“In 1833, British anatomist Sir Charles Bell published a book whose premise was that the very existence of the human hand proved the existence of God.” So opens Arnold (Arnie) Arem’s book In Our Hands: A Hand Surgeon’s Tales of the Body’s Most Exquisite Instrument; from the get-go, we understand that we are in the presence of a man who loves his career focus. He tells us, “I’ve come to believe that hands are, in a true sense, the Rosetta stone of the soul. One has but to decipher the encrypted lessons locked in their deformities to uncover the wisdom they harbor,” and we appreciate how much he also values his patients and the way working to fix their hand injuries and disabilities have helped him grow as an individual.

Those of us who hope to write a book from our years of working in a particular field but are leaving our project too long on the back burner will find inspiration for ourselves in Arnie’s project. A lover of the hand, a lover of people and of culture, a fine listener, and an intuitive person, Arnie uses his stories to reveal the ways in which he worked with his patients out of a delight in observing them as people as well as bodies with hands in need of repair. His caring and his pleasure at being able to make things right, or as right as possible, come through on each page. His writing is clear and accessible, warm, funny, and informative.

Here is a short interview that reveals some of what went into making Arnie’s writing project a success story. The interview is followed by an excerpt from his book and a writing exercise to help you begin yours.

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Sheila
When did you realize you wanted to write a book about your years as a hand surgeon?

Arnie
I developed M.S. in 1996. Optic Neuritis in my right eye was the first major symptom and, with it, a loss of binocular vision. I was operating on a lady with a small cyst of a finger, and I couldn’t place sutures accurately or use fine scissors accurately. I realized immediately I could no longer do surgery up to my own standard. I was able to finish to case (it worked out fine) but that was the last one. I have not set foot in the O.R. since then (12 years ago).

I had done some creative writing in college, and liked it. When it was clear I could no longer do surgery the way I wanted to, I decided to write a book – not technical, it was for everyone – I would never have had the time while I was in practice.

Sheila
How did you approach the project?

 Arnie
I took courses with Meg Files at Pima College in Tucson. She was an enormous help and support. My patients were the heroes and heroines, and I wanted to tell their stories – that’s the first half of the book. I wanted to write about things that simply don’t appear anywhere else (my hand surgery colleagues only wanted to write about the surgical procedures they had done or invented): the story of Reike; the story of Louis Braille; the story of palmistry; etc., etc., etc. So the second half of the book took shape as a sort of “everything you ever wanted to know about the hand but were afraid to ask” sort of thing. No publisher has ever done this before, so I’m glad Holt decided to do it. Hands are what make you a human being, and I wanted to tell that story.

Sheila
What was most helpful to you in the evolution of the manuscript?

Arnie
Input from Meg and my wife, Cindy, kept me going.

Sheila
What were the hardest parts for you in rendering the stories?

Arnie
The hardest thing about writing this book was deciding what NOT to include. Deciding what to include was easy; In the end, Kirkus was kind to me with their review: “Thorough, informative, and warmly human.”

Sheila
How did you go about finding an agent/publisher?

Arnie
My agent came from one of Meg’s May workshops, and he was a substitute for a N.Y. agent who couldn’t come. Meg was kind enough to allow me to submit a few pages for him to read and critique. Within 24 hours, I had a contract. The first publisher to accept the manuscript was Freeman, publishers of Scientific American. But, as you know, in this business big fish eat little fish, and Freeman was bought out by Henry Holt, and they fired my editor. But, because she is quite competent, there was a great hue and cry and she was rehired and I was in business again.

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In the first half of In Our Hands, readers learn about people and their quirky ways of dealing with life and one another as well as about hands, how they work, how they can be repaired, what the risks are and how the surgeon makes decisions and employs his craft. In the second half of the book, readers are invited into the author’s collection of cultural knowledge about the hand and the way it is revered for its dexterity and sense of touch. We gain background that helps us understand the reason “hand” is so much used as metaphor in our language: We throw up our hands, hand it to others, agree that someone’s won hands down.

As you read the following excerpt from the book, list the techniques you observe the author using to make readers not only care about a particular patient, but identify with her emotional battles, even while learning drier technical information about hand surgery.

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Chapter Ten — Gossamer Wings

When I first met Kathy, she was a lithe, supple nineteen-year old, gregarious, with curly brown hair, an appealing smile and boundless energy. The campus pizza parlor job was perfect for her. It gave her the opportunity to meet people in an informal atmosphere, and the salary and tips helped with school expenses.

