Emergency Medicine is a tough sport. Whether it’s the torrential numbers of patients we see, or the mismatch between societal expectations and possibility, or simply having to slash through the jungle of bureaucracy, the demands of the profession never let up.

I’ve been a foot-soldier in the gritty, amazing world of emergency medicine for decades. It doesn’t get all that less difficult over the years, but the challenges, and the ways we deal with them, evolve.

Which is how we have landed here; me, talking to you, about why I write.

In its most simple terms, writing is an act of knowing. Without crafting thoughts into the written word, rarely can I truly understand things. Without writing I skim. I drift. I find myself, as we all do during certain epochs in our lives, in survival mode, bumping along in a half-asleep state of existing, far from the warm, lusty grip of living. And this is when I am at my most dissatisfied, my most unhappy. To write, which is little more than thinking with a bit of poetry thrown in, I have to crack that somnambulism. I must get down amongst it all – feel things, see things anew, question all of it and find my own understanding of what it means to be here, next to a dying body, or teaching a junior about the magnificence of a triple gas disorder, or tending to the wound of somebody scared, or questioning my own abilities, but mostly, to be present, as a deeply flawed human full of wonder. Perhaps it’s simply that writing allows me to outfox reality.

To write means paying attention. To people. Their words. The way they act. The way I act around them. The way the world feels on my skin, or how it smells, or when it is unexpected and amusing. Attention means being all in. I am frequently reminded, as I’m sure you are working in the land of freakish accidents and life lottery, how fragile and fleeting our time on this planet is. We get one shot, one blink, bookended by vast manuscripts of nothing, and paying deep, fascinated attention to both the good and the bad, and certainly the colourful, is one way to have as much of it as possible.

Novels are only a small, and perhaps anachronistic, aspect of the written word. I have found myself writing novels because it was the reading of novels that let me soar as I grew up, and it is hard to fall out of love with the thing that gave you wings. Long form fiction allows you to explore depths of the human condition you can’t do in any other way. And issues! I wrote my first (not autobiographical, oh no, not at all) novel about medical error and its consequences, which permitted me to say things I couldn’t in a different guise. But writing essays, blogposts, tweets for goodness’ sake, is joyful if you pay even the barest of homage to the English language and its possibilities. A novel takes many years to write. Dustfall took me six. But a post can be written in days and can be just as satisfying.

There is an urgency to making art. Art, literature, music, poetry, these things are more necessary than ever. We live in different times now. The online world which, sure, has its benefits, also has a dark, corrosive element; animalistic and violent. It is full of savage untruth. It delights in misinformation, in mob attacks, in ego, in oppression. Often, we humans, when in group-mode, are not necessarily wise and kind, however engaging with art strips away some of those layers. Removing the knee-jerk outrage, questioning what’s underneath, coming to grips with your own sophistication of thought and then going on to craft those thoughts into considered sentences, is a mighty weapon in the war on sense.

Writing well is more than just having a barrel full of fancy words. It is the way words are arranged into sentences, syntax, music and prosody that makes them, as Maya Angelou says, slide straight through the brain and into the heart. But this skill needs to be learnt. When a quiet and resolute voice came to me without warning or fanfare, saying, ‘I shall write a novel,’ I had no idea how much I had to learn (and this voice has taken some forgiving). But I am nothing special – all it took was years of being prepared to fail, a passion for great sentences, and some hard love from friends and mentors.

So, write. See things anew, think of things anew, and say things in new and wonderful ways. Write. That’s all there is to it.

Want more from Michelle? Listen to Resa E. Lewiss talk with Michelle on the FemInEM podcast here.