As a longtime New Yorker staff writer Rachel Aviv has covered some of the more fascinating topics in mental health: what happens when people reject their diagnosis, the challenges of going off psychiatric drugs, and whether suicidal students should be forced to leave college campuses.

In one of her latest stories, “Mary Had Schizophrenia and Then Suddenly Didn’t,” Aviv examines a phenomenon that doctors have only recently begun to uncover: Some people who experience psychosis are misdiagnosed with schizophrenia when in fact they have treatable autoimmune conditions that attack the brain. 

Earlier this month, Aviv’s story was named a Pulitzer Prize Finalist in Feature Writing for its “extraordinary exploration” of two daughters’ search to understand why their mother was relieved of her 20-year-long psychosis and what it was like to observe her recovery. 

Aviv said she was surprised when the piece was selected as a finalist, largely because of the challenges she had writing it. “Of all the stories I've written in the last however many years, it had been the one that caused me the most grief in terms of the actual writing process,” she told me. “I had structured it one way, and then maybe five days before the piece closed, I just felt like the structure was not serving the story as well as it could, and I was in a state of despair.”

With her editor’s support, Aviv restructured the story — a process she explains in greater detail in the annotation below. As I heard her recount this last-minute pivot, I was reminded of the value in acknowledging when a story’s structure isn’t working as well as we hoped and acting accordingly — even when it requires a last-minute scramble.

The final structure that Aviv arrived at reflects a masterful blend of historical context, immersive reporting, and rich source materials that help us see how a single diagnosis can alter the course of a life and shape one’s identity. Several related questions drove Aviv’s reporting, both in terms of the science behind a new category of illness referred to as“autoimmune psychosis,” and the family at the heart of the narrative. 

“There were the scientific questions, which were pretty straightforward: Is this real? What is happening? Why don't we know about this? Why has it taken so long? How many people is this affecting?” Aviv told me. 

“And then there were the more personal questions of: What is the experience of a mother who has been in another reality for an entire lifetime for her children, and then they're coming back to her as this person who is suddenly sane? What does that feel like to be returned to consensual reality, both for the person who has been ill and for the people who loved her and couldn't relate to her in that previous state? How do you rebuild a relationship when your past feels so split in terms of perspective and memory?”

The story’s driving questions and themes dovetail with Aviv’s bestselling book, “Strangers to Ourselves,” in which she writes about the limits of psychiatric explanations and the ways in which people can feel trapped or freed by stories of mental illness. Aviv’s next book,“You Won’t Get Free of It: Stories of Mothers and Daughters,” comes out this summer. 

To learn more about Aviv’s writing process and interest in psychiatry, I asked her to annotate her award-winning story and offer a behind-the-scenes look at how it took shape. Her responses have been lightly edited for length and clarity. 

Mary Had Schizophrenia—Then Suddenly She Didn’t

By Rachel Aviv, The New Yorker (July 21, 2025)

When Christine was nine years old, her mother, Mary, said, “Come here. I want to tell you a secret.” They sat on a brown couch in their living room, in Santa Ana, California. Mary, who was forty-three, said that a man she had known in medical school, a professor, was sending her messages about a plan to take her away and live in a mansion together. “I remember feeling really excited, because that fit with my sense of what should be happening,” Christine said. “I was really into ‘Harry Potter’ and the idea that, if you are part of the select, you can see a bigger story happening out there.” 

Mary leaned over and began separating strands of Christine’s hair, as if searching for lice. “Does he put listening devices in your hair?” Mary asked, about the professor. “Does he ever ask you to say things to me?”

Christine, the older of two sisters, said, “I believed everything she said until she accused me of something that I knew wasn’t true.” Mary had always been tender and doting and practical, and, Christine said, “I just had this feeling in my body that she was not the same.” [annotation q="MT: How did you find Christine and Angie as sources?" a="RA: I had read a story in The Washington Post about this center at Columbia University where they were looking for other conditions (often autoimmune conditions) that were masking as more typical mental illnesses."] [Read the Washington Post story.]

[annotation a="I had called the center and just talked to them about the work they were doing, and I remember thinking they were doing something that felt close to a paradigm shift in psychiatry. Having covered psychiatry and written about it for many years, I thought it felt very new. I had asked them if there were any current or former patients who might want to speak. They got back to me and said that Christine had been wanting to tell her story."]

Her sister, Angie, who is seven years younger, learned to follow their mother’s instructions, whether or not they made sense. “I was taught the rules of her delusions at the same time as I was taught other rules and norms about the world,” Angie said. She came to view her mother’s stories about the professor, and about friends who were part of his mission, as akin to tales in the Bible. “It’s kind of like, O.K., some of these people are real, and some of these people aren’t real,” she said.

Christine was often cast in the role of the villain. Her mother would yell at her for poisoning her pizza or hiding her keys or other menacing deeds, even as Christine tried to explain that she hadn’t done them. Sometimes Mary smacked her. (Mary doesn’t remember this.) [annotation q="I appreciated this simple sentence, both because it shows the reader early on that you spoke with Mary and because it signals the importance of being transparent about memories that don't align. Why was it important to you to include this line?" a="The story felt like it was so much about memory and perspective in general. One of the most traumatizing aspects of this experience for Christine and Angie was that they felt like they were living in a reality that was very different from their mother's reality, and that their complaints for years couldn't be validated. And then they had gotten to this point when I met them, where their mother was lucid and receptive. And anytime they would mention something that had been painful for them, she would be encouraging them to share what that experience had been like."]

[annotation a="But it felt like they could never quite figure out whether she was in denial or evading painful experiences, or whether she truly had some sort of cognitive dysfunction where she could not remember. That felt like the trickiest part in the whole piece — having conversations around this memory hole."]

[annotation a="As we continued with our conversations over the course of a few months, I think we all had a clearer sense of the contours of that hole and what it was that she couldn't remember. And then toward the end, we started really talking about the actual things in that hole. There was a way in which their mother would say, 'I don't remember this' (but not as a way of saying 'I didn't do that.') And so I think with something as serious as a mother smacking her child, it felt important to make it clear whose memories these were."] Christine began to mistrust her own memory, too. “My mom would accuse me of things, and then I’d be, like, Maybe I did do these things,” she said. In fifth grade, she asked Santa Claus for a polygraph machine. [annotation q="This detail made me think about how, when reporting on people's childhoods, it could be revelatory to ask: What did you want for Christmas when you were X years old? Did you ask a question along these lines, or did this detail come about more organically?" a="That wasn't my question. That was something Christine told me about how unbearable it was to feel like her mother was doubting her — she had an excruciating desire to prove to her mother that she was reporting reality honestly. The polygraph detail captured so much about Christine's desperation — if only she could prove to her mother that she wasn't doing the things her mother was accusing her of."] “I just had this baseline sense of: I could be doubted at any time.”

She felt that people might help her mother if she could just find the right language to describe her transformation. By high school, she was spending so much time studying the Diagnostic and Statistical Manual of Mental Disorders that she texted a friend that she had actually “married the dsm-iv.” [annotation q="Did you ask to see the text messages? For this story, how did you go about establishing trust so that Christine and Angie would will feel comfortable sharing personal correspondences with you?" a="They had read the previous New Yorker piece I had written about Alice Munro and the sexual abuse that was hidden in her family, and it actually had resonated with them previous to even my getting in touch. I think they were familiar with my approach, and that helped a lot. Christine had this archive of childhood materials that she'd been keeping. She jokes that it was like she had been waiting her whole life for a fact checker. She had sent me a Word document of the diary she had been keeping from that time, and she had included the text conversations in that diary."] She explained that her mother suffered from the “fregoli delusion,” a belief that strangers were disguised as doubles of people she knew. In her journal, Christine wrote, “My mom has erotomanic delusion disorder with a splash of persecutory delusions.” She asked for help from teachers and a school counsellor, but, she said, the “message I got was, basically, Everybody has their shit, and you have to just deal with it and keep getting good grades.”

Mary, who was from India and had worked as a physician there for a decade, spoke so much about the professor that her husband, Chris, who worked at the California Department of Motor Vehicles, eventually found the professor’s number and called him. “He said, ‘I am not in contact with her,’ ” Chris recalled. “ ‘I didn’t even know your wife came to America.’ ” At the professor’s suggestion, Chris scheduled an appointment for Mary with a psychiatrist. Christine sat in the waiting room, hoping that this would be the beginning of getting back the mother of her early childhood, whom she remembered as a “magical, glowing figure.” But when Mary finished the appointment she said that the psychiatrist thought she was fine. Not long afterward, Mary kicked Chris out of the apartment and barricaded the door with a desk and two heavy suitcases. Christine and Angie allotted extra time to get to school each morning so they could remove the obstacles.

Karl Jaspers, the German psychiatrist and philosopher, has described what he calls the “delusional atmosphere,” a profound alteration in the way certain people experience the world. “There is some change which envelops everything with a subtle, pervasive and strangely uncertain light,” he wrote. People in this state search for a story that explains why everything suddenly feels uncanny and ominous. The “vagueness of content must be unbearable,” he wrote. “To reach some definite idea at last is like being relieved from some enormous burden.”

Mary had landed on a story that overwrote the reality of her daughters’ lives, but they also recognized in it a kind of emotional logic. Mary had been pressured to marry Chris, in an arranged match, and, when they settled in America, he had traditional ideas about a woman’s role and restricted her freedom to pursue her career. Christine and Angie came to feel that their mother’s delusions—that her former colleagues would free her from marriage and she’d be restored to her place in the medical community—were “a way of explaining how she ended up trapped in this position,” Christine said. “We theorized that psychosis was almost a reasonable response.”

Christine moved to New York after high school, because her favorite book, “Underworld,” by Don DeLillo, was set there, and because it seemed like the city where people went to escape their homes. She lived in the Bronx, near her father’s brother, and got a job at Planet Hollywood. She wanted to be a novelist, and obsessively re-read “Underworld,” covering the pages with determined annotations: “integrated dialogue”; “meta commentary”; “sensation of young immediacy.” [annotation q="This is another great example of how you use source materials to fill in gaps and add color to the piece. Did you ask to see her copy of the book?" a="She was in London at the time, so she just took photos of her book. I thought it was so interesting that ‘Underworld’ had been such a meaningful book for her, and I couldn't quite see the line of continuity in terms of her own life. So I did ask her a lot of questions about what that book meant to her. In general, I always love to know what people are reading at particularly pivotal moments in their lives."]

Angie and her mother would text Christine asking for groceries or pizza, and she would order the food for them from across the country. Mary was still barricading the door. Chris slept in his car. (Eventually, he moved in with a girlfriend.) Christine worried that Angie, who was eleven, was growing up in a kind of folie à deux, a delusional system that structures two lives. Angie said, of her mother, “I could never figure out why she was doing these things to me, and I had this kind of emotional explanation: Other things are just more important to her. I’m only there as a vessel for the magical thinking.” After about a year, Christine arranged for her mother and Angie to move to New York, too. (Mary asked me to use only her middle name, to protect her privacy.) [annotation q="Why did you think it was important to heed this request and protect her privacy?" a="Because she was sharing very private medical information, as well as medical records, which made her feel vulnerable."]

Mary moved into an apartment in the Bronx, in the same building as her brother-in-law, and plastered the walls with tape, to prevent reality-TV shows from recording her and Angie through the cracks. Angie tried to bathe while her mother was asleep because Mary believed there was a camera in the showerhead, and had covered it with a sock. Angie felt as if she were living in a kind of urban version of “Grey Gardens,” a formative movie for her. The documentary chronicles the lives of a mother and daughter, relatives of Jacqueline Kennedy Onassis, who live together for years, piles of trash accumulating around them, social conventions becoming remote.

After two years in New York, Mary seemed increasingly unable to care for herself, so Christine, who had enrolled at Columbia, called the city’s mobile crisis unit, a team that assesses people in psychiatric distress. The crisis unit knocked on Mary’s door, and, after a conversation in which she described receiving electric transmissions through a filling in her tooth, she was admitted to Mount Sinai Beth Israel hospital, in Manhattan.

Psychiatrists there petitioned a judge for permission to hospitalize her for a month and treat her with antipsychotics, over her objections. “I believe that she has no judgment concerning the nature of her illness,” one of them wrote. On an evaluation form, another psychiatrist initially wrote that Mary had an “unspecified psychotic disorder.” Then, perhaps uncomfortable with such a vague diagnosis, she crossed out the phrase and wrote, “Schizophrenia.” [annotation q="This detail that really illustrates the uncertainty surrounding Mary's illness. Can you talk about how you happened upon this detail, and why you knew it needed to be in the piece?" a="I think I saw it upon second or third read of her medical records. The first time I didn't quite grasp how interesting it was that the psychiatrists needed to get her committed against her will, so they were looking for a diagnosis that was serious and concrete enough that, from a judicial perspective, they could justify committing her. And then they had given her this diagnosis, and it seemed like no one had re-evaluated it. Once she had that diagnosis, it just stuck, and that seemed really tragic. It stuck for a decade."]

[annotation a="There is this sense that you're being told schizophrenia is somehow part of your essence, when actually it's part of this arbitrary bureaucratic process where a psychiatrist has to come up with something in the spur of the moment, and schizophrenia feels like the least worst match."] Mary was fifty-five years old, and her symptoms had begun in her early forties, which is unusual for schizophrenia. Most people are diagnosed in their twenties or early thirties.

Christine moved into her mother’s apartment and filed a petition for joint custody of Angie. Their father, who was living in California, did not contest the petition. “I make breakfast in the morning,” Christine wrote in her journal, describing her new routine with Angie. “I wash the dishes. I lock the door at night. I have established, kicking and screaming, my own rightful place as an active agent in the universe.” [annotation q="You effectively used journal entries here, and I've seen you do it in other stories as well. When you read Christine's journal, what were you looking for as a journalist? And why do you think journal entries can be so effective in stories?" a="We discussed it fairly early. Over the course of a few conversations, Christine sent installments. Some of her journals were written for a class at Columbia, and I felt like I was looking for the less ‘written’ parts."]

[annotation a="There was a way in which, for her class, she was seeing herself as a writer seeking meaning from a hard situation. And in some ways, I was more interested in the rawer, less processed moments that she could not convert into meaning right away. Retrospective writing or talking can't capture that immediacy."]

[annotation a="I did tell her that I would check to make sure she felt comfortable with what I decided to quote, because obviously it's a very vulnerable thing to just hand over your journal."]

When Mary was released from the hospital, she stopped taking her medications. Neither she nor her daughters thought they had helped her. For about a third of people with schizophrenia, antipsychotics do not work. “I wish my mother’s delusions and paranoia were treatable,” Angie wrote, in a college-application essay. “However, she has lived with them for 12 years, and her institutionalization last year had no effect.”

Mary’s admission to Beth Israel was the beginning of a nine-year cycle in which she was sent to psychiatric hospitals for weeks at a time before being released, unchanged. Mary said that each time she was admitted to a hospital the staff “kept asking the same questions, and it never made anybody have a different outlook on the situation. Everyone stayed with the same thing. It was schizophrenia.” [annotation q="This is the first time we directly hear the words ‘Mary said.’ Was it a deliberate choice on your part to initially tell her story through her daughter's voices before introducing us to Mary's voice?" a="Somewhat, and I think there was also the issue of Mary actually not remembering. I was telling their perspective, and if I had told it from Mary's perspective during those years, it would have been very different and more confusing because her memories of that time were jumbled. I felt like it was more coherent to just start with the daughters' perspective and then bring in Mary's perspective once she's chronologically in a state where she is more lucid and able to acknowledge the difference in her daughters' experiences."]

[annotation a="In that way the structure reflects the experience of the daughters: they had a mother who was unreachable in some way, and then with this sort of accidental cure, she becomes reachable. That's the moment at which Mary enters the story and has more of a speaking presence."]

After five hospital stays, including one in which the police led her to an ambulance in handcuffs because she wouldn’t leave her apartment, Mary was transferred to the Bronx Psychiatric Center, a state facility that provides long-term care. She observed that when patients refused medications staff would sometimes call security, and the patients would be injected with drugs, a prospect that terrified her. “I would take the medication without any question, because I’m not risking fighting with security,” she told me. “These people are very sensitive to what they call ‘challenging authority.’ ” She spent her days dreading the moment when she’d be forced to swallow her pills.

Mary sometimes imagined that God had a reason for keeping her in the hospital, but, she said, “I did not even want to go there, because the reasoning mind makes you feel very nervous and uncertain.” Her daily life became so narrow that she stopped noticing the weather. “They don’t remind you about the changing season—that spring is coming into summer or the winter is coming into spring,” she said. “You just pass the days as quickly as possible.”

Christine, who spoke to her mother every week, said that Mary never articulated her sorrow at the time. “I would have wanted to engage on the level of ‘I’m sorry you’re there, do you feel sad?’ And I’m sure she was having those emotions, but she wasn’t able to express them. It was always ‘I’m being attacked. I’m being held like a prisoner here.’ ” Christine felt that her mother was safer at the Bronx Psychiatric Center than she would be anywhere else, but she felt guilty for hoping that Mary would stay there for the rest of her life.

Mary was discharged in September, 2023, after a year. [annotation q="Reading this made me wonder: Did you create a timeline of events when working on this story? And can you talk more about the structural challenges you faced?" a="Any time I write a story, I'm always writing down the dates that are relevant and creating a timeline. I had originally started the piece with Mary's cure and then had gone backwards into her daughters' childhood. But then the cure felt less meaningful without the context of understanding what they'd been through in their childhood. But if I started with their childhood, the reader had to wait a long time to discover what this story was actually about — so that was the dilemma, and I basically emailed my editor, Willing Davidson, asking him if it was OK to try switching it up last minute, and he encouraged me to try."]

[annotation a="Usually when I'm writing a piece, it's the structure that I figure out first. I had to rework it all at the last minute, and that was an uncomfortable experience."] A week later, she collapsed in her bathroom and struggled to move. She was taken to a hospital in Brooklyn, where the doctors told her to stop taking antipsychotics, because they thought her condition may have been a side effect of the drugs. Then they discovered that she actually had lymphoma, a sometimes fatal form of cancer. She began seven cycles of a treatment that combined chemotherapy with rituximab, a medication that targets antibodies involved in the body’s immune response.

When Christine and Angie visited her at the hospital, Mary responded to their questions with one-word answers. Her face had a vacant expression. Christine and Angie thought she was dying. Mary did, too. She dreamed about being a child, playing with her sister and four brothers, in Kolkata, where she grew up. “I told myself, ‘This must be the end of it,’ ” Mary said.

Angie, who was now twenty-two and had recently graduated from Dartmouth, prepared in therapy for her mother’s death. She said, “I had multiple sessions where I was just crying about the fundamental things I wish she had given me, like ‘I wish she could have told me what was going on in her head,’ or ‘I wish she could have told me she was sorry for what she did.’ ”

By Christmas, two months after beginning chemotherapy, Mary was moving a little more freely, and she had begun to carry on conversations. Christine and Angie noticed that her personality seemed different: she was calm, outgoing, and polite, and she often expressed gratitude. Angie texted Christine that Mary seemed peaceful, as if maybe she was “getting some post-life or death clarity?”

