At the moment, Creative Nonfiction is in the midst of editing a book of essays—tentatively entitled Becoming a Doctor—that will explore all of the frustrations and triumphs of the healing art.

As with most projects of this kind, we began by commissioning seven established, well-known writers—all of whom also happen to be therapists or physicians. But since seven essays do not constitute a book, we did an open call for manuscripts, sending e-mails to writers who have written for us in the past (Creative Nonfiction has published two other collections of original essays—Silence Kills and Rage and Reconciliation—focusing on medicine and healthcare) and sent out notices in our monthly e-newsletter and fliers to listservs.

The response was staggering: by the time the May deadline rolled around, we had received well over 100 submissions from all over the world.

As is our frequent policy, I read and screened the essays first before turning them over to our editors to read more carefully and winnow the group down to a collection of finalists. What struck me about these essays was that they were so good.

When it’s all said and done, we’ll publish only seven or eight of these 100+ submissions, but there wasn’t really a “clunker” in the bunch. In fact, almost all of them could be published somewhere. Such a high level of quality is unusual, considering that we usually only publish one essay out of every 300 we receive, unsolicited, and over the counter.

There is a lesson here for writers having trouble finding an audience for their work. No, you don’t need to be a doctor to get published, but you do need to be able to write about something or somebody other than yourself. This is a primary problem with many essays we receive unsolicited at Creative Nonfiction: They are self-reflective—which is good to a certain extent—but they don’t gaze outward enough, taking in a world beyond a writer’s triumphs, hesitations and fears.

Doctors interact with other people. There’s science and psychology, character appraisal and business decisions, backbreaking and exhausting work—and much more—in what they do as they practice, day-to-day.

Memoirists, whether doctors or dishwashers, need to embrace the outer world as much or more than they do their own lives and stories. Readers need to know more than just what you think; they want to meet the people around you and they want to learn from you. They need a balanced combination of information and personal insight.

That is why Oliver Sacks, Jerome Groopman, and Atul Gawande are so popular these days. Not just because they are doctors, but because their stories and ideas go in and out—enlightening and engaging a reader from a number of diverse perspectives.

Recently, I received this email:

*************************************

Dear Mr. Gutkind,

Paul LaTour, staff writer
Naperville (IL) Sun

**************************************

There are actually two questions being asked here: 1) What is the difference between creative nonfiction and journalism? and 2) When writers make assumptions based on facts, can what they write still be considered factual?

1) While journalism begins with the facts—the who, what, when, etc.—creative nonfiction begins with the narrative, the story recounted in scenes. That being said, the best creative nonfiction requires an anchoring element of reportage. The facts cannot be changed or avoided.

Take for example Frank McCourt’s Angela’s Ashes, in which the reader learns a great deal about poverty and the Great Depression in the U.S. and Ireland, among other things. In various ways, Angela’s Ashes is very journalistic, as is, more recently, Eat, Pray, Love by Elizabeth Gilbert. And from the very beginning of the new journalism movement—the precursor to creative nonfiction—precedent setting work by Gay Talese, Tom Wolfe, George Plimpton and Norman Mailer demanded a high standard of information—mostly reportage, although these writers are narrative aficionados.

2) As for the Vann piece and other similar treatments (such as The Perfect Storm), it seems to me that a writer can make certain assumptions based on information and evidence he/she or others have collected.

Vann’s article is probably 10,000 words or more in length, and the only bit anyone has taken umbrage with is the first 300 words. The rest of the article makes it clear that Vann has done an incredible amount of research and conducted numerous interviews. Furthermore, we have to assume and trust that the Esquire fact-checkers have made Vann responsible for supporting his speculation with irrefutable information.

But, you’re probably asking yourself, what if they didn’t? And besides, how can Vann say what happened those last few minutes in the hotel room, if no one was there to witness it? What kind of irrefutable evidence proves that the shooter “checks himself in the mirror, walks to the door, then has to go back to check again, just to make sure”?

