Hello, everybody. Good to see y'all in this kind of attenuated but hopefully kind of warm way. It's good to see your faces. My name is Judy Frank. I'm the Director of Creative Writing at Amherst College and I'm happy to welcome you to this second reading in our fall reading series. Next Tuesday evening our very own Shayla Lawson will be reading from her new collection of essays, This is Major: Notes on Diana Ross, Dark Girls and Being Dope. You can register for it on our events page which I'm about to put into the chat. There it is. That's our events page
I'd like to thank Catherine Newman and John Kunhardt for setting this up for providing tech support, for being there 15 minutes before to reassure us that everything is actually working and please note that this event is being recorded.
It's my pleasure to welcome Rafael Campo to read tonight. Rafael teaches and practices general internal medicine at Harvard Medical School and Beth Israel Deaconess Medical Center. He's the author of seven volumes of poetry and the recipient of a Guggenheim Fellowship, a Pushcart Prize, and two Lambda literary awards, among numerous other honors. Mark Doty describes his work as inhabiting, quote, “the landscape of birth and of dying, sorrow and sex, shame and brave human persistence, first and last thing, center stage, in these large large-hearted, open deeply felt poems.”
Rafael started practicing internal medicine in the early 1990s at the height of the HIV aids epidemic in the U.S. His writing reflects his commitment to poetry which he has called this ancient art form that sustains us even when biomedicine can't, as the fullest expression of self and his understanding of it is an essential form of healing. We come to poetry, he has said, I think, because we are silenced in many ways in biomedicine. We're so good at appropriating the narrative the biopsy report, the CT count, the potassium level. Writing gives patients an opportunity to say this is my cancer, this is my HIV. He often jokes that when he came to Harvard Medical School, what most perplexed professors and classmates wasn't that he was gay or Latino, but that he was a poet. That really freaked everyone out, he says. He serves as a director of literature and writing programs of the arts and humanities initiative at Harvard medical school and is the poetry editor for JAMA. the Journal of the American Medical Association. He holds a B.A. and an honorary director of letters degree from Amherst College and he is also a former trustee of the College. Please join me maybe with your silent but maybe actual hands, in welcoming him back to Amherst.
Thank you very much. It's such a joy to be here with you this evening virtually and to be back at Amherst in a distanced fashion. But as Judy said, I feel very much connected to all of you through this very cozy Zoom format. So, thank you all for coming tonight. As Judy said in introducing me, I really felt that I wasn't likely to succeed when I first contemplated a career in medicine. I remember first reflecting on my faith and not seeing much of a spiritual life among physicians. I thought that would be a challenge for me. Then i remember considering my ethnicity and not having many Latinx role models to inspire me to have a career medicine. I thought that might be another kind of barrier in becoming a doctor someday and then of course is the fact that I'm gay, and I'd experienced enough homophobia in doctor's offices at a pretty young age to make me think that might be the biggest obstacle to this dream I had of studying medicine, and as it turned out, it was really the fact that I was a poet that really freaked people out when I finally got to Harvard Medical School. All these other aspects of who I am certainly posed some challenges. but being a poet really alarmed a lot of my colleagues and peers and others I came in contact with during my training, and I always loved to tell that story with a sense of the irony in it because I really cannot imagine the work of healing without the presence of poetry in my life. I thought maybe to start the evening you know we had a wonderful conversation earlier with just some extraordinary students around this connection between poetry and medicine poetry and healing, and so I really want to make my reading tonight an enactment of that of that profound connection and to do so, starting with a poem that I think does a couple of things. One, I think it locates us, locates me, in relation to some of these, in some ways, fragmented or divergent identities in a way that poetry really has the power to do. And I think it also is a poem that at the same time calls us into community and that's one of, I think, the most remarkable powers of poetry in terms of healing is the way in which it can bring us together across difference, across disparate experiences and so this first poem is a poem called Latinos, and it also makes me long for the pre-COVID days when we could actually have parties. So this is a poem called Latinos.
