Tag Archives: poetry

We’re all on Prozac now

Doctors with pharma giftsThis entire poem is available online, so I hope JAMA won’t mind if I reproduce it here. The concept might seem simply clever at first, but in fact it’s quite thought provoking.

Side Effects May Include

Now available
over the counter, the phone, or the Internet—
even on the corner—
with or without a subscription.

Clinically proven to
counteract depressed mood,
soothe frazzled nerves,
decrease heart and respiratory rate,
lower the heart from the throat,
warm the heart,
coat the pit in the stomach,
moisten eyes with tears of joy,
motivate individuals to fulfill their potential, and
inspire groups of people to alter the very course of history,
including (but not limited to) putting a man on the moon and
casting off the shackles of racism and political oppression.

Side effects may include
malapropisms,
Freudian slips,
tears of sadness,
things said that can never be taken back,
false hopes,
and, in general, the exact opposite of what’s intended.

So,
talk to your loved one,
your neighbor, your doctor,
to everyone you can, about
Words.

(Words is a registered trademark of Language.)

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The physician as humanist

Still life with porcelain bowl and plums Ladislaus Rath BergerI have eaten
the plums
that were in
the icebox

and which
you were probably
saving
for breakfast

Forgive me
they were delicious
so sweet
and so cold

— William Carlos Williams

William Carlos Williams is part of an honorable tradition in the history of medicine — the physician/poet. He followed the example set by previous physician/poets, such as John Keats, Friedrich Schiller, and Oliver Wendell Holmes (of “Chambered Nautilus” fame). Physicians have also been writers, painters, musicians, philosophers, and – since the 19th century – photographers.

Yet in 1980 the historian G.S. Rousseau expressed concern that modern physicians no longer embodied the humanist tradition of their predecessors. Now that medicine had overwhelmingly become a science and not an art, he claimed, the interests and accomplishments of physicians had narrowed. (emphasis added)

In our century nothing has influenced the physician’s profile more profoundly than the loss of his or her identity as the last of the humanists. Until recently, physicians in Western European countries received broad, liberal educations, read languages and literature, studied the arts, were good musicians and amateur painters; by virtue of their financial privilege and class prominence they interacted with statesmen and high-ranking professionals, and continued in these activities through their careers. It was not uncommon, for Victorian and Edwardian doctors, for example, to write prolifically throughout their careers: medical memoirs and auto-biographies, biographies of other doctors, social analyses of their own times, imaginative literature of all types.

In twentieth-century America, the pattern has changed; only the most imaginative physicians can hope for this artistic lifestyle as a consequence of the economic constraints and housekeeping demands placed upon the doctor …. [T]he diminution of ‘humanist’ content in the training of physicians has lent an impression – perhaps falsely so but nevertheless pervasively – that medics are technicians, anything but humanists. As a by-product, it has nurtured a myth (already old by the eighteenth-century Enlightenment) that medicine is predominantly a science rather than an art. Both notions require adjustment if physicians hope to return to their earlier enriched, and probably healthier, role.

Rousseau’s comment on constraints (for “housekeeping demands” substitute “dealing with insurance”) is even more true today, especially for primary care physicians. A liberal education that values the humanist tradition is also in danger. See, for example, Martha Nussbaum’s Not For Profit, where she writes that contemporary education favors profitable, market-driven, career-oriented skills and devalues imagination, creativity, and critical thinking – qualities essential to the art and science of medicine.

But Rousseau’s assessment that physicians lack artistic interests is simply not true. Physicians continue to be prolific in their contributions to the ‘humanist’ tradition, most visibly as writers.

A plethora of physician/writers

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The physician as reader of poetry

Dog looking in windowHere’s another wonderful poem from a recent issue of The Journal of the American Medical Association. It’s also about an animal, but with a different mood and tone.

It’s called “Why My Wife Should Let Me Have a Dog” and the poet is Gary Stein. Only the first 150 words are available to non-subscribers, but one can appreciate the poem even in its truncated version.

Why My Wife Should Let Me Have a Dog

If I had a dog his soft fur would not foliate
the sofa or trigger asthma attacks
in my dear wife, ending with a hospital trip,
an adrenaline shot and those inhaler tubes
littering the house.

