Dean Gianakos, MD, FACP
Lynchburg Family Medicine Residency, Virginia, United States

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Men and women who tout the value of poetry like to refer to a stanza in William Carlos Williams’ famous love poem, “Asphodel, That Greeny Flower”, written in 1947:


It is difficult
To get the news from poems
Yet men die miserably every day
For lack
Of what is found there.1

If what the physician-poet writes is true, then perhaps physicians—who are in the business of saving lives—ought to devote more attention to poems. At the very least they should determine what Williams means by these lines. Two questions to consider: what news in poems might save a patient’s life? Might save a doctor’s life? First, a few words about Williams.

William Carlos Williams, one of the most influential poets of the 20th century, was also a pragmatic physician who practiced family medicine and obstetrics in Rutherford, New Jersey, where he cared for many poor ethnic families. His busy medical practice in the early 20th century inspired many of his poems. Between patients, Williams often scribbled lines of poetry on prescription pads. How did he manage to write volumes of poetry and to see volumes of patients? In his autobiography, he explains:

“That is why as a writer I have never felt that medicine interfered with me but rather that it was my very food and drink, the very thing which made it possible for me to write. Was I not interested in man? There the thing was, right in front of me. I could touch it, smell it. It was myself, naked just as it was, without a lie telling itself to me in its own terms.”2

In his recent biography, “Something Urgent I Have to Say to You”: The Life and Works of William Carlos Williams, Herbert Leibowitz elaborates: “What most distinguished Williams was his drive to turn himself into a masterful American poet. He brought the same intellectual focus to that Herculean task as he did to deciding what sickness lay beneath a patient’s recital of symptoms.”3

In the verse above, Williams presses the reader to reflect deeply on one word: “news.” What kind of news is he talking about? Not the kind of news reported in newspapers or magazines. Not the news found in medical journals. For Williams, news is a metaphor for the emotions, feelings, and perceptions that are communicated in a poem. Through language, rhythm, rhyme, and figures of speech, poets like Williams create emotional pictures, images that help readers to understand the emotions of characters portrayed in poems, and also their own inner lives.

How does this understanding save lives? When physicians develop the skills to read poems and process poetic images, they may become more adept at reading the emotions of their patients, picking up subtle hints of depression, for example, and thus saving the lives of suicidal patients. Reading poetry with skill and care increases emotional intelligence.

In her short poem, “Passage,” Marilyn Donnelly creates an emotional image of a daughter watching her father grow old:

He who
Took the steps
By two
Now pauses
On each tread
And I
Who love him so
Am filled with dread.4

On the steps is an aging father or husband. He is different from the physically active man of earlier years; different from the man who ran on the treadmill of life. In the past, he may have moved so fast it was difficult to see the subtle changes that were occurring: new wrinkles on his skin, a slowly receding hairline, a slightly bulging abdomen. Instead of taking the stairs two steps at a time, he now pauses on each tread—tired, slow, uncertain of his next step. No longer is he climbing the corporate ladder as an ambitious executive or racing upstairs to help a child with homework- now he is physically impaired, possibly on a slow passage to heaven. His daughter mourns the loss of the man who once raced up the stairs, the man once active, vigorous, and full of life.
As a general internist reading this poem, I see the man on the stairs differently than the way I see him in the office. In a few short lines, I understand how the man’s aging affects his daughter who loves him so much. The news I get from the poem reminds me that one day I will also be on the same tread, that busy physicians used to taking the hospital stairs by two will one day pause on each tread. That understanding increases my empathy for the man on the stairs, empathy I will carry to the next frail patient I see.

The news I get from this poem also urges me to slow down for patients like the man on the stairs. It calls me to slow down for the daughters and sons who are grieving for the loss of the strong father they once knew and loved. These patients and their families need more than ten minutes in the office to air their stories. By empathically listening to them, I am better equipped to make subtle diagnoses like alcohol abuse or dementia—diagnoses that may help to save their lives. I am better equipped to understand their personal values and possibly prevent a patient’s miserable death on a mechanical ventilator. In short, reading poems with attention strengthens the empathic muscles I use every day as a physician to lift up patients from illness and despair. Empathy saves lives.

