Doctors Turn to Poetry to Relieve Stress

“To be able to re-engage with the human side you need a catalyst,” says Dr. Crossman, who recounts that during his medical training—long before the book came out—he used to read poems himself. “I felt hugely energized by reading them,” he says.

Some young doctors say the poetry book is helping them. Lewis Hughes, age 23, graduated from medical school in 2017 and is currently in Dundee, Scotland, in a two-year rotation of clinical training. A poem he found very meaningful is Bernard O’Donoghue’s “Going Without Saying,” which affirms the value of simply telling someone how much we like them. He says it is heavily related to his work.

https://www.wsj.com/articles/doctors-turn-to-poetry-to-relieve-stress-1519614120

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Sinéad Moriarty’s The Good Mother

In The Good Mother, Moriarty writes with compelling authority about the world of hospitals; the febrile atmosphere, the logistics, the visceral reality of being an unwilling patient in a hospital bed, when you’d rather be literally anywhere else in the world. She probably didn’t realise it, but her own unexpected stint in hospital some time ago gave her first-hand experience to draw on for this novel.

A year ago, Moriarty was diagnosed with rheumatoid arthritis, something that she is now choosing to speak publicly about for the first time.

“I had a sore knee for no reason,” she recalls. “I had iced it, taken anti-inflammatories, had physio, and it still wouldn’t go away. I was freezing during the day, and waking up at night drenched in sweat, and was exhausted all the time.” Her GP sent her for tests, and she remained in hospital for a week.

http://www.irishtimes.com/culture/books/sinead-moriarty-the-illness-that-started-with-a-sore-knee-1.2975580?ot=example.AjaxPageLayout.ot&mode=print

Alain de Botton presents some thoughts on what literature does to us

Thanks to Aileen for this

Discussion on extract from Cancer Ward

Cancer Ward, Aleksandr Solzhenitsyn

General consensus about the text:
 There were mixed emotions about the text, although the plot of the story was a tad cliché, it
still fulfilled the role of a good read. As the cliché acted as a contrast to communist soviet
Russia.
 Everyone agreed that there was some pity felt for the main character.
 The character’s personalities were all enjoyable, and it was interesting to watch them grow
and develop.

First Topic: The main character
 The main character in this extract was an important, wealthy and powerful Russian man.
 Diagnosed with a cancer.
 Although he is a powerful man, this scares him, becomes more superstitious.
 Tries to use his wealth and power to get better healthcare and fails.
 The hospital makes him feel mortal
 Although he doesn’t have the nicest personality, we all empathised with this character.

Second topic: How the text is a contrast to communism in Russia
 The whole text really acts as a contrast to communism in Russia.
 The main character may have worked hard to get where he is today, so maybe should be
able to use his wealth for an advantage.
 Russian expressions in this text emphasise this.

Third Topic: Doctors coming across as powerful
 Although there aren’t many moments in this text that involve doctors, it is interesting to see
how they are portrayed when they are involved.
 The main character goes into a lot of detail when describing the doctor in his opening scene.
 We agreed that this was to emphasise the power and effect the doctor had on him and also
how it affected him.

Prof Jim Lucey’s new book In My Room – the Recovery Journey as Encountered by a Psychiatrist

His new book In My Room – the Recovery Journey as Encountered by a Psychiatrist , is based on composite real-life experiences of depression, alcohol dependence, obsessive compulsive disorder and post-traumatic stress. What Lucey focuses on, though, is not treatment plans and therapeutic approaches, but how the individuals describe their experience and how, in most cases, they learn to move beyond it.

Lucey cites Dr Dorothy Keelan, former senior psychiatrist at the Mater Hospital and the late Prof Anthony Clare, former medical director of St Patrick’s Hospital, as the most significant influences on his decision to become a psychiatrist.

