Season 2 arrives on May 9, 2023!
May 10, 2022

From Journal to Book with Karen Propp

From Journal to Book with Karen Propp

What do you do when you want to read a book that’s not already out there? And what’s the difference between keeping a journal and writing for publication? In S1E1 of TBIHTW, writer and editor Karen Propp explores these and other questions. She...

What do you do when you want to read a book that’s not already out there?

And what’s the difference between keeping a journal and writing for publication?

In S1E1 of TBIHTW, writer and editor Karen Propp explores these and other questions. She tells the story of how she came to write her memoir, In Sickness &  In Health: A Love Story.

Karen based her book on extensive journals she’d kept during her late ex-husband’s prostate cancer and treatment.

Published in 2002,  In Sickness &  In Health is a beautifully-written memoir – one of the very first to honestly and vulnerably explored the impact of illness on a caregiver.

In the interview, Karen also discusses:

  • her identity as the daughter of a Holocaust survivor
  • the MAUS controversy
  • the importance of writing groups
  • how to find urgency in your writing
  • AND unintended consequences of publishing personal/confessional memoir

Today, Karen is an independent editor and writer who specializes in business, health care, and memoir. She’s a highly-popular writing consultant who with thought leaders across the globe.

Karen is also the author of the memoir, The Pregnancy Project: Encounters With Reproductive Therapy, and the co-editor of Why I’m Still Married: Women Write Their Hearts Out On Love, Loss, Sex, and Who Does The Dishes, the best-selling anthology of essays about marriage.  She has a Ph.D. in British and American Literature from the University of Utah.


“How to Hide: Instructions from a Daughter of Survivors” (Lilith Magazine):

In Sickness &  In Health: A Love Story:

More about Karen Propp



This episode was edited and produced by Magpie Audio Productions. Theme music  is "The Stone Mansion" by BlueDot Productions.



[introductory quote by Karen Propp]: The best reason to write a book is because you want to, for the experience itself, especially if it's a personal book like a memoir. I was wishing there was a book that could be kind of a guide or a companion to me as a woman, as a spouse whose partner was going through this illness. I think that kept the urgency alive for me.


[host introduction by Paul Zakrzewski]: Welcome to "The Book I Had to Write". This is the podcast where I talk to authors about their most compelling stories, and why these journeys matter to anyone who wants to publish. I'm Paul Zakrzewski, I'm a writer and a book coach. In this episode, I talk with Karen Propp. These days, Karen specializes in writing books for clients in the areas of business and healthcare, but she published her own memoir In Sickness & In Health back in 2002.

It's a smart and honest exploration of how a partner's illness can impact a marriage. This book came out of Karen's own experiences as a caretaker. It's the book she wished was already out there when she wrote it. Our conversation opened into some important questions that any writer of memoir might consider. Like, what's the difference between keeping a journal and writing for publication? And what are some of the potential consequences of writing about those closest to us?

Before we get to that, we kick things off on a different note. Both Karen and I are children of Holocaust survivors. As we recorded this episode, book bannings were very much in the news. Back in January, the McMinn School District in Tennessee banned the MAUS series. That's the Pulitzer Prize-winning memoir told in graphic novel form by cartoonist, Art Spiegelman. So, I wanted to ask Karen about this part of her story. She obliged by reading a brief section from an essay she wrote back in the 1990s, it's called "How to Hide: Instructions from a Daughter of Survivors". Our conversation picks up after that.

Karen [reading]: “Train yourself in outdoor survival, winter camping, recognition of edible and poisonous plants, long-distance swimming. Experiment with giving a false name when making reservations or when meeting strangers in bars, airplanes, supermarkets, make a game out of these opportunities to practice answering to a name your parents would never have considered, Heather, Vanessa, Bobby, Anne. Tell friends who witnessed this behavior, that it's the repressed actress in you. Be drawn to men who suffered early irretrievable losses, such as physical or sexual abuse or the death of a parent.

