Of Sanity, Illness and Ruin. An Interview with Jacob M. Appel
by Bryan R. Monte
© 2017 Amsterdam Quarterly. All rights reserved.

Polymath Jacob M. Appel (b. 1973) is a lawyer, physician, psychiatrist, bioethicist, certified New York City tour guide, university professor and award-winning writer. He has won the William Faulkner-William Wilson short story award (2004), the Dundee International Book Prize (2011) for the novel, The Man Who Wouldn’t Stand Up, the Black Lawrence Hudson Prize (2012) for the collection Scouting for the Reaper, the Serena McDonald Kennedy Fiction Award (2014) for the collection The Magic Laundry, and the Howling Bird Press Fiction Award (2016) for The Topless Widow of Herkimer Street. Stories. Below is an interview conducted with him in January 2017 about his writing discipline, his literary influences, and the effect medicine and his Belgian-American background has had on his writing.

BRM: With such a busy life, as a bioethicist, doctor and teacher, how did you/do you find the time to write so many award-winning papers, novels and memoirs?

JMA: It’s easy to find time to do things I love doing. I’ll confess that my relationship with writing is much like the relationship some of my patients have with heroin. I look forward to sitting down at my keyboard each day, and if I miss a few days, I suffer through psychological withdrawal. Being a physician and teacher actually helps, as these are rather flexible callings. If I had to be at the coal mine twelve hours a day, six days a week, it would likely be much more difficult to write.

BRM: Do you watch television?

JMA: No.

BRM: Follow social media?

JMA: No.

BRM: Belong to a gym?

JMA: No.

BRM: Have any kind of a social life?

JMA: Yes. Of course, much of my time with friends and family is spent imagining how our conversations, lightly edited, would sound in short stories or novels.

BRM: Do you have any hobbies other than writing or studying for degrees?

JMA: Reading history, attending the theatre, flirting with barmaids. Since I don’t drink, the last proves rather challenging—most women find it odd when you tip five dollars on a glass of water.

BRM: Do you have a secretary who sends out and tracks your manuscripts?

JMA: I should be so lucky!

BRM: A regular time and place when and where you write?

JMA: I write whenever I can cobble together a few hours of down time, often at the hospital in a quiet nursing station or unoccupied examination room. But most of my best writing is done before I put pen to paper—inside my head, mulling over storylines and characters. The American short story writer Grace Paley used to say that she did her best writing in the bathtub. Metaphorically speaking, I assume, although I was never invited to bathe with Grace Paley. That’s sort of what I do, although rarely in the bath.

BRM: How do you shift gears between working on different genres and projects? For example, I knew someone in San Francisco who had separate tables for writing poetry, fiction, and non-fiction with the pertinent papers and books on each, and he’d visit each one over a three-day period. Do you have a similar system or schedule for your writing in four major genres (drama, fiction, essays and memoirs) or do you do a bit of each, each day?

JMA: That would involve the luxury of having an apartment with enough space for three tables, which might be possible in San Francisco, but is a pipe-dream in New York.

BRM: Yes, he had a three-bedroom house.

JMA: I generally only work in one genre at a time, although I may occasionally write a short essay or even a poem while at work on a longer project. As a rule, I choose the genre and project based upon the time allotted—if I am going to have a quiet month at the hospital, I might embark upon a novel, but if my opportunities to write will be sporadic and short, I choose a project that can be completed in days or weeks.

BRM: You seem to be a very prolific writer. Had you been writing and storing up work that you’d written years ago or did you experience a sudden burst of creativity in your mid- to late thirties regarding fiction?

JMA: I’ve been writing seriously for about twenty years. At least since I attended law school in the late 1990s. Through much of that time, I suffered from “publisher’s block” – this is sort of like writer’s block, only the obstacle to publication occurs at a different step in the process. Slowly (all too slowly!) this is beginning to change, as publishers are starting to show an interest in my work. Alas, my writing is about as commercial as soot, so I still have lots of stockpiled fiction. Particularly long fiction. If you know anybody who wants to buy a novel, please send her my way.

BRM: How have the topics, themes and techniques of your pieces changed over time?

JMA: I think writers have a “natural range” and part of developing as a writer is learning to embrace one’s limitations. Faulkner was wise enough not to write about Russian peasants; Henry James avoided whaling expeditions and tales of runaways on Mississippi rafts. Occasionally, a writer is fortunate enough to claim a very wide range. Henry Green. E. M. Forster. Or William Styron, who can write about the Holocaust and African-American slavery and clinical depression with equally powerful insights. When I started out as a writer, I tried to push myself outside my range of comfort – writing about people whose experiences were alien to my own. With time, I’ve come to focus on what I know well—upper-middle class urban and suburban professionals, clinging to order amidst the frustration and chaos of their narrow, tenuous worlds.

BRM: Have you gone through any stylistic/thematic experiments that you later exhausted and/or abandoned?