Christine, who was twenty-nine and had settled in London, having moved there for a master’s degree in psychology, was struck by her mother’s ability to watch the news and absorb the information on its own terms. For years, the television had been a source of agitation; Mary had said that people were using her ideas and repeating her lines.

One day, when Christine was visiting the hospital, Mary asked for a phone. “I sort of teased her, ‘Now you’re asking for a phone?’ ” Christine said. “I wasn’t really making much of it, but then afterward I thought, Why has she asked for a phone? That’s quite unusual.” Mary already had a phone, but it was in storage because she’d told Christine that it contained spyware.

Angie gave her a flip phone and, to be safe, covered the camera with a piece of tape. “She seemed fine using it, which was odd,” Angie said.

In May, a month after Mary finished chemotherapy, Christine and Angie asked a psychiatrist at the hospital to examine her. Christine said, “The psychiatrist was, like, ‘Why have you called me here? I don’t understand. She has no symptoms.’ And we were, like, ‘Yeah, that’s the reason we’ve called you here.’ ”

Christine had the same feeling in her body that she’d had when her mother first became ill—the sense that something at Mary’s core had changed. She tried to get the doctors to grasp the scale of her mother’s recovery. By the summer, her cancer was in remission. She hadn’t taken antipsychotics for months, and yet “her psychotic symptoms are gone,” a doctor wrote. Christine told the doctors, “She had a twenty-year psychiatric history. Have you heard of this? Could any of her medications have caused this?” She spoke with a neurologist at the hospital, but he didn’t have an answer. Omid Heravi, one of Mary’s oncologists, didn’t understand what had happened, either. “Medicine is very specialized—we don’t get involved in other fields,” he said. He guessed only that one of the cancer drugs she’d been given had had collateral benefits. “In medicine, all side effects are not bad,” he offered.

When a person recovers from an illness, it is usually seen as the end of the story. [annotation q="This line made me think about one of my favorite lines from your book ‘Strangers to Ourselves’: ‘There are stories that save us, and stories that trap us, and in the midst of an illness it can be very hard to know which is which.’ What compels you to want to explore the narrative aspects of illness and recovery?" a="I think I had to justify why the story wasn't ending with this unlikely recovery, but why it kept going. I had to explain that what I was interested in was not just, 'here we have this amazing new way of seeing mental illness,' but also, 'here's an opportunity to understand what recovery means.'"]

[annotation a="We don't often get to see recovery from psychosis in this way, and, at my editor's suggestion, I was trying to alert the reader that there was still a third part coming — that there is real work to be done, after you've recovered from a long illness, to make sense of what has just happened and to integrate it into your sense of identity."] But becoming sane also causes a kind of narrative collapse, a confrontation with a personal history that is no longer recognizable. Christine encouraged her mother’s friends and siblings, whom she’d been estranged from for years, to get back in touch. She wanted to restore her mother’s sense of connection, but, she said, “I also wanted them to be able to tell me—outside of my childhood memories—if this is the person she used to be.”

For years, Christine’s friends had known little about her mother beyond the details of her mental illness. “Suddenly, I was, like, ‘Hey, my mom’s better now. Would you like to call her up and talk to her?’ And that was a shocking concept for them,” she said. “I mean, there are a lot of people who wouldn’t necessarily be open to jumping on a call without planning, but my mom was now the type of person who is quite flexible and responsive and conversationally fluid.” Christine described her as a “psychological débutante.”

Angie, who was living in Queens and working at a firm where she analyzed data on sexual violence, felt skeptical that their mother’s transformation was real. Christine said, “I felt like, If Mom can disappear, then she can come back.” But Angie didn’t have memories of Mary from before the illness, and it felt to her like she was being asked to believe that her mother had become a new person. “I tend to choose security over the process of discovery,” Angie told me. “I didn’t have a curiosity that felt worth the emotional risks.” Angie had always felt that, on some level, her mother had “chosen her delusions” over her children. She didn’t want to experience that choice being made again.

Christine searched for medical papers that might explain her mother’s recovery and allow Angie to believe in it. She read about each of the medications that her mother had taken and concluded that the key drug may have been rituximab, the immunosuppressant. “I have a new working theory,” she texted Angie, in May, 2024. “Theoretically her chemo could have incidentally cured” her.

Christine found a handful of recent case studies that documented drastic psychiatric recoveries after people were treated with drugs that dampen immune activity. A 2017 study in Frontiers in Psychiatry described a woman with a twenty-five-year history of schizophrenia. She also had a skin disease, for which she was given drugs that reduced inflammation and suppressed her immune response. Her doctors noticed a pattern: when they treated her skin lesions, her psychosis went away. They hypothesized that the rash and the psychosis had been caused by a single autoimmune disorder, and were cured by the same drugs. Another paper in Frontiers in Psychiatry described a man with “treatment-resistant schizophrenia” who developed leukemia. After a bone-marrow transplant, which reconstituted his immune system, he startled his doctors by suddenly becoming sane. Eight years later, the authors wrote, “the patient is very well and there are no residual psychiatric symptoms.”

Christine also discovered a Washington Post article from 2023 about a woman named April, who had fallen into a catatonic state at the age of twenty-one and been diagnosed with schizophrenia. Sander Markx, a professor of psychiatry at Columbia, first encountered April at a psychiatric hospital on Long Island when he was a medical student; twenty years later, he was dismayed to find her at the same hospital, in the same condition. “She has not been outside for twenty years—out of sight,” he said, at a symposium at Weill Cornell’s medical school. He and his colleagues gave her an extensive workup and found that she had lupus, an autoimmune disorder that, in rare cases, can induce inflammation in the brain, causing symptoms that are indistinguishable from those of schizophrenia. After undergoing immunosuppressive therapy, including rituximab, April emerged from, essentially, a “twenty-five-year-long coma, and was able to tell us everything,” Markx said. “We don’t have a script for this. We don’t see patients coming back from this condition.”

April’s case helped give momentum to the founding, in 2023, of the Stavros Niarchos Foundation (S.N.F.) Center for Precision Psychiatry and Mental Health, at Columbia, which is working to uncover biologically distinct subtypes of illness that have been obscured by the broad categories in the DSM. Christine sent an e-mail to Markx, a co-director of the S.N.F. Center, with a brief time line of her mother’s life. “Her psychiatric symptoms disappeared and have yet to resurface months later,” she wrote. “But her current clinicians are stumped as to why it has happened.” When Markx didn’t respond, Christine, who was visiting New York, decided that she and Angie should go to Columbia to introduce themselves in person. Markx wasn’t in his office—he had just begun an ongoing medical leave—but they slipped a handwritten card in a pink envelope under his door and used inter-campus mail to send cards to the other directors of the center. They tried to think of this step, Angie said, as “the part in the documentary where the cameras go all shaky and you get the sense that someone is about to break a hole in the case.”

Emil Kraepelin, who developed psychiatry’s first modern diagnostic system, in the eighteen-nineties, defined the disease we now know as schizophrenia largely in terms of its hopelessness. [annotation q="Throughout the piece, you sprinkle in historical context related to the field of psychology. Do you outline your pieces ahead of time to figure out where to include context and research?" a="I go through every single note I have, whether interview, research, whatever other personal documents, and then over the course of several days I go from top to bottom and place each relevant detail or quote or fact into the section that I think it will appear in."]

[annotation a="When I then go to write, I am starting with all the material that I think will go in the first section. So that's how I structure it, and it always changes it, but at least I'm working with more contained material as I move to each new section. I'm always thinking about, when is the moment when the reader in the narrative needs and actively desires some context?"]

[annotation a="With this piece, there was so much research and context that I wanted to put in, and I wanted it to occur at the moment in which the reader actually wanted it, as opposed to too early when they're not ready to do that kind of work without the narrative, or not too late when they needed it earlier to understand something."] The diagnosis allowed hospital administrators to separate patients with “periodic insanities” (like depression and bipolar disorder) from those who were believed to be incurable and belonged in asylums. Kraepelin hoped that schizophrenia would eventually reveal itself to be a disease like neurosyphilis, which was then responsible for a large portion of the cases of insanity in psychiatry wards. In 1913, scientists demonstrated that bacteria had infected the brains of these patients. “The diseases produced by syphilis are an object lesson,” Kraepelin wrote, four years later. “It is logical to assume that we shall succeed in uncovering the causes of many other types of insanity that can be prevented—perhaps even cured—though at present we have not the slightest clue.”

Psychiatry and neurology were originally one medical discipline, but gradually neurologists took responsibility for diseases like neurosyphilis and dementia, in which the pathology could be seen in an autopsied brain, and psychiatrists handled the illnesses that were left behind, their causes still a mystery. [annotation q="I like that your transitions never feel forced or overdone." a="I guess the ideal situation is you do not need a transitional sentence, because you've structured the paragraphs in such a way that it feels fluid. I actually never want to find myself in a situation where I'm like, 'my job right now is to write a transition sentence,' because that sort of means that I'm juxtaposing two things that don't flow together naturally."] Schizophrenia, which affects roughly one per cent of the population, became the disorder through which psychiatry worked out its identity, in part because it seemed to embody the mystery and intractability of madness, presenting basic questions about what it means to have a self. “The history of modern psychiatry is, in fact, practically synonymous with the history of schizophrenia, the quintessential form of madness in our time,” the psychologist Louis Sass has written.

But psychiatrists struggled to pinpoint a single feature that unified the diagnosis. “The great question is what is this ‘something’ that underlies the symptoms,” Karl Jaspers wrote, in 1963. [annotation q="You do such a good job of including research that advances the storyline. Can you pull back the curtain on your process for finding relevant research for this story?" a="I spent a long time just trying to even find the small field that I was looking at and figuring out who the people who specialize in it are. So a lot of that was just searching for any terms related 'autoimmune.' Then I noticed there were a couple of researchers who had honed in on this area, and then I called them and asked them for reading recommendations."]

[annotation a="And then there's historical context, which in a way is more fun, because it's like, 'OK, now that I know what the current research is, what sort of lines can I trace in terms of the history of psychiatry?' There are certain thinkers (Karl Jaspers is one of them), and I'll think: What would they say about whatever issue I might be thinking about? I'll often look up and see if they have ever written about the issue."]

[annotation a="For this piece, because the research area was so new, a lot of it did come from interviews with researchers and then asking them to point me to whatever the most relevant recent specific research was. It often involved a very small sample size."] Three decades later, the psychiatrist Ian Brockington warned that the obsession with schizophrenia had stifled clinical curiosity. “Smaller, more homogeneous entities have been sucked in by the gravity of the big idea, and annihilated,” he wrote. For decades, scientists have been searching in vain for a biological marker that would confirm whether someone has schizophrenia. Last year, in a paper in Schizophrenia Research, seventeen international experts concluded that schizophrenia was defined by no single etiology, symptom, or biological mechanism. “It is prudent to wonder if the construct around which we are organizing this information is fundamentally flawed,” the authors wrote.

Perhaps the most vivid disruption to the idea of schizophrenia as a monolithic concept began in 2007, when Josep Dalmau, a neurologist at the University of Barcelona, started publishing papers with his colleagues which described young patients with delusions, hallucinations, and sudden changes in their behavior, like agitation and inappropriate giggling. Within days or weeks, they deteriorated, developing seizures, losing consciousness, or struggling to breathe. Dalmau discovered that they had a form of encephalitis, inflammation of the brain. Their immune systems had misidentified the NMDA receptor—a protein in the brain that affects mood and memory—as foreign and produced antibodies that attacked it. When these patients were treated with immunotherapy, the majority of them recovered completely, sometimes within a month.

Thomas Pollak, a neuropsychiatrist at King’s College London and the Maudsley Hospital, told me that treating patients with the condition was “revelatory and disquieting, because some of them looked exactly like the people I’d been seeing in the psychiatry ward. It was uncanny to see that a presumably totally different pathway could lead to this.” Their illness, which was named anti-NMDA-receptor encephalitis, usually began in their early twenties, just as schizophrenia often does. The discovery of the illness put pressure on the artificial division between psychiatry and neurology—the only two fields of medicine that focus on the same organ. “Many of the symptoms are shared, but we are using different words,” Pollak said.

In “Brain on Fire,” a memoir from 2012, the journalist Susannah Cahalan—the two hundred and seventeenth person in the world to be diagnosed with anti-NMDA-receptor encephalitis—describes how for a month, in which she swung between paranoid aggression and euphoria, some doctors treated her as if she were just a difficult psychiatric patient who drank too much. “If it took so long for one of the best hospitals in the world to get to this step,” she wrote, “how many other people were going untreated, diagnosed with a mental illness or condemned to a life in a nursing home or a psychiatric ward?”

Since Dalmau’s discovery, scientists have identified more than twenty new antibodies linked to psychiatric symptoms. In 2020, in a paper in The Lancet Psychiatry, some two dozen researchers proposed a new category of illness called “autoimmune psychosis,” which may look like a milder or incomplete form of encephalitis, the illness never progressing beyond psychiatric symptoms. Christopher Bartley, the chief of a unit at the National Institute of Mental Health which investigates the role of immune dysfunction in mental illness, said that the twenty known antibodies may be a “drop in the bucket.” There could be countless targets in the brain that antibodies attack, some subset of which may alter people’s perceptions and behavior. “We have to have epistemic humility and accept that there are alternative models of disease,” Bartley said.

To find psychiatric patients who might benefit from immunotherapy, researchers have set up centers, roughly similar to the one at Columbia, at Baylor College of Medicine, in Texas; King’s College London; Uppsala University, in Sweden; and the University of Freiburg, in Germany, among other places. Some of the best research into the phenomenon has been conducted in Germany, where it’s more common for patients in a first episode of psychosis to have lumbar punctures to access their spinal fluid, which can reveal the presence of antibodies. Bartley estimates that between one and five per cent of people who have been diagnosed with schizophrenia actually have an autoimmune condition—a figure he based on his own lab’s research, which has not yet been published, and also on a German study of a thousand patients, the most extensive study of autoimmune psychosis so far. “Even one percent ends up being almost a million people in the world who should be treated with a different kind of medicine,” he said. [annotation q="I found this quote really helpful because it contextualizes a statistic and helps put it in perspective. As a journalist, what are you looking for when determining which quotes to include in your stories?" a="I really did want to make it clear that there were real stakes — that yes, this is very, very rare, but the worldwide implications are quite significant."]

[annotation a="With quotes, it's often question of, ‘What is someone else able to say that I couldn't say myself?’ either because it lends credibility or authority, or because there's a level of specificity or vividness, or emotional immediacy that just straight narration wouldn't achieve."]

The pharmaceutical treatment for schizophrenia has not meaningfully changed in three-quarters of a century. Many pharmaceutical companies have left the field entirely. To get approved for the market, a medicine that works for one schizophrenic patient must have a reasonable chance of working for another. But only blunt instruments have been effective in treating an illness that takes such varied forms. Newer antipsychotics are more refined than earlier ones, with fewer side effects, but almost all of them work in the same broad way, alleviating some symptoms, like hallucinations and delusions, but not other common ones, like lack of motivation and an inability to experience pleasure. Andrew Miller, the vice-chair for research in the psychiatry department at the Emory University School of Medicine, said that the field is haunted by the early success of antipsychotics, which were discovered by serendipity, in the nineteen-fifties. “You get lulled into this sense that, because the drugs are one-size-fits-all, the disease is also one-size-fits-all,” he said. “With autoimmune psychosis, it’s so clear that there is something different. And then you start to say, ‘Hey, is it possible that there are other clear-cut mechanisms to pathology that we’re missing because we’re lumping everyone together and saying they all have the same illness?’ ”

The S.N.F. Center is embarking on a project, beginning this fall, to screen all the patients hospitalized in the New York State mental-health system for autoimmune, metabolic, and genetic disorders, to see if there are people whose symptoms can be traced to a distinct biological mechanism. “I’ve always been aware of the possibility that there are treatable causes for psychosis lurking in chronic long-term patients,” Joshua Gordon, the executive director of the New York State Psychiatric Institute and a former director of the N.I.M.H., told me. “But the notion that we could make this work practically—that we could test for it—has really only become apparent in the last few years.” The S.N.F. Center will do blood work for everyone in the state’s psychiatric institutions, offering follow-up testing, such as lumbar punctures, to those with unusual results. Gordon said that, if the S.N.F. Center identifies a few dozen patients who can be treated effectively enough to leave the hospital, “we will be able to start answering the question of whether this is worth trying across the whole population of people with schizophrenia.”

Psychiatry has a legacy of implementing drastic procedures, like lobotomies, that later come to seem like folly. But it also has a history of proffering psychological theories for illnesses that are not yet understood on a biological level. Several psychiatrists told me that they’d found themselves rereading the history of the discipline, wondering, for instance, if some of those patients of Emil Kraepelin’s whose symptoms helped define schizophrenia might actually have had encephalitis or autoimmune conditions—specifically, a subset he described as having “spasmodic phenomena in the musculature of the face” and an inability to walk without falling. There were also questions about whether these diseases could explain a condition called “lethal catatonia,” which was frequently described as a manifestation of schizophrenia: these patients became extremely agitated, and then slipped into a stupor. In 1986, in a study that inadvertently revealed the dangers of conceptual inertia, the American Journal of Psychiatry reviewed nearly three hundred cases of lethal catatonia. Nearly all the patients in the study had been treated with antipsychotics, and more than half of them died.

After reading Christine’s description of her mother’s case, Steven Kushner, a co-director of the S.N.F. Center, arranged a meeting with her and Mary and Angie. Mary was living at a rehabilitation center in the Bronx while she regained her muscle strength. She was reluctant to meet another psychiatrist, she told me, but she felt she needed to “rise up to the level of my daughters’ studiousness.” In October, 2024, Kushner and three colleagues came to the rehabilitation center and spoke with Mary for three hours. “Her psychosis was gone,” Kushner said. “There was no other conclusion. There was no way that she could have the quality of the conversation that we had and willfully suppress psychotic symptoms.”

In the conversation, Mary recounted intimate details about her daughters’ pasts—what they would eat for breakfast, their arguments at recess—but she made no reference to the delusional beliefs that had dominated their lives. When Angie told the doctors that her mother had sometimes prevented her from going outside, even to do homework with classmates, Mary offered a practical explanation: there was crime in the Bronx, and she worried about Angie’s safety. To explain why she put a sock over the showerhead in her bathroom, she said that she’d hoped to filter sediment from the water. She seemed to have filled in gaps in her memory in a way that was consistent with her current identity, as a sane person. [annotation q="I noticed you've used the words ‘sane’ and ‘sanity’ at various points throughout. It seems these words used to be more commonplace than they are now. Why did they feel appropriate to use in this story?" a="I felt it was the plainest word to use in this context. I like that it does have a bit of an old-fashioned feel; I also like that it isn’t clinical. It describes a particular way of relating to and being seen in the world."]

