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by Carolyn Thomas ♥ @HeartSisters
Earlier this year, I was asked by my book publisher (Johns Hopkins University Press, the oldest academic publisher in North America) if I would write an updated 2nd edition of my book, A Woman’s Guide to Living with Heart Disease. At first, I said NO, and then I said MAYBE – and then when JHUP’s Senior Acquisitions Editor told me we could change the title of a 2nd edition, I immediately said: “Well, YES!!
I have despised that title since the book was published – specifically because of that word “guide”, which is inaccurate. To me, a guide is directive, advising readers to do this but not that, go here but not there. Yet here’s how I ended up with a book title I’d vigorously argued against:
Authors and their editors often use a working title during the early writing/editing stages until the publisher’s marketing and publicity department wades in when the book is almost ready to go to print. The decision on titles is influenced by which title the publisher believes will help to sell a book. I’m not alone in battling a publisher over titles – as the author Tony Tulathimutte explained in his essay called “Title Fights” in The Paris Review:
“The history of writers fighting for their book titles is extensive and bloody; so powerful is the publisher’s veto that not even the late Toni Morrison, fresh off her Nobel Prize in Literature, got to keep her preferred title for Paradise (which she had called War.)”
Like many thwarted authors, I was ultimately forced to cave in because the then-manager of JHUP publicity refused to budge on his title choice. Despite countless hours of phonecall debates back then, he had never read my book, cared nothing about its content, and worse, he treated me with aggressive contempt because I didn’t like his title.. But he also wielded final authority on the ultimate title. The title stayed, unfortunately, but happily for future JHUP authors, that manager (since relieved of his duties) did not.
It was that unique possibility of a new title for this 2nd edition that was so appealing to me. But while I was celebrating this unexpected opportunity to change my title, I was still a heart patient living with ongoing cardiac symptoms of a coronary microvascular disease diagnosis – mostly central chest pain, shortness of breath and unexpectedly severe periods of crushing fatigue.
I often describe myself as being like a balloon with a pin-hole in it. I’m relatively perky in the early morning (the only time of day, in fact, when I am fit to write this Heart Sisters blog post or anything else – like thinking, making decisions, giving presentations, having normal conversations or meeting up with my morning walking groups). I now live with what I call “one-outing days” or “two-outing days” or (rarely!) “three-outing days” on my calendar. And most days so far, I’ve learned to carefully balance things out pretty well.
My now-former family physician once asked me shortly after my heart attack if I couldn’t just “fight through” my persistent symptoms. (This, by the way, is a common perspective from those who dismiss or ignore the reality of chronically ill patients, mostly because they have no clue).
But when I said YES to the 2nd edition, I too must have believed I could somehow “fight through” those debilitating symptoms, even though “fighting through” cardiac symptoms is not something I’d ever recommend.
But all along, I was having second and then third thoughts.
I now suspect that I felt so pleased at first about a new title that I convinced myself I could somehow manage the overwhelming reality of this huge project. Many of my readers, by the way, tell me they also tend to overestimate their ability to participate because they really long to participate – even when there are predictable physical and psychological costs for doing so. Some experiences may be worth it, yet most are not.
Enter the useful wisdom of a Seth Godin essay called The Lazy Jugglers – which finally brings us to our blog post topic today.
This author of 20 books was writing about how jugglers learn to juggle, but one line in this unlikely topic helped to change my mind about writing that 2nd edition. His wisdom read like this:
“Throws are far more important than catches.”
Seth’s juggling metaphor suggests that a thrower is the one who carefully aims the pitch while the catcher is the one who watches and waits for whatever is being thrown. The catcher simply reacts to the throw. Hence the importance of throws. We all know, for example, when what we’re being asked to do is something WE want, or when it’s something others want.
When I signed my first book contract with JHUP, I was the thrower. It was thrilling! For years, I’d wanted to write a book based on my most-read Heart Sisters articles, and had already imagined what my 10 chapters would look like, long before I signed that book contract. For almost two years, my Coroplast chapter outline board was propped up on my dining room table, covered with oversized post-it notes. It became a decor feature in my dining room during writing, editing, re-writing, proofreading, and many phonecalls to Baltimore about the book. I was so proud to finally see our finished book arrive in my mailbox from JHUP – and then stunned to learn at our public book launch that it was Amazon’s #1 New Release in the Medical/Public Health category – remarkable news for any heart book – especially one that’s written not by a cardiologist, but by a patient.