The Friday evening I was called to see her she had been busy at work, catering to a massive, hungry college crowd. Kathy’s job was to shred cheese for the pizza. She took whole wheels of provolone and muenster, cut them into blocks, and fed the blocks into a home-style grinder with a Teflon screw, the kind you use to extrude spaghetti or grind meat. The hopper opening was small, and a Teflon plunger forced the cheese into the corkscrew gear.

Harried and rushed that night, she found it was faster to feed in the blocks by hand. To hell with the plunger. If the cheese blocks were stacked up, the one to be shredded was forced in by the one behind it.

When the paramedics brought Kathy to the emergency room, they brought in with them the disassembled grinder. In haste, she had pushed the cheese into the worm gear a little too vigorously and her small, delicate right hand was caught and pulled in. The photograph I took was of the corkscrew gear.

The Teflon corkscrew lay in a metal pan. Tightly wrapped around its threads was the deep flexor tendon to the long finger, violently pulled out of her forearm by the inexorable force of the worm gear. The finger, cold and lifeless, had been torn from the hand, the lower end of the tendon connected to bone, bits of muscle still clinging to the upper end. The other two fingers, also ground off at the base with their avulsed tendons attached, floated in a plastic bag next to the pan.

For her part, Kathy was Miss Cool–in public. From the moment it happened, though, I knew she knew this injury had forever changed her life. If she grieved over the loss, she must have done it in a big hurry, probably in the ambulance on the way to the hospital. By the time I first saw her, she was calm and lucid, and remained so throughout my treatment.

Jeff, her fiancé, wasn’t.

“Surely there’s something you can do to fix her hand like it was before. This is the age of medical miracles, for Christ’s sake. I refuse to believe you can’t put her fingers back on. There must be somebody around here who’s competent enough to do it.” His lips were drawn back in a grimace, exposing perfect teeth below a thin brown moustache.

“Jeff, don’t be a schmuck,” said Kathy. “Mom says Dr. Arem’s the best. I want him to fix my hand, and that’s that. What he says goes. If he says the fingers can’t be replanted, they can’t. End of story.”

“Replace ‘can’t’ with shouldn’t,” I said, adding a postscript for Jeff’s benefit. “Eight laborious hours of microsurgery might stick the three central fingers back on and get them to live–barely. Maybe. They haven’t been kept cold, the critical tissues are crushed to hell and they’re badly contaminated. But, even if they survived, they wouldn’t work worth a damn and they’d screw up the function of the small finger and thumb, all Kathy has left. An unacceptably long run for a painfully short slide.”

“Yeah. Well, we’ll see. I’m sorry. The future Mrs. Marshall simply isn’t going to have finger amputations. If we go dancing. If we give a dinner party. Can you imagine the reaction? Endless questions. Endless explaining. Endless phony sympathy. I’m not sure I could deal with the revulsion, expressions of disgust hidden behind a caring facade. My dad knows Dr. Franklin. If he’s available, let’s find out what he says. He has a reputation for doing microsurgery.”

Kathy’s venomous glare was short-lived. The center of her makeshift bandage was staining bright red, the thick layers of gauze obscuring the amputations. She hadn’t been moving. More likely, her anger raised her blood pressure enough to cause a little bleeding. It would quit soon. But the operating room was ready, and I needed to get her upstairs. “We have to go now, Kathy,” I said. “Sorry, Jeff,” she said, “I really don’t want to wait for Dr. Franklin’s opinion. I’ll see you and Mom on the ward in a few hours.”

Glancing back, I saw Jeff pacing the floor, wearing a sour expression.

Kathy was visibly shaken by her fiancé’s reaction, relieved to be under way. I couldn’t blame her. I, too, was disturbed by Jeff’s obstinacy. I knew Franklin, knew what he’d say if Jeff reached him, so I wasn’t concerned.

The anesthetic block was perfect, and I blessed my anesthesiologist for her skill. Superbly trained, she was refreshingly competent.

For incorrect reasons, finger amputations have been relegated, perhaps by default but largely by tradition, to inexperienced junior surgeons in training programs. I’ve always suspected this was because such programs in large universities tend to be frenetically busy, not outcome oriented, or simply understaffed. If you care about results, though, amputation is one of the most complicated and demanding operations in a hand surgeon’s repertoire. Definitely not for amateurs.