In 1911, the psychiatrist Eugen Bleuler described how schizophrenic patients are capable of a kind of “double bookkeeping”: they may simultaneously live in two “disjoint” worlds, one grounded in shared reality, the other in private delusions. They might believe that they are the center of a conspiracy involving nearly everyone they see but also make small talk at a deli and remember to give the correct change. [annotation q="I appreciate how, throughout the piece, you introduce us to complicated concepts and then explain them comprehensibly. One of the ways you do this is by providing related examples that ground the concepts in everyday life. Do you have any tips for other journalists who want to take a similar approach in their own work?" a="I just found 'double bookkeeping,' to be a very beautiful idea. I've been drawn to it in a lot of different ways, but it's hard to understand."]

[annotation a="In general, I don't like examples that much because it takes you away from the narrative. But here, it's such a profound phenomenon that I thought a sentence would illuminate the strange contradiction in which people can live in two modes of reality, which I think all of us do in some way — but not with such starkness."] It’s as if the delusions occupy their own ontological category, sealed off from the logic used to move through the world. Now, when Mary recalls her decades of illness, it is as if she is accessing only the shared-reality side of the ledger. When she talks about her time at the Bronx Psychiatric Center, her memories sound like those of a person trapped in an environment where she doesn’t belong. “Angie and I treat it as if she had two selves,” Christine said. “But Mom describes her self as continuous.”

The S.N.F. Center arranged for Mary to have a lumbar puncture, to see if she had any antibodies associated with known neuropsychiatric conditions. During the procedure, Kushner said, he could sense that Mary had once had a “fantastic professional identity: she was holding court, telling stories about the lumbar punctures she used to perform, how many patients she used to see in a day.” The test came back negative. Kushner tried to recover a frozen sample of Mary’s cerebral-spinal fluid from when she was ill—a test done on that fluid would have been more revealing—but the fluid had been discarded. He believed that the most likely explanation was that she’d had a form of autoimmune psychosis for which the associated antibody has yet to be discovered. “I think the consensus is that we are probably only aware of the tip of the iceberg of different kinds of antibodies that can produce autoimmune diseases, and certainly that holds for autoimmune psychosis,” he said.

Some people, when they recover from psychosis, understand that the strange enemies who plagued them never actually existed. Others say that they are relieved their enemies stopped pursuing them, but do not disavow the reality of the experience. “We don’t know what happens for someone who was in a psychosis for twenty years and then they are—let’s call it ‘cured,’ ” Kushner told me. “And I hesitate to use that word, because the idea that this word is ever used in psychiatry is so exceptional.” But, he said, “the treatment modified Mary’s biology such that the disease is basically gone.”

Kushner began meeting with Mary and her daughters every few weeks, in part to help monitor for possible signs of relapse. At the meetings, they mostly avoided talking about Mary’s delusions. When the subject came up, Mary was quiet, or responded in a tangential way, changing the subject. “She has this extraordinarily pleasant way of disarming the situation,” Kushner told me. The thought of having caused her daughters suffering seemed too painful to allow into her conscious awareness. “There’s not an appointment that goes by where she doesn’t remark, spontaneously, that her daughters are doing well,” he said. “I don’t think that’s by accident.”

Kushner did not believe that Mary’s memory gaps reflected cognitive impairment—on a neuropsychological exam, her memory was better than average—but he also didn’t believe that she was purposely not remembering. “To look back and say, basically, ‘Twenty years of my life were out of reality’—that would be a fundamental blow to her identity as a physician and mom,” he said, a challenge to “one of our most primitive instincts, that we can discern what is real.” When I expressed concern about how to present the disparity in memories sensitively, he told me, “I think that is the story. How do you reconcile with, and compensate for, all those missing years?” [annotation q="This passage is striking, both because you're giving us a first-person, behind-the-scenes look at your conversation with Kushner and you're revealing the heart of the story (at least according to Kushner). I'm curious, did this conversation change or crystallize your thoughts about the deeper meaning and/or focus of the story?" a="I felt like I needed to know from him that it was OK to ask these questions of Mary, and I think Christine and Angie also needed to know that. We wanted to make sure it was safe for us to be thinking about this with someone who had been so vulnerable. And so it was very helpful to hear that Kushner, too, felt this was an integral part of the story, if not THE story."]

[annotation a="There was a lot of concern that it was this taboo subject, and that talking about it would do something harmful to their mother's mind. He really was like: No, it's OK, she can handle it; she's strong."]

When people emerge from chronic delusional states, the work of psychiatry is considered complete. They are largely left on their own, with two irreconcilable views of reality. “We need to really start thinking about what happens the morning after these disorders are treated,” Kushner said.

Christine wasn’t sure if she could call her mother “cured” simply because she lacked her previous symptoms. “She’s not fixated on things like contamination and surveillance, but at no point has she said she’s left those beliefs behind,” she said. Christine felt that it was taboo to talk to her mother about who she had once been. She suffered from the intrusive thought that if she confronted her mother with destructive things she had done, Mary would somehow revert back to the patterns from that time and become psychotic again. “It is quite a traumatized-kid thing to say, but I sort of feel like, How greedy can you get? Don’t look a gift horse in the mouth,” she told me.

Christine didn’t know how to have an ordinary conversation with her mother. For twenty years, Mary had been suspicious when Christine asked her questions about her life. Christine now felt like an adopted child “meeting my biological mom for the first time,” she said. She bought a book by an anthropologist called “The Essential Questions: Interview Your Family to Uncover Stories and Bridge Generations” to help guide their conversations. “It says, ‘Allow them to talk about what’s important,’ ” Christine said, reading from the book, during a visit to her mother’s rehabilitation center. “If no one has ever let you speak about yourself, it can be hard,” Christine went on. “You have to kind of—”

“Think,” Mary said.

“Maybe practice—gain your voice,” Christine said.

Christine, who recorded the conversation, began with warmup questions: “When you were a kid, what was your favorite activity?”

“Running,” Mary answered immediately.

“What did you like about running?”

“It makes you feel you have wings.”

“What is your favorite TV show?” Christine asked.

“ ‘Seinfeld.’ ”

“ ‘Seinfeld’!” Christine said. “What did you like about ‘Seinfeld’?”

“The absurdity.”

Every few weeks, they tackled a new theme outlined in the book: time, identity, body, belief, possessions, memory, fear. Initially, Mary answered in few words, but eventually she became much more expansive. During one session, she offered that her views on physical discipline had evolved: she no longer thought that smacking was acceptable. Christine said, “Without relating it to me or Angie, she sort of said, ‘That’s what we were taught when we were younger, but I don’t think that’s the right way to raise a kid.’ ” Christine felt that her mother may have been reflecting, obliquely, on what had happened in their home. “The ability to say, ‘I’ve changed my mind’ felt like as much as I could ask for,” Christine said.

For years, Christine had been documenting her life—keeping a journal, saving records, recording important conversations—to compensate for the fact that she, too, had blank periods in her memories, coinciding with traumatic events. [annotation q="Prior to picking Christine as one of your main sources, did you know that she had been documenting her life so meticulously? I'm curious as to whether you ever select sources based on the kinds of access you'll have to source materials like this." a="When she told me about the records she kept, that solidified my feeling that I could write a piece about her. Sometimes it's just not possible because there just aren't enough records or material, or you're relying so heavily on someone's memory that it becomes very hard. So that is definitely a large factor."]

[annotation a="With the piece I'm writing right now, for instance, there were many different subjects I could have chosen who had gone through a similar experience, but it was the person who had kept journals who I decided to focus on — and also the person who felt he had a story to tell and wanted to tell it."] She wasn’t sure if her mother’s breaks in memory—what she and Angie called “the missing years”—were different from her own. Recently, she had come across a proverb: “The axe forgets, but the tree remembers.” She felt that maybe she and her mother had reached an impasse that was actually universal—children have always formed their identities around blows that their parents don’t even realize they inflicted.

Angie felt less accommodating: “I’m happy that my mom is normal now, that we can have a deep connection and I can share my life with her. And, at the same time, I want justice for the child who was hurt by that other mother.”

Mary’s sister, Nima, told me that before her illness Mary was “very enduring, very patient.” Mary’s recommendations from professors at medical school describe her as “kind and sympathetic,” always “willing to shoulder any extra work.” When she came out of her psychosis, Mary returned to this dutiful version of herself. She and her husband, Chris, began speaking on the phone every day. Chris told me that he felt as if he were re-meeting the woman he had known in the early years of their marriage. “How come I lived all these years of darkness, and she suddenly looks normal to me?” he said. “She gives me comfort. She gives me emotional support.”

He asked her to do things, like travel to India to resolve a family financial dispute, that Christine and Angie found inappropriate. They encouraged Mary not to comply with the request. Mary had let go of her paranoia that everyone was targeting her, but they wished she could retain a wariness about people who had hurt her in the past. “Now that she’s better, you can see how the delusions protected her from people stepping on her boundaries—and she doesn’t have a replacement strategy,” Christine said.

Mary readily agreed to speak with me for this story, but she struggled to imagine that she could be anything more than a marginal presence in it. For years, she had described how people on TV were lifting ideas and plots from her life story. “It was like she was saying, ‘I’m important,’ ” Christine said. “ ‘I have value. I have things to say.’ And now we’re saying, ‘You’re important. You have value. You have things to say.’ And she can’t access that sense of deserving to be the main character.”

When I first met Mary, on a Zoom call with her and Christine and Angie, I asked if I could read her psychiatric records. [annotation q="This paragraph, and the two that follow, are so telling — in part because they reveal how trust evolved over the course of your reporting process. Why did you think it was important to 1.) highlight Mary's ambivalence and 2.) to insert yourself in the story while doing so?" a="I think because the ambivalence felt like it was so much a part of the experience — the experience of reckoning with one's life, and reckoning with the profound impact an illness has had on a person."]

[annotation a="I also felt it was expressive of Mary's love for her children — that even though she had these conflicted feelings about it, she really wanted to do it for her children. And I did feel like she cared about the scientific record and had an altruistic desire to help others. So I thought that working through the various dynamics that were both keeping her from wanting to look at those records, and then ultimately allowing her to share them, was part of the story."] She said yes but warned that they would be very boring, adding that she couldn’t remember any of her psychiatrists. “I left the memories long before I left the place,” she said. Christine suggested that we interpret this as her mother’s gentle way of saying no.

A few weeks later, Christine told me, Mary found a pile of psychiatric records in her room: “She was, like, ‘I don’t want to see them anymore, so Rachel can have them and can get rid of them.’ And I was, like, ‘Yes, Mom, but Rachel is a journalist. She’s not just a professional shredder.’ ” She said that her mom responded, “I just don’t want to see them myself.”

Mary seemed to be working out her ambivalence about her memories through this pile of papers. After speaking on Zoom every week for two months, Mary and I met at her rehabilitation center, along with Christine and Angie. [annotation q="How long did it take you to report this story?" a="I think my first conversation with Christine was maybe in late March, and then the piece was published mid-July. We were all talking (on Zoom and in person) regularly throughout that period."] Toward the end of our conversation, she stood up without explanation, walked to a cabinet, retrieved the psychiatric records, and gave them to me. “I felt like what happened was a miracle,” she told me. “If it will give anyone else confidence, I’ll go with it.”

There is almost no medical literature about the afterlife of madness, the experience of letting go of what Jaspers called the “definite idea.” Autoimmune psychosis raises the possibility of a swift, full recovery—a trajectory not typically seen in schizophrenia—and in doing so supplies a new category of witness: a person who can describe what it feels like to look back on a self that is, in some sense, defunct. And yet sanity does not mean that a person views the past without defensiveness or distortion. (To see too clearly can lead to a different kind of insanity, depression.) One of Christine’s fears was that, in talking with her mother about what she and Angie had been through, she would “rob her of the human capacity for denial.”

During one of my visits to the rehabilitation center, I asked Mary if she’d like to know how I was writing about her daughters’ memories of her illness, or if she’d prefer not to listen to that part of the story. Christine and I sat in chairs, and Mary sat on the edge of her bed, beside a wooden table on wheels that she used both for eating and as a desk. Mary quickly responded that she wanted to know what her children recalled. “I’ll go with that, because that way it will help me to remember,” she said.

“You remember things very differently, and it might be painful,” Christine said, gently. “Do you feel comfortable emotionally with that?”

“Yeah, go ahead!” Mary said. “I’ll remember like a mother. I won’t remember from your point of view.” She told her, “This is the best time for me to relate to these memories and make amends.”

Christine shared her first memory of the illness: sitting on the couch as her mother told her that the professor from medical school was in love with her.

Mary sat straight up on the bed, holding her arms over her stomach, staring intently at Christine. She had the bearing of a diligent student determined to pass a difficult test.

“You asked if they had ever put things in my hair so that”—

“Microphones,” Mary said quickly. “Microphones.” She said that the professor and his friends kept urging her to leave her husband: “They said, ‘Don’t worry about the in-laws and all—just move away and begin on your own.’ ” The friends were trying to help, but they were also harassing her, and she had no one to confide in. “I felt like she was supposed to be there for me,” Mary said, gesturing toward Christine. “But she was talking on behalf of my friends.” [annotation q="The dialogue here and in the next few grafs helps us to better understand how Mary and Christine interact. Dialogue can be a powerful tool, but only if it reveals something about the sources. How did you decide which lines of dialogue to include in this story?" a="I initially included a lot of dialogue because when I was there, I was amazed by the experience of Mary remembering and addressing directly these memories. It was so profound to sit there, and I felt so personally invested, that I initially included too much. My editor cut some of it, which was helpful because it made me realize I was spending too many sentences sort of reinforcing, layering onto, ideas or moments that could be revealed in one or two sentences."]

“You would think that I was repeating phrases that were said to me by other people.”

“I remember that very well,” Mary said.

“As a kid, I found it very hurtful.”

“I never blamed you,” Mary said. “But my classmates—I trusted them so much.”

“I was not in contact with your classmates,” Christine said, in a measured tone. “I would explain that to you, but it felt like you didn’t believe me at that time.” She asked, “Now that I’m older, do you trust me when I say they weren’t talking to me?”

Mary said it was possible that Christine had been reading her e-mails, rather than talking directly to the classmates, or that Christine’s father was the one telling Christine what to say. “She was very articulate,” Mary said. “She would do everything he would tell her.”

Mary explained that the feeling of being harassed—sometimes by people from her past, sometimes by strangers—continued until several weeks after her cancer diagnosis. “I felt like they were working through the doctors, and I had to take the chemotherapy just to hurt me and make me bald and make me lose weight and humiliate me,” she said.

But then, a few weeks into her treatment, her dreams became uncharacteristically pleasant. She kept dreaming of her sister and brothers, and they were so sensitive and loving that she thought maybe this was the prelude to a kind of heavenly afterlife. In time, the dreams began to feel more conscious, as if she were guiding the scenes herself. Lying in her hospital bed, she tried to recall details about her childhood home which she hadn’t thought about in years. “Whatever I could catch on to, I would collect,” she said.

Her reëmergence seemed to have occurred weeks before her daughters grasped what was happening. Her muscles were so weak that she couldn’t say more than a word at a time, and she wished she could communicate to her daughters, “I’m smiling. I’m all right with this.”

The thought that people were secretly trying to punish her hadn’t completely disappeared, but it felt distant, a relic of a different era. When the thought resurfaced, she said, “I take myself out of it, and I say, ‘It’s not my burden.’ I put the whole thing, like a gift basket, to God.” She’d been taught this coping mechanism as a schoolgirl, but until recently it hadn’t worked.

Christine felt both validated and disoriented by the idea that, between her and her mother, the facts were never really in question. “It is painful to hear that she still thinks I was spying on her all those years, but now she says, ‘I am so proud of my daughters—they take care of me,’ ” she said. “Maybe her interpretation is that through the power of forgiveness she can now interact with me as her loving daughter. So can I make do with that?”

For a year, Christine and Angie had been speaking on Zoom with a family therapist, to help process the changes in their mother. Recently, Mary had begun participating in the conversations, too. During a session, Christine suggested that the three of them begin a process of sharing grievances, each taking a turn. “There were different times when each of us was a flawed caretaker,” Christine said. She knew that her mother must have felt betrayed when she called the mobile crisis unit. Mary agreed: “I felt very let down because nobody trusted me enough to share that information.” Christine began by telling her, “I did my best, and yet I’m sorry I hurt you.”

Although Christine and Angie felt they had already worked out the conflicts in their own relationship, they tried “performing a kind of play,” as Christine put it: they shared resentments—Angie’s feelings of abandonment, Christine’s sense that Angie didn’t want her help—and then apologized, “so that at some point she can say the words to us.” Each emphasized that she didn’t think the other was a bad person, and that it was O.K. that they remembered things differently. They tried any exonerating phrase they could think of, “in case these might be the mental blocks for her,” Christine said.

Mary was enthusiastic about the process, but Christine sensed that she didn’t quite know what to say when it was her turn. A lifelong student of her mother’s mind, Christine had several justifications for her mother’s failure to respond in kind: she had not grown up in a culture where regrets were aired in this way; the inability to see her daughters’ perspective was a lingering cognitive symptom; in her fragile state, apologizing required a level of confidence she didn’t yet have. “At this stage of my life, I need to feel like my mother is back,” Christine told me. Later on, maybe in a few years, she said, “I’ll deal with the fact that it was an imperfect mother who was returned to me.” [annotation q="I found this quote so striking because it's both familiar and unfamiliar; many of us know what it's like to have an imperfect mother, but fewer of us can relate to the experience of having our mother ‘returned’ to us. I'm curious to hear your thoughts about this quote and why you decided to end with it." a="A few days before the piece closed, I still felt discontent with the way the piece ended, and I decided to call Christine and talk through some lingering questions. It was in that final conversation that she said the thing about having an imperfect mother returned to her. By that point I had a much clearer sense of the tension and uncertainty that the ending seemed to point to—I'd had a friend read the piece and she left it with certain questions, and I basically relayed those questions to Christine in that last conversation."]

***

Mallary Tenore Tarpley is a journalism professor at the University of Texas at Austin and the award-winning author of the new memoir SLIP: Life in the Middle of Eating Disorder Recovery. She publishes a weekly newsletter, Write at the Edge, featuring writing tips and best practices.

The post Annotation: Rachel Aviv on reporting and writing her Pulitzer finalist story about a schizophrenia diagnosis appeared first on Nieman Storyboard.

It started with a photograph. While doing research for an article about people trying to escape land during the pandemic, Sophie Elmhirst came across a website featuring a compendium of castaway tales from decades past. The stories were accompanied by photographs, mostly of lone men who had ventured out to sea. But there was one that stopped Elmhirst in her tracks: a black-and-white photo of a cheerful-looking woman and man. They were the only couple pictured.