For those two years of writing, I had loved the daily exercise of writing the kind of book I’d been searching for, but couldn’t find, after my own heart attack years earlier. I loved carefully deciding which excerpts from which Heart Sisters blog articles would be most useful to most of the women reading this book one day in the future, and how I could seamlessly massage key points from one article into specific book chapters. I especially loved working with the former JHUP production editor, Deborah Bors – who skillfully stick-handled me through what I was soon calling “our book”.
But for this new 2nd edition, I would not be the one doing the throwing. Writing a 2nd edition some day had neither been on on my radar nor on my wish list. Ever! I’d be catching whatever was being thrown by others, for reasons that were not mine, and all the while needing to “fight through” my cardiac symptoms in order to get it all done in time to meet the deadline of others.
In Seth Godin’s essay about juggling, he offers a number of other approaches to keep in mind – whether you’re improving your juggling skills or making a hard decision, including these two wise reminders:
- Don’t take on more than you can handle
- Frantic leads to more frantic. Let it drop and begin again.
Basically, the question I had was: do I want to be the one who throws, or the one who catches what’s been thrown?
I knew the answer to that question last week when one fine day, I contacted the JHUP Senior Acquisitions Editor again, this time to tell her that I would not be doing a 2nd edition after all. I decided to say NO to something I thought I wanted in favour of protecting something I knew I wanted. And I felt so relieved!
Baseball image: Tomislav Jakupec at Pixabay
♥
NOTE FROM CAROLYN: I wrote more about the importance of saying NO when you mean NO in my book, A Woman’s Guide to Living with Heart Disease (published by Johns Hopkins University Press). You can ask for it at your local library or favourite bookshop (please support your independent neighbourhood booksellers!) or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 30% off the list price).
Heart Sisters 
Hello Carolyn,
I work for the Board of Elections. Five weeks after my triple bypass surgery, I was back to work part-time. This past week has been downright crazy. My mind is saying NO – but YES keeps coming out of my mouth.
I run a warehouse, and keep saying I am too old to continue this heavy work. But YES keeps coming out of my mouth!
Tuesday I turn 62. It may be time to turn in my catcher’s mask and warm up my throwing arm and move to a desk job.
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Hi Susan – You work in such a high-stress pressure-cooker environment, and you’re doing heavy work. It almost sounds like you already know what you need to do (for the sake of your health at the very least) but something is holding you back still. I’ll quote here my wise friend Liz who reminded me (see her comment below):
“If it isn’t a definite YES, it’s a NO!”
I can certainly identify with your reluctance. Many of us tend to make up reasons to stay when we know we should leave (a job, a relationship, a house, a promise, etc etc) – so many reasons to just keep on keeping on, whatever that reason may be.
But it does seem that you’re on the very brink of turning in your catcher’s mask at last. I just hope that you can make this decision to warm up your throwing arm (I love that image of yours!) BEFORE a work- or stress-related injury (or heaven forbid: another cardiac event!!!) stops you in your tracks – thus making the decision for you.
Take care Susan – good luck to you, and happy early 62nd birthday on Tuesday!!! ❤️
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Dear Carolyn,
I’m so glad that you listened to your beautiful little heart and decided not to go ahead with a revision of your book. It would have taken you away from the things that matter most to you…your family and friends, and could have jeopardized your health.
I think most of us are people-pleasers and find it really hard to say no. There is wisdom in a quote I heard a long time ago and while it isn’t appropriate in all circumstances, I think it applies here…
“If it isn’t a definite YES, it’s a NO!”
I’m sure the relief you felt when you said no was huge and you knew it was the right decision. There is that ever present voice with its ongoing chatter in our heads that we need to harness – so good for you for paying attention to your own needs.
As you say, take care and stay well.
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Hello Liz – thank you so much for sharing that brilliant and wise reminder:
“If it isn’t a definite YES, it’s a NO!”
That is SO important for each of us to keep in mind, because it clarifies what we DO want. You’re so right, Liz – I knew my decision was exactly the right choice – and that huge wave of relief confirmed it.
Take care and thanks again. . .❤️
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Sometimes it’s good to explore – but within your capability, not put you out of balance.