Have a deeply enduring sympathy for these lovers. Nevertheless, expect pain, play victim to a man's victimizer. Given your guilt, you'd rather be hurt than hurt. Hide in a marriage to a man with an important career and serve him, his work, his name. Expect your children's lives to become your own. Live with a quiet, unrelenting and nameless fear in the midst of good fortune and ease. A whispering secret that won't leave you alone, and one that arrives like an intruder when you are alone. You are mostly alone.

“Your life is like a thin strip of light under the door, surrounded by blackness and in danger of being shut off. And you aren't even the one who was in the war. Hide from yourself. Who are you anyway? Isn't every breath of your existence taken at the expense of 6 million, that readiness to step into the crevices others leave and unwillingness to impose your famous reticence without even having been told you act as if the penalty for a real self is to be shot down, turned in, taken away? Remember, a nice person is the American translation of a good German.”

Karen: As an aside, it's very strange to read words you've read and haven't looked at for quite a number of years because you've sort of become a different person. And you're sort of like, "Who wrote that?"

Paul: Right. That was written a while back.

Karen: Yeah.

Paul: Well, welcome, Karen. And thanks for being here.

Karen: Thank you.

Paul: So, I thought we could start off actually before your book. So, this is going back a ways, and as I mentioned, you read from this piece "How to Hide: Instructions from a Daughter of Survivors". And, you know, it's weird, even though I've known you for over 15 years, not only had I never read this piece before a couple of weeks ago but I didn't know that you were also the daughter of a survivor. So, it's just interesting, even though you wrote this piece...when was it?

Karen: 1994, I think.

Paul: Okay. It feels like suddenly really relevant again. I'm thinking, you know, as we're recording this in the news, over the past couple weeks, there's been this ban, you know, on Art Spiegelman's MAUS  books.

Karen: Yeah.

Paul: You know, it's suddenly shot up to, like, number one on Amazon, tons of money is pouring into the school district to buy, like, you know, tons of books for the kids. So, I guess I wanted to ask you what you make of incidents like this.

Karen: It's scary. And I just wanted to look up when MAUS was actually published. Yeah, it was published in 1991. So, I remember when MAUS was published and it had a big impression, it was, wow. Someone's really saying this, spelling it all out. It's so readable. There's graphics. At the time I was teaching in college, and college students and I assigned it. And I think that that was also about the time that "Schindler's List" came out. And so, it seemed like there was this whole sort of, you know, willingness to talk and look at what had happened during the Holocaust.

So, it's sort of blows my mind that in our lifetime, we are now seeing a reversal of that. I mean, those books and movies were welcomed and celebrated. And even though maybe they were scary or unsettling, there was a sense of, like, the floodgates opening. So, I'm just sort of shocked that things are turning the way they are.

I have to say that I probably was not as shocked as I should have been about the MAUS  controversy, because it just seems like it's one in a whole line of things. And I'm happy that this one has been so well-publicized. And there's been some pushback with the buying of the copies. But I don't know. I mean, as you have, I'm sure I read a lot about, "Is this like Germany in 1930, whatever?" And I think I don't wanna come to those easy conclusions either, but we're just seeing a lot of antisemitism.

Paul: Do you remember what prompted you to write the piece in the first place?

Karen: The "How to Hide" piece?

Paul: Yeah.

Karen: Yeah. Well, at the time, I was in my 30s, I'd say, early to mid-30s. And I was very active in these second generation after, one generation after groups. And that was another part of this whole floodgate and awakening. And so, I was going to...I was meeting with a group. We started out under some official auspices, and then we started meeting in each other's homes every month. And so, the piece definitely grew out of the conversations in that group. And it's, you know, not everything in the piece speaks to my experience. Some of it was sort of pulled...sort of a composite portrait from things in my family and other people's family.

Paul: It sounds like you felt like even back then, like, some need to represent a group experience.

Karen: Yeah. I think that's a good way of putting it. Right. I wasn't only speaking for myself, but for a group. Yeah.