There are two possibilities: Esquire was a pioneer of new journalism, publishing a number of those groundbreaking early pieces, and perhaps their editors today feel like they are permitted certain liberties. After all, they seem to enjoy stirring the pot lately [there was a bit of controversy regarding another Esquire article, “The Last Days of Heath Ledger” by Lisa Taddeo—which I blogged about a few months back. The difference, however, is that Taddeo’s piece was billed as fiction.]

But the most likely possibility is that often in articles such as this one—after so much research is conducted and information collected—writers often develop such an intense closeness with their “character” that they feel like they can actually enter that person’s head. This technique is often referred to as psychoanalyzing your character, a technique that has recently gained popularity among some historical nonfiction writers (Erik Larson’s The Devil in the White City is a good example).

I’ve recently compiled a book, Keep It Real: Everything You Need to Know About Researching and Writing Creative Nonfiction, which happens to have a chapter devoted to this technique (there are also chapters that cover fact-checking and getting inside characters’ heads). Here is an excerpt from “Psychoanalyzing Characters,” written by Dennis Palumbo, a therapist and an experienced creative nonfiction writer:

"Today’s nonfiction writers delve more intimately than ever into the lives and subjective experiences of the real people they depict. While this approach has always been a crucial component of the fiction writer’s art, there’s a specific danger involved when the people depicted actually exist—namely, that much of the authority behind the nonfiction writer’s voice (and opinion) derives from the reader’s belief that what’s being described is “true.”

In the end, I agree that parts of Vann’s lead is obviously speculation, and I believe that a lot of the controversy could have been avoided if he made this more explicit. But I also think, as a reader, considering the context, I know what he is saying is speculation. So if I already know, does he have to tell me?

David Sedaris is interesting to interview anytime, but because of the publication of his new book, When You Are Engulfed in Flames, he’s getting a lot of attention lately. Recently, Time.com invited readers from all over the world to ask Sedaris questions, and I was amused (sort of) by Sedaris’ response when asked what section of the bookstore—fiction or nonfiction—his books should be shelved.

Sedaris’ reply: “Nonfiction. I’ve always been a huge exaggerator, but when I write something, I put it on a scale. And if it is 97% true, I think it is true enough. I am not going to call it fiction because 3% of it isn’t true.”

I wasn’t surprised by his answer, and in some ways, I don’t disagree. But frankly, it rankles me. I am not opposed to exaggeration; it can be funny and effective. I find myself exaggerating from time to time, both in my essay writing and in conversation, but my writing (and my personal conversations) still, at the core and foundation, needs to be true. Exaggeration is kind of a vague word, but it means, essentially, over-stating, over-emphasizing, making things larger or more prominent than they might have been.

But exaggeration is different than writing something that didn’t happen—that’s fiction. Exaggeration doesn’t mean that you make up details, create dialogues and conversations that you know didn’t happen. Unless, of course, you come clean with a reader and admit that, “This could have happened.” Or, “I wish this would have taken place.” We do this all the time in our own interactions: “Wouldn’t it be funny if…”

But okay. We can quibble about the meaning of “exaggeration” all we want, but last year Alex Heard, writing for The New Republic, decided to put Sedaris’ 3% to the test by fact-checking his stories and interviewing family members and other people about the humorist’s storytelling techniques.

So when I saw the Time.com interview, I emailed Alex and asked him about Sedaris’ 97% claim. Here is Heard’s reply:

He’s just being a smartass, I think. Once it became clear that he wasn’t going to get in trouble for any of this—which wasn’t his attitude when I interviewed him while reporting the story …he and his dad both seemed worried that he might get sued by somebody—he’s basically turned it into schtick. If you Google around, you’ll see that he’s not consistent in what he says. Answers have included:

When he says I didn’t catch him on anything he’s simply lying, and nobody’s calling him on it. He’s been telling interviewers that my reporting technique involved casting around until I found somebody, anybody, who would say that he had made something up, no matter how dubious the source. He always neglects to mention that he himself was my confirming source. I set a pretty high bar and didn’t write about anything as a fabrication unless I got him to admit to it over the phone. I don’t think he applied the same level of fact-checking rigor when he decided to invent characteristics and speeches for his midget guitar teacher.

