“First do no harm”: Poetry & Medicine

Poetry

By Christy Tidwell

As I observed in last week’s National Poetry Month post, both poetry and science provide us with new ways to see the world we live in. This week, I want to get more specific and consider one STEM field with a significant relationship to poetry: medicine.

Poets Imagining Doctors

There is a long history of poetry representing doctors and medicine. Robert Southey’s “The Surgeon’s Warning” (1796) provides one Gothic and rather gruesome vision of doctors (thanks to Laura Kremmel for the recommendation!). In it, a doctor on his deathbed worries about how his corpse will be treated:

All kinds of carcasses I have cut up,
        And the judgment now must be–
    But brothers I took care of you,
        So pray take care of me!

    I have made candles of infants fat
        The Sextons have been my slaves,
    I have bottled babes unborn, and dried
        Hearts and livers from rifled graves.

    And my Prentices now will surely come
        And carve me bone from bone,
    And I who have rifled the dead man’s grave
        Shall never have rest in my own.

This is an image of the doctor as monster, as one who perhaps deserves to receive the treatment he’s given others’ corpses (ultimately, “they carv’d him bone from bone”), and it reflects 18th century fears of doctors and surgeons themselves as well as those who worked alongside them (graverobbers, for instance).

Interior of an unidentified classroom, students posing next to three cadavers and a skeleton
United States, ca. 1910. Photograph. National Library of Medicine

Medicine (and its perception) underwent massive changes in the 19th and 20th centuries, and Anne Sexton provides a more thoughtful take in “Doctors” (1975). She too reveals fears of doctors, but these are less spooky and more mundane: “If the doctors cure / Then the sun sees it. / If the doctors kill / Then the earth hides it.” Here, the grave is not a source of stolen bodies but a place where doctors’ failures and mistakes are laid away. On the whole, though, Sexton’s poem reflects a shift toward more positive ideas about doctors, noting that “they work with gentleness / and the scalpel” and that “they are only a human / trying to fix up a human.”

But all along the doctors remember:
First do no harm.
They would kiss if it would heal.
It would not heal.

Anne Sexton, “Doctors”

Some skepticism about doctors persists in James Tate’s “On the Subject of Doctors” (1991), however, in which the speaker describes doctors by their failings: “Some of them smoke marijuana / and are alcoholics, and their moral / turpitude is famous: who gets to see the / most sex organs in the world? Not / poets.” There’s a sense of them as at-risk themselves (“With the hours they keep / they need drugs more than anyone”) and the poem ends with a line about “the doctors, who are dying,” but this acknowledgment is counterbalanced with a sense of them as willing to “grab all your money / just when you’re down.” Doctoring has become – by this point – a profession with clear monetary and societal benefits, but it is also a demanding one.

In “Consultation” (2014), Chris Woods emphasizes the demands on doctors, describing in just 12 short lines a person who “doesn’t look too good” and “doesn’t look too hot.” At first, the poem seems to be about the patient, who is not well, but the last line reveals that the poem is actually from the patient’s perspective, asking “Doc. Are you all right?” Woods sees yet another shift in doctoring, in which doctors are “in the driving seat / no longer.”

Doctors Writing Poetry

Doctors also write poetry, as a way “to capture the fragility, tenacity and universality of the human experience.” This isn’t exactly new, since there have been doctors writing poetry basically since there have been doctors (Oliver Wendell Holmes, Sr., and William Carlos Williams are two well-known examples), but it’s worth noting that JAMA: The Journal of the American Medicine Association includes a poetry section, and this is one of the most popular sections in the journal.

Rafael Campo, who teaches and practices medicine at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston, is one modern doctor-poet. He writes about his responsibility to the bodies of his patients in “Morbidity and Mortality Rounds”: “Forgive me, body before me, for this.” A litany of “forgive me” statements, the poem acknowledges the weight of doctoring and the need for doctors to face their patients’ deaths and their role in them.

Forgive me for my bumbling hands, unschooled
in how to touch: I meant to understand
what fever was, not love. Forgive me for
my stare, but when I look at you, I see
myself laid bare.

Rafael Campo, “Morbidity and Mortality Rounds”

In his poem “The Chart,” Campo describes a small moment of medical practice – reading a patient’s chart – and connects i to larger issues within medicine. The chart reads “fifty-four-year-old obese Hispanic / female,” but – as Campo notes – this could mean any number of people. Could it refer to the Peruvian, Dominican, Cuban, Mexican, Colombian, or even “the one who never says / exactly where she’s from”? The poem gestures toward the racism that exists within medicine, both in the blindness to these differences between people and also in the final lines, which connect the speaker personally to this issue and indict some doctors for their inability to see these patients. He writes that the one who never says where she’s from reminds him of his grandmother, “poor but refined,” a woman “who died too young from a condition that / some doctor, nose in her chart, overlooked.” Her death represents the higher mortality rate of people of color in the US because “Black people simply are not receiving the same quality of health care that their white counterparts receive, and this second-rate health care is shortening their lives.”

Campo’s poems give the rest of us a chance to see how it feels to be a doctor and to gain a more complex sense of doctors – both as professionals and as people. It’s hard to see doctors as Gothic or money-grubbing when given this insight into their thoughts and experiences.

For more from Rafael Campo, check out this conversation between him and poet Mark Doty

Doctors Using Poetry

In addition to sharing their own experiences, doctors use poetry to help them better understand their patients’ experiences (as a means of empathy) and as a way to share their own humanity with their patients. Rafael Campo says, “When a cure isn’t possible, when there isn’t going to be another round of chemotherapy, or there isn’t another procedure to perform, what do we still have to offer our patients?” The answer, found in poetry among other places, is “our own humanity. That can be really healing for patients.”

Doctors are using poetry as part of treatment, too. For instance, Harvard medical student Danny W. Lingonegoro describes a clinical study of the effects listening to music or poetry have on cancer patients, writing that “Only poetry . . . increased hope scores. The researchers conjectured that poetry can break the so-called law of silence, according to which talking about one’s perception of illness is taboo.”

Finally, reading poetry can help doctors deal with their own emotional responses to their work. Colleen M. Farrell, M.D., writes about bringing poetry into the ICU and reading them with her medical students. She says, “On rounds, we never acknowledged just how heart-wrenching this man’s condition was. But the poem provided an opening, a permission slip to name the grief we experience vicariously and the helplessness we feel when medicine has reached its limits.”

As these poems and uses of poetry reveal, the humanities and STEM fields like medicine are deeply connected. Medicine does not exist in a vacuum, separate from the stories we tell and the arts we create, and more and more people are recognizing – within medical fields themselves and within the medical humanities – how much medicine benefits from incorporating poetry (and other arts). Similarly, poetry provides a space for both doctors and patients to reflect on medical practice and on their experiences with medicine. And it can, as Rafael Campo writes, connect the people involved in medical care: “Poetry gets us past all the machines, literally to the heart of the matter; poetry expands the interaction with a patient to a space without time limitations; poetry bridges those cross cultural gaps by speaking in the most elemental and mutually understood form of language we have.” Technology is useful, he indicates, but on its own it is not enough.

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