Another avocado and I'm done. The guacamole I prepare is for the super bowl a party for a game we watch because Americans love football and after all we want to be like them. A couple drops of hot sauce and I'm done. I spoon the guacamole into bowls. You say you love to watch football games. I say you're Puerto Rican and we're gay so really must we host this stupid party. A sprig of fresh cilantro and it's done. You taste the guacamole then you smile reminding me of why I married you. It's just a game I think. (speaks in Spanish), you say and pat me gently on the butt. The guacamole finally is done. You sure you aren't a little Mexican? This guacamole is delicioso. I tackle you onto the couch. We kiss a while. Watch JLO in a Pepsi ad. I feed you chips with guacamole. Done with games, I ask you seriously, not in Spanish but almost as grave, is it too late to reconsider? Suddenly you look delicious, like Lorca. Surreal. I taste the guacamole on your tongue. The super bowl is just a game, you say. Miami versus San Francisco. Sea to shining sea. We sing beneath the strobes and stars, beside Americans, like us. (pause)
Now that I'm on the faculty at Harvard Medical School, much of what I teach is how poetry and the arts and humanities more broadly can help us be better healers, help medical students in particular, but also many of my interns, residents and colleagues, fellow faculty members. One reason I think that poetry is so important in medical practice has to do with empathy and the way it resists the biomedical approach to illness and to disease. I remember my own medical training which was largely focused on biomedicine, anatomy, pathophysiology, all the sort of hard science of medicine, and really at the expense often of the humanistic aspects of medicine which I imagined would actually be more central to my own education. I remember attendings of mine, supervising physicians who would scold me for spending too much time on the social history and telling me always to tell them more of the facts, as Judy was saying before. Also, what’s the potassium? How many lymph nodes are enlarged on the CT scan? The data of the disease and not the who was at home that was going to be able to support the patient after we discharged her from the hospital, or again, some of the social aspects, humane aspects of the experience of illness were really discounted. So I still have colleagues now who really look at any effort to teach humanistically in medicine, even the notion of teaching empathy, with a lot of suspicion, and they say, or tried to remind me that well empathy can't really be taught, can it? It's either innately in us or it's not, and it's something that really our learners, their parents ought to have taught them. But I do think that we can, if not teach empathy, perhaps we can model it more effectively than we do, and certainly we can use the humanities perhaps or employ the humanities in a way to really interrogate the kind of distancing, and the ways in which we use science to insulate us from the human experience of illness, in a way that would help our students, I think, really learn about how to heal in this broader sense. So, I wanted to read next a poem that to my mind is a kind of an enactment of empathy. Again, I think it is very hard to define what empathy is but perhaps this poem represents it in some way, and again I hope points to a way in which poetry does have utility in in medicine. So, this is a poem called Iatrogenic. The term iatrogenic refers to a condition that is actually caused by the medical treatment itself and so, just to define what iatrogenic is. Iatrogenic. You say, “I do this to myself.” Outside, my other patients wait. Maybe snow falls; we're all just waiting for our deaths to come, we're all just hoping it won't hurt too much. You say, “It makes it seem less lonely here.” I study them, as if the death deep red cuts were only wounds, as if they didn't hurt so much. The way you hold your upturned arms, the cuts seem aimed at your unshaven face. Outside, my other patients wait their turns. I run gloved fingertips along their course, as if I could touch pain itself, as if by touching pain I might alleviate my own despair. You say, “It's snowing, Doc.” The snow, instead of howling, soundlessly comes down. I think you think it's beautiful; I say, “This isn't all about the snow, is it?” The way you hold your upturned arms, I think about embracing you, but don't. I think we do this to ourselves. I think the falling snow explains itself to us, blinding, faceless, and so deeply wounding. (pause)
Another reason I think poetry has a role to play in medical care has to do really with seeing so many of my writer friends make use of creative self-expression so powerfully in responding to their experiences of illness. One example that always comes to mind is my very dear friend and mentor, Eve Sedgwick, who I first got to know at Amherst College. I took my first poetry writing workshop with her many years ago, and not long after I went off to medical school she was diagnosed with breast cancer that had actually already metastasized or spread to her neck to her cervical spine. I remember her doctors telling her at the time that her prognosis was very, very poor and her response to that news in a sense was actually to write. Not only did she produce several seminal volumes that are really considered the sort of primary texts of a new discipline at the time, now known as queer studies, but she also produced advocacy work. She wrote poetry, and I really believe that her writing sustained her and she lived on another 10 or more years after her diagnosis in spite of all of those bleak prognoses. So, I want to read this poem in Eve's memory and in her honor> It's called Heart Grow Fonder and
I hope that she in a way lives on in these lines just as she does of course in her work, which is extraordinary. Heart Grow Fonder. The leg bone’s connected to the shin bone. An apple a day keeps the doctor away. A little voice inside me said beware. A tumor big as a grapefruit killed her. Tamoxifen. Oxycodone. Bengay. The breast bone’s connected to the rib bone. Like a patient etherized, I can't say what evening looks like, but I feel alone. A little voice inside me said, unfair. My brain's a sieve, she'd say. We mourned her hair. She'd get lost on the way to San Jose. The rib bone’s connected to the backbone. I plunged my heart in San Francisco Bay. A scar across her chest. One breast was gone. A little voice inside me said, I'm scared. Some final pleasures. Slices of ripe pear. Massages strangely not unlike foreplay. The backbone’s connected to the neck bone. Old voicemails from her that I still replay. Physician, heal thyself sweetly intones the little voice inside me. I can't bear. We read together almost every day. After great pain, a formal feeling comes. The neck bone’s connected to the head bone. A little voice inside me says, beware. (pause)
