Nonfiction: Essays on Medicine, Writing, and Making Things

This section is where I write in my own voice about the work behind the work. The health articles elsewhere on this site are meant to be practical and steady, the kind of thing you can read the night of a new diagnosis. These essays are different. They are about motives and craft. Why a physician spends his evenings writing short books for patients. Why the same person would start a game studio. What medicine has taught me about making things, and what making things has taught me about medicine.

I don't think those pursuits are as separate as they look on a resume. They all come from the same place: curiosity, a habit of paying attention to how systems behave, and a stubborn belief that people deserve clear explanations and good experiences, whether they are sitting in an exam room or picking up a controller.

Writing for people, not for other doctors

A lot of medical writing is written for other clinicians. That makes sense. It needs to be precise, and it assumes a shared vocabulary. But the person who just heard the words "high cholesterol" or "diabetes" for the first time is not reading journal articles. They are trying to figure out what this means for their week, their family, and their future.

That gap is why I write the patient guides and other books I publish as J. Wayne Saul MD. In why I write medical books for patients, I go into the thinking behind the Your New Diagnosis series and Heart Strong: what a short appointment can and cannot do, why something you can reread at home matters, and why a book should support your relationship with your own doctor rather than replace it.

If you are looking for the practical side of that same idea, the health articles are the place to start. The essays here explain why those articles are written the way they are.

Medicine and play

People are sometimes surprised that a doctor runs a game studio. I understand the reaction. Medicine is serious, and games are supposed to be fun. But the longer I've done both, the more the overlap shows. Good clinical care and good game design both depend on systems thinking, feedback loops, and real empathy for the person on the other side of the experience. Both require you to test your assumptions, watch what actually happens, and adjust.

I write about that overlap in why a doctor makes video games. It covers why I started Mirrorshard Studios, what play means to me, and what it is like to build independently from Arkansas instead of from one of the usual industry hubs. If you want to see the projects themselves, the Mirrorshard games page has the current lineup.

Building from Arkansas

I care about where I work. Arkansas is home, and I think there is something worth saying about building things here: books, games, companies, and opportunities for the next generation. You do not need to move to a coastal city to make something good. You need time, focus, a little nerve, and people willing to try what you made and tell you the truth about it.

Being a physician-founder means splitting attention between very different kinds of responsibility. Clinical work leaves no room for carelessness. Creative work needs room to experiment and fail. Learning to hold both, and to keep them from bleeding into each other in the wrong ways, is an ongoing project. Some of these essays are me thinking out loud about how that balance works, and where it doesn't.

Craft notes

I'm interested in how things are made. How you take a complicated medical topic and make it readable without making it wrong. How you decide what to leave out. How you set up a game world so that its rules feel fair and its surprises feel earned. How you pace a story so the reader keeps turning pages.

Those questions show up across everything I do, so they will show up here too. Some essays lean toward medicine and plain-language writing. Others lean toward design and storytelling. If you are more interested in the fiction side, including notes on my techno-thriller and on worldbuilding for the games, head over to the fiction section.

What you will not find here

These essays are not medical advice. When I write about medicine here, I am writing about how I think about communication and care in general terms, not telling you what to do about your own health. That conversation belongs with your own doctor, who knows your history.

You also won't find hot takes or productivity hacks. I'd rather write a few honest pieces that hold up over time than a stream of quick ones that don't. The aim is to be useful to a particular kind of reader: someone curious about how a doctor thinks, someone who writes or builds things and wants company in the process, or someone who simply wondered how all these projects fit together.

Where to start

• If you have a new diagnosis or love someone who does, start with the essay on writing medical books for patients, then visit the books page.
• If you play games or make them, read why a doctor makes video games, then look at the Mirrorshard Studios projects.
• If you love stories, the fiction section collects behind-the-scenes notes and craft essays.

New essays will appear here as I write them. Thanks for reading, and for being curious enough to wonder why one person would try to do all of this at once. Honestly, I wonder about it myself sometimes. Writing these pieces is part of how I figure it out.