Carolyn, 👍 that was a wise choice!
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YES! That’s exactly what I finally decided as well! And this wouldn’t be a one-time event, but months and months of fastidious writing and editing. You’re right – those months would very likely put me “out of balance”. Is that how I want to spend the very limited hours I have left on this earth (as we all have)?
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Like minds huu 👩❤️💋👩
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Good morning! Second edition, schmecond edition!
I am still giving copies of your book to every cardiologist I encounter and every fellow heart traveler who would like one.
Would a new title jazz it up? Maybe that would be a choice the pundits would like.
You prioritizing you is the best choice.
Rock on, Carolyn!
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Thank you Dr. Anne for making me laugh out loud this morning! And thanks especially for your ongoing support all these years. I hope you and your own precious heart are doing well.
One of the “advantages” of a 2nd edition that JHUP suggested was that I could update the 13 pages of journal citations at the end of my book. I signed my book contract in 2015, so all of the research studies I referenced when I started writing back then were pre-2015. A 2nd edition would allow me to go through those 13 pages, replacing some of the older studies with newer studies. But I’m thinking that few if any of the women who read my book actually care about those 13 pages of citations.
And writing the original book was a fun and creative experience for me. Updating 13 pages of citations (carefully applying the appropriate Chicago Manual of Style rules as JHUP requires) would be neither for me!
Thanks once more – take care. . .❤️
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Oh my gosh, Carolyn. I have been inspired several times to comment on columns of yours that resonated with me, but this one hit a home run.
I live this particular battle on more days than I should. In 2008, I solo-cycled across Canada, 8000 km in 67 days and a year later I had open heart surgery for an aortic aneurysm, a pacemaker in 2014 and a diagnosis of CMVD in 2015.
My lifestyle was “go and keep going” for 16 hrs a day and I still, after all that time, don’t want to listen to my body.
I hope I am learning to show compassion for myself, but when I am sometimes too tired to chew my food at dinner I have to throw aside my pride and confess I have overdone it. Again. I had some wonderful advice years after my OHS – your life is like a bank account, if you make withdrawals you need to make deposits! I try to keep that in mind and hope I am making progress.
I also remind myself of a great line in a song by Lyle Lovett: “She wasn’t good, but she had good intentions”.
Love your columns and your wisdom.
Lauren
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Hello Lauren – Oh my! “Too tired to chew your food!” THAT is some kind of self-care deficit warning sign, isn’t it?
I used to proudly describe my “old” pre-heart attack self as “running around with my hair on fire!” My standard response when asked “How are you doing?” was “Oh, I’m CRAZY BUSY!!!” as if bragging about being exhausted was a good thing, or that insisting on being the first to arrive and the very last to leave was “normal”.
I really like that wonderful “life is like a bank account” advice about making deposits!!
That reminded me of another wise reader who once told me: “I have more balance in my life now – because I HAVE to!” Some of us seem to need a catastrophic diagnosis to get that message!
Thanks for your kind words – Take care Lauren! ❤️
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Good for you Carolyn!
Now that I’m living with my multiple myeloma as a chronic condition, I’m toast after dinner, and limit myself to one or two outing days too.
But I really relate to what you said here: “…they also tend to overestimate their ability to participate because they really long to participate – even when there are predictable physical and psychological costs for doing so.”
It is so hard saying NO! But it sounds like you know what’s the right choice for you. (Your blog still continues to be an excellent resource.) I still struggle with taking on too much and becoming frantic, almost all thanks to things I dream up myself!
p.s. Can you tell us what was the title you were lobbying for?
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Hello Cheryl – lovely to hear from you. I can sure relate to your description of being “toast after dinner” Once, my sister phoned me at 8pm and my first thought when I heard the phone ringing was: “Who on earth would be calling me in the middle of the night?!?!” I’d already been asleep for 2 hours by then!
You have been through so much in the past year or so, Cheryl. I sure hope you continue to feel more like YOURSELF as every day, week and month goes by – and less frantic.
I’m happy to answer your title question here: our working title for two years was this:
“HEART SISTERS: A Survivor’s Take on Living With Heart Disease”
BUT when the publicity manager mentioned in this post heard that title, he said to me (out loud!!!):
“That title would be too confusing for women. They might think it’s a book about Valentine’s Day. Or a romance novel. . .”
