Poetry


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First & foremost to say, it was such a thrill & privilege to be able to conduct – thanks to Siobhan in the department – our session in the beautiful atmosphere of the old Anatomy Building lecture theatre (as photographed so perfectly here by Fionn McCann). Everyone was most impressed … even a tad sorrowful!

Opened up with our group recitation of Yeats’ ‘Paudeen’. They’ll know it off by heart by the end of the module!

Then had quick recap from one of the group on last week’s proceedings.

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Then I set the mood for this week by reading Tríona Ní Dhomhnaill’s ‘The Mermaid in the Hospital’ as translated by Paul Muldoon. (“It was the sister who gave her the wink / and let her know what was what.”)

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Then, somewhat unusually, I gave a sort of lecture on anatomy as a human pursuit and its significance in medical training – based on an essay I wrote for the ‘Irish Medical Times’ years ago when the Anatomy department was moving from its charming, nineteenth century home to the shiny new Biosciences building >

https://arsmedica.wordpress.com/2011/08/02/feature-on-anatomy-building-in-trinity-college/

The idea is that perhaps to ensure the students adopt the appropriate attitude towards the privilege that it is learning from cadaveric dissection, some civilising influence of the aesthetic on display in the old building (architecture, art, history) needs to be / is being replaced by comparable influences in the new facilities – the orientation programme, the relatives room.

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Keeping it somewhat personal, I told them about an old friend, Max Aguilera-Hellweg, who sat in this very room as a first year MATURE medical student in 1998/99, but who transferred back to the USA for the rest of his degree because of a dispute with the School arising from conflicting views of his book ‘The Sacred Heart’, which he had just published the year before. I read and analysed extracts from Max’s book, highlighting how his interest in medicine arose (a photographic assignment that led to an obsession) and his resulting intense, artistic fascination with representing the most full-on images of the workings of the body as revealed by surgery.

… Far from getting sick, I felt what I can best describe as awe. Photographing my first surgery was so foreign to any of my previous experiences that I couldn’t place it. I couldn’t compare it to anything. It is one thing to know there is a spinal cord in the hollow of your back; to see one for real is altogether different…

The cardinal glow of oxygenated blood reminded me that there was a man in there. A thick, milky-white strand covering the nerve tissue that stretches from brain stem to tailbone, splitting off into minute and multitudinous nerves, producing the sensations of heat, cold, pleasure, pain; the dura of the spinal cord lay revealed. I saw the painting above my grandmother’s bed. The one I saw as a child waking up from my nap. The one of Jesus. His heart bleeding, wrapped in thorns, engulfed in flames.

I realised I was in the presence of the most intimate, most vulnerable, most inviolate thing I had ever seen. The spinal cord had never seen light, wasn’t meant to see light, and at this moment was bathed in light. My first impulse, I must confess was to spit. To defile it in some way. Bring it down to my level. I didn’t, of course, but I felt I was in the presence of something so precious, so amazing, so powerful, so pure, I couldn’t bear the intensity.

“What is that?” I asked. “What’s it made of?”

“It’s like a sausage,” the surgeon said, “with toothpaste inside.”

 

We discussed the heightened language and thinking here; the artistic impulse; the impact such descriptions have on a reader, particularly whether or not they can be said to have benefits for medical student readers; we debated why Max’s impulse was to spit (including wondering was it actual!); we discussed the surgeon’s disabusing and mundane reply, in terms of professional distance and general normalisation.

Where before [as photographer] I searched the eyes of a man [for his soul!], the wrinkles of his clothes, the wear and tear of his shoes, I look now in the recesses of his flesh, the colour and texture of his liver, the markings and capacity of his lungs.

We discussed our impressions of Max from the extracts we’d read and how suitable his motivations were for someone becoming a doctor. We got into a detailed discussion about empathy.

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Then we read and analysed extracts from Sinéad Gleeson’s essay ‘Blue Hills and Chalk Bones’.

We discussed how the suddenness of the migration from the Kingdom of the Well to the Kingdom of the Sick is handled (“It happened quickly, an inverse magician’s trick: now you don’t see it, now you do. From basketball and sprinting to bone sore with a limp. Hospital stays became frequent, and I missed the first three months of school four years in a row.”); the unbelievable trauma to the body and soul some treatments involve; how quickly a patient, even a young patient, become conversant if not fluent in the language spoken in the Kingdom of the Sick.

We went into some detail on the particular impact of physical difference on young people (“I got used to the limp … but gained a new self-consciousness… What I felt more than anything was overwhelming embarrassment. Ashamed of my bones and my scars and the clunking way I walked.”) and how if it’s difficult for a doctor to properly empathise with an adult patient, it can be even more difficult when the patient is a young person or a child. (Though some of them have thicker skin than others, was a point that was made.)