Paul: So, you know, of course, this podcast is called "The Book I Had to Write". But the idea is just, it could be, I guess the story I had to write, you know, it's just this idea of urgency. When does urgency come up, and all the different reasons people have for urgency? Obviously, that identity was very close to you at that time, I'm wondering.

You made a comment a little while ago that that person seems far away from you. I've had a similar experience. I mean, my second-generation identity was...felt much more closer to me, you know, back in my 30s than it does today. It's important but in a very different way. What do you think about when you read that story today?

Karen: Yeah, I'd say it's the same thing. It's know, maybe it was a developmental phase or something. It was very important for me to access it and uncover it and realize it. I wouldn't say it's gone away, but it's not as, you know, front and center. But it's interesting what you say about writing for a group because...and the compulsion to...

I mean, I'd say that both pieces, one about being a child of a survivor and being the spouse of a cancer survivor, they were motivated by a personal need at the time to just kind of come to terms with emotions that were overwhelming me, that I didn't know how to sort out except in writing. However, I think, in retrospect, probably their strength comes from my ability to connect it to a group. And with the book about prostate cancer, I was very much aware that not much had been written from the woman's point of view, the spouse's point of view, the family point of view. And indeed, after it was published, you know, I did get some letters from women who said, "Thank you." And so, yes, it came out of kind of a, I don't know, a personal need, but I think the writing was stronger because I could see myself as part of a group as well.


[Karen Propp reading] “In the waiting room, I think about fathers. Sam inherited this disease from his father. Sam hates his father, hates the belt with which his father spanked him. He hates his father's little mustache. He hates his father's taunts, "You'll never amount to anything." This is from a man who was a community leader, a charismatic Zionist, a celebrated ophthalmologist. Sam now undressed naked under a silver machine, black magic marker drawn on his groin as target lines for the radiation's charge. Sam now trusting to the invisible, high beams will burn out his shame. Shame on Sam, the invisible son. Shame on Sam in trouble.

Invisible too, not even a glimmer yet, is Sam's future son. For Sam hopes to pass along only the smart gene, the funny gene, the genes for hitting balls and loving cars and tools, the genes for solving mathematical equations, but not the genes for aberrant prostate cells. I see the fear now on Sam's face when he turns the corner from the treatment room. I see the quiet way he folds into himself on the ride home. He is a heavy-lidded with fatigue. He pecks me goodbye on my cheek, a sweet bird peck. When I pull up in front of my own house and turn off the ignition key, darkness has already fallen. I'm afraid of being abandoned. I am abandoned.”


Paul: So, you know, a few years after you...I guess, maybe 10 years or so after you did this essay, then you published this book "In Sickness and Health". And as you mentioned, it was, you know, this personal journey that you had gone with your, I guess your ex or your late ex-husband. And, you know, when you and I were talking about this interview beforehand, you mentioned that you had been keeping journals. Can you talk to me a bit you remember that process?

Karen: Yeah. Yeah. Well, I mean, I don't know about you, but, I mean, you know, when I was eight years old, I kept a journal that was, you know...religiously. So, that was always my first impulse to write. And so, yes, I would come home from these appointments, and just feel overwhelmed by emotion, and also information, and a sense of just having to, you know, get it all down to work it through. At the time, there was, like, a lot of medical information as well that I was absorbing. So, I wanted to record that. There was also a sense that, like, this was sort of an extraordinary thing happening in my life that I wanted to write about, but it was very much reader-centered prose. You know, I was just really writing for myself and venting and not worrying about what it sounded like, not thinking about an audience.

Paul: You were keeping a journal kind of throughout this experience you were having?

Karen: Yes.

Paul: Wow. Like, you would write in it every day?

Karen: No, not every day. But I think I remember coming home from appointments and just feeling like I had to write it down.

Paul: So, then I know we're going back a while, but do you remember when you realized that you wanted to turn these journals into a book?

