An Interview with james hamblin, md
James Hamblin, MD, is a writer and senior editor at The Atlantic, where he also hosts the video series If Our Bodies Could Talk. His book of the same name, a general-interest textbook of anatomy and physiology that covers topics such as sleep, aging, diet, and more, was released in 2016. Hamblin was a finalist for the 2015 Webby Award for Best Web Personality, was named by Time as one of the 140 people to follow on Twitter, and was called "the most delightful MD ever" by BuzzFeed. His work has been featured in the The New York Times, Politico, The Guardian, and The Washington Post, among others. Follow him on Twitter at @jameshamblin and Facebook at @jameshamblinMD, and visit his website, jameshamblin.com.
Q: You grew up in Indiana, which is usually considered to be a conservative state, but it seems like you have a fairly liberal mindset. What was the influence of your environment, growing up?
JH: Well, it was a pretty apolitical upbringing. It wasn't a conservative Indiana, Christian-conservative political NRA-based household or anything. I didn't really think about politics in any serious way or develop a worldview until I went away to college.
Q: How did that happen in college?
JH: Gradual process, learning about the world. I think you go away—at least a lot of doctors do—thinking that it's going to be just the science. "I just want to practice medicine and help people, I really want to stay apolitical." Then you quickly realize that everything is heavily politicized, and that's totally impossible—from funding of scientific research, to delivery care models, to access to abortion and prescription medications, and onward down the line. And the things that actually make and keep people really healthy—which is education and access to safe neighborhoods and clean drinking water and reasonable food systems—are contingent on the role of government. I made a gradual realization: it's not impossible to practice medicine or be a good doctor and be apolitical, but I think it's irresponsible.
Q: You had a career in radiology, but eventually became dissatisfied. You wanted to take a hiatus, and then you came across The Atlantic's posting for Health Editor. Why did that appeal to you?
JH: I had always considered myself a writer. I like writing, I'd been good at it in high school and college, and I was also into comedy. I got really into stand-up and improv comedy when I was living in LA, and I’d been in a sketch comedy troupe in college. Part of the realization of what I was lacking in radiology was that I wanted to do something that would be creative. Magazine journalism specifically married a lot of the instincts of what I wanted to do with comedy and my knowledge-base about health and science—also the super serious world of radiology. I had thought about magazine journalism in 2012—specifically internet writing, which was very different from internet writing in 2017—while I was figuring everything out.
Q: It feels like a success story. Some people's parents may say, "You should put that on the back burner. Don't be an artist. You should do something more practical, like law or medicine." You didn't really do the opposite, but you left practicing medicine to go write about medicine.
Don't try to make a living out of art unless you're 100% certain that there's really no other way you could pay the bills, and you're so passionate about it, and really think you're good enough.
JH: I had similar messages, growing up. And I still advise people similarly. Don't try to make a living out of art unless you're 100% certain that there's really no other way you could pay the bills, and you're so passionate about it, and you really think you're good enough. Everything gets confused when you start paying the bills with your creative work, and I don't even have to worry about anyone other than me right now. I'm not providing for kids or anyone. I imagine how you would question your status when you're thinking about paying your kid's college tuition, or turning down a job based on your artistic instincts. This is kind of a tangent to that point, but I still do think that if I could've stayed in medicine—if I had really liked it more and been more happy with it, and then done writing on the side—that might be even more ideal. But, I love the way things worked out for me.
Q: Did you have any fear leaving that stability to go into a creative field?
JH: That's something I still think about almost every day. I left on good terms, and I finished out the academic year; it was technically seen as a hiatus, so I could have gone back and reapplied at any point. I didn't spit in anyone's face and burn down the building when I left. I have a medical degree, I have my California licensure, I have all my board exams and everything, so I didn't take this plunge irrevocably. But it would be annoying. Every day, I think: Was it the right move? Especially on the days where I'm having trouble focusing on making anything that I like.
But once I started sitting in that radiology room for ten hours a day, and envisioned myself doing that for the next 50 years, I realized pretty quickly that I was not going to be happy. I'm just lucky to have the option to try to live a life beyond just making ends-meet, and being safe and well-fed and warm—to actually try and thrive as a creative, which is above and beyond. I'm lucky to have the chance to do that.
Q: With your Atlantic work, you're also helping people—informing them, making them laugh. And that's super important.
JH: Not to get too high-minded about it, but I think you can do a lot of good just by straight-up conveying information in some way that might help people make healthier decisions. Reading something that you enjoy reading, or watching a video, takes your mind off of stress for a minute and makes you a little happier. I don't think any single thing I've done has made a momentous impact on anyone's life in that way, but if you add up the cumulative minor happiness that I might have brought to people with any given thing, maybe it adds up to some fraction of good that I might've done as a practicing doctor. It'd be an interesting calculation to make.
