The PEN Ten is PEN America’s weekly interview series. In this week’s interview, Davie Loria speaks to medical historian Dr. Lindsey Fitzharris, author of The Butchering Art, which won the 2018 PEN/E.O. Wilson Literary Science Writing Award.

1. How does your identity shape your writing? Is there such a thing as “the writer’s identity”?
I’m not sure there is a single “writer’s identity,” as that implies homogeneity. Poets are different from nonfiction writers, who are different from novelists, and so on and so forth. Being a writer is only a small part of my identity. I’m also a historian, academic, public science communicator, and woman—to name a few! All of these roles influence my writing in a variety of ways.

2. In an era of “alternative facts” and “fake news,” how does your writing navigate truth? And what is the relationship between truth and fiction?
As a historian, I have quite a bit of experience distinguishing between fact and fiction when it comes to sources. I mostly deal with the “long-ago” past, however, so my challenges are different from those writing about contemporary issues.

3. Writers are often influenced by the words of others, building up from the foundations others have laid. Where is the line between inspiration and appropriation?
This is no truer than in history. Every scholar builds upon the work of others in his/her field. Nobody owns the past, so one can easily find oneself writing about a subject that has been extensively covered by another historian. If you’re writing nonfiction, the key is to cite frequently, accurately, and honestly. For commercial books, it’s often difficult to include footnotes because of style restrictions, but every writer should insist on extensive endnotes and a bibliography.

4. “Resistance” is a long-employed term that has come to mean anything from resisting tyranny and societal norms, to resisting negative urges and bad habits, and so much more. It there anything you are resisting right now? Is your writing involved in that act of resistance?
I like to say that my book The Butchering Art is a love story between science and medicine. It details the first time that a scientific principle (germ theory) was applied to medical practice through the development of antisepsis. Joseph Lister was a visionary surgeon who persevered with his work despite a prevailing climate of skepticism and denial. In this way, his story is more relevant today than it has ever been. At a time when attacks on science are becoming a global contagion, I wanted to write a book that demonstrated the power of fact over willful ignorance, of empirical data over anecdotal evidence. I hope people read this book and are inspired by Lister’s story.

5. What do you consider to be the biggest threat to free expression today? Have there been times when your right to free expression has been challenged?
There are so many threats to free expression today that it’s difficult to pinpoint the biggest. Just the other day, a cartoonist was fired for being too critical of Trump. It’s distressing to see what is happening around the world, and in the United States in particular. If I had to pick, I would say the greatest threat to free expression is sitting idly by while these sorts of things happen.

6. What’s the most daring thing you’ve ever put into words?
My book was born from desperate circumstances. I’m an American living in the United Kingdom. I found myself going through a traumatic divorce several years ago. My (now) ex-husband abandoned me and reported me as illegally in the country since I was only on a marriage visa at the time. My passport was confiscated, and I wasn’t able to work. I had no money, and his lawyers painted a grim picture of me as a failed writer. I sat down and worked on this book. It was the only thing I could do. I half-joke that Joseph Lister saved many lives, not least my own as this story lifted me out of a terrible situation and has enabled me to become a full-time freelance writer.

It’s been very difficult writing about my personal struggles during that time. But I hope that my story might comfort others who are going through similar situations. There is light at the end of that long, dark tunnel.

7. Have you ever written something you wish you could take back? What was your course of action?
I think every writer has experienced this at least once, and I’m no exception to the rule. Unfortunately, once something is out there, it’s out there. We can only strive to be better the next time around.

8. Post, stalk, or shun: What is your relationship to social media as a writer?
I post a lot of content online, but I have a love/hate relationship with social media, as probably most writers do. I love that I can reach people I would never have reached otherwise, and inspire them to take an interest in medical history. But there is a lot of toxic energy online these days, and it can distract one from the more important task of getting on with writing. I’ve gone down the rabbit hole many times!

9. You received your PhD from Oxford, went for your postdoc at UCL, and wrote a fantastic book about the turning point in terms of the Age of Agony: The Butchering Art: Joseph Lister’s Quest to Transform the Grisly World of Victorian Medicine, which won the PEN/E.O. Wilson Literary Science Writing Award. Do you consider yourself a doctor, a historian, or a writer?
Although I have a doctorate in the History of Science & Medicine from the University of Oxford, I consider myself first and foremost a storyteller, and a historian second. After all, in the words of Ken Burns, “people often forget that the word ‘history’ contains the word ‘story.’” I sometimes use my academic title “Dr.,” but please don’t ask me to perform any medical procedures!

10. Can you tell us about a piece of writing that has influenced you that readers might not know about?
Pretty much anything by Erik Larson. He has an incredible talent for transporting readers back in time, and he’s had a huge influence on me ever since I began reading his books back in college.