Conjoined Twins

Chang and Eng Bunker. Born 1811. Thailand.


One might wonder how conjoined twins manage to survive – physiologically, mentally, and emotionally – after surgical separation. While some sets of conjoined twins, for medical reasons, cannot be separated, as in the somewhat famous case of Brittany and Abby Hensel, since 1987 several have been successfully separated. In some cases, conjoined twins, who are old enough to make thoughtful choices, have refused to be separated. Lupita and Carmen Andrade, who were expected to live only three days after they were born, not only defied the odds, but are now living together, literally. Both refused the option to be separated. According to the Deccan Chroniclethe twins say “it would be like cutting them in half.”

The decision to surgically separate conjoined twins is not one to be taken lightly. Inevitably, ethics comes into play. The most urgent question of all: What if one twin must be sacrificed? Do we allow one twin to die to save the other? Which twin’s life matters more? The questions are endless, questions I can’t imagine having to face if I were the parent of conjoined twins.

You might be wondering why I’m writing about conjoined twins, why I’m sharing with you this extremely rare and mind-blowing phenomenon. I’m sharing all this with you because I cared for a set of conjoined twins as a neonatal intensive care nurse. Though decades have passed since I held all *fourteen pounds of sweetness in my arms, fed them, changed their diapers, and held my breath as I waited for the then eight-month-old twins to come out of the hours-long surgery, I’m still awestruck. So what does a writer do with all that awe? Naturally, she writes about it. Which is exactly what I have done in my essay, “After,” published today at Intima, a literary Journal dedicated to promoting the theory and practice of Narrative Medicine. Created in 2010 by graduate students in the Master of Science program in Narrative Medicine at Columbia University, Intima has featured writers in the literary and medical fields from around the world.

Thank you for reading “After,” and feel free to follow-up with thoughts, questions, and, of course, your own awestruck moments.


*fourteen pounds is a guesstimate.

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Memoir Dialogue

When writing memoir we’re expected to tell the truth, the whole truth, and nothing but the truth, right? Blanket lying to readers is a definite no-no. For instance, I’ve never been to Abu Dhabi, so I can’t (or should not) write about the year I spent (did not spend) in this major cultural and commercial metropolis on coast of the Persian Gulf. But when writing memoir dialogue, it’s impossible to recall, say, the exact conversation you had with your grandmother just hours before she collapsed from a stroke twenty years ago, or precisely what your mother said to you when she dropped you off at school on your first day of kindergarten.

“We alter our memories just by remembering them,” says McGill University psychologist Alain Brunet. The more we recall a piece of dialogue, or event, the more we change it. So how do memoir writers stay as close to the truth as possible when writing dialogue? In every memoir workshop I’ve attended over the past eight years, that question has been the single, most urgent one asked by my writing peers. Dialogue is the brick-wall writers often fear scaling. It’s the aspect of memoir that can easily drive us to say, “Maybe I shouldn’t write this book after all.”

But, wait, if you’re working on a memoir, and considering giving up on it because you can’t seem to find a way over the dialogue wall, I’m here to spot you on your climb upward. This is what I learned about writing dialogue during a recent memoir retreat led by award winning authors Kate Moses and Elizabeth Cohen:

Unless you were blessed with the opportunity to record or write down every last word of the conversation you had with your grandmother twenty years ago, or happen to have had enough savvy as a kindergartner to crayon what I hope were your mother’s encouraging words, then you might want to try what is called the “subjunctive,” or “suggestive,” mode. In this case, you might preface the dialogue with “something like” or “as if.” You can also use “I imagine,” as in “I imagine my mother said, ‘Sweetie, you’ll be okay, I’ll be right here to pick you up …’”

The other option is to employ “representative” dialogue. For example, you might write, “Whenever I was afraid, my mother would assure me, ‘I’m here for you.’” It’s the word “would” which shows readers that your intention is to capture the sentiment of what your mother actually said. The dialogue does not have to be exact, as long as you convey the intended information: maybe it’s how comforted you felt knowing you could rely on your mother to protect you.