Q: You didn't receive the health editor job without a background—you've always liked writing. What role did art and creativity play in your upbringing?
JH: It was a comedy thing. I liked entertaining people. I liked writing when I could make people laugh. I wasn't a literary kid, but I loved Jack Handey and David Letterman.
My father is super creative—I mean, he's a dentist—but in the things that he did around the house, in his spare time, he's an artistic guy. That always encouraged in me. Part of it also was sort of reactive. Basically, my parents encouraged me to go into something traditional, like medicine.
When I got to Wake Forest for undergrad, I auditioned for this sketch comedy troupe. There were around 75 kids—all theatre people—that went up for it, and they only cast four of them. I got cast and I had never done theater before. It was a four-year casting thing, and it was a huge commitment to be a part of this troupe. I ended up loving it and spent so much of my time doing it—more time than I spent with my fraternity. But I always saw it as a distraction from pre-med. I kept thinking I needed to focus, but that thing was just sitting right in front of me; something that I really loved doing, and I wasn't even considering it.
I kept thinking I needed to focus, but that thing was just sitting right in front of me. Something that I really loved doing, and I wasn't even considering it.
Now one of the four people I got cast with is a head writer at Saturday Night Live, and other people have gone on to do creative things and made careers out of it. I just never thought of it as possible. Thinking back, the signs were there all along that I wanted to do something more fun, and it took actually being confronted with the extreme, where I put myself sitting in a dark room reading CT scans for potentially the rest of my life, before I thought, "Okay. I gotta try something else."
Q: It's been said by some that the people who are the funniest are the people who are the most troubled inside. What are your thoughts on that?
JH: I definitely know my fair share of comedians who were picked-on as kids and use comedy as a coping mechanism, but that was never it for my friends and I. I think that comedy can be an extremely cathartic and effective coping mechanism, but it's much more than that. It can be simply because you enjoy it.
I get that certain people who are really trying to make it in comedy, there's no other life for them. The only thing they can do is this: a die-hard, improv/standup-type. These people usually have some reason that's motivating them behind that.
If you're used to a certain level of attention, you need to keep growing, or else you feel like you're failing.
I think some of it might be the origin; that they're given to sadness, or have suffered some injury earlier in life. But also, the life of a comedian is depressing. You're putting yourself in a position where your career is contingent on other people's approval. In the plainest sense, if people are not showing up and laughing, you're objectively not going to continue working, thus think of yourself as a failure. That's an unhealthy situation, and you quickly acclimate, too. If you're used to a certain level of attention, you need to keep growing, or else you feel like you're failing. That's probably a bigger reason why it's rare for actual professional comedians to be sane.
Q: In what you're doing, have you encountered anything like that, in terms of having to hinge off of other people's approval?
JH: It's always a little bit like that. When I was working on the book, it was a very isolating process, and then I got to go out on the book tour and it was great. I met a ton of cool people, a lot of people coming to events just to say that they appreciate what I do. It was this abundant amount of attention, and then that ends. Then you're back to the drawing board of normal life, and that's this weird swing, where it can feel easily like you're not doing the right thing anymore because people aren't paying as much attention, just because it comes in bursts.
I feel like I'm dealing with it okay; it's not to the extremes. I imagine, now, how rock musicians become addicted to heroin because—I had nothing near this, obviously—but if you had a stadium full of people screaming your name and the next day you're just in line at the deli, it could feel … you know.
It can sound super privileged and oblivious to be at-all complaining about it, but there's a weird, perverse thing of the fact that it wasn't just for fun that I wanted people to come out and meet me. If people don't read this book or don't like it, then I don't get to do another book. At some level, your ability to continue working as a writer is contingent on people appreciating what you do. You could have attention blindness—I don't think that's a real disorder—and if you didn't care at all, you could have a stadium full of people cheering for you and it wouldn't make a bit of difference to your ego. But you would know, "That means that I probably get to do more books." And you could take more time doing them, because if they sell well, you get a bigger advance and can invest more time in it. All these things are intertwined.
Q: Journalists put a lot of effort into articles, and then just like that, it's gone and onto the next one. Does that exhaust you, at all? Having to constantly churn out content?
JH: It's a little bit exhausting because the pace of the news cycle is so quick now. It used to be that things would last longer than they do now, but now people want the thing that was just published five minutes ago. There's weird tension of incentive, to publish more quickly, and not to invest more time and energy, because you know it's just going to fade and won't last long anyway. But then you risk making something you're not quite as proud of, or isn't as rigorous as it ideally would've been.
