Like many 20-somethings, Robert Oldshue graduated from college unsure of his future path. So he backpacked for a year, traveling far and wide, all the while keeping a journal of his adventures. At year’s end, he arrived at the obvious conclusion: He was meant to be the next Ernest Hemingway. Or so he briefly thought.

Fast-forward to a different trek, this time to South Africa, where the would-be author, still in his 20s, worked for a doctor. Oldshue was awakened in the middle of one night to help the doctor deliver a baby who would be born into poverty. And something clicked. He knew this was his calling.

“That made sense for what a human being should do,” he says. “To me, that was it – that’s a man.”

Years later, those disparate paths would merge into an accomplished double life. In one, Oldshue is a family-care doctor in Boston, where he also teaches at Harvard Medical School. In the other, he’s an author whose debut story collection, “November Storm,” recently won the prestigious Iowa Short Fiction Award.

Oldshue spoke recently from his Boston office about empathy, courting his wife and nailing the perfect phrase. This interview has been edited for length and clarity.

Q: How strange is this whole process of the book’s publication, given that your daily life is so different?

A: I’ve been thinking about that balance – about how my writing relates to my medical practice. I teach interviewing and history-taking over at Harvard Medical School. Today we were talking about empathy and sympathy.

Empathy, at least as we teach it to students, is an act of professionalism, a disciplined concern for others in which you consider their needs and you meet them. Sympathy is “Oh, my Gosh! I can’t believe what you’re going through.”

At the office, I’m required to show empathy. I may personally like or dislike you, but I have to show disciplined brotherly feeling anyway. There’s a distance, a role, a duty. In my short stories, I put down that role. I think I write out of sympathy. This is the place where I can explore freely ideas, or characters, or people who have moved me.

Q: That seems to suggest that writing somehow requires less discipline than medicine. Yet it takes great discipline to get characters on the page in a way that makes sense.

A: My job as a doctor is to take the particulars and generalize about them – to make sure that whatever treatment I give would be the same treatment a patient would get in Omaha or Portland, Oregon. Fiction-writing is about specifics and potent details. Those two processes are opposite to each other, and it’s taken me many years to understand that.

Q: You must find writing incredibly liberating since you can let the characters go, without intervening.

A: Yes, that’s true. It’s also an opportunity to explore their motives, or mine, and to reveal myself in ways that are not appropriate in the office.

A lot of us are worried about our fallibility and the fact that we could badly hurt somebody. The way I look at it, there are doctors who have hurt people and know it, and there are doctors who have hurt people, and don’t know it. And unfortunately, there aren’t any other doctors. There are enormous burdens of guilt, and we all put them somewhere.

Q: After your medical residency, you took two years off to get an master of fine arts in writing. Clearly you had decided that writing was more than a hobby.

A: It was a big risk, and I wasn’t sure what was going to come of it. I came out knowing how to write better, but it turns out there wasn’t a line of agents waiting to turn my stories into huge collections. I got kind of down and depressed about things. But thankfully, I had not burned any bridges, so I could go back to medicine. Then I found a new balance in my work life.

I’m here in the office every day. I take Monday and Friday mornings to write, and weekends. So I’ve tried to integrate those two people.

Q: How does it feel to finally have a collection of your stories published?

A: It may not seem like much of a life to creep away from your office and go up to your attic to type out a few more sentences with action verbs, and get rid of your adverbs and buff up your concrete nouns. But it is a life! The fact that there is some editor or contest judge across the country who will read your essays and stories, and give them a shot – that keeps many of us going.

Q: Tell me what you like most about writing.

A: My favorite thing is the moment when you take a complex idea that isn’t fully formed, and you nail it! You’ve had many themes that you didn’t really understand and they’re coming along, and finally you can bring them all together in a resonant ring at the end. It’s a wonderful feeling.

Q: And what do you like least about writing?

A: The self-promotion. But the part that gives me real pain is when I’m on a roll, and I just have to quit anyway. I have to do rounds at the hospital, or deal with some fevers and I’m just right on the edge of making connections in a story. That hurts.

Q: You’ve just defined frustration.

A: On the other hand, I can’t tell you how many times that’s kept me from writing too fast. I have to sit. Things have to deepen a little bit. I think James Baldwin said that there is no perfect writing life; every life is imperfect in its own ways. So the blemishes in the writing life become part of the beauty.

Q: Have you written in other forms besides the short story?

A: I just finished the first draft of a novel. And my wife loves it. I’ve got to tell you, I showed my little stories-with-a-staple-in-the-corner to her 25 years ago. We had gone out a couple of times, and I said, “There’s something I really have to tell you about myself.” And she sort of blanched, waiting to hear some horrendous secret. I said, “I write.”

Q: Of all the confessions people make, that’s pretty low on the list of crimes.

A: Well, maybe. I think I showed her a talking dog story, or something. But she said, “There’s a voice here.” And she just has never let me stop.

Q: Have you figured out which form of writing you prefer?

A: Even as a doctor, I still can’t decide whether I prefer working with adults or kids. I go back and forth. So I can’t decide. At the moment, I have several ideas for short stories that I want to be working on. I’ll probably pick some compromise as I go on.

Q: Now that you have this book and you’ve won an award, I’m wondering whether your thoughts on retirement include much more writing.

A: I do think about that. I do want to write. On the other hand, I get so much charge out of my patients. I love them – they’re my crew! I live across the street from my clinic. I get to be the mayor! I get to walk down the street and see my patients, say hello, meet their kids. In a world of increasing specialization, it is just such a gift to be part of people’s lives as a family doctor. And I see the writing as an extension of that. My stories reflect that I take their issues seriously. The writing is an opportunity to sit down and say, “Well, who are these families?” In my writing life, I don’t see the big divide between my issues and theirs. It really recharges me to go back into the office and try again.

Joan Silverman writes op-eds, essays and book reviews. Her work has appeared in The Christian Science Monitor, Chicago Tribune and Dallas Morning News.

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