Karen: I don't remember that transition, but at a certain point I did. I was in a writer's group, and maybe they encouraged me or something, but at a certain point, I was like, "I wanna write about this," or "This might be a book." After that, I will say that it went through a lot of iteration. The journal keeping was easy. You know, that was catharsis, that was therapy. But then the actual writing of it called upon my training and schooling as a writer and it required many drafts and revisions. It required reading it out loud and getting feedback. So, I wrote a whole manuscript and sent it to the person who was then my agent, who actually did send it out to editors. And the response was, "Nobody wants to hear all this medical stuff. It's too much of a cancer journal and a cancer story."

So, I was encouraged, and I rewrote the whole thing to make it more of sort of a family story and less of a... you know, at the time I thought all the scientific details were really important to narrate and record. But the feedback I got from readers, from readers in the industry, was that it would be more appealing to a wider audience if it was a family story with the medical information, sort of as, you know, the B line, the B story. The A story was the family, and the emotion, and me as the woman. And the B story was the medical information. So, that was part of its iteration is what I'm saying. The "How to Hide" piece had very little revision involved. "In Sickness and Health" went through many different transformations.

Paul: What was hardest for you about turning it from a journal into a book? Do you remember?

Karen: I think it was getting that feedback and realizing that what I wanted the book to be, wasn't necessarily what readers wanted the book to be. And then I had to kind of rethink and pretty much dismantle the whole manuscript and rewrite it.

Paul: It's interesting because today, I feel I'm gonna go on a limb here and say that you would get the opposite feedback because the trend in publishing now seems to be what one writer I know calls this Memoir Plus. So, you've got the story.

Karen: Oh yeah.

Paul: Yeah, the kind of the research that everyone would see, because now people want their memoir with a side of information.

Karen: That's true. That's true. But no, that is a good point. And however, I will say that I think those Memoirs Plus, there's...the whole point seems to be how artfully you can weave the two together. Whereas, I think I just had these big sort of information dumps about whatever was happening then, in the medical treatment.

Paul: You mentioned a writing group a short while ago, and this is a writing group that you've been in for a long time now, right? It's the same writing group?

Karen: Yeah.

Paul: Yeah.

Karen: For over 20 years.

Paul: Can you tell me a bit about the group and how that's kinda helped shape you as a writer?

Karen: I mean, I think writing groups are really important, in general, because once you're out of school or if you haven't hired somebody, then you don't have any kind of audience. Plus, I'm always someone that works better with more support. But I also, in general, think writers' groups are almost like marriages. Like, it depends on the chemistry as well. And it's important that you all respect one another and can help one another. And that has been the case pretty much all the way through this writing group I'm in.

Paul: Partly because it's really small, right? There's just two or three other members, thereabout.

Karen: Well, we've had a changing membership, but there's never been more than...there's usually four or five, no more than six. And I've been sort of briefly in larger groups, and it doesn't feel like everyone gets the chance to be heard in that sense, in that thing. Yeah. I will say also that I feel like writing groups fall into two categories. One of them is just, you meet, talk about the work, give critiques, you know, go home, more, like, a workshop. And then some of them are more writing/support groups. What's going on in your life that's preventing you from writing? How are you making a living? What is your mood like these days? Do you know what I mean?

So, this writing group has gone through various iterations of those between those two pools. I think depending upon our needs. I think when we were younger, also there was a lot more kind of...we used to sometimes joke that it was like a slumber party. You know, we'd stay up all night and, you know, just talk. And it's a little bit's gotten a little bit more professional, I'd say, as we've gotten more professional as well.


Paul: The other thing I to ask you about is, I know that you know, you work as a ghostwriter, and book coach, and with clients. And do you feel like you are able to help other folks kind of find that urgency in their writing? Or what is it that you feel like you tell them to do, to find that?