The fingers work as a unit, referred to as a “community of digits.” Not only are the tendons anatomically tied together in special ways, but the brain, the “master puppeteer,” oversees their coordinated action. Deleting a part of the hand is tantamount to a functional lobotomy, and treating and overcoming the injury is like threading your way through a minefield, finding and defusing each mine as you go. Every tissue is important and must be handled thoughtfully to prevent problems.

Ragged bone ends must be smoothed, preserving critical length when possible. Managing joints, knowing when or whether to preserve them and how to do it, is a textbook in itself. Tendons arc trimmed so they don’t adhere to hone ends and get stuck in scar, lousing up movement of the other fingers. The major arteries must be ligated or coagulated to prevent bleeding. Each main digital nerve must be trimmed back in a special way to prevent formation of a neuroma (a tender lump of scar and regenerating nerve) in the amputation stump where it can easily be touched and drive people crazy with pain. The skin must be draped over the reconstruction with the finesse of an expert carpet installer adjusting to an uneven contour. Pull too loosely and you leave unsightly excesses and bumps. Pull too tightly, or take off too much, and you have inadequate coverage.

In the days before anesthesia, speed was the criterion of surgical skill. Especially in wartime, the best surgeons could remove a badly crushed, injured, or infected arm or leg in a few minutes. Of course, such rapidity in amputation did not permit the meticulous attention to detail required to achieve trouble-free healing. It’s a miracle many of the amputation stumps healed at all.

The popular media image shows those in attendance getting the patient drunk in preparation for the surgery. Strong booze was relied on to provide more than mere distraction. It is not generally recognized that ethanol is a classic anesthetic agent; even complex abdominal surgery can be performed quite well under ethanol. The problem with routine clinical use of ethanol is that the anesthetic dose and the lethal dose are too close to make such use safe for patients. Undoubtedly, over the centuries, many were lost as this fine line was crossed, with fatal results.

Kathy’s amputations were a typical mess. The grinder wasn’t neat pulling off her fingers. The remaining central skin was ragged but sufficient to close the defect without loss of palm length and contour. The remaining small finger and thumb had superficial lacerations. They would heal promptly, without difficulty.

But this attractive young woman would live out her remaining years with a major hand deformity. Jeff’s speculations were relevant. His attitudes may have been juvenile, but his observations weren’t.

How would she deal with the losses, both functional and cosmetic? What about school and future employment? How much help would she need, physically and spiritually? How much emotional support, and who would provide it? Was she a sensible candidate for a prosthesis, and would this help her?

There was no saving the three central fingers. They were gone, never to return. The trick now was to make what was left work as well as possible. Kathy was way ahead of me.

“Dr. Arem, while you’re there, can you do anything to strengthen my little finger and thumb? Spruce them up? Make me double jointed or something?”

“No, Kathy, I can’t, but you can. As fast as the pain subsides, start moving like hell. Pull out all the stops. Don’t let things stiffen. You’ll make a lot of scar tissue–that’s inevitable–but the scar needn’t be tight or restrictive. You can remodel it to make it amazingly soft and loose. It’s really up to you.”

Silence. But I could almost hear the wheels in her brain churning furiously.

From beneath the surgical drapes came the sound of Kathy clearing her throat. “Doctor, it’s me again. How long do I have to stay in the hospital?”

“Not long, Kathy,” I said. “Just long enough to be sure your pain is controlled and there’s no infection brewing. Maybe a day or so. Maybe less.”

“I want to leave as soon as I can. But Jeff will want me to stay. He’ll insist, I know.”

“Up to you, Kathy. Do you have an ally, someone who sees things your way who can influence him?”

“My mom. She’s a feisty lady. Been through three husbands, all dead now. Their doctors will say they had terminal illnesses, but I know better. Mom just wore them out. You’ll like her.”

“I do already. Anyone who can survive such a pile of misfortune and stay sane has earned my respect. At the very least, she’ll have perspective.”

“She also has a filthy mouth. I hope you’re not easily offended.” I laughed. “There are few enough words in this language· to say what you want to say. I believe in using everything you’ve got.”

“She and Jeff don’t get along too well. He has rules and he plays everything by the book. She doesn’t.”