Seriously. 😦 This was the person I had to deal with. . .
Hence his current “GUIDE” decision. As you may recall, the way I tend to write (both a book chapter or a blog post) starts with a brief personal narrative followed by some academic research citations or expert quotes about the topic. The personal narrative is the key part of each chapter, setting a unique theme and then fleshed out with that background info.
But ironically, at least two book reviewers, when the book was first launched, mentioned the title’s “Guide” word negatively (because what they’d expected was a GUIDE). One wrote a really positive review, but added: “This actually reads more like a memoir than a guidebook!” My point exactly!!!!
Take good care, Cheryl! ❤️
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Brava, Carolyn!
Saying “No!” can be excruciatingly difficult, especially when one has been raised to believe she is responsible for not disappointing others. (Guys aren’t raised this way, as a rule. They are raised to believe they are responsible for telling others what to do. That’s been happening since ancient days, and it ain’t gonna change any time soon!)
You have this WONDERFUL website, filled with such valuable information — knowledge that women dealing with heart problems can’t find anywhere else, let alone from their physicians. It’s a gold mine! Thank you for all the effort, concern, and LOVE you have put into it.
You are NOT obligated to try to fit all that in between 2 covers, my dear!
Thank you for saying, “No!” and being a shining example to other women!
Blessings,
Gloria
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Hello Gloria – I appreciate your kind words.
You are so right: I’m NOT obligated to say YES (except for very special circumstances – like emergencies involving my grandbabies, for example!) Everything else requires careful consideration before saying “YES of course I’ll do what you want me to do…”
I write about what I need to learn, which is why I wrote “WHY NO IS A COMPLETE SENTENCE!” 11 years ago!!
I really enjoyed reading your comment today – thanks again! ❤️
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Hello Carolyn,
As I was reading your post this morning, I was shaking my head NO, this would not be good for her.
When I got to the end of your post, I too felt relief that you ultimately chose to say NO and truly give the time to yourself.
To answer your “Q: Have you had the experience of catching, when what you really wanted was to throw?”:
Yes, I have. I was so unwell after two months trying to manage alone after a diagnosis of CHF in ICU hospitalization for 12 days, and financially broken that I turned over my power of attorney for my complete care to an older brother who had not spoken to me in years. I was desperate for help.
That decision was a mistake that I made while desperate and unwell. I was not allowed to speak any words to him other than YES or NO; and I had no say in how anything would be handled. I was the person catching all of his years of resentment and anger that he had towards me. It was awful.
He lasted for a short period, then he resigned as my power of attorney without notice. I have not heard from him since that day he told me over the phone that he resigned as my power of attorney, leaving me in a worse situation that I alone had to dig myself out.
I am the person in charge of my care and the person throwing in charge of my own life. This was another life lesson for sure.
I am glad to hear that you are continuing to be the person throwing in charge of your own life! I believe that you made a great choice. ❤️🍎
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Hi Teri – I knew right away that I had made the correct decision (to say thanks but NO thanks! ), the minute I’d informed my editor last week. Relief is a good sign, I think. It wouldn’t be every person’s choice, but all that counts in this example is what will work for me and my own circumstances at this particular time in my life.
I remember this terrific quote:
“Whenever you say “yes” to something, you’re saying “no” to something else!” AND I believe the opposite of that statement is true as well. So by saying NO, I’ve just said YES to an unlimited array of other potential good things ahead. . .
What a horrific and hurtful experience you endured with your brother. I’m so sorry you had to go through all that. As you correctly observe now, however, it was a mistake made while you were desperate and unwell. Many of us would have made the same decision if we too were in your shoes. Being sick and desperate often results in decisions we’d never make on better days.
I think we generally make the best decisions we know how to make at the time. If you’d had other better options back then, you would have chosen differently.
But here you are now, “the person throwing in charge of your own life.” Congratulations on surviving that.
Take care. . . ❤️
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Thank you Carolyn for your kind words about my mistake that I made when I was unwell and desperate for help. You are absolutely right when saying NO to something you are saying YES to something else!
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Hi again Teri – I suspect that the more comfortable we are in deciding what exactly it is that we want or need, and if we keep clear about those wants and needs, it becomes easier to say NO to what we DON’T want or need, and YES to what we do. It takes practice, right?
❤️
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