“Dr Keelan showed me how to engage with the whole life of the person in such an intelligent and kind way. And I was so fortunate to work with Dr Clare, who was generous in his teachings and insights and open about psychotherapy. He also saw art, poetry and literature all of value to working with mental health.” (Irish Times) >

The Fault in Our Stars: John Green

Wondering if this would be useful in medical training classes: (From Wikipedia >)

The Fault in Our Stars opens with 16 year old Hazel Grace Lancaster reluctantly attending a support group for children living with cancer. Hazel was diagnosed with Stage 4 Thyroid cancer when she was 13 (three months after her first period). At support group she meets Augustus “Gus” Waters, a former basketball star who lost a leg to osteosarcoma, and quickly becomes infatuated with him. Hazel convinces Augustus to read ‘An Imperial Affliction’, her favourite book, and he becomes almost as obsessed with it as she is. Intrigued by her intelligence, Gus begins to reciprocate her feelings, and the two begin to text and call each other frequently.

After Hazel is admitted to, and later discharged from the hospital with serious pneumonia, her relationship with Gus deepens. Gus had saved his wish from “The Genies” (a fictionalized version of the Make a Wish Foundation), and decides to use it to fly himself and Hazel to Amsterdam in the Netherlands to meet Peter van Houten the reclusive author of ‘An Imperial Affliction’.

On their first night in Amsterdam, they are treated to an elaborate meal, courtesy of van Houten. Their meeting with the author goes less smoothly, as it emerges that Lidewij, his assistant, set it up without his full knowledge in the hopes that it would inspire him to give up alcohol and write again. Van Houten is scornful and rude to the teens, and refuses to answer their questions. Distraught by their reception, Hazel and Augustus leave van Houten’s house, accompanied by a disgusted Lidewij. She takes them to the Anne Frank house, where they kiss.

Afterwards, Augustus reveals that his cancer has returned and has metastasized to several other parts of his body. Even though he starts an aggressive treatment regime when he returns home, he is not expected to survive long. Shortly before he dies, he asks Hazel and Isaac, another friend, to conduct a pre-funeral for him, so that he can hear how they will memorialize him.

Eight days later, Gus dies, and Hazel speaks at his funeral. Instead of the earnest speech she gave to him and Isaac, she repeats platitudes that will reassure his parents. After the funeral, she meets van Houten, who traveled to America to be there. He reveals that his daughter died of cancer. She provided the inspiration for Anna, the main character of ‘An Imperial Affliction’ and his rudeness can be partially attributed to Hazel’s appearance (she had dressed just like Anna).

She also discovers Augustus had been writing something for her, although the pages were torn out of his notebook. Eventually, she is able to track the pages to Amsterdam, and after an email to Lidewij, they are retrieved from van Houten. Augustus wanted van Houten to turn his notes into a fitting eulogy for Hazel, but van Houten decides to leave Augustus’s words alone.

The book ends with Hazel accepting Augustus’s eulogy with a present tense, “I Do.”

Enthusiasm becomes exhausting and unbelievable in Stephen Hoffman’s ‘Under the Ether Dome’ extract

(by fdonnel)

It was clear from the start of Stephen Hoffman’s “Under The Ether Dome” that the writer had a great head on his shoulders – a maturity and ability to see into the heart of matters. This is evident from the start as he says “Our subject after all was people”- which showed a solid understanding of the fact that medicine is about people and their individual all-round situations and not just the science of their disease.

He appreciates the role played by those physicians that went before him and pays due respect – he refers to Newton’s belief that he himself would only find success in life by “standing on the shoulders of the giants that preceded him”.

He appreciates the footsteps he is following in and wonders if he will “prove equal to the task” before him.

He seems a very holistic thinker, both scientifically and non-scientifically, he questions whether medicine’s “reductionist attempts” really uncover the true essence of human physiology and anatomy which seem to “politely rebuff” the efforts of those who try to uncover “her infinite wisdom”.

He sees the diagnosis and treatment of disease as but a sub-section of the subject of medicine, which he views to be more anthropology than mere physiology and pathology; “Our education provided us with a broad mandate to learn what we could about people, and to that end, almost everything qualified as important.”

The enthusiasm and intrigue expressed by the writer in absolutely every little thing he learned in medical school, however, soon became exhausting, not to mention unbelievable. Instances of him and his classmates “edging forwards in their seats” in lecture halls, coupled with constant intrigue in every and any detail passed onto him by his professors were far too frequent and, in the opinion of a current stressed, knowledge saturated medical student, completely unbelievable.