“It touched various curious nerves, I suppose, and I was intrigued,” said Elmhirst, a longtime journalist.

She soon learned the incredible story of the man and woman, named Maurice and Maralyn Bailey. In 1972, the young married couple left behind their lives in England and set sail for New Zealand in their boat, the Auralyn. Nine months into their voyage, deep in the Pacific Ocean, a breaching whale struck and sank their boat. The couple was left adrift on a life raft and dinghy for seven arduous weeks and nearly died before being rescued in June 1973.

Journalists had covered the Baileys’ rescue at the time, but Elmhirst had never heard of them.

“It seemed like such an extreme, extraordinary story,” said Elmhirst, who’s based in London. “Obviously, it had been a big story in its time, but had just been completely forgotten. Or at least, whenever I mentioned it to anyone of my generation, no one remembered.”  

Elmhirst found herself wanting to change that. She started reporting on the Baileys’ story and uncovered so many details that she realized she had enough material for a book. What resulted was “A Marriage at Sea: A True Story of Love, Obsession, and Shipwreck,” a narrative nonfiction book that became a runaway New York Times bestseller. The New Yorker, NPR, TIME Magazine, Vogue and The New York Times all named it a Best Book of 2025.

“A Marriage at Sea” is gripping not just because of the story itself, but because of how Elmhirst tells it. The book reads like fiction, with a propulsive plot that situates us side by side with Maurice and Maralyn as they fight for survival.

Elmhirst has long appreciated true stories that read like fiction and was intrigued by the idea of approaching her debut book as “a nonfiction novel.”

“I wanted it to read as smoothly and as perceptively as fiction as possible, and for it to be really rooted in character and story,” said Elmhirst, who has spent the past 10 years of her career writing longform pieces. She knew that Maurice and Maralyn’s story warranted a book, and not just a longform piece, in part because of all the access and source materials at her disposal. Though Maurice and Maralyn had already passed away before Elmhirst began writing, some of their friends and family were still alive and willing to be interviewed.  

Elmhirst also had diaries, letters, photographs, old media coverage, documentaries, and the Baileys’ own books to draw upon. These materials helped her to not only accurately piece together the story of the shipwreck but to also explore a deeper layer of interiority — hard truths around who we become under the most extreme circumstances and how we find the strength to carry on.

As Elmhirst aptly writes, “It is not so much the feats of endurance that keep people alive, so much as the absence of surrender.”

There were many times when Maurice was ready to surrender, and he considered taking his own life. But Maralyn buoyed him. She persevered, holding steadfast that they would eventually be rescued. Elmhirst sensed this determination from Maralyn’s diaries, which were filled with practical lists and aspirational ideas about all that she would one day do once back on land. A journalist’s goldmine, the diary entries had been photographed and were freely available online.

“They don't necessarily give you what you hope diaries will give you, which is that great insight into the sort of heart and soul and mind of someone … but their limitations were also their strength,” Elmhirst told me. “I loved all of the extraneous stuff that was in them that I felt like was very reflective of Maralyn as a person — the drawings that she does, the menus that she writes out, the plans that she's always making, the references she makes, things she misses. I guess it's seeing a mind at work, actually.”

Elmhirst wove the journal entries and other source materials into her descriptions of Maurice and Maralyn so seamlessly that you can’t help but wonder if she was on the same voyage, witnessing every event firsthand. This firsthand feeling also stems from the writing itself, which is never wishy-washy. Instead of couching her descriptions with qualifiers (e.g. “Maurice must have thought,” or “Maralyn likely wondered”), Elmhirst wrote with authority about the Baileys’ thoughts, observations and actions.

“This was a stylistic choice. It was being given the confidence by my editor to do it in a certain way — to write that interiority,” Elmhirst said. “You’re not saying anything that didn’t happen, but you’re doing it in a mode where you’re seeing it through the characters’ eyes. I’m sure there would be purists who would say that I pushed that maybe a bit too far, but I felt like I had enough to go on.”

Elmhirst’s reporting helped her to accurately recreate immersive scenes. She visited the places where Maurice and Maralyn grew up, the bungalow where they lived after getting married, and the garden they tended together. She also spent a considerable amount of time by the water. She would sit by the ponds near her home in London, and during a trip to Wales, she found herself “staring at the sea and trying to find different ways of describing it.”

She even applied for a grant to help fund a sailing trip off the south coast of England so she could experience life on the water.  

“I did not get the grant, which is fair enough,” she said with a laugh.

Elmhirst is humble about the book’s success, saying it’s “so crazy” to see the response it’s gotten. Her work is one of the latest examples of books that take an untold or forgotten story from the past and report it out in the present. Other examples include the bestselling books “Hidden Figures” by Margot Lee Shetterly, “The Art Thief” by Michael Finkel, “The Boys in the Boat” by Daniel James Brown, and “Seabiscuit” by Laura Hillenbrand.

Elmhirst advises writers who want to pursue these types of books to look for shards.

“You don’t find it as a perfect crystal vase. You find shards, and you have to fit them together,” Elmhirst said. “You find a lot of waste material that doesn’t fit into the vase that you have to get rid of, and you do a lot of your own work to fill out the structure — to turn that shard into something.”     

When writing “A Marriage at Sea,” Elmhirst laid out all her shards on the page. She’s the type of writer who feels wedded to source material, so much so that she compiles her transcripts and notes into a long document and then starts writing around them. During the revision process, she finesses the story and puts it in her own words.

“It all comes together in the revision,” said Elmhirst, who kept photographs of Maurice and Maralyn propped up on the window ledge in front of her as she wrote. “I’m a real obsessive reviser; I go over and over it many, many times, and that’s when my best writing happens.”  

To learn more about Elmhirst’s process, I asked her to annotate an excerpt from the first chapter of “A Marriage at Sea,” which begins in medias res, with a scene of the whale crashing into Maurice and Maralyn’s boat. Below, Elmhirst gives us an inside look at the writing behind it.

Excerpt: A Marriage at Sea, Chapter 1

One 

4 March 1973 

Maralyn looked out at emptiness. There was little to see except the water, shifting from black to blue as the sun rose. A clear sky, the ocean, and themselves: a small boat, sailing west. [annotation q="MT: This line seems to foreshadow what's to come — the shift from time as automatic to agonizing. Would you agree?" a ="SE: I was very interested in how time changed in their story, from the ultra-regulated routine of their life on the boat to a kind of formless expanse once they were adrift. I think a large part of how they survived was Maralyn's insistence on maintaining rhythm and habit, structuring the shape of the days and the order of meals when it would have been easy to surrender to the nothingness of their existence. (She determinedly imagines their future too, never abandoning the idea that they had one — which was another way of contending with the black hole of time on the raft.)"]  

[annotation a="Anyway, here I think wanted to set up the notion of that rigid routine in order to almost immediately break it apart with the collision."]

At seven o’clock, Maralyn left her watch on deck and went down to the cabin. Maurice was still asleep in his bunk, stirring a little. The morning would follow the certain rhythms of every other morning: coffee and breakfast, then all the checks and jobs a boat requires. A formula so practised after months at sea that it had become as automatic as time. 

Except this morning, in the precise moment that Maralyn put her hand on Maurice to wake him, they felt a crack, a jolt, the sound of a gun going off, as if the violence had come from her touch. The noise split the air. Books leapt off the shelves. Cutlery flew. [annotation q="These first few paragraphs are so immersive. From a journalistic standpoint, how did you go about recreating this scene, and which source materials did you rely on?" a="I was lucky: I had access to rich material and there were multiple versions of this scene to draw on. First, I turned to their own written accounts in Maralyn's contemporaneous diary, their published book ‘117 Days Adrift’ and Maurice's self-published letters written much later in life, after Maralyn died. Then there were the versions they gave to the media in press and radio interviews and various documentaries over the years. Finally, their old friend Colin Foskett (who sailed with them on a subsequent voyage and appears in the book) showed me a series of incredible photographs that Maralyn took shortly after the collision — of their boat sinking and of Maurice in the raft. These not only gave me vivid detail but also a kind of atmosphere — the utter loneliness of their situation and the emptiness around them."] 

[annotation a="As for the immersion: I wanted the opening to be as dramatic as possible to throw the reader right into the centre of the crisis. But it took me a while, if I'm honest, to give myself the permission to write it like this. The voice seemed performative, almost anti-journalistic, in that I obviously wasn't there witnessing the scene myself. I knew it would require a leap of faith for me as a writer even though the nonfiction novel, or narrative nonfiction, or whatever you want it to call it, is hardly a new form. I'm a longtime fan of it as a reader, but new to it as a writer, and it felt distinctly odd at first and dangerously (and thrillingly) close to that wavering boundary between fiction and nonfiction. Nothing is invented, but it's a stylistic decision to unfold the action in this way, without constantly caveating it with reference to sources. I think it makes the experience more pleasurable and immediate for the reader — at least I hope it does — but you have to let go of some fairly fundamental journalistic habits and guardrails along the way."]

They thought of their boat as their child. To hear her wood tear and splinter was like hearing the pained scream of an infant. 

Up on deck, they discovered the cause. A whale was next to them in the ocean, massive and alive. Water was streaming down the dark cliffs of its body as it twisted and writhed. It looked as if it were trying to climb out of the waves, hauling its dark bulk up, then smashing back down, a meteor landing in the ocean, showering spray. Its tail, ten feet across the flukes, was beating at the surface in a kind of fury. Blood poured from its body into the water. 

Maralyn couldn’t understand where it had come from. She’d just been up here, waiting for the dawn, and seen nothing but a fishing boat when she’d taken over from Maurice at three. You don’t miss a whale. 

But perhaps you do. [annotation q="You use the second person really effectively here and in later chapters. Why did you choose to use it here?" a="I'm not sure the second person is a good habit, but I think I was instinctively trying to move from a distant narrative voice into a more intimate register, and also to sidle up a little more closely to both Maurice and Maralyn's interior worlds. I wanted their different reactions to the whale to reveal not just the particular ways they thought, but something of their character and tone: her great empathy for the whale contrasted with his instinct to categorize and deal in facts."] It must have risen from the depths just after she’d gone down the ladder and broken the surface right where they were. She couldn’t bear the thought that they’d somehow hurt the creature. It seemed uncanny that in the entirety of the Pacific this would be the spot it chose. 

What did it matter? There it was. A sperm whale, Maurice could tell, from the blunt, square block of its head. He knew his whales. It was forty feet long, he guessed; a good ten feet longer than their boat. 

This close, it was difficult to take in. Whales were best admired from a distance, like certain kinds of paintings. He could identify its parts—the blowhole, the lower jaw, the pectoral fin—but they didn’t seem to add up to a coherent whole. The creature was out of proportion, unnatural in its size. One rogue swipe of its tail and they would be cleaved in two. It was monstrous, he thought. Only compared with them. 

The whale was still thrashing, as if it were trying to shake something off, or escape its own body. It was dying, Maurice realised. These were its death throes. 

And then it was gone, sucked into the unknown darkness of the ocean. It would likely die down there, blood leaking into the water, alerting other creatures to its presence. Great whites and blue sharks would gather, rip it apart, and feast on its blubber. [annotation q="In this sentence, I sensed that you likely consulted research and literature about sea creatures, including the whale you write about here and the turtles that become pivotal later on. Did you do a lot of reading about sea life, and if so, how did you incorporate your findings in ways that would enhance the narrative rather than distract from it?" a="I read a mixed bag of ‘Moby Dick’ and two wonderful books by Rachel Carson on the ocean, as well as sailing manuals and accounts of Darwin's travels to the Galapagos. I also watched plenty of documentaries about the Pacific and its wildlife so I could see how the creatures moved in the water. It's tempting to pour all your wildly irrelevant research into a book, but that's why I like the discipline of story: I tried to only use the parts that supported the narrative, or colored in a scene. I don't know If I succeeded, but the aim was for the reader never to feel like they were being instructed. Or to put it another way, I wanted to avoid having those information-heavy paragraphs which as a reader I tend to skip over. (But maybe that's just me.)"]

They stared at where it had been, the surface marked by dissolving trails of blood. Such stillness, after a performance like that. 

𛲗

[annotation q="You have visible line breaks (in the shape of a wave) here and throughout each chapter, and they usually appear after a compelling line. Why was it important to you to provide so many breaks?" a="I think it's a desire for a little pause in time or space: to allow for a jump either in perspective or in the action itself. I find a lot of effort can go into connecting things in writing which don't actually need to be connected, and you end up with a sort of artificial arrangement, or a sense of meaning being forced to keep the narrative going when it would have been much simpler and more pleasurable for the reader to come to a rest, have a break, and then start afresh."] 

[annotation a="And yes: I like the effect it has on the line before the break. The space allows that final thought to reverberate a little longer. But I suspect it's a trick that can definitely be overused. Also, I wonder if it's a giveaway sign of a slightly nervous first-time author, who doesn't quite trust themselves to say what they want to say without landing on a line and building various bits of architecture and space around it on the page to hammer it home."] 

[annotation a="To be honest, it might also just be indicative of my short attention span — I like breaks as a reader as much as I do as a writer. My brain can only hold on to a thought for so long."]

Wait. The crack. Never mind the whale. [annotation q="You do a great job of varying your sentence lengths, which no doubt helps with pacing. Why the short sentences here?" a="I like variety, I guess, and especially here where a sense of pace and drama felt important. Short sentences helped create that feeling of urgency, but also of that tight feeling of a racing mind in crisis."]

Down in the cabin, water was already coming up through the floorboards. How long had they wasted up on deck, staring at the whale! Maralyn worked the pump while Maurice splashed around searching for the damage. There it was: a hole below the waterline near the galley, about eighteen inches long, twelve inches wide, the size of a briefcase. 

Maurice was shouting. Get the spare jib sheet. Clip it to the corner of the head sail. Lower it over the bow and drag it to cover the hole, then make it fast at both ends to secure it. The pressure from the ocean should force the sheet into the hole, plugging it. He adjusted the sails to keep the boat moving at about two to three knots, and they hurried back down below deck. 

Maralyn kept pumping, hoping the water level would now go down. But the sheet wasn’t working; the water kept rising. They needed a way of plugging the leak from the inside. Maralyn found clothes, cushions, and blankets and stuffed them into the hole. That didn’t work either. Perhaps there was another hole they hadn’t found. Some unseen damage where the water was pouring in. [annotation q="You use a fragment here and throughout other parts of the book. We're often taught (in school) to avoid fragments. But as we grow older and more experienced, we learn how to skillfully break with convention, as you've done here. Why do you use fragments, and how do you think they can be effective?" a="Ha, well, now is probably the time to admit that I was never taught writing in any formal sense — I didn't do a postgrad or MFA or a journalism course. So I don't have those kind of fixed rules in my head, which can be a good and liberating thing but also, at times, a bad thing... It means I write by ear in a way — and in this example I liked the slightly breathless, urgent pace a fragment gave to the narrative."] 

[annotation a="More generally, and as a reader, I like writing that can switch between registers, that isn't overly smooth or consistent, but almost reads like a more eloquent version of speech, or at least mimics some of the irregularities of how we speak and think. Fragments can help with that, but they're a trick that can be overused. I rewrote this opening section many times — it's often the way with openings — and the result can be prose that feels a little overworked, and quite staccato. Now when I read it, I wonder if it could do with some loosening up!"] It was too late to find it now. The water was up to their knees, and the cupboards were starting to spring open, unleashing their contents. Eggs and tins bobbed around them. They looked at each other. 

Maurice fetched the life raft and the dinghy, then collected as many freshwater containers as he could find. Maralyn waded round the galley, filling two sail bags with their things. Two plastic bowls, a bucket, their emergency bag, passports, a camera, a torch, their oilskins, her diary, two books, two dictionaries, and Maurice’s navigational tools: his Nautical Almanac and Sight Reduction Tables, his chart, sextant, compass, and logbook. 

They worked fast and in silence, strangely calm as the water rose. It wasn’t easy, gathering possessions from a vessel filling with ocean. Ten minutes, it took, to gather what they could. Then they climbed off the boat into the dinghy. 

Around them the Pacific was moving gently. Maralyn watched cushions she’d spent hours embroidering float away on the waves. Their boat settled low in the ocean, then lower. [annotation q="I appreciate how you zoom out here to show us the Pacific. You do this so gracefully throughout — zooming in so we can see Maralyn and Maurice up-close, and zooming out to show the vastness of the ocean. This gives your writing a cinematic effect. Why did you decide to zoom in and out throughout this chapter?" a="I think I felt about space similarly to how I felt about time: part of the challenge of this part of their story was to create a sense of the expanse around them, of what it would be like to wake up day after day to the never-ending, blank ocean. Their world was tiny, trapped on a raft, but it was also vast. And that strange contrast demanded a kind of varying perspective, between the micro-detail of their day-to-day existence and the endlessness of the night sky and the ocean. In a way, the only way you could understand how tiny and vulnerable and lost they were was to zoom right out until you could hardly see them at all. Having that sense of scale added another layer to the intimacy and claustrophobia of their life on the raft, and this was what interested me most of all — the idea of living in such inescapable proximity to your partner while surrounded by the terror of infinite empty space."]

Maralyn found her camera and took a picture of Maurice, who was sitting in front of her, shirtless. He turned back to look at her, every muscle of his back delineated under the harsh glare of the sun, wearing an expression not of fear, not yet, but of a kind of taut blankness, as if he had not quite grasped what was taking place, the sight of their boat tipping to one side as she sank in the middle of the ocean. [annotation q="Here we have a relatively long sentence. You could have just as easily written this as two or three sentences. Was the longer sentence intentional, and if so, what effect did you want it to have?" a="Yes, I like the way a long sentence can build and gather pace, as if it can create its own drama within its clauses. There was also something about burying that ‘not yet’ in a flurry of detail and observation — to not dwell on what was to come, but to gently hint at the bleak reality they were about to reckon with. I think I tended towards short sentences in the early parts of the book and while they were on the raft — they're good for action and urgency. But an occasional long sentence allows for a different mode and tone, more of my voice I guess, and something more reflective and expansive — it can open the narrative beyond the relentless unfolding of events."]

She went down so gracefully. The solid bulk of her hull, the deck, cockpit, sails, and ropes all quietly swallowed by the water. Maralyn took a picture as the last triangle of sail and the tip of the mast disappeared beneath the surface. Frozen in the photograph, the mast looked as if it might be coming the other way, emerging from the water like a thin arm hoping for rescue. [annotation q="This line felt transportive. After reading it, I could envision the ship's disappearance and feel the desperate hope for rescue. How did you arrive at this closing line?" a="I think this line appeared somewhere else in the book for a while, but as I struggled to write this part I kept returning to Maralyn's photographs. It was extraordinary to me that she'd had the presence of mind to take these pictures in a moment of such total personal crisis. Sometimes I think a first, gut reaction to the raw material is a better guide to what might work than the over-thought 20th draft, and my response to this photo was always one of total amazement that it existed and horror at what it depicted. There was always something almost human about their boat, Auralyn — the way they named her, talked about her and took care of her. Looking at the pictures of her sinking, I think it felt natural to turn her into a sort of being, to understand their loss as a human loss, and to see that final part of her disappearing as having a human quality — the arm reaching out."]