Heard’s article is by no means a hatchet job; it is a good example of how to be fair, fascinating and informative. He makes it clear that he in no way wants to compare Sedaris with James Frey, Stephen Glass, or Jayson Blair. In fact, Heard is a Sedaris fan, even after some very telling research unveiled Sedaris’ definition of exaggeration demonstrates that he gets his numbers and percentages confused.

1. The New York Times’ Janet Maslin loves the book so much she imitated Frey’s writing style and called it a "big book, random, but smart." Not long ago, the Times lambasted Frey in dozens of articles written by a cadre of writers, slashing away at agents and editors and other memoirists in all directions, gloating with self-righteous superiority–in the face of their own scandals. I am not buying.

2. Big book sellers like Barnes & Noble and Borders are promoting Frey unceasingly. I am not buying.

3. He already made millions by misleading readers and telling untruths. Even if this one is being billed as fiction, no more from me. I am not buying.

4. He used his mother as a shield on Larry King Live and maybe even lied to her. I am not buying.

5. He is an opportunist, and I am not buying.

What are your reasons for not buying James Frey’s new book?

Every time a writer or a publication seems to cross the murky line between fact and fantasy, by accident or by design, some reporter, somewhere, seems compelled to take a potshot at creative nonfiction. Mostly these reporters don’t know what they are talking about–but I guess, like Robert Leiter, writing in Philadelphia’s Jewish Exponent, they’ve got some space to fill.

Leiter is annoyed with David Granger, the editor in chief of Esquire Magazine, who asked a writer, Lisa Taddeo, to dramatize and fictionalize actor Heath Ledger’s final days. Taddeo wrote the story in the first person, as if Ledger was narrating.

Leiter disapproves, evidently, and so, what does he do? He attacks the creative nonfiction genre in his April 17 Exponent column, explaining how, in part, college courses in creative nonfiction have led to an era of "forged" memoirs.

I won’t even legitimize Leiter’s assertions by debating them, but I will point out that he ought to take the basic tenets of his own profession more seriously before he starts dissing other genres. First of all, Leiter evidently did not speak to either Granger or Taddeo; he is quoting from and responding to a March 6 New York Times article by Tim Arango about the Esquire feature. How’s that for original research?

Second, "creative nonfiction" is not mentioned in either the Arango article or the Taddeo feature–for one good reason: Taddeo is not writing creative nonfiction. Her piece is fiction, fantasy, made up, based on kernels of fact and truth, like The Da Vinci Code.

A similar issue came up recently, this time involving me. In a March 9 column, Bob Hoover, Pittsburgh Post-Gazette book editor, used a sentence from a solicited letter I wrote for Harper’s Magazine to demonstrate that I believe truth in memoir is unnecessary, that creative nonfiction and memoir can be fiction.

In this case, Hoover quoted me totally out of context. I was replying to a question posed by Harper’s in response to a particular issue in a specific essay published in the magazine. Hoover made it seem as if I am generally cavalier about truth and accuracy–which is positively incorrect and unfair. Hoover would have easily been able to discover my ideas about the subject by consulting the many books and essays I have written about ethics and moral responsibilities and challenges in memoir, most recently, Keep It Real, published last month by W.W. Norton.

He could have also picked up the telephone and asked me for clarification. It is easy to quote someone out of context; I am certain I can snatch a sentence or two from his columns and make him seem pretty lame and unethical, as well.

Hoover also referred to the creative nonfiction genre as being limited to academic institutions. This is total nonsense, just like Leiter’s assertion that college writing courses lead to forged memoir. The National Endowment for the Arts has offered fellowships for creative nonfiction writers for more than two decades. Many book publishers have creative nonfiction books series’. Leading veteran journalists are part of creative nonfiction programs and have written books about creative nonfiction. Recently, the Pulitzer Prize winning New Yorker reporter, John McPhee, was given a lifetime achievement award for creative nonfiction by the prestigious George Polk journalism awards committee. I could go on and on. Hoover and Leiter should know better.

To hear how I really define the genre of creative nonfiction, click here.