I like having multiple formats to play with: doing some video and some magazine writing and some web writing and some Facebook and Twitter and radio and whatever else I can do. I think that's the key to sustainability for me: having a bunch of different types of canvases on which to put things.
Q: With you, these different formats inform each other. There was a day where you posted about Facebook Messenger, saying, "You are now connected." The next day you had an article written about that. It's neat that the concept then became bigger. How do you know when an idea is good? Do you have to mull it over?
JH: Sometimes I'll use one of these formats to say something that I'm thinking, and if people react to it positively, or people start talking in a way that gets me thinking more, I'll build it into something else. Or just keep it in mind for something I might write later. I think that's how standup comedians do it. Jerry Seinfeld will just randomly show up at dive bars around New York while he's working on new sets that he's perfecting before he goes on tour. Not saying that I'm like Jerry Seinfeld, but there are ways to work things out publicly, and I think that's valuable.
As far as when I know an idea is good: I don't know. That's a huge question. I think it's rare to not have any regrets about the way you executed something, or didn't fully develop something. It's never really good.
Q: What was the process for If Our Bodies Could Talk? How did you know, "Okay, this is finished, it needs to go to print."
JH: There was a very hard deadline from the publisher, and I agreed to it, not ever having done it before. I thought, "A year will be enough time. I will take every-other month and work for The Atlantic, and every other-month to work on the book." And I ended up just getting way more material. I filed it at 110,000/115,000 words, and the contract was for 80. So then we were cutting things down. The editing process is a lot faster with books than it is with magazine pieces, which I learned.
There's not a moment of, "Well, it is complete." I hear from a lot of authors that once you've written the book, it becomes really hard to read it or open it or think about it again, and I thought that would be a ridiculous thing. But I'm scared to open it because I know that I'll want to change things. Not just the book—pretty much anything. To be clear, I don't regret the major points that I've made, including big ideas in the book that I think are wrong. It's more thoughts like, "Was this sentence written in a way that I wish it had been written?" And part of that is that I like a liveliness and spontaneity to the tone of whatever I'm writing, and I don't want it to be over-thought and edited a million times until it feels really dry and boring. But there's a price that comes with that.
Q: Have you read any reviews for If Our Bodies Could Talk, or do you stay away from that?
JH: I talk to a lot of people about the book. I've been fortunate that I didn't see any reviews that were actually thoughtful reviews that were negative in any way. The New York Times guy didn't read the book, it seemed. I can't imagine writing, "I didn't think this was funny," and then ending it there. If I was Amy Schumer or Jimmy Fallon and wrote a book of just jokes, and you didn't think it was funny, I think that would be a totally fair book review. This book is a lot more than that, and it presents a lot of big ideas about what health is and how to deal with a lot of bigger ideas. I'm totally open to being criticized on any of those, and during the process, saying that you don't like my style of execution for XYZ reasons—but it was weird to see that. I'm told it's weird to just pan a first-time author, at all. Out of good respect, you usually just ignore someone unless they've done something like Why Climate Change is a Hoax, and the public needs to know it's a shitty book. So I don't understand it, but maybe I wronged that guy in some way that I don't realize. But other than that, I guess people did the thing where they were either nice about it, or quietly didn't say anything.
I think there were a lot of people who would have liked the book, and it will never get in front of them because the bookstores didn't put it out because The New York Times said it was bad. I do have a sense of injustice just because it doesn't feel like an earnest review.
I talked about The New York Times review with my editor. It's an opportunity when you have a newspaper like The Times review your book—a lot of people become interested in it and aware of a book that they weren't going to hear of before. But when they pan it, it just means that no one is going to read that book who wasn't already planning on it. It's a missed opportunity, I think. I think there were a lot of people who would've liked the book, and it will never get in front of them because the bookstores didn't put it out because The New York Times said it was bad. I do have a sense of injustice just because it doesn't feel like an earnest review. If someone genuinely engaged with the book and didn't like it, then fair enough, you move on.
I didn't realize the effect it would probably have on the market. The fact that the book is reaching a lot fewer people is the sad thing, I guess. Personally, I'm not really bothered.
Q: In 2014, you wrote an article about Ben Carson before he became a national figure as a presidential candidate, and the article came off very neutral. When you write more political pieces, how might you avoid bias in your journalism, if you have to? How do you tell a story plain and simple without putting a personal spin on it?
JH: That's a huge question, and something I've started to think about a lot more lately. I've started to really reject the idea that journalists are biased and that's the reason we don't like Donald Trump—because we have a "liberal bias." No. Journalists are criticized when they don't say, "This is a lie, he's directly contradicting what he said before." It's so easy for people then to say, "You're projecting a bias."