Karen: Yeah. Well, it's interesting, you're talking about the book I had to write. So, I was thinking about that, and I think that writing a book is a daunting process. I don't think anyone would tell you differently, and you sort of have to be in it for the long haul. And so, what I'm trying to say is, I don't think anyone can really stick with it unless they really do feel it's the book they have to write. Do you know what I mean? It kinda tests you along the way. I'd say as a coach and an editor, the number one thing I see is people saying, "Oh, I have a great idea for a book. Oh, why don't we just, you know, dash it off? And it's going to be a best-seller, and the movie rights will be bought."

And that is just...personally, I try to discourage that sentiment. Other people may play into it, but I try to, you know, keep expectations low. And what I say is that the best reason to write a book is because you want to, for the experience itself, especially if it's a personal book, like a memoir. We've talked about platform books, and if somebody already is doing workshops, or teachings, or has a message and that they're spreading, you know, that they're already known for, then I'd say writing the book is both easier and maybe more obvious, because you're sort of just putting into words what they've already been, I don't know, implementing, I guess.

So, that's a different kind of book. And I would say, probably the person has already felt the urgency to develop the materials, you know, in webinars, or conferences, you know what I'm saying? Like, it's a different story if people have developed their message and their material and their content in a different medium, and they just wanna sort of record it or, you know, contain it within the covers of a book.

Paul: And you were just saying, writing a book is a daunting task and you have to feel this urgency. I'm wondering if you can just help unpack for me a little bit of what you thought the urgency was, motivating you when you wrote, for example, "In Sickness and Health". You had mentioned to me, just even in the past, just your role as a caretaker, like, that, the experience felt underrepresented and just was so immediate for you. Can you talk a bit about that?

Karen: Yeah. I don't know if this answers what you're saying, but it was also about feeling like I wanted to write a book that wasn't out there yet, write the book that I wanted to read. And so, at the time, yes, I was wishing there was a book that could be kind of a guide or a companion to me as a woman, as a spouse whose partner was going through this illness. I think that kept the urgency alive for me.

Paul: It was interesting because I feel like when I was first talking to you about this interview, looking at this question of being a caretaker and kind of the urgency of writing coming from being a caretaker.

Karen: Okay.

Paul: And it sounds like that's actually an impulse. Even though this book is, you know, 20 years old, that that's actually an impulse that has continued with you. Can you talk about that?

Karen: Yeah. Yeah. We were talking about how I've had a lot of responsibility for both my parents in the last five years, who have been ill, elderly and ill. And as the oldest child and the daughter who lives nearby, it's kind of been predetermined, this role has been predetermined for me. So, it's been a very transformative experience.

Again, it fits under the caretaking rubric. And I think there's a lot to be said about it. And again, as I think I told you that I'm feeling once again that maybe my personal experience might be of help to others in this. Just demographically, so many more Boomers and those of us who will be aging or caring for aging parents. So, it's just kind of brought it forward to me at the forefront. But, yeah. And the whole caretaking experience is very...I don't know, maybe it's indicative to my personality in some way. But it seems like a rich kind of vein to probe.

Paul: And obviously this is a very forward-looking question. It might be hard to answer now. But since I know that you're keeping a journal and that you might wanna write about this experience that you're going through, what is it about going through the experience, you know, 20 years ago, writing this first memoir that would be front and center for you, if and when you started writing a new book? Is there anything that you...would be a guiding kind of principle or thought?

Karen: I don't know. That's a good question. Okay. I think that I'm more aware maybe just in terms of developmentally. As I've gotten older, I'm more aware that if I write and publish it, I want it to be something that, I don't know, is a contribution, or useful to others, or adds value. And I think when I was younger, I was more self-centered and just wanted to sort of get a book out there and see my name in print and everything like that. So, I think I'm more wary or hesitant about where to put my energies now. But in terms of the actual writing of it, I'm not sure I can answer that.

Paul: Okay.

Karen: But I think what you said about it being a Memoir Plus, would be more front and center than it was then.

Paul: Great. And then, you know, fast-forwarding to after the book came out, I was asking you about, you know, the impact of having this book out there. And you mentioned one effect was it sounds like a lot of writing opportunities came your way in the health world. Does that sound right?

