is that more than 75,000 Americans over the age of 85 die in the ICU annually. Some of them were there by desire and design, perhaps because they thought that they would be part of the first generation to beat the certainty of death. Most were there because they had not prepared for the inevitable.

Is 75,000 a lot or a little?

Debbie thinks that 75,000 is a comparatively small number. In the absolute sense it is, as 2.6 million Americans die per year. In a relative sense it is not. My interpretation is that it represents 75,000 people who have exceeded the average life expectancy and who are physically plugged into a medicalized death with tubes in every orifice.

They are separated from their family, homes, and peace because they misunderstood the false promise of American medicine. They were tortured because the “promise” of their treatment proved to have the side effect of a false hope for a “cure.”

These ICU deaths represent 14 percent of the 540,000 85-year-olds who die in hospitals annually. Most of those patients would have preferred to die at home, in comparative peace, but they were not prepared to make the difficult choices to make that happen.

When my father died last April, I was self-released to write the bulk of my book about preparing for death. He died “quietly” with his oldest daughter at his side. His other children had visited and made their goodbyes. We buried his ashes without recrimination.

Over this past winter and spring I pounded out my book in the Brooklyn Law School library. I hired a book coach. I started to rewrite (mostly rearrange) the book with her vision in mind. Then summer happened.

Summer meant constantly struggling to refocus

Long-scheduled family reunions, family visits, and guest visits were interspersed with more spontaneous weekend trips and guest arrivals. The book progressed (or not) in fits and starts. While each reunion, visit or excursion stands alone as a delightful experience, they made a patchwork of the summer.

I was continually struggling to refocus on the book project. In my former life, I was not given to procrastination. A big writing project, however, lends itself to procrastination like no other enterprise. In doing so, the delay in writing amplifies the stress of arriving at an outcome.

I am now in the process of writing a book proposal, a 60 to 80-page document that will crystalize the book contents and render it “irresistible” to an agent and a publisher. It is another step in my commitment to an end and it represents a stressor in the creativity process that I have not faced before. I must justify my particular book in a nonfiction world crowded with end-of-life books and I must do so in a way that is uniquely compelling to an agent. And, I am just a beginner writer without a platform and only a passion to guide people away from a medicalized death.

Worse than having to crystalize the work, I have to come up with a plan to promote it and market it. One aspect of this means creating the online persona that I have assiduously avoided. Prepare reader, I will be blogging book excerpts in the next few months.



Prepare reader, I will be blogging book excerpts in the next few months.


Of course, “my book” has been written before. What book hasn’t? Few of the competitive titles sold well. My thesis that most patients can better prepare for the inevitable is difficult to communicate. But there remains the rationalization that if I do it properly, I can make my mark. There is also the reality that the vast majority of book proposals go nowhere. In that case I will proudly self publish it with Debbie’s company, Voxie Media.

As my summer schedule comes to an end, I see the potential for progress, a window of opportunity before my contract with the book coach expires, but the existential angst of the first time author persists.

And when I finish… what will I do next?

When I have finished this book (assuming I am not on a national book tour, The Today Show and Obama’s ad hoc Committee for Natural Death – JK) what will I do with myself? What will be my next project? Most of me wants to finish the book. A small part of me subverts the process for fear of the future.

There is a lesson in there, somewhere, for Gap Year wannabes. If you are an introvert who values the completion of tasks and who hopes to become a first-time author, prepare for discomfort.

8 Responses to The Angst of the First-time Author

  1. Andy Franklin September 28, 2015 at 1:25 pm #

    Why isn’t Debbie your book coach? In any event, I can’t wait for the book. I know someone (very well) who will need to read it. I’m very confident you will get it published.

    • Sam September 29, 2015 at 7:41 am #

      Andy, we tried the coach/client relationship for a while but decided to stay married instead. Thanks for your encouragement. Sam

  2. Debbie Weil September 28, 2015 at 5:45 pm #

    Andy, I am his über book coach, without a doubt. But he’s working with another editor as well. Makes for a calmer household. As you can see from his blog post, emotions run high when you’re writing a book. xo

  3. Nancy September 28, 2015 at 9:41 pm #

    Go fishing, go biking! Take a French class! Travel, visit the grands. You have plenty of stuff to do!

  4. Frank Weil October 12, 2015 at 3:59 pm #

    Does the fear of success or failure of writing compare at all with your fears the first time you did an unaided colonoscopy?? The first is very rarely life threatening the second could be. Relax and enjoy every moment of freedom! F

    • Sam October 13, 2015 at 9:49 am #

      Frank, you are correct. There was a certain angst associated with every” first time” doing an advanced endoscopic procedure. I think of my Amanda with empathy as she steels herself to her daily challenges. And, I appreciate your comparison. What is different about my first time authorship is that I must expose more of the inner me than I am comfortable with especially in the on-line format. As a gastroenterologist, people came to me for my expertise and I could hide beyond a barrier of professionalism. As an author I am “out there,” swinging in the breeze.

      I have participated in or led three colloquies on end-of-life issues here in town. They have gone well and have helped me frame my message. This helps me believe in my project but doesn’t make me want to build a Twitter following.

      In the end, I will soldier on and get this book project (and then the book) done. I am enjoying that challenge. I appreciate your support. Sam

  5. Rachel Rodgers November 7, 2015 at 9:16 am #

    “As a gastroenterologist, people came to me for my expertise and I could hide beyond a barrier of professionalism. As an author I am “out there,” swinging in the breeze.”

    As a lawyer, I so identify with that statement. I have been on my own “coming out” journey this past year, sharing more of myself in ways that make me feel totally uncomfortable as well as free, all at the same time. It does feel good to be unapologetically me and to be hiding a lot less.

    I am working on a book too. Enjoy the crazy journey! xo

  6. Sam November 7, 2015 at 1:15 pm #

    Rachel, Thank you. The journey is getting crazier. Sam

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