An Interview with Jack El-Hai (Regular Contributor)
Wonders & Marvels: Two of your books, including your newestThe Nazi and the Psychiatrist, delve into medical history. Do you find that writing medical history differs from other histories you have written?
El-Hai: Stories from the history of medicine are often high-stakes narratives — they’re tales of life and death. And medical stories are inherently dramatic. Will the patient get better? Will the physician succeed? What is the cause of the medical problem, and which treatments might work? Just as important to me are these questions: What motivates the physician/investigator? Which of the physician’s passions and shortcomings will affect the investigation? The answers are, with luck, the stuff of tragedy and comedy.
Writing about medical history is different from other kinds of historical writing in one important way. I often find myself considering various aspects of patient privacy. If my research turns up the medical record of, say, a lobotomy patient from the 1950s, should I include in my writing that patient’s name and other identifying information? I’ve long struggled with this sort of situation, and I’ve discussed such matters matters of medical privacy with physicians, lawyers, and other writers. My conclusion, at least for now, is that I will not shrink from including identifying information on patients if it contributes to the narrative and the reader’s understanding of the story, and if I have determined that the patient is dead. If anyone is interested in reading more of my thoughts on this problem, see my recent article in Aeon.
W&M: What kinds of sources do you rely on when writing medical history? How do you find these sources?
Materials belong to the family of Dr. Douglas M. Kelley.
El-Hai: I’m a big archive hound and a worshiper of archivists. I have learned that so much of the best research material for nonfiction history stories awaits a lucky finder in government, academic, or other institutional archives. Generally, the best sources are not digitized or otherwise available online. When I’m considering a topic for a book, one of the first things I’ll do is go to archivegrid.org to see if any institution has collected manuscripts and other materials connected to my topic.
But that doesn’t mean I rely exclusively on materials in public archives. My book The Nazi and the Psychiatrist — which is about a U.S. Army psychiatrist’s examination of the top German leaders held for trial after World War II — is based on a unique collection of Dr. Douglas M. Kelley’s manuscripts, photos, and artifacts that his family has kept out of view for more than 60 years. I was astonished to learn of its existence and to dig deeply into it, because a great deal of its contents clearly are historically precious, flabbergasting, and revealing. I found the collection after a long and difficult search for Dr. Kelley’s remaining family members.
Interviews, when possible, are also essential to my research. I was very lucky to have tracked down the last two living people who worked with Dr. Kelley and the imprisoned German leaders at the Nuremberg jail. Both in their nineties, they gave wonderful interviews full of detail and vivid impressions of their work. Web searches led me to both men.
W&M: Can you tell us a little bit about the process you use to turn various primary sources into a reader-friendly historical account?
El-Hai: It’s more an approach than a process. I take a literary interest in historical events, which means that I’m compelled to focus on the people involved in history (we can call them characters) as well as their motivations. I’d never write a book about World War II, for instance, but I have written a book about a small group of people active in the war and the psychiatrist who studied them. One of my central questions is usually about what made the characters do what they did. Once I have developed two or three central questions, I build a story around the examination of the questions. How will I unspool the events in a way that intriguingly addresses my questions? What is the best factual tale I can construct to satisfyingly bring the reader to the final scenes?
I treat letters, journals, and other manuscripts as sources of thoughts, feelings, and motivations. Even business records and other seemingly dry manuscripts can contribute to character development. Throughout it all, I never fictionalize, invent thoughts, create composite characters, rearrange events, or write anything that cannot be supported by my sources and survive a thorough fact checking. One of my reasons for including extensive endnotes in my books is to send readers the message that I have not made anything up.
W&M: As a writer with different interests, how do you decide which stories you want to tell?
El-Hai: I keep a queue of ideas in my head, on my computer, and in my file cabinets. Most of the story ideas I like areconcerned with historical characters who have psychological conflicts or exhibit seemingly inexplicable behavior. These ideas can percolate for a long time until essential sources appear, I find a compatible buyer, or I come to understand what the narrative is really about. The Nazi and the Psychiatrist went 11 years from idea to book. I conceived my previous book, The Lobotomist, nine years before I wrote it.
I am patient and persistent because the passage of time only improves most of the stories that interest me. There’s no reason to rush. I’m not like a newspaper reporter who may feel pressure to break a story.
I know a story’s time has come when I grow obsessed by it, the sources have fallen into place, and I can explain the outline of the story to other people in a sentence or two. My mind then fills with its possibilities and my wife and children get sick of hearing me talk about it.
There’s one history narrative that I’ve been researching and developing since 1988. I came upon the story in a footnote. Everyone I interviewed for my research is now dead. This story isn’t a book yet, but I hope its time will soon come.
Jack El-Hai is a writer of books and articles who covers medicine, science, and history. His books include The Nazi and the Psychiatrist: Hermann Göring, Dr. Douglas M. Kelley, and a Fatal Meeting of Minds at the End of WWII (PublicAffairs Books, 2013; optioned for screen and stage by Mythology Entertainment), Nonstop: A Turbulent History of Northwest Airlines (University of Minnesota Press, 2013), The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness (Wiley, 2005), and many volumes of regional and business history.