May 15, 2026

Publish or Perish

In science, there’s a saying: publish or perish.

Not because scientists are particularly obsessed with writing, but because unpublished work is invisible. You can spend years running experiments, collecting data, refining hypotheses, failing, repeating, discovering. But until the work becomes language, a publication, a paper, something documented and shared, it barely exists beyond the walls of the lab.

Last week, I was at a recurring medical meeting I’ve been part of for six years now, working as a medical writer on a project I’ve followed for nearly a decade. Every year, I write a report summarizing the discussions, decisions, debates, progress, and uncertainties. And each year, before beginning the new report, I go back and read the previous ones, amazed by how much can evolve over time.

You can trace the evolution of ideas in real time. You can read the progress between the lines.

Questions that once felt impossible slowly become answerable. Uncertainties narrow. Language sharpens. Entire fields move forward, one meeting, one discussion, one publication at a time.

The reports become more than documentation. They become a record of progress, of thinking, of people trying to make sense of something together.

Sitting on Data

During this meeting, I was approached about supporting the writing of another publication. And as I asked myself whether I realistically had time to take on another paper, I found myself thinking again about how difficult writing can be within science and medicine.

Scientists and physicians are expected to publish, careers can depend on it. But the writing itself often happens outside the workday; evenings, weekends, and family time, after already full days of research, clinical care, meetings, administration, and emails.

A single publication can take hundreds of hours. Even after the data is there, to shape the language around it clearly and precisely enough for others to understand, challenge, reproduce, and build upon.

And so sometimes important data simply sits.

But in science, if it isn’t published, it almost doesn’t exist.

Mouse Dreams

My first real job was at the National Institutes of Health. I spent my days with mice and mouse brains. Closed-toe shoes and long pants became my new uniform, even in the scorching mid-Atlantic summer.

At that point in my life, I was applying to medical school while also wondering whether I might want to pursue a PhD, trying to understand what a future in science or medicine might actually look like. The day-to-day life of an NIH researcher I could see and understand, but I was surprised by how much of my laboratory chief’s time was spent at his computer writing: grant applications, publications, revisions, responses to peer reviewers.

At the time, I thought the real work of science happened at the bench, in the experiments themselves.

But slowly I understood something else: the publication is the visible tip of the iceberg, the final piece rising above the surface after years of work that otherwise might never be seen at all.

Behind every paper are years of failed experiments, repeated protocols, rewritten sentences, rejected drafts, funding applications, uncertainty, and invisible labor. I’ve written scientific publications myself, and I know how many hours can go into a single sentence.

Research stays with you in strange ways. Even now, I am terrified of mice and occasionally still have stress dreams about my year in animal research. There are so many parts of scientific work that a publication can never show.

And lately, I’ve been thinking about how true this feels beyond science too.

Why I Write

This morning, I opened an email about how to grow and monetize a Substack newsletter. It outlined the steps: build your audience, optimize your funnel, convert subscribers, create recurring revenue.

And of course, publishing can become a business.

But it made me reflect on why I write at all.

I started writing as a little girl. In a diary that was masterfully hidden between my mattress and boxspring. Before phones, or even digital cameras, documented everything for us, writing was how I remembered my life. Journals, notes, fragments of conversations, thoughts I didn’t want to lose.

A photo captures a moment.
Words capture meaning.

My childhood journals, photo credit to my dad :-D

Writing fixes thoughts, emotions, contradictions, context, and questions in time. Sometimes before we fully understand them ourselves.

I once heard someone say that gratitude journaling is not really about writing. It’s about teaching yourself to notice things throughout the day that are worth writing down later.

I think that’s true of life more broadly too.

Writing makes us notice.
Writing makes us reflect.
Writing makes experiences harder to dismiss or forget.

I rarely go back and reread my journals.

Maybe one day I will, when I’m older and life is quieter. Maybe I’ll want to remember who I was at different moments in time.

Or maybe I never will.

And maybe that isn’t really the point.

Perhaps the value was never only in preserving the memory, but in the act of writing itself.

In slowing down long enough to notice.
To process.
To digest.
To make sense of things while living them.

Right now, life often moves faster than reflection. Writing is one of the few things that makes me pause long enough to fully register what is happening.

And maybe that is part of why I continue writing here.

Not because I have polished answers or a perfect strategy. And certainly not because parenthood, ambition, care, identity, or modern working life can be reduced to content pillars.

I write because so much of what shapes us most deeply often remains unsaid.

The transitions, relationships, mental load, identity shifts, and invisible negotiations of modern life are profoundly felt, yet rarely fully articulated. They shape people quietly, while remaining strangely absent from our workplaces, systems, policies, and conversations.

A Record

Perhaps that is part of what writing really gives us.

Not perfection.
Not certainty.
Not polished conclusions.

But a record.

A way to trace how ideas changed.
How people changed.
How we made sense of things while living through them.

When I go back and read reports from meetings years ago, I can watch entire scientific fields evolve in real time.

And occasionally, when I come across old journals, I can return just as vividly to personal moments too: the uncertainty, the hope, the pain, the versions of myself who wrote those pages without knowing what would happen next.

Recently, I found an entry from my second pregnancy, which ended in my first miscarriage. I reread a line I had written at the time: that documenting was, for me, a way to “publish.” Perhaps only for a friend who might one day need those words during her own period of grief.

Not publicly. Not professionally. But as part of a much longer instinct toward writing things down, trying to give shape to experiences before they disappear.

Perhaps that same thread has followed me for much of my life: from scientific publications, to journals, to this newsletter, to the work I do now.

And sometimes I wonder what would happen if we documented our lives, transitions, identities, relationships, and experiences with the same care.

Not because every thought needs to become content.
Not because every story needs an audience.

But because writing makes things visible.
Even to ourselves.

Maybe this is still the stage we are in collectively: naming things, documenting them, making visible what has too often remained private, minimized, or unseen.

The policies that exist on paper but not always in practice.
The invisible negotiations happening inside homes, relationships, teams, and careers.

This feels like the early part of the story: the part where we are still trying to describe the experience clearly enough for systems to finally respond to it.

And years from now, I hope we will look back on the records not simply as stories, but as part of the long process of making work and parenthood more compatible than they once were for the families trying to navigate both.

Yours,
Erica

A few popular pieces I revisited recently, that you might enjoy: