It's such a risk to write a novel that it's easy to become conservative - you're spending what would be, for me, a couple of years of my life on a single idea. Which is maybe one of the reasons I write stories - if it doesn't work, you've only lost a month.

I was born in Ann Arbor. I lived for a while in Ohio; Pennsylvania, California for 10 years, and now in Boston. And I lived in Iowa for a couple of years, where I studied at the Writers Workshop.

Although I think I'm relatively happy as a person, I think there's something unhappy at the root of all my writing. I'd say optimistic but unhappy. Nothing that's particularly original, other than that we're going to live and die, and terrible things happen.

I still don't know whether I know how to write a sentence.

Doubt is the enemy of mania. It's trying to get aloft strung with weights. The moment I like writing is three sentences in, when somehow those weights drop away, and you can invent. I cannot tell you the dread I have.

I'm a Jew. I think every Jew is dark in certain ways.

I've discovered over the years that being subject to both the adoration and the vilification actually makes me more disciplined. It makes me understand that it's the idea of writing a great book that propels me now, whereas it used to be the idea of success.

Any writer who says he loves writing is crazy. Or lying.

I don't think there is such a thing as pure imagination. I think it's a combination of memory and invention.

There's a beauty to math. Math is so simple. It's just one step after the next.

Medicine ended up being the best thing I ever did for my writing.

Your first book is kind of a labor of ignorance. You don't realize the difficulty of it. Your second book is sort of a labor of fear. Then you sort of either hit a stride, or you don't.

Fiction is about small ambition, small failed ambition, small disappointed hope.

I have a very bad memory. I can't remember my own life very well.

There once was this powerful, both capital and political, class who cared about supporting and affirming a solid middle class in this country.

Every time I'd sing or play piano when I was a child, my dad would yell up from the basement, 'That's B-flat!'

Medicine involves dealing with people who are going through changes and cycles, often people trapped in bodies that are going out from under them. Spending time with them lets you think their way, gives you insights as a writer.

I like to write about the moment of light in the hour of darkness.

Point of view gets me. If I can feel like a character rather than a reader, I'll read that book.

Writers of literature make very little money.

When you're in medicine - especially when you're a resident in a public hospital - you feel like you're doing your part. But not when you're a writer.

People are surprised when Hollywood characters act the way a real person would.

A novel, at least for me, cannot be visualized at one time.

When I write, I can become this ecstatic, crazy fellow, hearing the voices and just loosening up and letting them grow.