Creating worlds

Balance in Practice

David Biro, MD, PhD

This month's author discusses how he balances his career in dermatology with his passion for writing and literature.

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Are you ever so immersed in a piece of art that time seems to stop, a chill runs down your spine, and you become obsessed with the idea of creating something equally beautiful yourself? I get this feeling whenever I read a great book. Ever since I became hooked on novels in high school, I’ve always wanted to write one of my own.

Pursuing passion

My father was a doctor and as a result I grew up thinking about medical school. But I also felt an undeniable pull towards literature. I majored in the Classics as an undergraduate, drawn to the poetry and plays of the ancient Romans and Greeks more so than their history or architecture. It was during this time that I also read Somerset Maugham’s novel, Of Human Bondage. Phillip, the protagonist and Maugham’s alter ego, desperately wanted to be an artist but settled for medical school when his teacher expressed doubt about his creative abilities.

In my first year of medical school I began to think that I had settled too, and spent a good deal of time thinking of ways to escape. I would eventually take a leave of absence to pursue a PhD in literature at Oxford, a dream come true for me. For a while, I couldn’t have been happier, reading my favorite authors, going to lectures, and writing about the metaphors we use to express our most private experiences like pain.

At a certain point, however, I realized that the solitariness of a writing/academic life would not be enough for me. I needed more interaction with people and the belief that I was doing something more practical. I returned to medicine and soon began to embrace it with an enthusiasm I hadn’t known previously. I had made the right choice all along. [pagebreak]

Finding balance

What I would come to realize was that my dual passions were not mutually exclusive. Eventually, I completed my doctorate during dermatology residency and decided that I would continue to write and practice just like some of my newer literary heroes, Abraham Verghese and Oliver Sacks. (See the sidebar for a few of my favorite books.)

A second major interruption on the road to becoming a full-fledged physician occurred at the end of my residency when I was diagnosed with a rare bone marrow disorder and had to have a bone marrow transplant. The experience provided the raw material for my first two books of non-fiction: One Hundred Days: My Unexpected Journey from Doctor to Patient and The Language of Pain: Finding Words, Compassion, and Relief.

I have been practicing dermatology for almost 20 years now and finally found the perfect schedule. After taking my twin fifth grade boys to school, I write until noon and then go to the office and see patients for the rest of the day. The satisfaction I receive from solving medical puzzles and helping people never wanes. The writing part of my life, however, is not always so rosy. I spent years on my first novel that no one wanted to publish. Still, despite the rejections, I’ve forged ahead and am just about finished with a second novel. Something drives me to keep going and I can’t stop — the desire to create an alternate world that others will want to spend time in. At this point, it may also be an unwillingness to fail.

I love variety in life. It’s what attracted me to dermatology. I see people of different ages and backgrounds, conditions that are serious and not so serious. I prescribe medicines and perform surgery and am constantly learning new things. And I’m writing novels that I hope will move others as they have moved me. I feel very fortunate to be able to pursue the two great intellectual loves of my life. 

Dr. Biro’s favorite books

Of Human Bondage, Somerset Maugham

Cloud Atlas, David Mitchell

The Man Who Mistook His Wife for a Hat, Oliver Sacks

My Own Country, Abraham Verghese



Dr. Biro’s favorite books