Use these strategies judiciously, though. Relying on them too often makes for an unwieldy narrative.

Another alternative is to announce, “I don’t remember what my mother said to me on my first day of kindergarten. All I know is that I was afraid.” Admitting you don’t remember makes you, the author, more credible.

If you’re looking for a good example of how an author recalls dialogue and scene from childhood, Kate and Elizabeth suggest reading Running with Scissors by Augusten Burroughs.

Good luck!







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The importance of wasting time

The other day, while searching for ideas to jumpstart my writer’s brain, I decided to haul out from my file cabinet the library of journals fat with notes from lectures I attended as a Vermont College of Fine Arts graduate student. I thumbed through each page, scanning for a word, a phrase, anything that made my heart skip a beat. Aha, after several minutes, it finally happened, the one sentence I needed most to see, to hear, to touch, to taste: “The importance of wasting time.”I let out a long, calming breath, comforted by this affirmation: it’s okay to be idle.

Creative people do take time off from their projects to engage in completely different activities. Maybe a writer takes time to paint or doodle, to play music, to learn a new skill, or to take a nap – imagine that, taking a nap during the day. Such idleness allows time for “incubation,” says Connie May Fowler and Patrick Madden, prolific writers, authors, and VCFA faculty members. This incubation period works best when we first identity the problem with our manuscript, then step away from it, throw all the worrying over it in the trash – and live our lives. (Take that nap.)

Think of the incubation period as a time for “cooking your book,” Connie and Patrick say. Of course, to leave your book, or project, “cooking,” requires trust – trusting that you’ll eventually be served a heaping plate of creativity while you watch for the water to come to a boil, or the edges of your project to turn a sugary golden brown. But if you’re open to the process, if you are curious and interested in every cobwebbed moment, awake and responsive to every random swirl of a leaf, every sigh of a passing stranger, every intentional touch of a hand on the curve of your back, the creativity will come.


Yet it is in our idleness, in our dreams, that the submerged truth sometimes comes to the top. ~ Virginia Woolf




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After a freak car accident, I thought I was too broken to find love

I did it! After I spent the better part of four months working on an essay about how I found love after a deadly car crash left me wounded, and feeling ugly and unworthy, it has been published in the The Washington Post. This piece is not for me alone to read and remember how far I’ve come. It is for all of us who have been scarred and fractured by trauma – any kind of trauma. It is for those of you who still feel lost and alone and afraid. My essay, “After a freak car accident, I thought I was too broken to find love,” is my gift to you.

(Sorry if you have already seen the link to the essay.)

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Past Ten

Below is a piece I wrote at the urging of author, editor, and teacher Donald Quist. He asked me to contribute my reflections about how I’ve changed over the previous ten years to his project Past Ten in which various writers share similar recollections. As Donald says, the personal stories in Past Ten are a “testament to the transformative power of time and the human capacity to turn the unpredictable into art.”


June 21, 2007

It’s 2:06 p.m. The summer solstice. I’m sitting at my desk at the Vermont Lung Association, where I work as an administrative assistant. I’m tapping at the computer keys, logging contributions from donors into an Excel spreadsheet longer than this day. My fingertips turn numb with boredom. My vision blurs from all the lines and rectangles and numbers. Bringg, bringg, bringg. My head thumps with each shrill ring of the telephone. I answer the call from a board member, and pencil his message on a sticky note to be passed on to the CEO. But when I hang up I’ve forgotten his name. Bob? Jim? Ted? My brain’s gas tank is near empty, and I want to lay my head on my desk, nap away this day. I want to sleep off my traumatic brain injury, close my eyes against a diagnosis that still paper cuts my tongue each time I speak it.