“Kathy, I’m a prisoner of human biology. I don’t have a magic wand. I didn’t invent the limitations of the flesh I’m stuck with. Nature has a two-million-year head start on me, and I can’t simply change those rules for anyone’s convenience. Not Jeff’s, not anyone’s. Healing will progress at its own rate. In a young, normally nourished person like you–yes, you’re well nourished in spite of the pizza–the rate is already optimal and no chemical, herbal or pharmaceutical, can speed it up.”

I knew she’d like my conclusion. “Only your hand is sick. The rest of you is fine. I see no reason why you can’t go home.”

“You’ll tell Jeff I can? He might listen to you.”

“Only if he’s not pissed off at me for not replanting your fingers. But I write the orders. If I kick you out, there’s not much he can do. If you were married, he might have more of a say.”

“Yes. Well, that remains to be seen.”

Far be it from me to participate in a lovers’ squabble. I finished applying the bandage, and a sobering bandage it was. There was no hiding the loss of the three missing central fingers. An optical illusion, I was convinced, exaggerated the visible space between the thumb at one end and the small finger at the other.

Kathy’s mom was waiting for her.

“So. The master pizza chef returns, after a hard day in hell’s kitchen. Now that you’re finished rearranging the pieces of your hand, do you have any other recipes you want to try? Only, skip the ground meat. It’s not healthy. Stick to vegetarian.”

“Look Ma, I didn’t plan this. It was just one of those things.” “Yeah, right. A crazy fling. But now that your trip to the moon is over, flit over here with your gossamer wings and give your mom a hug.” Kathy smiled, tears welling up in her brown eyes, and grabbed her mother, careful to keep her bulky white bandage elevated, the
missing fingers evident by the wide space between the small finger and thumb. Their hug was fiery, passionate, clutching. Desperate? Change is stressful, and both were dealing with enough tragedy to keep them busy for a while.

Jeff fidgeted in his chair, took shallow short breaths and looked pale. Excusing himself quietly, he fled to the room’s bathroom and shut the door. Above the whoosh of the air conditioner I could hear the unmistakable sounds of retching and liquid dropping into the toilet.

Jeff, still pale, returned to his chair wordlessly. His discomfort wasn’t lost on Kathy. “I’m sorry my bandaged hand bothers you so much. Don’t I at least warrant a hug?”

“You and your mom seem to have everything under control. I didn’t want to insinuate myself into your tender scene.”

“Cut the bullshit, Jeff. Are you going to support my little girl in her time of need, or not?”

“Well, Verna, of course I am. It’s just we all do it in different ways.”
“Right now, I think Kathy would appreciate loving physical contact. You do believe in physical contact, don’t you?”

“Look. I’m doing the best I can to deal with a complete assassination of my plans. This is a heavy blow. A heavy blow. You do understand.”

“Do I? I understand you’re a selfish asshole who doesn’t give a piss for anyone else. Hard as it is, Kathy’s going to deal with this, with or without your help. She’s going to have my help, whether she asks for it or not. She’ll learn new ways to do everything she did before. Knowing her, she’ll amaze us. But then, she’s an amazing young woman. I wonder if you appreciate what you’re getting.”

Jeff smiled a grim smile. But there was no warmth in it.

“Of course I do. And you’re right. It will be hard.” Jeff looked at me. Did I detect a sneer on his lips?

“Incidentally, I called Franklin right away. He was noncommittal about the advisability of replantation. But he wasn’t willing to come in, or to send in his team. So I guess we had an answer, of sorts.” Jeff rubbed his eyes with the back of his hands. “Well, Doctor. What happens now?”

“Kathy stays overnight. Then she gets to go home.”

“That’s ridiculous. After all, she did undergo a major trauma.”

“She’s reliable. I trust her to take her temperature and report back to me. But there’s no dead tissue left, she’s on antibiotics, and the pain pills work fine, so I don’t expect any problems.”

Verna piped up. “Kathy will stay with me. We’ll have a fine time.”

Neither Kathy nor Jeff voiced an objection.

“Then it’s settled,” I said. “I’ll write the orders. Verna, you’ll bring Kathy in to see me for a dressing change next week?”

“Will do. In the meantime I intend to shower her with physical contact. I’m her mother, and rank hath its privilege.”

As I left, Kathy and Jeff were looking warily at each other. From a distance.