Donnelly’s poem emotionally resonates with me more than other poems because I am a middle-aged physician who has frail aging parents. I can see my own parents pausing on each tread, and like the narrator in the poem I am occasionally filled with dread. Although I may be discouraged and sad at times, the poem lets me know I am not alone. That knowledge provides solace. I know there are others in the same passage, looking up at their aging parents. And of course, I already know this, because I am a physician who sees patients like this every day; but to see one in a poem—and to take time to reflect and to write about the experience—is different than seeing patients in the office, where time constraints force action rather than reflection. The poem validates the feelings I have for my own parents.

Is it a stretch to say poems literally save lives? I don’t think so. Reading poems may inspire depressed caregivers to persevere, to not give in to despair—despite the enormous challenges of caring for chronically ill, elderly persons. I have already mentioned how Donnelly’s poem creates feelings of solidarity among readers with aging parents.

Williams, however, is more interested in how poetry figuratively saves lives.5 For physician readers, poetry may break the monotony, stress, and tedium of medical practice. Poetry is an antidote to burnout. It has the potential to deepen a physician’s knowledge and appreciation of many things, including the beauty of the physical world, human emotions and relationships, and the resilience of the human spirit. Furthermore, poetry is well suited to the daily demands on a physician’s time and energy: many poems are short, yet packed with meaning, such as the few verses examined in this essay.
Why is it difficult to get the news from poetry? I would never have found the news in “Asphodel” on my own, had it not been delivered to me by someone else. Why? Because I rarely read long poems like “Asphodel.” As a busy physician, I prefer shorter poems I can read quickly and reflect on before I start my day in the office.

It also takes time and practice to develop the necessary skills to read a poem with empathy and care—in the same way it takes time and skill to listen to a patient’s story, especially stories that involve complex medical, emotional, and social nuances. What the poem is trying to say—what the patient is trying to say—is not always clear, and demands knowledge, analysis, empathy, and attention from readers. More importantly, reading poetry requires motivation. Physicians must be convinced it is worth the effort to get to know a poem. They must be convinced that reading poems will help them to better understand patients and make their own lives more enjoyable and meaningful.

Despite the demands of a busy medical practice, Dr. Williams found time to write some of the best poems of the 20th century. His patients provided him with unique dialects and language, varied emotions, and medical experiences that nurtured his writing. They stimulated his imagination, making it possible for him to write great poetry. His avid practice of both medicine and poetry makes Williams a credible witness to the value of poems to doctors. It is difficult to get the news from poems, but those physicians who take Dr. Williams’ words seriously may indeed save a few more lives, including their own.

References

  1. Williams, WC. William Carlos Williams: Selected Poems. New York: New Directions, 1969.
  2. Williams, WC. The Autobiography of William Carlos Williams. New York: New Directions, 1967, p.357.
  3. Leibowitz, H. “Something Urgent I Have to Say to You”: The Life and Works of William Carlos Williams. New York: Farrar, Straus and Giroux, 2011, xxix.
  4. Donnelly, M. “Passage.” From Coda. Autumn House Press, 2010. Accessed from The Writer’s Almanac with Garrison Keillor, February 20, 2011. http://writersalmanac.publicradio.org/index.php?date=2011/02/20
  5. Gianakos, D. Getting the News from Poetry. Family Medicine. 2007; 39(6)390-1.


DEAN GIANAKOS, MD, FACP is a general internist who serves as the Associate Director of Lynchburg Family Medicine Residency and Geriatrics Fellowship, Lynchburg, VA. He is board certified in Internal Medicine and Hospice/ Palliative Medicine. Dr. Gianakos frequently writes and lectures on end-of-life care and the medical humanities. He serves on the editorial board of the medical humanities journal, The Pharos.