We discussed the clinical aspects of acne and blushing.

There are a couple of particularly harsh doctors portrayed in Gleeson’s essay, and we discussed how prevalent their behaviour might be in healthcare settings these days and whether or not efforts were being made to reduce the instances of such ignorant behaviour:

I explain this to the orthopaedic doctor, this man I’ve never met, and he does that thing I’m used to male doctors doing: he tells me I’m overreacting. A rotating blade is slicing into my flesh, but I need to calm down. When my mother starts to cry, he demands that she leave the room. Fifteen minutes later, I plead with him to stop and he finally gives up, annoyed.

And:

On an early visit to the surgeon, to check my spine for scoliosis, I was asked to wear a swimsuit. Mortified, I cried all through the exam, and the doctor, growing impatient, threw a towel over my lower body.

‘THERE, is that better?’

It wasn’t. I was a self-conscious girl being humiliated for her sense of shame.

Perhaps understandably considering her analysis and perspective, Gleeson summarises perfectly the lop-sidedness of the relationship, particularly as it was back in the 80s:

The Doctor patient relationship had its own imbalances. I have never forgotten the sense of powerlessness in instruction: lie down, bend forward, walk for me. I have felt it counting backwards from ten under the stark lights of an operating theatre. Or when skin is sliced cleanly through. You are in someone else’s hands. Steady, competent hands – hopefully – but the patient is never in charge. The kingdom of the sick is not a democracy. And every orthopaedic doctor who examined me during those years was male.

We discussed the difference between Gleeson’s language / perspective and Aguilera-Hellweg’s.

A variety of analyses were put forward on this idea: “Our bodies are sacred, certainly, but they are often not ours alone… we create our own matryoshka bodies, and try to keep at least one that is just for us. But which one do we keep – the smallest or biggest?”

We noted the empathy behind her observation of another person in Lourdes hoping for a miracle: “He twitches occasionally but is otherwise motionless. There is drool on his face, and I want to say something to him but can’t.”

Also the pathos in: “This is the breakdown of bones, the slowing of a heart, the confinement of our own bodies: a being that once sprung into the world, vibrant and viscous and pulsing with life.”

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Finally, we read and discussed Doireann Ní Ghríofa’s poem ‘To the Stranger Who Will Dissect My Brain’ (unpublished) and the students who spoke were extremely moved and impressed with the final description of the “exchange” that happens at the end of the poem between the remains and the (say) anatomy student: “Your brain will blaze bright,// alive and wild, and I,/ I will be the light.” Not only capturing the awe felt by medical students (& some photographers) but also the enlightenment – the final gift of the person who has donated their remains to medical education.

One student spoke about how the poem captured in a way that she could never achieve herself (and that no other language register could, perhaps) that feeling of awe that some students experience when they begin their anatomy dissections.

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And to top it all off, the students were able to look around the old Anatomy Museum and get a sense of the history – betimes quite freakish and grotesque – of their studies.

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“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

For Savita Halappanavar

The procedure complete, I wake alone.

The hospital sleeps…

http://www.irishexaminer.com/lifestyle/artsfilmtv/news/the-tuesday-poem-242567.html

In the worst hour of the worst season

of the worst year of a whole people

a men set out from the workhouse with his wife …

ORIGINAL POST IS HERE >>> http://medhum.blogspot.ie/2010/03/poetry-in-medicine.html

Poetry in Medicine

When I make rounds with my students and interns, I always try to sneak in a poem at the end. I think poetry is important because it helps convey the parts of the medical experience that don’t make it into textbooks. It’s important because it teaches creative thinking—something of immense value to doctors.

It’s important because interpreting metaphors is a critical clinical skill in diagnosis; patients’ symptoms often present in metaphorical manners and we doctors need to know how to interpret our patients’ metaphors. Last but not least, there is a therapeutic value to introducing beauty into a situation that is not commonly associated with aesthetics.

I’ve been giving poetry to my medical team for a few years now, but I’ve always wanted to give poetry to my patients. Unfortunately, English is not the first language for most of the patients in my hospital, so this has been challenging.

But there is one set of patients that seems to consistently speak English—the alcoholics. The Bowery-type alcoholics aren’t necessarily the favorite patients of the interns. These patients are frequent fliers, they are clinically “uninteresting,” they are often malodorous, and their illness is perceived as self-inflicted. But they do speak English.

So one morning on rounds, our team went to examine a new alcohol-withdrawal admission. His condition was standard: alcohol-on-breath, speech slurred, fingers trembling, hair and beard disheveled, body odor a mix of unwashed socks and cheap beer. He was cranky, and impatient with the detailed questions we asked.

