Jacob M. Appel is a bioethicist and fiction writer. He holds a B.A. and an M.A. from Brown University, an M.A. and an M.Phil. from Columbia University, an M.D. from Columbia University's College of Physicians and Surgeons, an M.F.A. in creative writing from New York University, and a J.D. from Harvard Law School. He has most recently taught at Brown University in Providence, Rhode Island, and at the Gotham Writers Workshop in New York City. He publishes in the field of bioethics and contributes to such publications as the Journal of Clinical Ethics, the Journal of Law, Medicine & Ethics, and the Bulletin of the History of Medicine. His essays have appeared in The New York Times, The New York Daily News, The Chicago Tribune, and other publications. Appel has also published short fiction in more than one hundred literary journals. His short story, Shell Game With Organs, won the Boston Review Short Fiction Contest in 1998. His story about two census takers, "Counting," was shortlisted for the O. Henry Award in 2001. Other stories received "special mention" for the Pushcart Prize in 2006 and 2007.

Question: How do you pursue creative writing on top of two other careers?

Jacob Appel: Well, I think part of it is the importance of viewing them as separate careers. I think there are some writers who view writing and practicing medicine are very much interrelated and they write short stories about medicine or **** by medicine, some of them are very talented. Perri Klass comes to mind, Ethan Canin comes to mind, for me they're two very separate animals. And I view my occupation as being a bioethicist. And any extra benefits or extra blessing I get from being a writer, I'm very happy to have but if it doesn't work out, I'm not devastated by it. And in some ways that makes it easy to do, I know I can step back from it and go to the hospital and do my job and I haven't abandoned something that is essential to my well being.

I don't have to earn a living as a writer, which makes being a writer both more interesting and more pleasurable. That being said, my wisdom to anybody out there who is thinking about become a writer, and I tell all my writing students, is that the vast majority of success as a writer comes just not from persistence, but relentlessness.

I have recently reached a point where I have now more than 20,000 rejection letters. I don't know if 20,000 rejection letters is a record for people submitting small journals, but it shouldn't be because anybody else out there who wants to be a successful writer should also accumulate 20,000 rejection letters. The most successful writers I know, even those who are doing well who have several good books out still submit to small journals, still submit articles and reviews, get rejected, pick themselves off of the ground and fight back again.

Question: How do you persist in spite of so much rejection?

Jacob Appel: Well it's interesting, I actually did an interview a couple of years ago where 11,000 was the number, and I have a nice little journal where I keep track of every submission I have made, and if I ever do become a more successful writer, which is not a guarantee, but if I do, some day somebody will have my journal and be able to see exactly every submission I have made. And I've gotten some horrifically discouraging rejections. I've gotten rejections that say things like, "Not only will we not accept this story, but please never submit to us again." Or, "Consider this a preemptive rejection of anything you might write in the future." And the way you deal with that, on the one hand, is to know that writing is very much a matter of taste. And once you have a certain number of acceptances, you can say to yourself, I know I've gotten 20,000 rejections, but I've gotten over 100 acceptances, so somebody must like what I'm doing. And the other half of it is to realize that the same story that may be rejected by numerous journals, or numerous periodicals can then be accepted, which shows that someone else shares your sensibility.

One example I cite frequently is, I had the honor and privilege of a story of mine called "Shell Game With Organs" receiving an award from the Boston Review about a decade ago; my first significant literary honor, actually more than a decade now. It was rejected by more than 75 journals before I finally placed it; some of them rather unceremoniously, which suggested that it wasn't the shortcoming of the story, but simply a failure of the story to match the taste of a particular writer. I also urge people submitting stories to write a cover letter that convinces whoever the intern or college student first reading your work that you are somebody important enough that they shouldn't pass up on passing this letter on to the next stage.

The story I always tell, I was once a screener, at one point, I worked for Congressman Ted Weiss down here in lower Manhattan back in 1980’s. And I screened all of his phone calls, and the poet, Allen Ginsberg called to congratulate him on a recent election and I didn't believe it was Allen Ginsberg the poet, so I told him to write a letter and hung up on him. And about 10 minutes later he called back on the Congressman's private line and I nearly lost my job. Your goal is to convince whoever has the role like mine at a literary agency that you are important enough to get through to the boss.

Question: Should writers change their work based on rejections, or have faith in it as it stands?

Jacob Appel: I think you just have to have faith. I often make changes to the work based on acceptance. The editor who will call me and say, "We loved your story, but we had trouble with the ending." We are still thinking about publishing it, will you change the ending. Now, that's someone who is invested enough in the story, but I'm willing to say, maybe this person has a point and I'll go back and take a look at it and often, I will make changes. I think one story that comes to mind was a story of mine, "Grappling," that appeared in Stories South a couple of years ago about alligator wrestling. And the editors there, Jason Stanford particularly, were excellent advisors who said, "We loved your story, but you should really change the order of the scenes. And they were dead on. The advice I give young writers is never take advice from anyone that doesn't have a vested interest in your future. Once an editor says, we might publish the story; they have a vested interest in your future. The editor that sends you a note that says, we're not publishing your story and it's no good for the following reasons, has no vested interest in you and you take their wisdom with a grain of salt.

Recorded on March 1, 2010

Interviewed by Austin Allen