***
Mallary Tenore Tarpley is a journalism professor at the University of Texas at Austin and the award-winning author of the new memoir SLIP: Life in the Middle of Eating Disorder Recovery. She publishes a weekly newsletter, Write at the Edge, featuring writing tips and best practices.

The post Annotation: How Sophie Elmhirst wrote a bestselling nonfiction book that reads like fiction appeared first on Nieman Storyboard.

Over the years, I’ve gotten better at heeding Sir Arthur Quiller Couch’s advice to “murder your darlings,” or part with passages that don’t serve a story well. But rather than murdering my darlings, I prefer to metaphorically kick them out of the house and give them a place of their own.

That place is the “outtakes document,” where I keep a running list of phrases, quotes, scenes, and details that have been cut from stories I’ve written. There’s something about the preservation of words — and the reassurance that I can return to them whenever I want — that brings me comfort as a writer. 

This proved especially true when I wrote my forthcoming memoir, “SLIP: Life in the Middle of Eating Disorder Recovery,” which took shape over the course of many years as I worked to figure out the story I wanted to tell and how I wanted to approach it structurally. I kept a separate outtakes document for the book along the way, and it ended up being more than 40,000 words long. 

While revisiting the document, I began to wonder how other journalists use their outtakes. I’ve compiled related examples from my own work and from a handful of other journalists and authors, who have discovered how helpful it can be to hold onto cuts — and how hard it can be to let them go.

Having a safety net for overwritten copy 

In talking with other journalists who are authors, including Marshall Project reporter Shoshana Walter, I realized I wasn’t alone in having a lengthy outtakes document. Walter’s outtakes for her forthcoming book, “Rehab,” which will be published by Simon & Schuster in August, was also about 40,000 words. 

The book, which follows four people through different stages of treatment during the opioid crisis, required years of in-depth reporting that led to several hundreds pages of notes. Walter had so much material to work with that she found she needed to write her way toward a focus. Her book-writing process involved “word vomiting” onto the page, identifying the parts that strayed from the book’s focus, and then making related cuts that went into the outtakes document — or “scrap heap” as she likes to call it. 

“I could endlessly describe people’s stories and go into every nook and cranny of what happened to them over these many years of their lives, but I realized that not all of the material was in service of the point I was trying to make in the book,” Walter said. “Writing a book taught me to be less precious about what I’ve written. A lot of shaping what you’re writing and what you’re saying comes from cutting words back until you discover what you’re really trying to say.” 

Walter hasn’t repurposed any of the scrap heap, but she found comfort in maintaining it during the writing process. “I guess the scrap heap is like a safety blanket — like, I’m cutting this, but I don’t want to erase it off the face of the Earth completely. I still want it to be there in case I need it.”

New York Times reporter Elizabeth Williamson hasn’t repurposed any of the content from hers either. When writing her 2022 book, “Sandy Hook: An American Tragedy,” Williamson ended up with an outtakes document that was a whopping 100,000 words. 

“I actually wrote two books, contractually speaking,” said Williamson, whose publishing contract called for a 90,000-word book. “But that was sort of my strategy from the beginning. I just thought, ‘I’m going to write everything, and then I will go back and take stuff out.’” 

Many of Williamson’s cuts centered around one of the conspiracy theorists whom she had reported on extensively. Williamson had so much material on this one source that she couldn’t help but write about her at length. But during the self-editing process, Williamson ultimately realized that she needed to scale back.

It took her two-and-a-half years to report the book, about a year to fully write it, and only four days to edit out the 100,000 words. “I didn’t have a huge love affair with what I cut,” said Williamson, who put all of her cuts in the outtakes document. “I thought, ‘I will always retain this, and I might be able to use it.’ It’s the story you tell yourself.” 

Generating new ideas and stories

For a while, I wouldn’t look at my outtakes document; I feared I’d fall back in love with the copy and lament the fact that it wasn’t in the book. But about six months after finishing my manuscript, I revisited it and found myself drawn to a specific part: my book’s prologue, which I had cut in favor of having an author’s note instead. 

This was ultimately a smart editorial move, but I nevertheless hated parting with the prologue, which included an opening scene of my daughter looking in the mirror for the first time and a closing scene of what I see when I look in the mirror. Rather than letting those scenes sit in silence, I gave them voice in an essay about how I’m teaching my daughter to navigate body image as a woman in eating disorder recovery. The piece ran in the Tampa Bay Times in February and helped me further build the audience for my book. It also served as a reminder that outtakes documents can be fertile ground for future stories.

Freelance journalist Hannah Seo was reminded of this recently, too, after a quote was cut from her Guardian story about how GLP1 drugs affect people with eating disorders. The quote came from a source who talked about all the concerns that ran through her mind when she started taking GLP1s, including her fear of needles. The quote, which ended up in Seo’s outtakes document, led her to report on another story for Scientific American about why GLP1 pills hadn’t yet taken off. 

Just recently, Seo has begun organizing her outtakes into what she calls “ideation documents.” 

These ideation documents include cuts from previous stories, as well as names of potential sources and links to related research and coverage. As a freelancer, Seo has created an ideation document for each of her various beats: environment/environmental health, health and society, and social science. 

“Especially as a freelancer who works in various beats, my mind is always in so many different places. I think having things organized will really help me remind myself that, ‘Hey, I haven’t written about this topic in awhile. Let’s see what I have from previous pieces that could lead to a new pitch, or a new story,’” Seo said. “If your outtakes document is just there to kind of be a museum of all the artifacts of your brain, I don't think that's particularly useful. But if your outtakes doc is the soil for growing new ideas, then that’s really the best-case scenario.” 

Building a resource for other reporters and your future self

Longtime San Francisco Chronicle reporter Kevin Fagan has notes and outtakes documents dating back to 1978. 

“I have always taken outtakes very seriously,” said Fagan, who spent much of his career covering homelessness. “I still have boxes of categorized, organized files from nearly every major story I covered — and this was after having to throw away literally two full dumpsters of neatly filed folders a few years back when the editors got rid of all the filing cabinets in the newsroom and made us strip down.” At the time, he took 15 boxes of documents home with him for safekeeping.

Fagan, who retired from the Chronicle earlier this year and published his debut book “The Lost and the Found,” passed some of his outtakes on to other reporters in the newsroom with hopes that they’ll use them as an ongoing reporting resource. 

Fagan thinks back fondly of all the times that his past outtakes documents ended up being gifts to his future self. Once, for instance, he drafted a profile of Richard Allen Davis — the killer from the infamous 1993 Polly Klaas kidnapping and murder — through the eyes of the underground homeless and drug crowd that Davis hung out with. The profile ultimately didn’t run, so Fagan kept it in his outtakes document. Five years later, he repurposed it into a lookback story. Similarly, when covering the 1989 Loma Prieta Earthquake, Fagan kept all his notes and outtakes. When it came time to do a 35th anniversary story, he was able to repurpose scenes he had written, but never published, from the earthquake’s immediate aftermath.

“I was the only guy on staff who had actually been in the quake and covered it as a reporter. Everyone else was in diapers when the thing happened,” Fagan said. “There were victims I interviewed, and notes I took … that would have been impossible to find or recall decades later when I wrote anniversary stories on the quake.”

Outtakes also proved helpful when Fagan was writing his book, which offers up a deeply reported narrative of the homeless population in San Francisco. At one point, he referred back to a scene that had been cut from his “Shame of the City” homelessness series, which ran in the Chronicle in 2003. 

“When I needed it for rewriting into my book, I had the whole thing in my files,” Fagan said. “I save every cogent passage that gets cut from stories, or research that I just think might be useful, in case I need it later.” 

This approach can also make the editing process more efficient — especially for books, which typically go through multiple rounds of edits over an extended period of time. Fagan’s first book editor wanted him to cut a 5,000-word introduction in which Fagan talked about his own experiences with homelessness. But a second editor, who came on board later in the process, asked him to add it back in. Fortunately, Fagan had easy access to it in his outtakes document. 

“I did absolutely save that intro,” he told me, “ because I figured it would pop back up into the mix.”

Seeing how you’ve grown as a writer

As my own book gets closer to publication, a lot of people have asked: How long did it take to write your memoir? It’s a difficult question to answer. The short answer: Five years. The long answer: More than half my life. 

I started writing different iterations when I was 17 years old, and every few years I would write a new version as my life evolved. When I began writing the actual book five years ago, I re-read all the earlier iterations and was struck by how much my writing improved over time. My thinking around the story I wanted to tell had grown deeper, and my telling of the story had become increasingly authentic. 

I’m glad those earlier iterations were never published because they pale in comparison to the finished product. But individually and collectively, they hold value. Each iteration is its own outtakes document of sorts, filled with copy that didn’t make it into the final product but nevertheless informed my thinking. Though I hardly reused the copy from these iterations, I repurposed the ideas and themes embedded within them. (And, had I added these iterations to my existing 40,000-word outtakes document, the document probably would have been four times as long.)

All my outtakes were building blocks for what will soon become my first published book — and they’re a hard-won reminder of the circuitous, but worthwhile, path to publication. 

***

Mallary Tenore Tarpley is a journalism professor at the University of Texas at Austin. Her debut nonfiction book, “SLIP,” will be published by Simon & Schuster’s Simon Element imprint in August 2025. Mallary maintains a weekly newsletter, Write at the Edge, geared toward helping writers hone their craft. 

The post In praise of outtakes: How journalists make the most of their story cuts appeared first on Nieman Storyboard.

In my office, I have a long table full of books that share a common theme: they’re all focused on the craft of storytelling and writing.

I’ve turned to these craft books time and time again, and I never seem to outgrow them. I recommend them to my journalism students at the University of Texas at Austin and often refer to them myself — especially in moments when I am navigating a writing challenge, craving a dose of creative inspiration, or needing a reminder that the work we do as writers matters. 

Craft books proved especially helpful while I was writing my debut narrative nonfiction book, “SLIP,” which comes out in August 2025. In particular, they sharpened my vision of what’s possible when structuring a book like mine, which blends memoir, reportage, and science.

To put together this list of books on storytelling, we asked journalists, authors, producers, filmmakers, and you, our Nieman Storyboard readers, for recommendations — and you more than came through. I’ve also included some of my own favorites, including work from the likes of bell hooks and Matthew Salesses. Though this list is by no means exhaustive (I could write a whole book about all the craft books that exist), it nevertheless captures an array of genres and perspectives that writers of all kinds can learn from. 

Writing, storytelling, and general inspiration

• “Bird by Bird: Some Instructions on Writing and Life,” by Anne Lamott, is equal parts witty and instructional. This classic explores myriad topics, including perfectionism, which Lamott refers to as “the main obstacle between you and a shitty first draft.” Several Nieman Storyboard readers recommended this book, including writing coach Ben Riggs, who said: “While her ‘shitty first drafts’ is famous, her chapter on ‘character’ is so underrated.”

• “Still Writing: The Perils and Pleasures of a Creative Life” by Dani Shapiro. Full of mini meditations on the craft of writing, this book is a worthy addition to any writer’s library. The audiobook version includes a guided meditation and a micro-journaling exercise that makes for a great daily writing practice and a helpful classroom exercise.

In 2023, Haymarket Books answered one of my literary prayers by re-releasing “Black Women Writers at Work.” In interviews with Claudia Tate, The Greats — Toni! Maya! Audre! Nikki! Alice! (To name a few) — discuss not only their craft, but grant us insight into the details of their writing life, how they do the work of writing as Black women and the everlasting importance of that work. Often times, the writing life can feel very opaque, and there are additional hurdles I must overcome as a Black woman writer to establish myself in this industry, so it’s validating to know that this is the lineage I’m writing into. This book is the blueprint.

— Storyboard contributor and author Minda Honey ("The Heartbreak Years") 

• “Remembered Rapture” by bell hooks is a remarkable collection of essays that blends the personal and intellectual to celebrate the joys of writing and reading. She tackles topics that are often overlooked in craft-related books, including how writing can be redemptive, how identity shapes our work as writers, and the class and politics of writing.

• “The Science of Storytelling” by Will Storr weaves together psychological research, neuroscience, and narrative to relay writing-related best practices. To illustrate his points, Storr pulls from a wide range of writing samples featuring Jane Austen, Native American folk tales, Shakespeare, “Breaking Bad” scripts, and more. Nieman Storyboard reader Donna Otter says Storr’s advice on the “five-act structure” for storytelling is especially helpful.

• “Language in Thought and Action” by S.I. Hayakawa explores the role of language in human life and the ways in which it shapes our thinking. The book features an especially helpful section on “the ladder of abstraction,” a tool that helps writers think about how to move between abstract ideas and concrete details to tell more compelling narratives.

Storytelling in journalism

• “Telling True Stories: A Nonfiction Writer’s Guide,” The Nieman Foundation's own collection, edited by Mark Kramer and Wendy Call, features essays from some of the field’s greats, including Isabel Wilkerson, Gay Talese, Kelley Benham French, Tom Wolfe, and Susan Orlean. It’s a fan favorite among Nieman Storyboard readers, including feature writer Will Coldwell, who says: “Whenever I hit a block with a story, I go back to this book.”

• “The Girl in the Window and Other True Tales” by Lane DeGregory is a wonderfully curated collection of DeGregory’s Tampa Bay Times stories, including her Pulitzer-winning longform narrative,  “The Girl in the Window.” DeGregory includes annotations alongside each story, offering up tips on channeling your subject’s voice, celebrating tension, and finding meaning in details.

• “Writing Tools: 55 Essential Strategies for Every Writer” by Roy Peter Clark is an essential go-to book for journalists. Clark, a longtime writing coach, offers tried and true tips to enhance your journalistic storytelling, whether you’re reporting breaking news stories or longform narratives. Tips include  “get the name of the dog,” “order words for emphasis,” and “draft a mission statement for your work.” Nieman Storyboard reader Ben Riggs also recommends Clark’s “Murder Your Darlings.”

• “Good Prose: The Art of Nonfiction” is the result of a longtime collaboration between Pulitzer winner Tracy Kidder and his editor Richard Todd. They’re in conversation with each other throughout the book, which digs deep into relevant topics for journalists, including the ethical challenges of nonfiction and how to find story ideas in surprising places.

• Finally, journalist and professor Erika Hayasaki mentions several books that are used in the Literary Journalism program at UC Irvine, including “Immersion: A Writer's Guide to Going Deep,” by Ted Conover; “The New New Journalism,” by Robert Boynton; “The Craft of Science Writing,” edited by Siri Carpenter; and “The Art of Fact,” edited by Kevin Kerrane and Ben Yagoda.

Narrative nonfiction

• “The Situation and the Story: The Art of Personal Narrative” by Vivian Gornick came highly recommended by several Nieman Storyboard readers, including author Julia Scheeres ("Jesus Land," "A Thousand Lives"). The book explores the delicate and complicated art of writing about oneself and figuring out which “selves” we want to bring to our stories. As Gornick writes: “To fashion a persona out of one’s own undisguised self is no easy thing.”

• “Story Craft: The Complete Guide to Writing Narrative Nonfiction” by Jack Hart dives into the craft of narrative nonfiction and also offers up tips on when not to use narrative. Hart provides helpful examples from a variety of fields, including journalism, podcasting, and documentary storytelling. Patti Wolter, professor at Northwestern’s Medill School of Journalism, recommends reading “Story Craft” alongside Hart’s other book, “A Writer’s Coach.”  

• “Draft No. 4: On the Writing Process” by John McPhee includes tips and personal anecdotes on reporting, writing, and revising narrative nonfiction. The section on structure (which I turned to when figuring out how to structure my own memoir) features creative approaches not seen elsewhere, coupled with simple diagrams to help you visualize how each structure plays out on the page. “Readers are not supposed to notice the structure,” McPhee writes. “It is meant to be about as visible as someone’s bones.” 

• “Writing for Story: Craft Secrets of Dramatic Nonfiction,” by two-time Pulitzer winner Jon Franklin, is a master class in writing narrative nonfiction. With expertly wrought chapters, Franklin explains how to use some of the best elements of fiction — including flashbacks, foreshadowing, and complication/resolution — when writing nonfiction. Throughout the book, he provides detailed annotations of his own work to help readers see his tips in action. (For more on Franklin, read this tribute from Storyboard editor emerita Jacqui Banaszynski.)

• “You Can't Make This Stuff Up: The Complete Guide to Writing Creative Nonfiction" is a great read by Lee Gutkind, who has been referred to as “the Godfather behind creative nonfiction.” The book provides a comprehensive overview of the genre and includes related writing and reading exercises. The book came highly recommended by longtime journalist Nick Pappas, who said it was instrumental in helping him write his own narrative nonfiction book.

Oral storytelling: podcasting and live stories onstage

• “Out on the Wire: The Storytelling Secrets of the New Masters of Radio,” by Jessica Abel, is a fascinating graphic narrative that uses visuals to offer up a behind-the-scenes look at story-driven radio shows such as “This American Life,” “Planet Money,” and “RadioLab.” Accessible and fun to read, the book is an essential guide for anyone who wants to advance their audio storytelling and podcasting skills. 

"['Out on the Wire'] is not at all just for radio — the lessons are applicable across genres whenever the goal is to tell character-driven stories with characters that grow and change and learn new things and thus engage and surprise the reader/listener/viewer. Two takeaways in particular I come back to again and again: 

1. (To myself) Topics vs. stories vs. big ideas. What's the big idea that makes this story interesting to everyone on the planet?

2. (To others while interviewing) Expectations vs. reality: How did you think it was going to be before you started? And then what was it actually like? Why do you think what happened happened?

— Journalist Esmé E. Deprez  

• “The Power of Podcasting: Telling Stories Through Sound” is a fan favorite written by podcast scholar Siobhan McHugh, who has been an audio storyteller for four decades. Many Storyboard readers recommended this book, including Macquarie University’s Helen Wolfenden, who said: “McHugh’s passionate connection to spoken-word audio infuses every page. … Practical and wise, it is a love letter to voice and tape and makes the case about the power of stories that come to us via our ears.”

• “Storyworthy: Engage, Teach, Persuade, and Change Your Life Through the Power of Storytelling” by Moth StorySLAM champion Matthew Dicks, conveys an important message: We all have a story worth telling. Dicks shares practical tips for sharing your stories onstage and on the page, and he shows how storytelling can have a profound impact on our lives. (Nieman Storyboard editor Mark Armstrong highly recommended this one, alongside William Zinsser's "On Writing Well" (also picked by Storyboard reader Karen Springen), Christopher Vogler's "The Writer's Journey," and Verlyn Klinkenborg's "Several Short Sentences About Writing.")