Karen: Yes. I did start writing for some healthcare organizations, and I became more interested in healthcare issues. And so, I wrote some whitepapers, basically some whitepapers.

Paul: And then you suggested to me that there were unexpected results of publishing the book.

Karen: Well, I don't know. This gets to the heart of the memoir question about, you know, how personal do I want to be. And at the time I wrote it, I was kind of...part of my belief system was to write as personally as possible, or as honestly as possible about my personal experience, because I thought A, it would help others, and B, it was kind of...I don't know. I saw myself in kind of a confessional mode that began with, like, some of the poets, Sylvia Plath and Robert Lowell, and then continued through Virginia Woolf saying, "You know, women have to write the truth of their experience."

So, I was definitely subscribed to that belief system as a writer. And since then, I've seen that the people in your life then have to read what you write. And also, the people that you haven't yet met but may become friends with, read all these personal things about your life, that you may not have chosen to tell them. So, as you noticed, I have not published a personal memoir since In Sickness and In Health.

So, I have ambivalent feelings. I would say my feelings are more ambivalent since I published it. I definitely feel like it' know, every writer has their truth and the right to tell their truth, and your story is your truth. But then afterwards, you have to think about how comfortable you are with that level of exposure.

Paul: So, it sounds like you had some experiences after the book came out that made you feel like maybe you had revealed too much. Does that sound right to you?

Karen: Yeah. I mean, nothing, like, blatant or really concrete. I just, myself, had a few misgivings. So then when my son was born, I have not really written about his life because I felt like maybe he didn't want that to be written about by me.

Paul: It's really interesting because you're raising this huge issue in, as you know, in the world of memoir writing. You can't pick up a guidebook without a big section on, you know, how do you write about your family. How do you write about those you are closest to? When you were writing this the first time, how did you come out with that question? Did you show the work in progress to, say, your ex or other people that you were...

Karen: Yeah, actually, several people asked me afterwards, "How did he let you do this?" Like, "Wow, you wrote all this personal stuff." And that's an interesting story. At the time, he subscribed to the belief system that he should not censor me in any way, shape, or form. And I could write whatever I wanted to about our experience. Then after it was...I did not really show him the manuscript in process. I did show it to him after it had been accepted for publication and was more or less ready to go. And he read it on two levels.

On the one hand, he read it very objectively and said, "You know, there's a few inaccuracies here you might wanna correct." And then on the other level, I think he was emotionally a little bit distraught or unsettled because it was not how he would have represented the experience that we went through. You know, like, his truth was different from my truth. And I think that he saw himself as much more heroic, where I saw him as much more difficult. So, you know, I think that that didn't go over that well.

Paul: What would you tell memoirs today, if you were coaching someone, how would you tell them to navigate this?

Karen: Yeah, I have had that question asked and I just say, I say, it's a personal decision, it's a personal choice. And I think it comes down to how much you wanna be true to your own truth or how much you wanna adhere to your own truth, and how much you want to consider the feeling because you...probably no matter what you write, you probably won't write what other people around you want you to write. So, in some ways, it's a losing battle. I've also seen memoir students who are afraid of offending anybody in their life, and therefore, what they write is very superficial, and cliched, and uninteresting.

Paul: So, there's a middle ground, it sounds like you're saying?

Karen: Yes. There's a middle ground.

Paul: So, Karen, I wanna thank you again for taking time to talk with me today.

Karen: Yeah, my pleasure. It's always fun to talk to you, Paul.


Paul [outro]: You've been listening to "The Book I Had to Write". I'm Paul Zakrzewski. My guest today was Karen Propp.

You can find her memoir, In Sickness & In Health wherever you buy your favorite books. To learn more about Karen, visit her online at That's Karen Propp, two Ps, all one word. If you're working on your own book you have to write or you wanna get started, maybe I can help. Find out more about me and my book coaching at, that's You can get more information about this show, including new episodes, show transcripts, and more at That's thebookihadtowrite, all one word, .com, and thanks for listening.