Hunter S. Thompson said that the only thing that came close to "objective journalism" was in the box scores. And I've come to think it's better for everyone to just be very frank with this stuff. I don't think it's a bias. Climate change is not a bias. The fact that people should be vaccinated is not a bias. These are the facts of the world. I don't identify as a Democrat or a Republican. I don't like when people talk about the Left and the Right, these either-or types of things. I think you can just reject the whole thing and try to see as much truth in the story as you can and tell it as plainly as possible. But everything is coming through the lens of the author. So if the author is trying to be this sort of completely-removed voice-of-God figure, I think that can end up turning off the people who don't trust the media even more. It's kind of like, "Who are you? Why are you telling me this?" And so you read people like Hunter S. Thompson, David Foster Wallace, people who really injected themselves into the stories and were "biased," but I don't think were any more biased than anyone else, except that you understood this person. You understood how they came to the story, and you got a real sense that you could trust them because they were in that story, and they told you where they were coming from. I think that's the most honest way to do journalism.
There's no need for me to say that Ben Carson is a lunatic who'd be bad for the country. That wasn't my mission. My mission was to find out about him and then tell the facts of him and the story of me meeting him. The conclusion that I came to is that he wouldn't be a stable, considerate leader for the country. Whatever lead me to come to that conclusion is what I put on the paper. So there's no need to state it explicitly at the conclusion. I think the reader came to the same one, in most cases.
If I stated something like that, people would assume my primary motive was that I already thought that, and then I went out to try to make him look that way. But it's not that. And I think that's why so many people who "don't trust the media" are assuming a motive and they're reversing the order here. Did you go learn about a thing and then come to a conclusion, or did you have a conclusion and go learn about a thing? I just want to try extra hard to make it clear that it wasn't the latter.
I reject the entire idea that there's right-wing media and left-wing media. We have a lot of problems with false equivalence right now, and that's one of them.
There are liberal advocacy groups that say, "Our job is to promote the Democratic party or a certain candidate," and that is the equivalent of Fox News and Breitbart. And there are people who are trying to communicate truth in the world, and those are journalists, who are firstly about truth and then have biases.
[Journalists are] some of the only people that are detached from any agenda or interest, and yet are among the least trusted groups of people.
There's no incentive. We have no ties to anything. You take on this life of a journalist, which is a pretty humble and detached existence, in most cases. You can't take speaking fees or sponsorships or the types of things that advocates or people in academia can. You disengage from that so that you can just experience the truth and be beholden to no one and say what needs to be said. That's the cool thing about getting to be a journalist, but that's also what makes it so strange. We're some of the only people that are detached from any agenda or interest, and yet are among the least trusted groups of people.
Q: Having to be detached, what do you consume to get your news?
JH: We publish so much on The Atlantic now, I could read that all day long. I read good journalists, I guess.
There's this idea, that if I only read people who are publishing mostly stuff that's negative about Trump, that I'm not getting "both sides." And I just know that that's not true. If we had a story that explained Trump in a way that made him look really human—an elaborate, humanizing piece about why he would want to build a wall, and why he would lie, and why he would talk about a Muslim registry—that would be a wonderful work of journalism, if someone could publish it. It just doesn't seem to be there. And the same reason that The Times has to hire a guy to be a columnist who is a climate science denier, because they're looking for a conservative op-ed columnist—it's so hard to find someone who can justify or defend Trump's position that you have to go to that length to do it. But every outlet wants that. Smart readers want to be challenged.
If it was simply a matter of differing ideologies, it's because you can't defend the contradictions that Trump is saying in an intellectually honest way. These arguments don't exist. The people who could make them, they don't exist. But The Atlantic would love to publish them. David Frum is a former Bush speechwriter, and he works at a conservative thinktank, and when he writes things—like this cover story—that are challenging the traditional liberal or Democratic party line, they're extremely popular and well-read by all of our readers. People want that challenge, and it's not out there. We want to publish as many intellectually honest pieces that challenge people's worldviews as possible, but there is simply no defense of a lot of what's going on right now.
If I emailed you, "Here's this reason why a border wall would be great for the global economy and for human rights and for safety and security of a lot of people," and it was considerate and made sense, that would be an amazing thing to read, wouldn't it? It would be extremely widely read on our site. I would love to read it. An important idea that I have been thinking about a lot is this idea of the liberal media, or the liberal agenda, and trying to suppress these sorts of pieces, and they just don't exist.
I read good sites that are written by journalists who are trying to put truth in the world.