JMA: I’ve abandoned countless projects. In the 1990s, I wrote about 75% of a novel that retold the story of Mrs. Dalloway in the past and present…and a few years later, Michael Cunningham published The Hours (a brilliant, moving book) that did largely the same thing, and better, and that was the end of that.

BRM: Which writers do you admire?

JMA: I’ll confess I read mostly classics, often over and over again. I could read Anna Karenina or Middlemarch several thousand times without tiring. (My favourite scene in western literature is when Koznyshev takes Varenka mushroom picking in Anna Karenina and fails to propose.) I love comedies of manners—Fielding, Austin, Lucky Jim. And works that capture, to quote Doris Lessing in The Golden Notebook, the “long littleness” of life. But I can also be entranced by the magical if it’s magical enough. What sane reader doesn’t have a soft spot for John Fowles or Thornton Wilder? Among contemporary American writers, I’m very much a fan of Kevin Brockmeier, Dan Chaon, Robert Olen Butler, Elizabeth Graver, George Harrar. I also recently discovered Michelle Herman and Rebecca Makkai. Both geniuses! And I adore Philip Larkin’s poems—even if he might not have been the ideal guest for Christmas dinner. My formers students and mentees like Chanan Tigay, CJ Hauser and Brigit Kelly Young are also brilliant and deserve far more recognition.

BRM: Looking at your short stories, I’d guess that Poe’s atmospheric darkness and O. Henry’s snap endings have had some influence on your work.

JMA: You’re not the first reader to suggest that, but they’re less direct influences than one might think. Candidly, I haven’t read O. Henry (or Maupassant, for that matter) in many years. The most significant direct literary influence on my work probably comes from contemporary drama: Paula Vogel, Tina Howe, Sarah Ruhl. Playwrights who push the limits of the possible, often with humour and whimsy and madness.

BRM: How does a story or memoir first come to you?

JMA: That is indeed the $64,000 question. I wish I could say I’m struck with wisdom, or envision an image, or find my way through a dream, but the not-very-helpful answer is, it just happens. Like falling in love. Or a fatal heart attack. So that’s the best I can offer: coming up with a story idea is something akin to falling in love and suffering a fatal heart attack. I will just somehow know that my next story is about a curmudgeonly landlord who rents an apartment to a mime or an extraterrestrial who finds himself disguised as a Latvian chef opposite an Alabama abortion clinic.

BRM: How does it usually develop?

JMA: That’s an easier question to answer. Once I have a premise—let’s say my mime tenant or Latvian alien—then I map out the scenes needed to tell the story. I always write in scenes and I always know how many scenes I require before I start writing. Even from early childhood, I have always possessed a talent for causing a scene, at least according to my mother, so this part comes naturally to me.

BRM: How do you know when you’re finished?

JMA: Honestly, I know I’m finished when somebody agrees to publish the piece. Or, on occasion, when I return the galleys and it’s out of my hands. The perfect, as Voltaire warns, is the enemy of the good…and fortunately the modern editorial process renders even the illusion of perfection impossible.

BRM: You mentioned to me in another conversation that you’d applied to writing classes at Brown, as an undergraduate, but were rejected. Do you remember the reasons given?

JMA: In my memory, I tell myself they were full and closed to enrolment. But it’s also possible I was rejected “on the merits,” so to speak, but have chosen to block this out.

BRM: Does your publishing success in at least four genres in the last decade seem like a vindication?

JMA: I should begin by saying, while I appreciate the kind words, that my successes are somewhat limited. (I’m not even the most successful writer named “Jacob Appel”; there’s another non-fiction writer, for whom I’m often mistaken, who generally gets better press.) But even if I win the Nobel Prize – and don’t cash in your frequent flyer miles on SAS just yet—it still wouldn’t be vindication. I write from a deeply-held sense of inadequacy, as I imagine many writers do, probably a congenital affliction or one acquired in early childhood. I’m not sure publishing successes will ever cure that…although I am certainly glad to have them. Psychotherapy might, of course, but I’ve worked alongside enough headshrinkers not to trust them.

BRM: What is the significance of your Belgian-American upbringing on your writing? You’ve mentioned it in your memoirs and Allen Lewinter, the protagonist in your short story, “The Current Occupant,” in your most recent collection, The Topless Widow of Herkimer Street, mentions his relatives arrived as refugees in America with 15 Belgian francs between them. What influence has your grandparent’s flight from Nazi Europe and their Flemish language and heritage had on your writing?

JMA: I was extremely close to my late grandfather, who was born in Eastern Europe but raised in Antwerp, Belgium, and always considered himself a Belgian-American. He was one of the most generous human beings I’ve ever known; he was also an amateur poet in his youth, and apparently published Flemish-language poems in several small journals in Belgium, although none appear to have survived. (If anyone can find any poetry by Sander Leo Appel from the 1930s, I’d be forever grateful.) As a result of his influence, I also consider myself a Belgian-American: I studied Dutch in college and made a pilgrimage to the alley off the Terliststraat where he grew up. His flight from the adopted homeland that he loved, and the stories he told, have heavily influenced my fiction. Many of my characters are psychological exiles or refugees, even if they haven’t been physically driven from their homes.