I think an appreciation of poetry also allows to better understand and make use of literary devices such as metaphor and irony and it turns out that some of these ways of thinking imaginatively are really quite useful in medicine. An example that comes to mind recently was a a visit I had to a school of public health here in Boston where the students and faculty were engaged in a kind of discussion of the prevention paradox, which some of you may know holds that public health prevention strategies aimed at high-risk groups actually end up benefiting the majority of people perhaps more than they do the actual folks in the targeted group. They were having a kind of argument about whether such strategies, which may in some ways heighten stereotypes or can make people in high-risk groups feel targeted or feel stigmatized, are actually worth that if not as many of those folks are going to benefit as compared to the larger group. They were having a kind of argument about this and I shared this next poem with them as a way of perhaps, not necessarily resolving the actual problem they were having with this prevention paradox, but really to perhaps cast it in a different kind of a light and help us to think about it perhaps in more human terms. So, we had a really, I think, very interesting discussion about this poem afterwards. This is a poem called Unexceptional which you'll see I think helps us think about some of these kinds of
target groups in perhaps a different way. This is, again, Unexceptional. Except we were in love, or so it seemed. The refugees kept streaming past. The cops kept shooting up the neighborhood. Except it seemed that we were happy, pulled the shades and set aside our textbooks. Brushed our teeth. The honor killings went unpunished while we aged together, holding hands as we succumbed to sleep. It seemed that life was good except black mothers kept on dying young. We said our vows in church and afterwards it seemed that queers were harmless, even mattered. The loved ones in our photographs gazed back at us, or at each other, or beyond. Except the virus struck. The pipeline burst. The hurricane made landfall, killing thousands. We splurged on business class as if the wine at thirty thousand feet could taste more sweet. Except that they worked hard, but since their son od'd, it seemed that it was pointless now. The oligarchs kept stealing from the state. The politicians blamed the poor. Except the lamp light glowed and music streamed as if the internet was limitless and magical, as if we knew that anything for which we searched was certain to be found. We watched a baseball game on television just like anybody else. It seemed like we were normal when the garden needed watering, while elsewhere in the desert someone was interrogated, beaten, kidnapped, raped. Except it didn't happen here, but there. Except it happened not to us, but them. Except the sunset from our porch refused again to be the last. So damn beautiful. (pause)
We were talking a little bit earlier today about how poetry I think also can help us not miss things in medicine, can really help us sort of enlarge the context of what we're doing every day in the hospitals, in the clinics. This next poem I always share because it really reminds me of an example of how that can happen and really how I think patients often take care of us in medicine, and this patient that you'll meet in this very brief poem that I'll read next, was just such an incredible example of that kind of care. I'll never forget him. I was doing my pediatrics rotation during my fourth year of medical school, and I was on call one night and got paged at around 2 a.m. to put an IV into a kid that had been admitted earlier in the evening. I dragged myself out of the call room and to the supply closet on the ward and gathered all the things I needed for the for the IV and trudged over to his bedside and set up all my little pile of equipment there. He was sort of half asleep and wearing dinosaur pajamas. I remember that so vividly. I started to try to put this IV into him and tried once and missed the vein. I tried a second time missed again. The sweat is starting to sort of trickle down my forehead. The nurse who’d paged me is glaring at me from the from the doors thinking, you idiot, you're torturing this poor. Just get the IV in already, and tried a third time. I missed again, and finally he looks up at me with these huge eyes and says, “Doctor, don't worry. You're doing a really good job.” I remember being just so struck by his capacity to empathize with my evident distress, despite the fact that he was really very ill, and that kind of gesture of care, of compassion at such a young age, was again just one of those kinds of unforgettable moments in my medical training, and again reminded me of why it's important to look up from our checklist and actually see the person in front of us. This poem is another way of seeing this patient of mine, and I wanted to share it with you tonight. It's, as I said, a very brief poem. It's called Age 5 Born With Aids.
In [inaudible] picture of the world a heart as big as South America shines out, the center of the only ocean. Three stick figures -- one is labeled me -- are drawn beside the world as if such suffering could make us more objective. [Inaudible] is bald and has no mouth. His parents aren't like him. They're all red lips and crazy yellow hair and grins. There is no title for his work of art except the names we give ourselves. (pause)
We also talked earlier today about metaphoric language and how it's useful in medical
settings, and how it helps us, I think, really better apprehend our patients’ stories of their experience of illness, and I wanted to read a little bit of an essay, an excerpt from an essay that that talks perhaps more explicitly about that and why language really is so central to the work that I do every day in in clinic. This is from an essay called Illness as Muse. I'll just read a few paragraphs from it because again I think it speaks to some of the themes we've been discussing today.