It’s been three years since my head smacked against the pavement when a car mowed me down, and no amount of sleep, or even the continuous sunlight on this day can burn off the smog obscuring my mind’s eye from seeing with any kind of mental clarity. I want this day to end. But I must keep tapping, plugging in numbers and names and dates. Filling up the rectangles of a spreadsheet is like filling in the white spaces of my unsure-where-I’m-going-life. How long I’ll pretend I’m happy working here in an office that smells like a basement, with plastic window blinds that clack each time artificial air from the vent gusts its cold breath into the room, I don’t know.

Of course, I’d rather be standing by a newborn’s crib side, where I stood as a nurse for fifteen years. Where I changed diapers, bottle-fed infants their mamas breast milk, cuddled preemies in cotton receiving blankets. But that was before the crash. Now my broken brain couldn’t bear the constant noise of a neonatal intensive care unit: wailing newborns, alarming monitors, dinging IV pumps. That’s why I am here, at this desk, where it’s mostly quiet and I’m asked only to accomplish one job at a time, like filling in rectangle after rectangle. Because it takes all of me to get through this day, I don’t have the mental energy to imagine the formula or function of my future. So I keep tapping.

The planet has raced around the sun ten times since that day. A decade. Another summer solstice has arrived, and I’m still tapping at the computer keys. I’ve figured out my life’s formula, or at least I think I have. With each keystroke, I fill up my own spreadsheet, one I created in 2010, when I enrolled in graduate school for an MFA in writing. That spreadsheet I have replaced with draft after draft of my memoir, with my favorite quotes from authors, blog posts to write, books to read, more books to write.

My brain still must work hard to hold onto names, though, and it still gets low gas mileage. Words and phrases skid away from me, emerge in anagrams, end in ellipses or in incomplete sentences. But I now look forward to the longest day of the year. The sun equals hope; as the days expand, it’s hope that keeps me from tearing up my draft and throwing it in the trash. Hope is the formula and function that carries me through the winter solstice, into the next decade.

Please visit Past Ten to read more inspiring stories.


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What I learned at the Muse & Marketplace Conference for Writers

What I learned at this year’s Muse & Marketplace, Grub Street’s National Conference for Writers:

  1. “Brevity is not the soul of a good pitch.” You need to give magazine editors enough information to help them decide if your story, essay, or op-ed is a good fit for their publication (Adam McGee, managing editor of Boston Review).
  2. Before choosing which publishing path – traditional, small press, self-publishing, partner-publishing – is best, literary agent  April Eberhardt encourages us to answer the following questions: What is my goal? What is my timetable? How much time am I willing to put into searching for an agent? How much money am I willing to invest? How much patience do I have? How do I define success?
  3. Don’t buy a $12 glass of mediocre wine at the conference’s lit lounge event when you could take the elevator seven flights to your room, where you have a $12 bottle of cabernet rated 90 points by Wine Spectator.
  4. Characters in our stories should not fit into neat categories. “Real characters lack perfect insight” (Nathan Hill, author of The Nix).
  5. Go through the first 30 pages of your manuscript, and look at each paragraph, asking yourself where your book really begins (Sorche Fairbank, Literary agent).
  6. When rejections from editors or agents are making you feel like you should never have quit your day job, or you’re experiencing burn out, try writing in a new genre: if you usually write memoir, try fiction, or poetry (Jennifer Brown, author of the debut novel Modern Girls).
  7. Never have a resolution at the end of a chapter; you want to keep the reader reading (Adam Stumacher, author and educator).
  8.  When a Grubbie offers you either a chocolate or a mint before you head into the Manuscript Mart to meet with an agent, ALWAYS choose the chocolate, and do not eat it until after your meeting. Remember: Chocolate is a mood-lifter.
  9. Change the font in each draft of your manuscript you read. Because our eyes become accustomed to the same font, we might not see mistakes. Changing the font helps us to see the narrative with a different eye (Sorche Fairbank, Literary agent).
  10. Even if it takes you 15 years to finish your story, it’s worth it. “Whomever is intended to hear it will hear it” (Isabel Wilkerson, Pulitzer Prize winner).


Photo used with permission from Grub Street.

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