As the team was finishing up, I whipped out some papers from my pocket—Jack Coulehan’s poem “I’m Gonna Slap Those Doctors. I gave a copy to the patient and distributed the rest to the resident, interns, and medical students. Asking their forbearance for this slight divergence from medical protocol, I plowed onward and read the poem aloud.

I’m Gonna Slap Those Doctors

Because the rosy condition

makes my nose bumpy and big,

and I give them the crap they deserve,

they write me off as a boozer

and snow me with drugs. Like I’m gonna

go wild and green bugs are gonna

crawl on me and I’m gonna tear out

their goddamn precious IV.

I haven’t had a drink in a year

but those slick bastards cross their arms

and talk about sodium. They come

with their noses crunched up like my room

is purgatory and they’re the

goddamn angels doing a bit

of social work. Listen, I might not

have much of a body left,

but I’ve got good arms — the polio

left me that — and the skin on my hands

is about an inch thick. And when I used

to drink I could hit with the best

in Braddock. Listen, one more shot

of the crap that makes my tongue stop

and they’ll have something on their hands

they didn’t know existed. They’ll have time

on their hands. They’ll be spinning around

drunk as skunks, heads screwed on backwards,

and then Doctor Big Nose is gonna smell

their breaths, wrinkle his forehead, and spin

down the hall in his wheelchair

on the way to the goddamn heavenly choir.

(from Medicine Stone, 2002. © Jack Coulehan, reprinted with permission)

As I read the poem, I could feel the atmosphere in the room changing, ever so slightly. The focus shifted from the patient to the poem, and everyone was an equal neophyte with this particular poem.

When I finished reading, some of the medical team looked uncomfortable, but the patient was smiling broadly. “This is great,” he said. “I love it!” With his pronouncements, everyone relaxed a bit.

“You know,” the patient continued, seemingly happy to have an audience, “ I used to read some books, back in the day.” He sat up in bed, more animated now. “I like history stuff—ancient Greeks, ancient Romans. Real characters, those guys.”

We ended up having a conversation about his childhood in small-town New Jersey, how he cut classes in high school to putter around on the beach.

We left the room feeling awkward but also somehow lighter. Suddenly our patient wasn’t just another alcoholic drying out on the ward. He was a real person, someone who stood out in our minds.

The poem certainly didn’t change the course of his devastating disease of alcoholism. It didn’t offer him the epiphany to suddenly quit drinking or to reconnect with his estranged family. His liver enzymes didn’t miraculously normalize. His platelets didn’t bound back to health. But it gave all of us a sense of human connection.

Throughout his four-day stay in the hospital, the patient was much more pleasant to the team. I noticed that the students and interns wandered in more frequently to say hello. We all felt just a bit more connected.

Rx: Take two sonnets and call me in the morning.

If you are interested in poetry and medicine, check out this unique conference at DukeUniversity on May 21-23. Life Lines: Poetry for Our Patients, Our Communities, Ourselves. (I will be giving a presentation there.)

Danielle Ofri is a writer and practicing internist at New York City’s Bellevue Hospital. She is the editor-in-chief of the Bellevue Literary Review. Her newest book is Medicine in Translation: Journeys with my Patients. View the YouTube book trailer.

You can follow Danielle on Twitter and Facebook, or visit her homepage.

Her blog, Medicine in Translation, appears on Psychology Today’s website.

Posted by Danielle Ofri at 14:36

Labels: art, culture, doctor, doctor-patient relationship, medicine, patient, poetry, translation

“After we published an anonymous account of life in St Ita’s psychiatric institution, a photographer and a doctor were among readers to add to its portrait of life there …”

Garrett Igoe’s poem, Patient:

I pierced your innocent vein with bevel up,
infused a swift sedating rush,
held back healthy curls
from your high brow,
applied the shocking cups.
You convulsed
in that red bricked
sea swept place,
memories eroded, like peeling paint,
decades of wasted afternoons,
one sock black, the other baby blue.
Rattle rattle dum dum dum
your mantra, drowning
shouts from the female side,
charge nurse X doled
out the Major, you told me
you liked the mauve
of Doctor X’s jacket.
On night rounds, I ignored
the scurry of black eyed creatures,
held tight the keys
of twenty four locked wards.
And finally I abandoned you,
left you to go on
showing your tongue
smacking your lips,
rolling your eyes,
uncontrollably.

 

The Irish Times >>>

A DEMONSTRATION

Letter by this morning’s post to say I may go home for Xmas if I won’t have a demonstration (do they picture bands?)
– Dr Kathleen Lynn

What might drive me, a doctor,
to jump out of reason and into the fire
of rebellion? Haunted by skulls
that boast through the thin skin of children
who ghost the alleyways, dying
young in silent demonstration,

I raise my own demonstration
against my limits as woman and doctor. (Continue reading rest of poem >>>)

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