• “How to Tell a Story: The Essential Guide to Memorable Storytelling from The Moth,” by Meg Bowles, Catherine Burns, et al. Journalist Cyndi Zaweski praised this book for the insightful way that it explains how to be vulnerable when sharing personal narratives. “Vulnerability in storytelling isn't about recounting all the details of the ‘bad thing’ that happened to you,” she said, drawing upon lessons learned from the book. “That's just the context for the real story: what you learned and how it changed you.”

Screenwriting

• “The Protagonist's Journey: An Introduction to Character-Driven Screenwriting and Storytelling,” by Scott Myers, is an encouraging guidebook for those at the start of their screenwriting journeys. 

• "Protagonist's Journey": I've been reading Scott for as long as I can remember working in Hollywood, and I've known him personally for more than a decade now, since I asked him to be the official screenwriting blogger of the Black List. His is a non-prescriptive approach, and I don't know that I've met anyone who cares more about aspiring professional screenwriters than he." 

• "Poetics," by Aristotle: The earliest surviving work of Greek dramatic theory. Start at the beginning.

— Franklin Leonard, producer and founder of the screenwriting and storytelling community The Black List

• “Screenwriting is Rewriting: The Art and Craft of Professional Revision” by Jack Epps Jr. is an indispensable guide to the craft of revision in screenwriting. Epps, who co-wrote films such as “Top Gun” “The Secret of My Success,” and “Anaconda,” explores the many layers of the rewrite process and explains how they can enhance the final product.

• “Story: Substance, Structure, Style, and The Principles of Screenwriting” by Robert McKee is an insightful manual from a master of the craft. The book offers practical advice for seasoned and aspiring screenwriters, and it illuminates deeper truths about how one can harness the power of good storytelling to capture and captivate an audience.

“Story by Robert McKee is my Bible. The book is very much about telling writers to get out of their own way. Taught me so much. Second is Janet Burroway's “Writing Fiction,” which is the most practical craft book I've read on the elements of fiction, followed by “13 Ways of Looking at the Novel” by Pulitzer Prize winner Jane Smiley.”

— Author Maurice Carlos Ruffin ("The American Daughters," "We Cast a Shadow," "The Ones Who Don’t Say They Love You")

• “The Anatomy of Story: 22 Steps to Becoming a Master Storyteller” offers up multifaceted tips and techniques from John Truby, a screenwriter, director, and acclaimed story consultant. The book tackles character, dialogue, tone, structure, and symbolism, and it “is great for helping anyone think about plot,” says writer and Nieman Storyboard reader Maura Kelly.

Fiction

• “Playing in the Dark: Whiteness and the Literary Imagination” by Toni Morrison. Author Shannon Sanders ("Company") first read this book in college and remembers being “haunted” by Morrison's lucid ideas and prose. “The book is about how African-Americans and Blackness generally have shaped the (predominantly white) classic American canon, but beyond that it taught me how in reading a text there is so much you can slice straight through and instead read the author: in their choice of symbol and motif, in the preoccupations they emphasize on purpose and by accident, you can access a new understanding of a world (perhaps the very world you live in, though you probably see it differently from, say, Willa Cather),” Sanders said. “As a Black writer starting out, I was very affected by this and return to it often when I am considering my own body of work.”

• “How to Write an Autobiographical Novel” by novelist Alexander Chee is a critical addition to the canon of craft books. Sanders, quoted above, calls it a “contemporary classic,” saying: “I think many writers feel a lot of loneliness and yearning because of how much of our lives we spend pulled away from our desks, agonizing through real-world experience and hoping to be able to bottle the tiniest bit of that experience in our work. Chee's book makes me feel less alone in that way of living.”

• “Craft in the Real World: Rethinking Fiction Writing and Workshopping” by Matthew Salesses is an essential read for educators who want to rethink traditional approaches to creative writing workshops and carve out new pathways forward. Salesses poses thought-provoking ideas about how to integrate diverse storytelling traditions into workshops and classroom teachings, and he shares practical suggestions on grading and creating syllabi for writing classes.

• “Refuse to be Done” by Matt Bell is a super practical guide for anyone who is working on a novel or aspires to do so. The book, recommended by Nieman Storyboard reader Tara Yarlagadda and author Deesha Philyaw ("The Secret Lives of Church Ladies"), is broken down into three sections that focus on writing, rewriting, and revising (a topic that often gets overlooked in craft books). Bell makes the daunting task of writing a novel seem more doable by laying out a roadmap and acting as a trusted guide.

• “On Writing” by Stephen King is a classic go-to for many Nieman Storyboard readers, including Yarlagadda, who appreciates King’s advice on how to develop a writing lifestyle. Personally, I like King’s insistence that writers mustn’t wait for the “perfect” conditions to begin writing. When teaching lectures on procrastination, I read aloud a related passage from King’s book: “I wrote my first two novels, ‘Carrie’ and ‘Salem’s Lot’ in the laundry room of a doublewide trailer, pounding away on my wife’s portable Olivetti typewriter and balancing a child’s desk on my thighs.” My students always look back at me, wide-eyed. This is perhaps one of the most telling signs of a good craft book: when it provides anecdotes and lessons you remember and can’t help but want to share.  

With King's advice in mind, I hope you’ll share this guide with other writers and journalists in your life — and remember that picking up a pen will teach you so much on its own.

***

For more resources for writers and journalists, check out Nieman Storyboard's books coverage, and our entire Story Craft archive. 

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Mallary Tenore Tarpley is a journalism professor at the University of Texas at Austin’s School of Journalism and Media. Her debut narrative nonfiction book, “SLIP,” will be published by Simon & Schuster’s Simon Element imprint in August and is now available for pre-order. She recently launched a newsletter, Write at the Edge, geared toward helping writers hone their craft.

The post The Nieman Storyboard guide to books on storytelling appeared first on Nieman Storyboard.

Letter-writing was one of my favorite hobbies as a child. My mother taught me to write thank-you notes for gifts, and I delighted in doing so. By age 8, I had my very own stationery stash, filled with colorful cards that I decorated with stickers and doodles. I saw my own handwriting as a form of decoration, too, and would fill every last inch of space with swoopy cursive.   

I continued to write letters into adolescence, and especially after my mother died from breast cancer when I was 11. They became a way to keep her memory alive, as well as a way for my father and me to communicate hard truths about life after loss; we often felt more comfortable expressing ourselves with handwritten words instead of spoken ones. 

But like many of us, I drifted away from the practice as an adult. Email became my go-to, a busy schedule my excuse. I would write the occasional letter, only to find it sitting on my desk a month later because I hadn’t made time to buy stamps. After a while, the letter felt too dated to send and would land in the trash.  

Over the past year, though, I’ve started putting pen to stationery again. While reporting my forthcoming memoir, I found myself poring over the letters my father and I had exchanged. They were valuable source material and sparked a new idea: Maybe letters were a better way to engage with some of the people I was interviewing for my book.  

Lest you think I’m low-tech and never on deadline, I contacted most sources for my book via email and conducted some 170 interviews via videoconference, often under time constraints. But in a few instances, I turned to more personal letters when I couldn’t reach a source through digital channels, or when asking about sensitive topics. It worked every time, resulting in interviews I may not have gotten otherwise.  

Letter-writing is more than a lost art: it’s a missed opportunity for journalists who may dismiss it as antiquated and a waste of time. With this in mind, I’ve compiled a few lessons from my own experiences and from a handful of other journalists who have discovered the value of handwritten notes. 

Sensitive topics 

While reporting my book, which explores my struggles with an eating disorder, I tried tracking down several girls I was in treatment with in the 1990s. I wanted to check my memories and get a sense of others’ recovery processes. In many cases, my efforts resulted in meaningful interviews. But others led to something I hadn’t expected: obituaries.  

My heart ached as I read about two young women, Lily and Tracy, whom I knew from our time in treatment. Both died in early adulthood. Lily’s obituary stated the cause of death: anorexia nervosa. Tracy’s obit did not list a cause.  

I assumed that she, too, had lost the battle with anorexia but wanted to know for sure. I pored through the comments on her online obituary and tried contacting a few of her relatives via Facebook — to no avail. Then I found her parents’ mailing address and phone number online. For months I debated whether to reach out. It didn’t feel right to cold-call, and I worried that mailing a letter might raise uncomfortable questions. Would they wonder how I had gotten their home address? Would they distrust my motives? 

As my book deadline loomed, I bought some stationery. With my still-swoopy cursive, I wrote to Tracy’s mother, expressing condolences for her loss. The personal nature of the medium led to more emotional writing. I wrote not so much as a journalist but as someone who once knew her daughter and now wanted to honor her memory. This made the outreach feel more intimate than invasive, more amicable than abrasive.  

At the end of the letter, I left my phone number and asked her to text or call if she felt comfortable doing so. Several weeks passed, and I had all but given up hope until one day I received a text from a number I didn’t recognize: it was Tracy’s mother. I called her that day, and we had a hard and heartfelt interview about her daughter, who had, indeed, died from complications due to anorexia. After we got off the call, I texted her a picture of a letter Tracy had written me when we were in treatment together. All these years later, I still hold it dear.   

Door-knock reporting 

ProPublica reporter Nicole Foy sent handwritten letters to several sources when working on a recent story about an immigrant who died while building a ship for the U.S. government. Foy drove around Louisiana, going to as many as a dozen homes to find immigrant workers who weren’t easily reachable by phone or email.  

“For most of these workers, email is not a thing they really use,” said Foy, who is ProPublica’s Ancil Payne Fellow focused on coverage of immigration and labor. “I was trying to reach a very difficult segment — undocumented workers who mostly speak Spanish in Louisiana, which is not known for having the biggest immigrant community.”  

Sometimes, her door-knocks yielded results. When they went unanswered, she would pull out her notebook and write a letter. She wrote in both Spanish and English, saying she had stopped by and hoped to talk. “With handwritten notes, anybody could pick them up,” Foy told me. “So I'm very careful about what I say and what I reveal.”  

She left her business card inside the notes and put them in mailboxes. “I think because we’re so used to recording interviews and doing things virtually, we miss a lot,” Foy said. “Showing up and leaving handwritten notes, or even mailing a note, is just a different way to interact with people. And sometimes it’s unique enough that it’s what gets someone to talk to you.”  

Cutting through the digital clutter 

Freelance journalist Alicia Garceau turned to letter-writing after finding an item that sparked a story idea. She was skimming through the FBI’s FOIA library — also known as The Vault — when she came across a potential source. She tried several phone numbers and left a few voicemails but never heard back. So she mailed a letter to his home address. It took a few months, but the source eventually called. 

“The event I discovered in The Vault happened 40 years prior, so I think contacting the source by letter allowed me to explain my intentions and gave him something to think about,” Garceau said. “Unlike an email that might have gotten deleted or buried in his inbox, a personal letter stuck with him.”  

I asked Garceau whether writing by hand influenced her writing style. Her response will resonate with many: “It encouraged brevity; my handwriting is terrible.”  

The final step in the outreach process 

Journalist Matt Wynn also claimed a slovenly scrawl, calling it “the worst handwriting on the planet.”  

Wynn used letter-writing years ago to contact a grieving mother. He called and left several voicemails but wasn’t sure if he had the right number. After not hearing back, Wynn decided to mail a letter as “a last resort.” Instead of writing by hand, he typed his letter and added a few handwritten sentences to make it more personal. He kept a cordial tone throughout and relayed his desire to learn more about the mother’s late son.  

“I do remember spending a tick of time wondering, ‘Do I put this on letterhead or not?’” Wynn said. He opted for plain paper — a choice that felt appropriate for a correspondence intended as more personal than official. The letter led to a response, and Wynn ended up interviewing the mother soon after. 

“Letter-writing is a way to shake loose sources who are otherwise not shake-loose-able. For me, it’s always a step on the I-can’t-reach-this-person path,” said Wynn, who is executive director of the Nebraska Journalism Trust. “Running this nonprofit newsroom now, it’s comical how much time we spend thinking [about] what envelopes we should use [or] ‘do we handwrite the address?’ These things affect how many people open a letter, and how they experience it, and they’re the same questions I was thinking about back in the day when I was working on that story.”  

Reminding sources that you care 

Tampa Bay Times reporter Lane DeGregory spent five years writing letters to a single source: a woman named Susie Wheldon, whose husband, Dan, a race car driver, had died in a fiery wreck. DeGregory wanted to write about Wheldon, who lived in Tampa Bay with her two young sons.   

DeGregory called Wheldon and left voicemails at least three times. She sent five or six emails that went unanswered. Then she decided to write a letter. She typed it on Tampa Bay Times stationary, folding it into an envelope with her business card and three clips she hoped would give Wheldon a sense of her work. 

“She was neighbors with a friend of mine, so I think I mentioned that, too, and outlined why I wanted to share her story. She never responded. I gave her space,” said DeGregory, a Pulitzer Prize winner. “The next year, before the anniversary of her husband Dan’s death, I wrote her another letter. This one, I think, by hand. I told her I was the mom of two boys (making that connection — I'm not just a journalist) and that I couldn't imagine having to raise them after losing their dad, and explaining to them what happened, and figuring out what came next.” 

DeGregory kept sending letters around the anniversary of Dan’s death or timed to the local Grand Prix race where he competed. Over the years, the letters got shorter. DeGregory didn’t want to bother Wheldon; she just wanted to let her know she was thinking about her and the boys and wondered how they were doing. 

“I'm not sure if it was the actual notes or my persistence. But five years after Dan's death she emailed me. She said she'd kept the business card I'd mailed her all those years ago and was finally ready to talk,” said DeGregory, who wrote this story about Wheldon. “People might be more likely to respond if they know you took the time to compose a note, write it by hand, put it in an envelope, find a stamp and send it out into the world. I also think people hold onto letters and cards — or set them aside to deal with later instead of deleting them. Bottom line: It can't hurt.” 

The importance of place 

I had this same mentality when reporting my book, which includes a chapter about my childhood home. I hadn’t stepped foot in that house for nearly 20 years but now found myself wanting to walk its halls and feel its walls. I hoped that returning might conjure up long-lost memories and reinforce long-lasting ones. I didn’t know the current owner, so a cold call seemed inappropriate; I wanted to take a more inviting approach.  

I wrote the homeowner about my book, our shared connection to her house, and my hope to visit it during a trip back to my hometown in Massachusetts. As I wrote my old address on the envelope, it struck me that mailing a letter there was a way to acknowledge the place that linked sender and recipient.  

I received a positive response in reply and had a chance to walk through my old home. The experience makes me think of a quote from 19th century scholar James Willis Westlake, author of “How to Write a Letter”: 

There is no other kind of writing that possesses for us such a living, human interest, as letters; for there is no other that comes so near to the private lives, “to the business and bosoms,” of the writers. In other productions there is the restraint induced by the feeling that a thousand eyes are peering over the writer’s shoulder and scrutinizing every word, while letters are written when the mind is as it were in dressing-gown and slippers — free, natural, active, perfectly at home. 

Coming full circle with thank-yous 

Some journalists I spoke with said they’ve sent handwritten thank-you notes to sources. As my mother’s daughter, I’ve done the same. After interviewing Tracy’s mom, I handwrote her a note expressing my gratitude for her time and willingness to talk.  

Reporting my book largely involved interviews with clinicians, caretakers, and people who have lived experiences with an eating disorder. It struck me that so many people had poured their heart out to me; the least I could do was take time to thank them. There was no way I could handwrite notes to everyone, so I often turned to email. But in some cases, when I could sense that the person had never shared their story before and had mustered the courage to confide in me, I got out my stationery.  

I also wrote thank-you letters to friends and colleagues who read early copies of my book, as well as those who had taken the time to blurb it. As an added touch, I crafted origami bookmarks and included one in each note. Sometimes, as happened all those years ago, the letters sat on my desk for a month as I waited to buy stamps. But eventually, I mailed every last one.  

* * *

Mallary Tenore Tarpley teaches at the University of Texas at Austin’s School of Journalism and Media. Her debut nonfiction book, “Slip: Life in the Middle of Eating Disorder Recovery,” will be published by Simon & Schuster’s Simon Element imprint in August 2025 and is now available for pre-order. She recently launched a newsletter, Write at the Edge, geared toward helping writers hone their craft. 

The post When digital outreach fails, try pen and paper  appeared first on Nieman Storyboard.

I recently came across a personal essay that captivated me — both because of the subject matter and the quality of writing. I read the piece once online, then printed it out and started marking it up. I circled phrases and sentences that stood out to me and scribbled related notes in the margins. 

“I Gave My Son the Books I Loved. He Chose ‘Heidi’ Instead” was written by Dave Kim, an editor at The New York Times Book Review. In it, Kim explores his 8-year-old son’s love for the classic children’s book “Heidi” and chronicles a related trip that he and his son took to the Swiss Alps, where they visited bucolic scenes from the book.  

Kim’s essay draws upon several writing techniques that are worth keeping in mind, especially when writing personal essays. I encourage you to read it (and admire the accompanying photo illustrations). Then, consider these 12 takeaways:  

1. Make good use of juxtaposition 

Throughout the piece, Kim places contrasting details side by side — a technique known as ironic juxtaposition. This technique can help highlight differences, create meaning, and infuse humor into your writing. Here are a few examples, with contrasting details bolded for effect: 

• “I went to the Alps in August because my son — a New York City third grader obsessed with baseball, projectiles and YouTube — fell in love this summer with the Swiss children’s novel ‘Heidi.’” 

• “I couldn’t work out how a boy who thrived on armed combat and poop jokes had fallen so hard for a tale of pastoral youth and spiritual transformation.” 

• “I took in the valley as I caught my breath, bludgeoned by the beauty, while my son relieved himself behind a spruce.” [I also love the alliteration of “breath,” “bludgeoned,” and “beauty,” coupled with the consonance of “himself” and “spruce.”] 

2. Sprinkle in relevant context 

“Heidi,” by Swiss author Johanna Spyri, was first published in Germany in 1881; an English translation was published in 1885. But rather than assuming all readers are familiar with “Heidi,” Kim provides a brief synopsis of the book early in his piece. He doesn’t belabor the description, but gives us just enough to understand the plot, time period, and pacing. (Action in the book is leisurely — so much so that Kim refers to “Heidi” as “the three-toed sloth of children’s books.”)  

Kim also provides context about the places where he and his son, whom he refers to as “R,” visited. This gives readers confidence that they are in the hands of a guide who won’t leave them behind. 

3. Weave in visual details 

I once had a grad school professor who read a piece I’d written about my father and matter-of-factly told me: “I still have no idea what your father looks like. Help me  see  him.” Perhaps because of my lifelong struggles with body image, I’ve always had difficulty writing physical descriptions of people. It often feels forced to me, and sometimes even trite. But since hearing that professor’s feedback, I’ve become more attuned to the ways in which good writing can help us see people in our mind’s eye. 

Kim helps us see his son in ways that are both specific and striking: 

• “He had a deep crimp between his eyes, the look of someone packing far too much into a suitcase far too small.” [This metaphor works especially well, since the essay is about travel.] 