The writer could again be seen letting his imagination run away with himself when he talks of his love of Medical Literature and how he would incorporate the fiction found in his beloved stories into his everyday rotations. His tendancy to look through “the lens of fiction” at real cases in order to gain a fresh, new perspective was, although a nice idea, somewhat OTT. Fiction is generally, by nature, something special and extraordinary and to think that it would be used in such a hands-on way with real patients does not sit well with this future health professional/occasional patient.

Hoffman displays great integrity when he hesitates to go through with his first suturing attempt on an actual patient as he doubts his fledgling skills. He puts the welfare of the patient before his own personal development as a professional and this is an admirable quality. He incites a certain poignancy when he refers to the gift of potential self-sacrifice given by patients in teaching hospitals when interns are let loose on the wards and he prays “One accepts it and hopes that it will have a return for others one day”.

Hoffman’s enthusiasm in this extract certainly rubbed off on me and reminded me of the importance of starting as one means to go on in medical school as we see that the qualities of integrity and respect he encompassed from the start of his studies stayed with him all the way to his clinical beginnings.

Shem’s ‘House of God’ simultaneously twisted and darkly humorous

(by Kennedf2)

‘The House of God’ is a satirical novel published in 1978 by psychiatrist Stephen Bergman, under the pen-name Samuel Shem. Bergman is a graduate of Harvard University College and Medical School, and also one of Oxford University, where he was a Rhodes Scholar.

After reading only twenty pages of Shem’s classic novel, it is clear to me that it is simultaneously twisted and darkly humorous. In its morbidity, it seems realistic, and yet the absurdity of the attitudes of the novel’s characters makes the events of the plot utterly unbelievable. Although the emotions within the novel (or at least of chapter three) are charged, and there is an urgency to the writing, the plot is minimal as the seemingly important events that happen within the House of God Hospital have very little impact upon the novel’s protagonists, and hence upon us as readers (For example on page 42, when Basch seems to quickly forget his distress at the thought of Professor Rokitansky overhearing the conversation between himself and The Fat Man. The incident is not mentioned again). This, however, seems to be a redeeming quality in the novel, as it is the characters and their morality that takes centre stage instead of the somewhat ridiculous events. In my opinion, the only way to read this novel is with an accepting attitude and a large pinch of salt, because without the absurdities that we associate with characters like The Fat Man, and the macabre humour that is so prevalent within the plot, the novel becomes wholly dark, twisted and ultimately disturbing.

Within the novel, the protagonist, Roy Basch battles between his professionalism and his humanity, between his former perception of reality and the reality that is forced upon him by the nightmare of his situation as an intern in The House of Gpd (For example, on page 39-“All was chaos. They were patients and all I knew was in libraries”). Shem offers us a uniquely honest account of the (occasional) triumphs and tragedies of hospital life, the anger and frustration that festered among interns, the abuse of young physicians by their superiors and the melee of poor practice and treatment of patients that fed into a murky purpose under the supervision of platitudinous residents (For example on page 35 when The Fat Man says “In internal medicine, there is virtually no need to see patients. Almost all patients are better off unseen”).

While the prevailing mood within the novel was quite morbid and macabre, there was an aspect to the way in which the story was told that I found refreshing. After completing only two months of medical school, I already feel as though I am out of my depth, and I found it honest and uplifting to hear that Basch felt somewhat similar as a new intern under the supervision of someone like The Fat Man (for example on page 40 “I started to panic” and on page 36 “He was he first person to tell us he knew about our terror”). There was also a heartening revelation made by Basch on page 51, when he remembers the reasons why he chose the profession he did, and this was somewhat relieving for me after often asking myself “what have a gotten myself into?” during earlier sections of the chapter-“I was moved. I was a doctor. For the first time that day, I felt excited, proud. They believed in me, in my art”. At risk of sounding too upbeat, however, Shem quickly quenches Basch’ enthusiasm in the paragraph that follows “We all expect the American Medical Dream-the whites, the cures, the works. Modern medicine is different”. Shem’s honesty, although somewhat cynical and pessimistic, comes as a welcome relief when I placed this text in comparison with one like “Under the Ether Dome”.