His rich brown eyes will convey profound
intelligence and sensitivity to the subtlest
shifts in my mood. Those eyes will never
get infected and fill with viscous yellow pus
we must wipe with Q-Tips and cure with
sticky ointment, awkward for us both.

My dog will lie by my feet while I read
the Sunday Times he fetched from the lawn
and delivered dry from his slobber-free
mouth, and he’ll wait for his walk
until I complete the crossword.

And when we walk he’ll heel until I hurl
a tennis ball. Watch him streak across
the grassy field, catch it on first bounce
and, with gleeful tail, surrender the prize to me
for another . . .

The rest of the poem continues to suggest the narrow line between comforting pleasures and the all-too-easily-imagined darker side of life. The last two stanzas begin “And when I have my heart attack …” and “While waiting for the ambulance ….” The poem concludes:

… this beast …
a gift as perfect as our children who,
when we play tennis, won’t serve as hard
as they can and will blow some shots
to let me think that by some necessary miracle
I’ve survived and will win in the end.

For the complete poem, consult the June 23/30 issue of JAMA, available in almost every public library.

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The physician as poet

SquirrelEach issue of The Journal of the American Medical Association includes a poem, usually written by a physician. I found this one, by Laurie Rosenblatt, MD, especially moving.

There is harm

because there is this innocent animal,
the body;

because a baby’s unguarded gaze,
and the open regard
of animals both hold patience
with the world,
with mineral fact. Impenetrable

consciousness
arising from, locked into flesh. So

the body’s harm

astonishes,
for instance when met in the eyes
of the squirrel, run over, still
alive
beside the road,

eyes near bursting
meeting your own
and holding
something—

   a plea?
Because there is
absence

of words, no telling
what is wanted, what
will help:
the question, “What is right to do?”

if anything,

and a need
to be
out from under this

responsibility,
my god, such need.

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Ich Habe Genug on Thanksgiving

It’s Thanksgiving and I’m feeling ‘Ich habe genug’ (I have enough). I’d like to share some poetry, music, and a film while continuing the ‘death’ theme of my last blog post.

wit
First the film, Wit, starring Emma Thompson and directed by Mike Nichols. It’s the story of Vivian, a woman with ovarian cancer who spends the end of her life in a hospital. Talk about aggressive treatment of the terminally ill. She’s basically a guinea pig for an experimental drug that has no chance of saving her life. The young doctor who oversees her treatment will get a publication out of the case. He’s a resident planning a career in research and has no interest in ever seeing patients again. He’s only there because it’s one of the requirements on the road to becoming an MD

Wit is based on a Pulitzer Prize-winning play. Very minimal. Lots of monologue. Vivian was a professor of English literature and quotes the metaphysical poet John Donne (of “Death be not proud” fame) throughout the film. The contrast between the poetry and the setting is beautifully done. Donne had much to say about death, but he lived in an era when death had a different meaning. Or more precisely, when death had a meaning.

Sounds a bit gloomy, I know, but it’s an excellent film. Watch it with a friend, if you can. It’s very thought provoking. This is exactly the way we don’t want to die. The more we’re aware of what we don’t want, the more we’ll be motivated to change the way things are.

Next, a poem by Jacques Prevert, “Pater Noster.” The poem received some publicity when Meadow Soprano read the first few lines to her Level 1 ICU-docked Dad: “Our father, which art in heaven, stay there. And we shall stay on earth, which is sometimes so pretty.”

Here is the French version. And here’s an English translation.

hospital

Philip Larkin’s poem “The Building” is about a hospital. Here’s the complete poem, and here are the last few lines:

All know they are going to die.
Not yet, perhaps not here, but in the end,
And somewhere like this. That is what it means,
This clean-sliced cliff; a struggle to transcend
The thought of dying, for unless its powers
Outbuild cathedrals nothing contravenes
The coming dark, though crowds each evening try

With wasteful, weak, propitiatory flowers.

I’ve been partial to Larkin ever since I read “This be the verse” at an impressionable age.

And continuing the theme of Genug, here’s the Bach Cantata, “Ich habe genug”.

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