• “R went off to find some sticks. He rushed back seconds later with dinner-plate eyes: He’d seen a sign for a pool.” 

4. Embrace dialogue and voice 

Along with helping readers see, we also need to help them  hear  the people in our stories. As journalists, we’re trained to capture quotes in response to our questions. But it’s just as important to listen for dialogue — two or more sources talking to each other. As I tell my students: Quotes are heard; dialogue is overheard.  

The best dialogue is brief but telling. Take this example, in which Kim is talking with his son during a visit to Heididorf, a village celebrating the beloved storybook character:   

“Was Heidi real?” R finally asked. 

I told him there were probably girls like her once. But she herself was pretend. 

“Then who lived here?” he shot back. 

“Nobody.” 

We only hear Kim once in this dialogue, but his one-word response speaks volumes.  

In another passage, we hear R’s voice again when Kim tries convincing him to go on a scenic train ride. Kim writes:  

But in the late-afternoon heat, with an orange Fanta against his cheek, R was in no mood for more “stuff.”  

When I read that, I could hear my own 8-year-old using the same word to describe excursions that sound fun to me but boring to her. And I could picture myself heaving an exasperated sigh in response. In listening to others’ voices, we sometimes hear our own.  

5. Zoom out with bigger-picture observations 

To write an effective personal essay, you need to zoom in on your personal experiences and help readers see the bigger picture you’re trying to convey. This requires widening the aperture beyond your own story so that readers can more clearly see its underlying universal themes — the connective ties that bind writer and reader. 

Sometimes, attempts to do this can come across as didactic or pedantic, so be mindful of your tone and intent. When you try sounding smart, readers get turned off. But when you aim to make readers feel smarter, they tune in.  

Kim made me feel smarter (and less alone) when he zoomed out in these three instances: 

• “Eight is the cruelest year, an age when myths deflate into hard forensic realities. Magic becomes sleight of hand; the logistics of Santa’s gift distribution stop making sense. But the revelation process isn’t so much like a veil being thrown off as it is a fuzzy world slowly coming into focus, and parts of it often go blurry again.” [Notice how he links to a secondary source here so that readers who are interested can click on the link and learn more.] 

• “Children are not miniature versions of yourself. They do not like what you like, or what you think they will like.” [I found this sentiment so relatable as the mother of a 7-year-old son and 8-year-old daughter. A few years ago, I surrounded the Christmas tree with toys that I had loved as a child, hoping my children would too. But they showed minimal interest and much preferred their great-grandmother’s dollar-store gifts.] 

• “It is a truth widely known among parents that no matter where you go in the world, or how exotic the itinerary, the hotel pool will always be the highlight for your young children.” [Reading this made me feel as though Kim was speaking directly to me, writer to reader and parent to parent. I immediately thought back to last summer, when I asked my kids to share their favorite part of our family trip to Hawaii, and they shouted in unison: “The pool!”] ¯\_(ツ)_/¯

6. Share headspace 

When writing personal essays, it’s easy to focus on what we were doing at a particular moment in time. It’s harder to look inward and consider what we were thinking in that moment. Always ask yourself: What was I thinking about? How was I feeling? What questions were racing through my mind? What fears were holding me back?  

Kim does a nice job of this when he describes R’s puzzlement over the religious undertones of “Heidi.” He lists the questions it sparks for him: 

Why do some people, like his grandmothers, believe that an all-powerful god exists, while others, like his parents, do not? How can one person’s reality differ so drastically from someone else’s?  

In reading these questions, we can more easily understand his son’s — and perhaps even his own — attempts to try to make sense of the world. 

7. Show us how you are one of many 

No matter how singular your story is, there are likely still parts of it that speak to our shared humanity. I always appreciate when writers describe how their own experiences relate to a broader community of individuals — not in a monolithic way but in a “me, too” kind of way. Kim does so effectively when comparing himself to other parents in this passage:  

Like many parents, I have tried to pass on the highlights of my early reading life to my children (R and his little sister). And, like many parents, I have been crushed when the box sets of serial mysteries and Beverly Cleary paperbacks I buy with aching affection remain untouched. 

The repetition of “like many parents” makes the writing feel more inclusive, and the Beverly Cleary paperback detail makes it more relatable. (I tried getting my 8-year-old daughter to read my old Cleary copies, but they have remained on the bottom shelf of her bookcase, untouched.)   

8. Remember the magic number three 

My longtime mentor Roy Peter Clark introduced me to the magic of the number three, and it has become one of my favorite writing tools. In his book “Writing Tools,” Clark encourages writers to think about the number of examples they provide when writing: “Use one for power; use two for comparison, contrast; use three for completeness, wholeness, roundness; use four or more to list, inventory, compile, and expand.” In personal essays, using three examples helps to encompass the whole.  

Kim takes advantage of the magic number three several times throughout his essay. Here are three examples (see what I did there?): 

• “He was expecting roller coasters, goat-shaped bumper cars. Animatronic Heidis with dark curls and dirndls.” 

• “The attractions were … rigorous hikes! Ye olde villages! Incredible views!” 

• “We did pass those meadows, but also vineyards, beefy medieval castles and flower-capped fountains.” 

9. Use strong verbs. 

When self-editing personal essays, circle your verbs. You may find that you tend to use the same verbs over and over, or that you overuse versions of “to be.” Switching up your verbs can keep your writing more specific and more dynamic.  

Consider the verbs in this passage from Kim’s essay:  

The hot grass thrummed with cicadas. We huffed uphill on narrow shoulderless roads as farm vehicles and bleating Peugeots swerved around us … 

These strong verbs create narrative energy and help drive the story forward.  

10. Climb up and down the ladder of abstraction 

On its surface, Kim’s essay is about a trip to the Alps and the book that (partly) inspired it. But at its heart, the essay is about so much more: navigating the father-son relationship; letting your child become their own person; appreciating how books can expose us to new worlds, both real and imagined …  

The late politician and scholar S.I. Hayakawa popularized the term “ladder of abstraction” in his book “Language in Thought and Action.” It’s a helpful technique for writers, who should always aim to move up and down the ladder. Concrete details reside at the bottom of the ladder. Universal themes live at the top. The key is not getting stuck in the middle, where rungs can be riddled with jargon, hard-to-understand concepts, or unnecessary details/context.  

In Kim’s essay, there’s a brief scene in which he writes about deciding to have a stick fight with his son. He moves down the ladder when he talks about the sticks that his son gathers (the sticks being the concrete detail). He starts to move up the ladder when he briefly mentions that his son stumbled upon the resort pool when looking for the sticks. Then he arrives at the top when he draws a connection between Heidi’s storybook adventures and his son’s sudden pool fascination:  

Theirs was a joy burdened by neither earthly concerns nor fantasy — a love of present circumstance, of a real life that was plenty good enough. 

11. Bring in source materials 

Some of my favorite personal essays pull in source materials, such as quotes from books, journal entries, medical records, and letters. Kim does this when quoting from a park map that stated:  

You are standing in the middle of the village of the most famous Swiss girl, Heidi.  

He had to have either taken a picture of this map or held onto it for safekeeping — two good strategies for any writer who wants to use source materials when writing about personal experiences.  

Kim also quotes directly from “Heidi,” which makes good sense given that the essay is largely about the book. He refers back to one of these quotes at the end of the piece. In doing so, he helps us see the connections between his own story and that of Heidi’s — and the sometimes surprising overlap between fiction and real life.  

12. Relay a moment of realization 

One of my former colleagues, Pulitzer Prize-winning journalist Tom French, once said a story is a promise that the end is worth waiting for. I’ve always loved this line, and whenever I write a personal essay, I ask myself: Did I fulfill the promise?  

I used to think I was fulfilling the promise by writing tidy endings that were all tied up with a pretty bow. But I’ve come to find that the best endings don’t require a happy ending, major turning point, or life-changing epiphany. More often, they recognize smaller moments of realization or growth.  

As Daniel Jones, editor of The New York Times’ Modern Love column, once said: “A happy ending is when the writer understands something he or she didn’t understand before.”  

I thought of this when reading the last couple paragraphs of Kim’s essay, in which he writes that  

... it became a little clearer to me why R and generations of other unruly children had found a counterpart in [Heidi]. 

The essay’s ending is not a pristine package wrapped with a perfect bow, but it’s still a gift. 

* * *

Mallary Tenore Tarpley  teaches at the University of Texas at Austin’s School of Journalism and Media. Her debut nonfiction book, “Slip: Life in the Middle of Eating Disorder Recovery,” will be published by Simon & Schuster’s Simon Element imprint in August 2025 and is now available for pre-order. She recently launched a newsletter, Write at the Edge, geared toward helping writers hone their craft. 

The post A journalist, a boy, and a surprising literary gift  appeared first on Nieman Storyboard.

As a first-time author, I’ve spent the past four years writing and reporting my debut nonfiction book, “SLIP: Life in the Middle of Eating Disorder Recovery.” It’s been such a long labor of love that some acquaintances have asked: “Wait, is this your second book, or are you still working on your first one?”

I understand why they ask; most people don’t know all that goes into landing a nonfiction book deal with a Big Five publisher. Sometimes, I give them the abbreviated version of how the process works, with the caveat that it plays out a bit differently for everyone. Here’s a quick overview of how it worked for me, followed by a special focus on what still needs to happen after you send in a complete manuscript:

Maybe you decide to self-publish. If not, you need to query literary agents, whose job is to sell your book to a publisher. If you’re lucky enough to sign with an agent and you haven’t already written a proposal, you write one with help from your agent. These are lengthy documents; mine was 85 pages. Your agent shops that proposal to various publishers — a submission process  that can take weeks, months, sometimes years. Amid the rejections, you hope for a yes.

After a tremendous amount of work, I got my own yes from a Simon & Schuster imprint in December 2022. By that point, I had been working on “SLIP” for about two years, exploring ways to convey the nuances of eating disorder recovery through a mix of personal narrative, research and cutting-edge science. Once I signed my contract, I had 18 months to complete my reporting and writing.

I finished my manuscript in early June, but the work is far from done. I spent the summer in back-and-forths with my editor to fine-tune the final draft. Being at this stage feels like completing the last few miles of an ultra-marathon: It’s both exhausting and energizing; it requires the humility to accept most edits and the confidence to speak up when you disagree with others; it demands time, undivided attention and an openness to change — all in service of making your book as good as it can be before it goes out into the world.

Along the way, I’ve kept note of some related takeaways that have helped me through this last editing stage.

Prepare for Tough Love

During the month in between turning in my manuscript and receiving edits, I wrestled with inevitable questions: Will my editor like what I wrote? Will her edits be minimal, extensive or somewhere in between? What if some chapters still need a lot of work? It’s one thing to rework an 800-word story; it’s another thing entirely to have to potentially rework a 100,000-word manuscript.

Instead of wallowing in uncertainty, I reminded myself of a quote from journalist and author Anne Hull. “Reviewing a draft with my editor is a tough-love session,” she’s quoted as saying in the book “Telling True Stories.” “I don’t want to be loved unconditionally; I want to understand what’s wrong with my draft so I can improve it.”

I wrote that quote on a Post-it note and hung it in my home office as a reminder of what the editing process is all about. It’s not about expecting perfection from yourself; it’s about pushing yourself to be better, with your editor’s help.

Do a Curiosity Read

I’m the type of writer who loves being edited. I admittedly winced, though, when I first scrolled through my editor’s many comments and questions in the margins of my manuscript. At this point, my book was like my third child, and I could feel myself being overly protective of it.

Not wanting to address the edits from a defensive stance, I decided to set the manuscript aside. I reflected on the edits, then revisited them a couple days later to do what I call a “curiosity read,” approaching them from a place of inquiry rather than defensiveness. I considered: What kinds of questions is my editor asking? What can I learn from her comments? How do her edits improve the overall writing?

In asking these questions, I could read the edits with an open mind and an appreciation for how helpful they were. I also could see that the notes were more complimentary than critical and that they weren’t going to require a heavy lift on my part. In a follow-up conversation with my editor, I came to understand her edits even better. Open communication is so key during this final stage of editing, and it helps move the process forward.

Create an Outtakes Document

The British writer Sir Arthur Quiller-Couch once famously advised writers to “murder your darlings.” By that, he of course meant that writers should be willing to part with passages they like, especially if an editor says they’re not working.

I have long appreciated this maxim, but instead of murdering my darlings, I send them to my outtakes document. This is a Word doc where I keep copy that didn’t make the final cut but still has potential. My outtakes document got longer during this final editing stage, and it’s now over 35,000 words. This isn’t unheard of; when at a writing conference a couple years ago, I met another author who said her outtakes document was over 100,000 words long.

Mine is largely filled with narratives from people I interviewed but ultimately couldn’t include due to space constraints. In the months ahead, I plan to use the document as a point of reference and a source of inspiration when writing stories related to the topic of my book.

Be Protective of Your Prose — But Not Overly Protective

I have always been a wordy writer. Though I had worked hard through several drafts to tighten my manuscript, I wasn’t surprised when my editor suggested some cuts. I agreed with most of them, shipping those bits to the outtakes document. But there were some that I wanted to keep in the book.

I marked them as “optional trims” (a tip I learned from my writing mentor, Roy Peter Clark), and then asked myself some tough questions: Why do I feel wedded to these passages? How, if at all, do they enhance the quality of the writing? Do they advance readers’ understanding of the subject matter, or complicate it? What, if anything, would readers miss out on if this were left out?

If I couldn’t come up with a good answer for each question, I sent the passages to the outtakes document. Otherwise, I kept them in and provided my editor with related context. This approach worked well, and my editor was receptive to it.

Don't Feel Obligated to Heed Every Suggestion

As I wrote my manuscript, I enlisted a science advisor, a sensitivity reader and eight early readers who read the book and sent me their overall impressions. I wasn’t required to seek out any of them, but it was important to me to get feedback from people with expertise and opinions I trust. They gave me confidence when I felt vulnerable about putting a personal book out into the world. They responded with encouraging feedback and helpful suggestions that I took to heart. I considered each suggestion carefully, and I made several small changes based on them. But I didn’t pressure myself to incorporate them all.

If you try to accommodate every single suggestion you receive, you can end up making unnecessary cuts or adding new passages that don’t quite fit. At this late stage, you need to consider all feedback but be judicious about how, or whether, to act on it.

Put Every Fact Under a Magnifying Glass

I kept an eye out for errors throughout the writing process, and I did an especially careful fact-check during this final stage, searching for inaccuracies. By doing that, I caught some incorrect name spellings and titles, as well as detail-related errors (like referring to Johns Hopkins University as John Hopkins University).

Some of the errors were almost comical. In one chapter, I mentioned “Boston Cream Pie Pop-Tarts.” I had read this detail dozens of times without questioning it, but during my magnifying-glass read, I decided to look up the flavor and saw that I had gotten it wrong. It’s actually “Frosted Boston Creme Donut.” (Who knew?) In another fun food-related fact-check, I realized that I had incorrectly referred to “Ritz Handi-Snacks Crackers ’N Cheesy Dip” as the less enticing “Ritz cheese and crackers dip.” (Whoops.) These were small but important fixes that have contributed to the book’s overall accuracy.

Intent on having an error-free manuscript, I also hired a professional fact-checker, who is now reviewing the final manuscript. (Publishing houses typically have copy editors but not full-fledged fact-checkers. Authors who want a fact-checker usually cover the cost themselves with some of their advance money or grant funds, as I did.)

Watch for Research-Related Generalizations

My book contains about 10,000 words of endnotes, mostly drawn from research on eating disorders and recovery. When reading the parts that summarized research, I paid careful attention to how I presented each study’s findings.

I especially wanted to make sure that I didn’t draw conclusions about an entire population based on one study alone — an all-too-common mistake. Sure enough, during one of my final read-throughs, I noticed a few places where I had done just this. In one chapter, for instance, I flagged a line saying that “less than 6% of people with eating disorders are medically underweight.” I had seen this statistic widely quoted online, and understandably so; it dispels misconceptions by showing that people of all different body shapes and sizes struggle with eating disorders.

But as I read the statistic, a nagging question — “How do you know this?” — kept coming to mind. In reading the research behind this statistic, I realized that it originated from one lone study. The sample size was large (about 3,000 adolescents), but certainly not reflective of an entire population. I modified the sentence to say: “One study surveyed over 3,000 adolescents with eating disorders and found that only 6% of them were underweight.” This made it clear that the data was based on one study and wasn’t representative of everyone with anorexia.

Make Sure the Writing Sounds Like You

After I made my edits to the final manuscript, I printed out a copy and read it out loud. This was time-consuming, but useful: I was able to hear what my eyes missed, including typos, choppy pacing, wordy sentences.

Whenever I read a sentence out loud and was out of breath by the end, I knew I either needed to trim it or break it into two sentences. I also heard a few places where the writing just didn’t sound like me; this was usually in parts that had been edited and therefore weren’t entirely in my voice. I tweaked these parts accordingly, fine-tuning words until they fit. By the time I finished reading the final manuscript, I felt proud of the way it read — and sounded.

Share (or Withhold) Courageously

I’ve known all along that I wanted to share “SLIP” with my father prior to publication. Sharing your work in draft stages is a personal decision that varies from author to author. I know some authors who couldn’t imagine writing a personal book without sending it to family members or other affected people ahead of time; others refrain from doing so, viewing the manuscript as wet clay that family will try to mold into something it’s not meant to be. Some wait until they have a galley copy; at that point, the manuscript is typeset and mostly ready for publication.

I decided to share the final draft of the manuscript with my father when it could still be tweaked. During a phone call the other day, I told him that I dedicated the book to him — to which he shrieked with surprise and joy. I also prepared him for the parts of the manuscript that might be difficult to read — especially the ones that recount painful periods he and I endured after my mother died and while I was sick with anorexia. I asked him to let me know if any of these parts come across as inaccurate or insensitive. And I told him that everything I wrote about him was rooted in a place not of anger or blame, but of love. By talking it through with him, I was reassured that he’ll read it from this place, too.

I’m still not done with my edits. The manuscript is now with my father and three other people: my fact-checker, sensitivity reader and copy editor. Over the coming month, I will make final, final edits — and be that much closer to the finish line: publication in summer 2025.

Maybe then I’ll start working on that second book.

* * *

Mallary Tenore Tarpley teaches at the University of Texas at Austin’s School of Journalism and Media. Her forthcoming nonfiction book, “SLIP: Life in the Middle of Eating Disorder Recovery,” will be published by Simon & Schuster’s Simon Element imprint in summer 2025. She recently launched a newsletter, Write at the Edge, geared toward helping writers hone their craft.

The post Think your book is done? Think again appeared first on Nieman Storyboard.

Seattle Times intern Xavier Martinez grew up mountain biking on the eastern slopes of Washington’s Cascades mountain range and remembers being “terrified” of encountering a cougar. Though he knew cougar attacks were rare, he rode with an awareness of the risk.

