Monday, June 20, 2005

Poetry in Medicine

Recent previous postings dealt with the possible role of humor in medicine. I would like to bring up the topic now of poetry in medicine and what it may represent. As many of you know, publication of poems relating to medicine is a regular feature in the Journal of the American Medical Association. What is it about medicine and disease that stimulates poetry writing and what effect does reading such poems carry? I found one discussion of the topic in
Community Ethics
, the Newsletter of the Consortium Ethics Program of the University of Pittsburgh titled “Why Poetry in Health Care?” and written by Eugene Hirsch, M.D. Here is an excerpt. Notice how writing poetry by this physician has provided him with a means of expressing what to him is most meaningful in his medical practice.

I suppose most poets write for more esoteric reasons. But, as a physician, I wanted to learn to come to terms with life without trying to control it - at least enough to resist losing my identity through the absorbing seduction of impersonal medical technology. Some physicians are fulfilled by centering their lives around tangible problems and systems rather than the intangible nuances which accompany long term interactions with people and their functioning. Indeed, in taking nebulous paths, I sometimes think I have failed in important aspects of medicine. With my limited ability to follow tangible guideposts in the rapid fire of clinical processing, I have gravitated toward patients with altered function and chronic medical problems rather than acute ones, keeping company with my geriatrician peers and with the imaginations of philosophers and English teachers. Indeed, I have wondered how it is that as humans we tend so well to fostering value-free hard science, yet seem so helpless in stimulating value-laden, humanistic progress in our affective and societal selves.

What does writing poetry accomplish for the writer whether a physician or a patient? Clearly, at least it provides a means of emotional ventilation that can be considered therapeutic to whatever the role of the author. I think also it becomes an educational tool for the reader, in that aspects of being a patient or treating a patient which may previously have been unrecognized by the reader can now become apparent. And with that knowledge, the reader will be more understanding of medical issues that will be personally encountered later.
Let me give you my comments about what I think is the medical value of poems such as the following two which were written and posted here by me last year.

July 22, 2004-
Unspoken Translation
by Maurice Bernstein, M.D.

“I have this”
She talked through a translator with a language I don’t know
“And it burns”
She pulls up her shirt and points to her kidney
“I am worried”
Why? I ask through a translator
“I am unmarried and have a small child”
Are you worried about your kidney? The translator speaks for me
Tears fill her eyes and move down her cheeks and
I don’t need a translator to tell me more.


This poem was based on a recent patient encounter. I have been frustrated by the need and process of translation as a means of communicating with patients. I wanted to show that there are times when empathetic observation can be sufficient to understand the patient.

August 29, 2004-
Uninvited Guest
By Maurice Bernstein, M.D.

Oh, Culex, you uninvited guest
Who kissed me, spreading your exotic gift
And leaving me weak, feverish, seeing double
And becoming suddenly a modern statistic.

Oh, Culex, where are you now?
What life are you going to challenge next?
Stay away. I'll be back.
And, you know, Culex, I have never been to Uganda.


Here I was sickened by West Nile virus infection and frustrated and angry by the degree of sickness from some small creature without any warning to which I could not react. As a patient, I wanted to ventilate my anger and I think I did this, in part, through writing this poem as I returned from the hospital.

What is your take on poetry in medicine? And do you have a poem to share you wrote as a healthcare provider or that came from you or someone else as a patient? ..Maurice.

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