The adjusters at the insurance company fawned over Kathy and, in an effort to minimize their liability, promised her the moon. They were willing, almost anxious, to send her to France that summer to have Jean Pillet, one of the world’s most respected prosthetists, fabricate a cosmetically superb hand for her. Figuring her mom would be better help there than Jeff, she had no difficulty wangling a free ticket for Verna. The two extended their stay for a few weeks and had a grand time.

On their return, I got to see the prosthesis. As anticipated, it was a work of art. The texture was soft and resilient, fleshlike with color variations flawlessly matching her left hand. There was a second prosthesis–it is Pillet’s custom to make a second, wintertime one, partly to use as a spare in case something happens to the first one, partly to account for seasonally induced fluctuations in hand skin color and complexion. The fingernails were superbly crafted and were made to accept a variety of polishes. The thumb web space, the wrinkles over the joints, the pattern of veins, all done with the sensitivity and skill of a Rodin.

Kathy showed it proudly to her friends, used it for a couple of weeks, then put it in storage and forgot about it.

It wasn’t that she was ungrateful. Her lawyers worked out a generous settlement, including funds for her future education and vocational training, so she was comfortably set. It was just she wasn’t the least bit self-conscious about her missing fingers. If anything, she was proud of what she had painstakingly learned to accomplish with what was left of her dominant right hand. And, as with everything, she improved with practice.

It never occurred to her to hide her hand. It was out there, for all to see. If you didn’t like it–well, that was your problem, wasn’t it?

Even Jean Pillet is bluntly realistic about his prosthesis. Motivation, he says, is “the attitude of mind which gives the amputee the will necessary to achieve a good functional result.” A prosthesis should never be referred to as an “artificial hand.” In his view it is not “a rival substitute for our marvelous hand.” Even in this era of technological triumphs, a true hand substitute is beyond our reach. Luke Sky walker’s new hand in Star Wars is pure science fiction. As Pillet says, “There is no miracle prosthesis.”

Writing was a special challenge for Kathy. She supported the pen over the back of her small finger, holding it in place with pressure from her thumb. But the position was only for starters. Her graceful flowing penmanship was a source of special pride for her.

“It’s all in the wrist,” she told me with enthusiasm. “See? I can make a pen jump through hoops. You told me I could soften the scar if I really worked at it. So I did, and I did. At first my hand got tired, but it’s toughened up a lot. I’m in school full-time, so I do a shitload of writing. Oops. I sound like my mom.”

“How is Verna? I haven’t seen her in a long time.”

“She’s fine. Just as profane and irreverent as always. I don’t know where I’d be without her support. Making my hand work the way I wanted it to was damned hard. I’ve had my down moments, but she’s such a positive person she always picked up my spirits. I couldn’t give up.”

“What about Jeff? I haven’t heard you mention him.”

“Jeff decided superficial appearances were more important to him than what’s inside. We could never make it work. Not now. He’ll find a Valley girl to trot off into the sunset with. Me, I’ve got work to do. And I’m seeing other young men who are interested in me, in developing a sustaining relationship with me,” Kathy threw up her arms, palms open. ”I’m not helpless. I can really do quite a lot. I really can. I hold up my end as well as anyone.” Red-faced, she hid the moisture forming in her soft eyes.

“Hey–I don’t need convincing. I know what you’ve accomplished. I’m a believer.”

“Don’t get me confused with women in James Bond movies. I’m not into martial arts stuff. At least, not yet. But what’s fair is fair. I don’t expect any special treatment. Just equal treatment. Piss on employers who hire perfectly formed but functionally inept warm bodies. Give me a performance-oriented boss any day. I do my job. Period. Just give me a chance to show my stuff.” Kathy jutted her chin upward and threw out her chest. She turned so I couldn’t see her wipe her eyes.

How could I tell Kathy she was what made it all worthwhile?

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After I read Arnie’s book, I listed the techniques I realized he uses to draw me into the situations he is describing, allowing me to learn about hand surgery while rooting for his patients. In the case of Chapter Ten, this means rooting for Kathy and feeling angry with her fiancé:

Setting – As I begin to learn about Kathy, I do not immediately know that she has come to the doctor’s care via the emergency room. Instead, I am introduced to her through her astute surgeon’s eyes; he brings in the background to her injury by mentioning that the personality characteristics of the young woman he is treating fit well with her job as a cook in a pizza place. We start to see the emergency room setting with sparing descriptions: medics, Teflon corkscrew laying in a pan with Kathy’s deep flexor tendon wrapped around its threads, other fingers floating in a plastic bag. I am upset envisioning the injury, but I know just where I am and whose life is at stake.