And so, when news broke about a mountain biker who was attacked in the Cascades last February, Martinez was drawn to the story. Local and national outlets recounted the traumatic incident, in which cyclist Keri Bergere was bitten by a cougar while biking with four of her friends. As the cougar sank its teeth into Bergere’s jaw, her friends took action. They pinned the animal down with a bicycle, pulled on its legs and hammered its head with a rock until it released its grip, then kept it pinned under the bicycle until wildlife officials arrived and killed the animal. All five cyclists survived, but Bergere sustained serious injuries.

This was the story that one media outlet after another told in the immediate aftermath of the attack. As the weeks passed, media coverage faded, but Martinez couldn’t let it go. A question nagged at him: How were the women recovering from this trauma?

“I had a hunch that there were some long-term repercussions,” Martinez told me. “It’s not like something like this just happens and then you just move on from it.”

He followed that hunch to a story, published earlier this month in The Seattle Times, about the nonlinear and ongoing nature of trauma recovery.

It’s also a good example of a restorative narrative — an approach to nonfiction that explores how people and communities rebuild in the aftermath of trauma. Instead of sensationalizing what’s broken, or suggesting that it’s already been fixed, restorative narratives probe how people move forward amidst the breakage. They reveal meaningful progressions — from illness to wellness, heartbreak to hope, suffering to survival.

No predictive interviews

Wanting to learn more about the five cyclists’ recovery progressions, Martinez started with Bergere. She then introduced him to her four friends; three agreed to be interviewed (the fourth was overseas and unavailable). As Martinez prepared for each conversation, he reminded himself that he wanted to reveal the different ways that individuals experience in the wake of trauma. This would require him to ask questions that he didn’t already have the answers to and to avoid any assumed storyline.

“I tried to stay away from asking questions about what happened that day, because, frankly, the information’s out there, right? We’ve all heard about the attack,” Martinez said. So rather than asking the women broad and predictable questions about their recovery process, he started off with a seemingly simpler question — one focused around a narrower timeframe: “After the attack, what was the rest of that day like?”

That’s how he learned more about the nine-hour surgery that Bergere endured. And how her four friends, in shock and in need of comfort, had gotten together later that night to drink tea and eat bread. The women’s willingness to talk about the rest of that day opened up windows of opportunity for Martinez to ask more sensitive questions, including: “How often do you think about that day?” and “Can you describe some low points in your recovery process?”

Each of the women’s responses to the same traumatic event differed. Bergere, the cyclist who was attacked, has struggled. As Martinez wrote:

After being rushed to Harborview Medical Center with serious injuries, Bergere spent nine hours in surgery. She was in the hospital for five days. Couldn’t eat for months. Couldn’t feel her face. Couldn’t blink her eyes in sync.

Throughout, Bergere has struggled. It’s hard to shake the memories of the attack: The blood running down her throat, the suffocating feeling of her face being pinned down in the dirt by the cougar. Sometimes, she remembers the moment that she was ready to, as she says, “just let go.”

Two of the women began therapy, including Tisch Schmidt-Williams, who had nightmares; at one point, she called a suicide-and-crisis lifeline. She spent less time with her cycling group, was slower to return to riding and may move to be close to family. From the story:

“I have to protect myself and my boundaries because I’m very vulnerable right now,” Schmidt-Williams said. “Everyone’s timeline is a lot different in terms of how they have to heal and what that looks like.”

The women’s stories reminded Martinez that recovery is not one-size-fits-all — a reality he tried to reflect in the story. When writing the piece, Martinez initially struggled to find the right structure. He laid out a few bullet points as a loose outline, then began writing about each woman’s experiences in chronological order. This meant he had to jump around from one woman’s story to another and then back again. Martinez said he felt constrained by the chronology and thought the story was disjointed. He also realized that the story relied too heavily on details about the attack — the very thing he had been trying to avoid all along. Martinez is used to writing stories about news events, but telling a story about the ups and downs of recovery was new for him, and it took longer to get it right.

Martinez knew that if the story he envisioned didn’t work out, he could default to Plan B, writing a short news update about how the women had recently received the Carnegie Medal for civilian heroism. But he also knew there was so much more to the story. With his editor’s help, Martinez discarded his first draft and rewrote the piece entirely, without strict adherence to chronology. Martinez started with Bergere’s experiences and then moved on to each woman, one by one, with transitions and context woven in. The piece flowed better, he said, and was easier to follow.

“For me, as an early career journalist, I think it was a good example of being honest with yourself,” Martinez told me. “Rewriting something doesn’t necessarily mean that it’s a bad story; it just maybe means that something needs to be told in a different way. That was a powerful lesson.”

To end the piece, Martinez resisted the all-too-common crutch of a happy ending. The women didn’t sugarcoat their own stories or pretend their suffering was behind them, and he wanted his story to reflect that truth.

“To all of the women’s credit, they weren’t trying to say that because they had completed the (mountain trail) course again, or because they had gotten on a bike since, or because they weren’t feeling physical pain anymore, that things were ‘all better,’” Martinez said. “We didn’t have to try to tease out this idea of it not ending; we were able to suggest this through their voices.”

No tidy endings

As I interviewed Martinez about his writing process, I thought about how challenging restorative narratives can be to report and write. They take time to unfold, so don’t always have convenient news pegs. They often involve messy and complicated storylines. And they defy tidy endings. But journalists like Martinez argue that they’re worth telling — a value that research reinforces. One study found that restorative narratives elicit positive emotions and prompt readers to want to help those in need — namely the people featured in the narratives and others like them.

Indeed, Martinez’ approach resonated with readers. “I got a few emails saying that they appreciated the follow-up and that we wrote it as a ‘checking in’ feature rather than a straight news piece,” he said. “Many people in the comments and emails mentioned that talking about the long-term impacts helped them realize the importance of being prepared for the wilderness in the first place.”

Martinez, who is now wrapping up his internship at the Seattle Times, said the restorative narrative genre appeals to him as a young reporter looking for different ways to tell stories. He plans to keep it in mind as he moves to New York for his next journalistic challenge.

“I’m excited to tell more stories like this,” he said. “I really think some of the best stories are about things that are ongoing.”

* * *

Mallary Tenore Tarpley teaches at the University of Texas at Austin’s School of Journalism and Media. Previously, she was the director of the nonprofit Images & Voices of Hope, where she helped develop the restorative narrative genre. Her first book, “SLIP: Life in the Middle of Eating Disorder Recovery,” will be published in 2025. She recently launched a newsletter, Write at the Edge, geared toward helping writers hone their craft.

The post Reporting the long arc of trauma recovery appeared first on Nieman Storyboard.

Up until I started writing my first book, I wasn’t a big outliner.

I spent the earlier part of my career writing news and feature stories about the media industry, then transitioned into writing personal essays. Outlining struck me as another tedious and time-consuming task to add to my to-do list, especially when I was on tight deadlines. I’ll figure it out as I go, I’d often think, (which, looking back, may explain why it took me so long to write my stories.)

Now, in the thick of drafting my book manuscript, I can’t imagine writing anything of substantial length without an outline. My book SLIP blends immersive reporting, emerging science and social history around eating disorders alongside my own lived experience with anorexia. It’s equal parts journalism and personal narrative, so I have to outline each chapter to keep track of all the story elements, research and interviews that are woven into each one.

Sometimes when we think of outlining, we flash back to middle school English classes, where we learned to use a series of letters and Roman numerals to organize our thoughts. But that type of outlining never really worked for me. It seemed so formulaic, and I would always forget where to put the Roman numerals, whether to capitalize or lowercase the letters and when to indent.

I’m a visual person. I’ve come to see outlining as a puzzle, where I’m considering the moving pieces of a story or chapter and determining how they all fit together. I write out the parts on Post-it notes or small pieces of origami paper, then I move them around and figure out where they go, which parts are missing and which ones I don’t need.

Once I’ve settled on an order, I tape the parts down on a large piece of sketch paper or stick them onto a trifold display board. On the other side of the trifold are three timelines that I’ve created for my book — one about the history of anorexia, the timeline of my mom’s cancer treatment and the timeline of my eating disorder treatment. As I start each chapter, the trifold and Post-its will act as my roadmap, helping to guide me through the writing process.

Every writer has a different process for outlining and structuring. This one has worked pretty well for me, and it’s one I’ve started to share with my journalism students at the University of Texas at Austin. As I tell them, the more front-end work you do and the clearer your roadmap, the quicker you’ll get to your destination (aka a finished story or chapter).

The key is following the roadmap but also allowing for detours or reroutes when the story calls for it. The outline, like so much of writing itself, is bound to evolve and lead us down paths of new discovery.

Mallary Tenore Tarpley is an assistant professor of practice at the University of Texas at Austin’s Moody College of Communication. Her book SLIP: Sickness, Recovery & the Space in Between will be published by Simon & Schuster in 2025.

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Washington Post reporter John Woodrow Cox has spent six years covering stories of gun violence and children, fashioning a beat out of one of America’s most heartbreaking realities.

Yet when he first heard about the shooting last May at Robb Elementary School in Uvalde, Texas, he was stunned. It had been just 10 years since 20 children and six teachers were killed at Sandy Hook Elementary School in Newtown, Connecticut. Despite that, and Cox’s deep immersion into a subject, he couldn’t fathom that so many children — 19, along with two teachers — had lost their lives.

The Post asked if he wanted to fly to Uvalde to cover the immediate aftermath of the shooting. He declined.

“I could not be one of the 10,000 reporters on the ground banging on doors, desperately trying to get a quote from one kid,” said Cox, who was in tears upon hearing the final death toll. Instead, he wrote about how survivors of other school shootings were responding to the news, and he began thinking about how his eventual Uvalde coverage would unfold.

One month after the shooting, Cox did fly to Uvalde and ended up spending the summer with survivor Caitlyne Gonzales and her parents. The Posts’s former managing editor, Steven Ginsberg, had encouraged him to travel Uvalde and pour all of his experience covering gun violence into a single story. What resulted was an 8,500-word piece that confronts the stereotype of the plucky survivor while uncovering the ups and downs of trauma and the challenges of recovery.

The story, “An American Girl,” published in The Washington Post on Oct. 24, 2022, is a powerful example of a restorative narrative – stories that show how people and communities are rebuilding in the aftermath of trauma. Rather than sugarcoating hard truths, these narratives address them head on and explore the messy middle between a tragedy and one’s recovery from it.

Showing a fuller picture of trauma survivors

 If you’ve followed the Uvalde coverage closely, you may have seen photos of Caitlyne speaking at school board meetings or delivering a talk to Congress about the need for a ban on assault weapons. She has become, as Cox wrote, Robb Elementary School’s most public survivor: “a voice for her friends who were dead and for those who were alive but too daunted to say anything … a 4-foot-8, 75-pound embodiment of the maroon ‘Uvalde Strong’ flags flying all over Texas.”

Cox used patience and insight to report past these outward displays of resilience and show the inner pain, fear, and struggles that Caitlyne has faced in the tragedy’s aftermath. He portrays Caitlyne not as a fully recovered survivor but as a human being who grapples with strength and sorrow, love and loss. He achieves this through a poignant mix of details, juxtapositions, interviews, and reconstructed scenes he witnessed first-hand.

The juxtapositions he sprinkles throughout are striking. In one part, Cox describes Caitlyne as

 a child who didn’t know how to ride a bike without training wheels but did know about ballistic windows and bulletproof backpacks and the movement to ban assault weapons. Who spent as much time following the Instagram pages of her favorite gun safety champions as she did Bad Bunny’s TikTok account. Who was 10, but seldom acted her age, speaking in public about fear and death with the eloquence of an adult, while in private, enduring flashbacks so vivid that she needed bedtime lullabies meant for toddlers to soothe her.

Later in the piece, Cox shows Caitlyne’s fear of going to sleep by herself. The night of the shooting, she had asked her mother to stay at the foot of her bed. As time passed, she asked her mom to sleep beside her, then face-to-face, breath-to-breath. “Caitlyne needed to know her mother was alive,” Cox told me.

After more than two months of building trust with Caitlyne and her family, Cox gained their permission to install a GoPro and baby monitor in Caitlyne’s room for one night. He wanted to see how she wrestled with trauma behind closed doors, when the world wasn’t watching. Cox recalls sitting in the Gonzales’ kitchen that night as Caitlyne’s parents tried having a few moments to themselves in the living room before going to bed. On the baby monitor, he watched Caitlyne unravel as she waited for her mom to come into her room. Audibly crying, she curled up in the fetal position on her bedroom floor in front of her Barbie Dreamhouse.

In an interview, Cox reflected on how difficult it was to watch this scene unfold. “Here’s this kid who has no ceiling, right? Her potential is just like, unlimited. But this is what she has been reduced to,” Cox told me. “She's the kid who cannot sleep alone, who cannot even be in a dark room alone without her mother for 15 minutes without coming completely undone because of something that she has no control over. She cannot control the way her body is responding to that fear.”

Unveiling the complexities of trauma

Cox’s story is a testament to the complexities of trauma and the unpredictability of its effects.

“A piece like this is important because it shows the broader, longer-term, insidious impacts of trauma,” says trauma psychologist Kevin Becker, who has helped journalists think through restorative narratives. “It helps people understand that the impacts of trauma ripple through many, many aspects of your life, even if you're a child.”

Trauma recovery, he said, is a developmental process – one that unfolds over time with ebbs and flows. Stories that pull back the curtain on this process can generate greater understanding and empathy compared to surface-level stories that show children recovering quickly from tragedy.

“The more accurate a picture people have of what trauma does and what the impacts of trauma are, the more caring we can be, the more understanding we can be and the more trauma-informed we can be as a culture,” said Becker, who founded ORI Consulting, an organization focused on trauma response and recovery. “If all we know is something that looks nice and neat and clean, and we don't hear about all the struggles and the messy middle, then we're really not educated about the impacts of trauma. And for journalists, if you're not able to tell these kinds of stories, then you're probably not telling a completely accurate story.”

There’s a tendency to think that children are more resilient than adults and that they bounce back faster from tragedy. “That’s one of those myths that's out there and it’s really not true,” Becker said. This isn’t to say that children’t aren’t resilient, but when we only focus on their resilience, we miss the opportunity to explore other aspects of their lived experience.

Cox was cognizant of this when reporting and writing about Caitlyne. “I've come to hate the term ‘children are resilient’ because it’s dismissive. It allows adults to not take on the responsibilities that they should,” said Cox, who authored the book “Children Under Fire: An American Crisis.” “We see children being happy and running around and joking around. And people think, Well, they're fine, right? We so desperately want kids to be okay that we will cling to evidence that they are alright. We will seek out that evidence and ignore the rest.”

Making the most of limited time

Though Cox was able to spend the summer with Caitlyne and her family, he normally doesn’t have this much time or access. When on tighter deadlines, he tries to spread his interviews out over at least a two-day period. Showing up on the second day shows children that you’re committed.

“There's a layer of trust that they afford you,” Cox said. “The leap that you'll make from that first conversation to the second is really significant.”

Before interviewing children, he asks their parents or guardians a couple of key questions: Is there anything I shouldn’t say? and Is there anything I need to avoid? He also asks them to describe the types of questions the children are asking.

“The questions they’re asking give you insight into their anxiety and what’s on their mind. Suddenly you’re getting past that initial barrier of ‘I’m fine,’” said Cox, referring to the common response children give when asked how they’re doing. “They aren't going to say, ‘This makes me sad,’ or ‘I feel bad about this.’ But if they're worried about the shooter coming after them, they might be asking about the shooter. If they're worried about the security of the school, they might say, ‘Well, is there going to be a fence? Are there going to be cops there?’”

Cox tells the children he’s interviewing that he’s not an authority figure — and that they can choose whether or not to answer his questions. He also tries to sit on the floor during interviews with children so that he’s not towering over them.

Cox asks questions related to details, scenes and memories, knowing that memories can be windows into a person’s innermost feelings and thoughts. When children start opening up, Cox likes to ask “What happened next?” as a way of showing interest and advancing the storytelling process.

Drawing upon his expertise as a trauma psychologist, Becker suggested some other questions that journalists can consider asking children (or anyone for that matter) in the wake of traumatic events:

• What’s been the hardest part about this? And what has been most surprising? These questions invite people to reflect on how a tragedy has affected them in ways they may not have expected.
• Is there anything positive that has come out of this? Not everybody gets to a point where something positive comes out of a tragedy, Becker said, but it can and does happen for some. Capturing this in the person’s own words is an important part of the reporting and storytelling process.
• How has the tragedy impacted your relationships with those closest to you? Whether we're dealing with trauma as a 10-year-old or 40-year-old, we lean on the people who are closest to us, Becker said. Trauma can shift and shape our relationships in unexpected ways.
• How has the tragedy affected your view of the world? This may seem like a lofty question, but it can reveal a lot about the ways in which trauma changes people.
• What’s been the worst part of this experience? When Becker asks his patients this question, he’s often surprised by the answer. It’s the type of question, he said, that can show how trauma rippled through a person’s life in ways that aren’t apparent to outside observers. And it can help a person open up on their own terms. Giving an interview to a journalist isn’t the same as therapy, Becker said, but it can be therapeutic for people who are struggling.

Transparency as an act of respect

 While reporting “An American Girl,” Cox structured the story in his head, plotting the beginning and ends of sections. He talked at length about the structure with his editor, Lynda Robinson, and together they arrived at a shared vision for the story.

”I write with so much more confidence and authority,” Cox said, “when I feel like somebody who I trust completely has the same vision.”

After he finished writing the story, Cox took Caitlyne’s parents through the story in detail as part of the fact-checking process. He asked them to let him know if anything was wrong or if they feared that any of the details could put Caitlyne in jeopardy or harm her emotionally. He later shared parts with Caitlyne as well.

Cox wanted to make the reporting and storytelling process as transparent as possible, knowing that many people have never been interviewed by the media and don’t know what to expect. Transparency is an important part of cultural competency – and of the understanding that different communities have varying levels of experience with, and trust in, the media. “I think the more people understand what we do,” Cox said, “the easier it is for them to trust us.”

By sharing parts of the story ahead of time, Cox could ensure that Caitlyne and her parents wouldn’t get caught off-guard when reading the published piece. In many ways, it was an act of reciprocal respect.

“(Caitlyne’s parents) were entirely open, entirely exposed, entirely vulnerable,” Cox said. “They gave me this extraordinary access into the most vulnerable moments of their child's life. They trusted me with that, and the least I could do was show them how the process works.”

Cox has kept in touch with Caitlyne and her parents in the months since the story was published and said he plans to continue reporting on her journey.

* * *

Mallary Tenore Tarpley is a faculty member at the University of Texas at Austin’s Moody College of Communication and the associate director of UT’s Knight Center for Journalism in the Americas. She’s the author of the forthcoming book, "Slip: Recovery, Sickness & the Space in Between," an examination of the under-discussed complexities of eating disorders and recovery.

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