Overall, Shem’s novel is certainly one I enjoyed, but not in a way I have ever experienced before. The cynicism, macabre humour and morbidity are strikingly apparent from the onset, which adds a sense of absurdity to the text, but is certainly something I enjoyed. On first reading, ‘’The House of God’’ was not a novel I thought I would have enjoyed, but after my somewhat inexperienced analysis of it, I found it became a text that I could relate to and certainly recommend.

Ben (Bad Science) Goldacre’s ‘Bad Pharma’ out today

Ben (Bad Science) Goldacre’s ‘Bad Pharma (how drug companies mislead doctors and harm patients)’ book is out today: ‘Medicine is broken. And I genuinely believe that if patients and the public ever fully understand what has been done to them – what doctors, academics and regulators have permitted – they will be angry.’ The introduction to the book is here >

Text pool

MEDICINE, TRAINING, DOCTORS, HOSPITALS

Vincent Lam’s Bloodletting & Miraculous Cures  (‘How to Get into Medical School Part 1’) – fiction

Stephen A. Hoffman’s Under the Ether Dome (Chapter 1 ‘Medical School’) – non-fiction

Johnathan Kaplan’s The Dressing Station (extracts) – non-fiction

Mikhail Bulgakov’s A Country Doctor’s Notebook (‘The Speckled Rash’) – fiction

Ian McEwan’s Saturday (extracts) – fiction

Samuel Shem’s The House of God (extracts) – fiction

Philip Roth’s Anatomy Lesson (extracts) – fiction

MATERNITY & OBSTETRICS

Rachel Cusk’s A Life’s Work (‘Forty Weeks’) – a non-fiction, ‘patient’ perspective

Vincent Lam’s Bloodletting & Miraculous Cures  (‘An Insistent Tide’) – a fiction, patient perspective

PAEDIATRICS

Lorrie Moore’s ‘People Like That Are the Only People Here’ from Birds of America  – a fictional, patient perspective

William Carlos Williams’ ‘The Girl with a Pimply Face’, ‘The Use of Force’, ‘Jean Beicke’ from Doctor Stories – a fiction, doctor perspective

COMMUNITY AND SOCIETY

John Berger’s A Fortunate Man  – a non-fiction, third-party perspective

JD O’Connor ‘Doctor in the Dales’ – a non-fiction, doctor perspective

Carlo Levi’s Christ Stopped at Eboli (extracts) – a non-fiction, doctor perspective

Gabriel Garcia Marquez’s Love in the Time of Cholera (extract) – a fiction, third-party perspective

CANCER

Barbara Ehrehreich’s Smile Or Die (‘The Bright Side of Cancer’) – a non-fiction, patient perspective

Sophie Petit-Zeman’s Doctor, what’s wrong? (extracts) – a fiction, third-party perspective

Lia Mills’ In Your Face (extracts) – a non-fiction, patient perspective

Paul Zweig’s Departures (extracts) – a non-fiction, patient perspective

DEATH

Sherwin B. Nuland’s How We Die (‘Doors to Death of the Aged’) – a non-fiction perspective

Joyce Carol Oates’ ‘Angel of Mercy’ from The Female of the Species – fiction

Leo Tolstoy’s The Death of Ivan Ilych – fiction

PSYCHIATRY & DIALOGUE

Sebastian Barry’s The Secret Scripture (extracts) – a non-fiction perspective on both doctor and patient

Oliver Sacks ‘An Interview’

Paul Valéry’s ‘Socrates and his Physician’ (extract) – fiction

Herman Broch The Death of Virgil (extract) – fiction

MAJORITY WORLD & MINORITY LIVES

Dave Eggers’ What is the What? (extracts) – fiction

Donnacha Rynne’s Being Donnacha (extacts) – non-fiction

Jean-Dominique Bauby’s The Diving Bell & the Butterfly (extracts) – non-fiction

POETRY

Work from poets including Patrick Kavanagh, Núala Ní Dhómhnaill, Anne Sexton, Nessa O’Mahony, John Stone, and Philip Casey

THEORY

Petr Skrabanek and James McCormick’s Follies and Fallacies in Modern Medicine