BRM: What is the role of medicine in your writing?

JMA: The impact is largely indirect. Because I’m a psychiatrist, I hear the most amazing stories nearly every day…and I’m not allowed to share them with anyone. So I have to push my imagination in the opposite direction – to create new worlds that I’m 100% certain aren’t drawn from reality.

I do find that medicine, and particularly psychiatry, reminds me daily how close we all are to the edge—of sanity, of illness, of ruin. Friendships and relationships are fragile; promises evaporate under strain. These sentiments form the backbone of my writing.

BRM: How have medical concepts, procedures or cases informed and inspired your writing?

JMA: I have written about a few cases in my collection of essays, Phoning Home, including a piece about my favourite patient (with his permission): a nonagenarian who had once been the chauffeur for American President Harry Truman. But I strive to keep my clinical experiences out of my fiction. My worst fear is that one of my patients reads my latest novel and believes I wrote about him, even if I didn’t. Okay, that’s not my worst fear. My worst fear is nuclear winter. But it’s a close second.

BRM: For example, William Carlos Williams’ “A Difficult Case” could almost be considered a memoir of the treatment of one of his patients, yet it follows the standard arc of a short story. Have you had any similar experiences?

JMA: Williams, who was both a gifted writer and a skilled clinician, had a couple of advantages that I don’t have: he was a paediatrician, not a psychiatrist, and rules governing medical confidentiality were much laxer in his day. I can’t imagine hospital bureaucrats threatening to fire Chekhov or Maugham or Walker Percy over violations of federal disclosure statutes. So I work in a system that makes even fictionalised accounts of cases difficult to write and publish. In the United States, permission from the patient is often not enough to print these stories…one also needs permission from the hospital, from one’s colleagues, etc. It’s much easier to make things up entirely.

BRM: What informs and motivates your writing about euthanasia? You mentioned that when you get to the end, you want someone to put a plastic sack over your head. I, on the other hand, want a computer I can write with by moving my eyeball, and as a result of “live organ donor” horrors, I have decided to exempt myself from the proposed, automatic, organ donor programme here in the Netherlands if it becomes law. How do you feel about that?

JMA: I think the most important objective, which I do believe to be possible, is a system that allows both of us to have our wishes fulfilled. I don’t think there’s a “right” answer about how or when to die, but rather, a “right” answer for each individual. From my work with patients, I’ve found that many people who would never choose assisted suicide still benefit from knowing that it’s an option in theory—that there is an “out” if they ever wanted to choose it. So it’s very possible I wouldn’t go through with my “plastic sack” plan, but knowing that’s a possibility is comforting to me. Of course, I think it’s also essential to have system with meaningful safeguards. Failure to protect those who do not want euthanasia is absolutely unconscionable. As we know, many people can live very meaningful lives and contribute considerably to the commonweal while in the throes of severe illness or disability. Steven Hawking. Jean-Dominique Bauby. I’ll have a novel out in 2018 addressing these challenging issues.

BRM: Most of your books are published by what some would consider indie presses (Black Lawrence, Snake Nation, and Howling Bird Press). Is there a reason for this or is this just coincidental?

JMA: Adam Smith’s “invisible hand” is at play here. Unfortunately, large publishers in the United States are reluctant to publish literary short stories, especially by writers who lack a pre-existing following. My first novel was published by a mid-sized British publisher and I have a new novel coming out with Permanent Press in 2017, which is considerably larger than many of the independents that I have previously worked with—although obviously not Knopf or FSG. But there are upsides to working with smaller presses: The editors tend to be lovely people, deeply invested in the projects. I have made some wonderful friends working with these presses. It’s harder to imagine that happening with a “Big Five” publisher who also manufactures household appliances.

BRM: I’ve dog-eared many pages of your books that mention Creve Coeur, (Broken Heart) Rhode Island. What is the special significance of this place in your fiction?

JMA: I went to college at Brown University in Rhode Island and later taught there for many years, so “Creve Coeur” is my rendering of Providence. The name itself is pinched from a rather dreary bedroom suburb of St. Louis, Missouri, which happens to be the international headquarters of Monsanto. I have been to Creve Coeur, Missouri, and I cannot imagine any place less romantic—not heart breaking, just heartless. In contrast, Rhode Island is a magical place brimming with the ghosts of whaling captains and mobsters.

BRM: What new projects (genres/themes) are you currently working on that you’d like to share with AQ’s readers with giving too much away?

JMA: I have a novel on the theme of assisted suicide coming out in 2018. And I’m currently working on a mystery novel narrated from the point of view of a psychiatric patient with schizophrenia, who believes one of her fellow patients has been murdered. But mostly, like the rest of the world, I’m trying to keep the photocopier from jamming, and looking for that missing sock, and dreaming, not too realistically, of a date with the novelist Karen Russell. Ah, the glories of the literary life….