Abstract
This column explores the links and synergies between medicine and literature. What roles can literature play in reflecting and influencing good practice, and what sorts of images of doctoring are to be found in drama, poetry, fiction, biography, electronic fora and film? The editors would be pleased to receive short papers, ranging from 500–1,000 words, on relevant topics. Those interested in contributing should email brian.hurwitz@kcl.ac.uk or neil.vickers@kcl.ac.uk
Just when and how I fell in love with poetry, I am not sure. But once I had done so, I found I could express thoughts and feelings anew, and sense and convey their possible significance in new ways. These effects extended beyond describing sublime sunsets on the Himalayas and into my work as a physician. Now, if an idea springs up at the back of my brain and demands expression in poetry, I write.
Yet I have had strange looks from many a doctor colleague when mentioning that I love and write poetry; this despite its healing power which is widely discussed, despite many celebrated physician and surgeon poets of the past, figures of medical, surgical and literary repute, one of whom became Poet Laureate.1,2,3,4,5,6,7,8,9 Today, physicians and nurses continue to pen poetry, poets offer therapies to patients and, in the 10 years of its existence, Poems in the Waiting Room has distributed millions of poems to general practitioner and hospital waiting rooms where they are pondered and enjoyed by patients and staff.5,10,11
Primary angioplasty (patient)
Like a nuclear explosion
it went on
and on
blowing my heart
to smithereens.
Raging inferno
in the chest,
arms like lead,
sweat on my palms
sweat in my hair
gushy waves of sickness
thundered through my body.
My mind was screaming
into a black hole,
a sea of pain and more pain;
there were distant voices…
‘STEMI…air ambulance is best…
phone the cath lab…’
Someone was doing something to my arm.
I felt a sudden sweetness
sweeping my body.
My mind was calmer
and drowsy…floating away…
‘You are having a heart attack sir. We
need to open the blocked heart artery.
Could you sign on that line?’
They were shaking my shoulders
hard. I scribbled
in a haze of drowsiness and pain.
I remember being rushed
on a trolley
a blur of
banging doors,
then silence and
the intense cold
in the lab.
Crisp commands slashing the silence,
‘start the Reopro please.
I will have a 2.5 by 15 balloon.’
The voice was strong and confident.
What was he asking for
next? A daxus?
Suddenly the pain was
Gone.
Relief was flooding in
and fatigue…extreme fatigue.
The doctor's account of the same situation as he responds to the emergency call could have an entirely different perspective.
Responding to a STEMI alert on a cold December night
The bell rings!
I am lifted out of my bed,
then driving
through the magical mist
toward the lights
of the university hospital.
It is a cold orange night
when the breath takes form,
clumps of fog
huddles around the streetlamps
like a hazy painting done
in water colour.
The drone of my black pet
tears and splits
the midnight hour
rushing away time;
lights in the cath lab
switch on;
the team arrives,
business is on.
It's Lynn's birthday,
wishes…starting mac lab…
sleepy smiles…giggles.
I arrive
with a breathless mind
my steps onto A&E are
quick and firm.
The registrar stands by
the corner bed
clutching an ECG.
Medical poetry
You could call these medical poems since they deal with medical issues quite specifically. This form of poetry is not such a bad thing since it will certainly be understood and enjoyed by the medical community and for patients it might help to de-mystify medical complexities making medical issues more understandable. But medical poetry could well be written with a health message. The message might be directed at the general public highlighting the ‘dos and don'ts’ from a health point of view:
Wake-up call
Frequent cheeseburgers and chips
Makes you heavy at the hips
Repeated doses of vindaloo
Sticks to your arteries like glue
Thick bars of sweet
With a drink to match
Might propel you into
The diabetic patch
Smoking is sin, fats taboo
Yes, it's you I am talking to.
The message may represent a personal medical view on a particular subject, eg on the appropriateness of resuscitation or a view on death:
Celebration
One day
while outside,
there is sunshine and laughter still
on some nameless hospital bed
my life will fade away.
My soul
will burst into freedom
flying at blinding speed
into a tunnel
of brilliant white and gold
eager to be united
with the creator.
On the ward
the cardiac arrest bleep
is screaming;
doctors huddled around the bed
pumping and pushing
the battered chest.
Adrenaline, adrenaline
is the chant
while I smile
in quiet celebration
and pray
for the dignity
of my old body.
Later at home
there are tears,
phone calls,
‘dad was a good man.’
I want to say no!
Don't cry for me.
Today is my day
of freedom.
Yet, I shall miss you all
and especially
our wonderful world.
Occasionally, like other doctors, I have done some soul searching about the way we conduct our professional work. I find great release in writing down my feelings, especially if I ever feel I could have done better for a patient:
Custodian
Even in the stillness
of death
I can't disown you.
For forty long years
of your life
you made me
the custodian of your
precious health.
Through all doubts and difficulties
you trusted me still.
Today,
as you lie silent
before me,
The time has come
To ask the question:
Have I served you well?
Has our relationship
been
a success story?
Most of all I think medical poetry is fun and through my poems I would like to bring a smile to the lips of other doctors:
Diarrhoea
If there is one thing I fear
While travelling far and near
It is developing diarrhoea
With an accompanying sore posterior.
Shigella, salmonella and campylobacter
The tummy grumbling like a tractor
Groan, splutter, bang and whoosh
I am still in the toilet. Don't push.
I will finish with a medical nonsense poem:
Mayhem
On a crazy Monday in the month of May
everything changed in a bizarre way.
The heart stopped pulsing
the spleen pumped blood!
The liver made urine
was all aflood.
The gut did the breathing,
kidneys made stool,
the brain was covered
in cotton wool.
The bones had a dance
in the moonlight!
While sarcomeres and neurons
engaged in a fight.
There was music in the nose
throughout the day,
on that crazy Monday.
Read the works by Robert Carroll and Ann Kelley for examples of some of the most moving poetry I have come across from patients, poems that have enthralled as well as soothed healing and palliation. Last week I bought a book entitled Pound a poem which contains poems in response to a cancer appeal written by children on the benefits of eating fruit and vegetables.12 I wonder what would happen if we opened a similar appeal to all medics of the world? I do believe poetry written by patients and healthcare staff will have an important role to play in medicine in years to come. It is time the medical world woke up to the power of poetry.
References
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- 11. Poems in the Waiting Room www.pitwr.pwp.blueyonder.co.uk.
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