Dialog – The exchanges between Jeff and the doctor and between Jeff and Kathy, between Kathy and the doctor and Kathy’s mom and Kathy build tension, teaming up the “good” guys against the “bad” guy, Jeff. We cheer for Kathy, feeling she is in good hands with Dr. Arem, and since she’s told the doctor about her mother’s strong spirit, we are very happy to get to witness it ourselves through the dialog included in the story. Each character sounds distinct. We can identify them by their concerns and speech. They sound like people in a tense and dreadful situation, trying to appear strong: Kathy as a lively, I-can-do-this person, her mom as not even thinly veiled in her dislike of Jeff, Jeff as someone who can’t yet admit that he won’t be able to continue on with Kathy as his mate, and the doctor as someone who is responsive to his patient’s needs.

Narrative – The flow of events through time is clear: The doctor assesses the personality and physical condition of his patient, makes decisions regarding her needs, observes the fiancé, motivates her to work hard to strengthen the dexterity of her remaining fingers, agrees that she doesn’t have to stay in the hospital long, realizes that Jeff will not like this action, and wonders what will become of their union. Later, he learns about the insurance settlement, Kathy’s progress, her break up with Jeff. At the opening, the doctor sees a levelheaded young woman who is calm and competent. At the end, he sees the inner emotions and the struggle she is admitting to vis-à-vis the way others treat her now. He sees the joy she has in finding men to date who see inner beauty and strength; he sees the sadness she feels at being turned down by some employers because of her injury. The writing includes a looping back to the opening by contrasting Kathy’s visible vulnerability with the “cool” and in-control veneer at the opening. I believe this change reveals that she and her doctor have grown close in the way two people involved in an important life challenge do.

Character Descriptions – We learn about Kathy from the way the doctor was filled in and from his observations. We learn about Jeff from his own dialog. We learn about Kathy’s mother from Kathy’s words to the doctor, assuring him how her mother will be a great support for her. We learn about the doctor from the knowledge he shares, the decisions he reports, the observations he makes, his understanding that Jeff’s concerns do have some basis, and his beautiful ending question, “How could I tell Kathy she was what made it all worthwhile?” No matter the method of delivery, each character description includes vivid images we can hold on to. Jeff’s lips are drawn back into a grimace exposing perfect white teeth below a thin brown mustache. Kathy’s bandage is staining bright red. The hug she and her mother share is fiery, clutching. When Jeff is in the bathroom there is the sound of retching and liquid dropping into the toilet. The doctor describes the brain that controls the fingers as a “master puppeteer.” To treat amputation of fingers, he says, is to deal with a functional lobotomy, walk through a minefield diffusing bombs, smooth ragged ends. His language portrays his knowledge, empathy and skill.

Author Commentary – Well-placed author commentary carries readers on through the story and allows them to get to know the doctor, as well as the situation. “If you care about results, though, amputation is one of the most complicated and demanding operations in a hand surgeon’s repertoire.” “Jeff’s speculations were relevant. His attitudes may have been juvenile, but his observations weren’t.” “I knew she’d like my conclusion.” “Far be it from me to participate in a lovers’ squabble.” “Even in this era of technological triumphs, a true hand substitute is beyond our reach.” The commentaries do not repeat what the dialog and narrative have already told us. They allow the doctor, with a light hand, to keep us focused on the impact of this injury and trauma.

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Readers learn more when information is part of a story about people they can identify with, even if the readers haven’t been in the characters’ particular situations. As authors, we make this happen when we use our five senses to create believable experiences on the page and when we describe how we process what is important to notice.

If you have wanted to write from your expertise in a field, take a lesson from Arnie Arem. Choose an encounter with someone or an event in your career and describe a time that you succeeded (or failed) in accomplishing an important task.

Start at a moment of crisis. Let the people involved talk for themselves. Help readers notice what is significant in the peoples’ appearances and in the setting they are in by showing them what you see and hear through your trained eyes. After you show what you notice, fold in more of your knowledge of the field you are writing about. The story you will be telling will prove to be about those you have worked with as well as about your own expertise.