I find myself in my clinic again, the exam room speaking aloud in all of its blatant metaphors. The huge clock above where my patients sit implacably measuring lifetimes. The space itself narrow and compressed as a sonnet, and immediately I'm back to thinking about writing. Soon enough, my patients start to arrive and the way they want me to understand what they are feeling only immerses me more deeply in language's compelling alchemy. “The pain is like a cold bitter wind blowing through my wound,” murmur's a young, infertile woman from Guatemala with what I have diagnosed, much less eloquently, as chronic pelvic pain. “Please, Doctor, can you heal me?” I regard her from across the desk and feel grateful for the computer terminal more immediately in front of me which allows me to type a little medical jargon into my note before having to actually speak to her. We have had this conversation before which I realize is another way of saying we are together part of a narrative, a story, a story in which irony matters, in which understanding metaphor, might her pain be a wordless expression of her deep sadness at her inability to have a child, or perhaps the consequence of some trauma on her journey north she has not disclosed, seems to have some irrefutable value. Now I am thinking again about writing, but not a prescription for the pain medication she always refuses. Instead I am thinking about writing a poem. I am thinking about the metal speculum clattering in the sink while she sobbed softly after I performed her last pap smear as if it were trying to reiterate something about coldness and bitterness or what we hear and can't hear, or pain and objection. Perhaps something about this young woman reminds me of my Cuban grandmother, herself an incurable and incurably hopeful immigrant which only amplifies my narrative impulse. After all, it was my grandmother who first inspired in me a love of stories. Her words were all she could give me of our homeland, Cuba, that exotic and forbidden place. Her own unspeakably painful void. My grandmother was afflicted with what seemed an unfair burden of illnesses. Her treatments for her ailments seemed just as varied as the ailments themselves, from the pills she dutifully swallowed each morning, some prescribed to her by doctors, some dispensed out of her friend's personal hordes, to the prayers she recited before her own tiny shrine to the Virgin Mary, from the magical strange-smelling potahe she brewed with roots and herbs that can't be found in most American supermarkets, to the sheer will to endure that seemed manifest in her meticulously kept apartment and her constant humming to herself of Cuban songs. Some of her illnesses were familiar ones, like diabetes and rheumatoid arthritis; others were conditions that seemed utterly untranslatable from Spanish to English, like the terrible [in Spanish], some kind of debilitating nervous attack, or the more insidious but equally awful [in Spanish] which could afflict her for weeks or even months. Through her experiences I saw firsthand just how indistinct could be the boundary between the tersely biomedical and the wildly superstitious. She took gold for her painful joints that the rheumatologist prescribed, the same doctor who ridiculed her use of traditional Cuban remedies. As an impressionable child, I marveled at the idea of this precious metal somehow gilding my grandmother from within, protecting her joints from damage by the power of our wonder at it. Decades later, when she finally died of kidney failure induced by the toxicity of what proved to be a worthless treatment for her, I learned the meaning of irony for the first time. If her rheumatologist in his starched white coat could have been so wrong about one form of treatment, maybe he was just as mistaken about the mystical powers of what was prescribed by the curanderos whom he regarded as ignorant savages. (pause)
Whenever I read these next poems, someone will come up from the audience afterwards and say, oh those poems you read towards the end really reminded me of that television show ER. Well, it used to be ER all the time. Now it's more like you know Grey's Anatomy or one of the other countless medical dramas that are on tv these days, and are being rerun for our COVID-19 viewing pleasure these days, all the time. I always have to say, in response, that these poems were really written well before any of those shows appeared and were really written with a different intent. I was thinking in these poems about how I could make my patients, people living with illness, the heroes of their own stories rather than the doctors in these tv shows who always seem to be the main focus and who are always working out their own neuroses, and the patients are the kind of substrate for them to have their own sort of dramas play out, and really again I wanted to try to elevate and make heard those those voices of people whose suffering I was present, together with them to try to make some sense of. I also, I think was really trying to make the “medicaleese” that we use in a way as another kind of distancing tool that keeps patients at bay and I think in some ways is sort of weaponized against them to assert our own kind of power and superiority. I wanted to explore how that that language might actually be reconceived as more truly in service to their stories. There is a kind of beauty to the medical language that I wanted to try to make heard as well, and so this series of poems is called Ten Patients and Another, and you may also appreciate that they are broken sonnets and so they're also really love poems, written for my patients, to remember their dignity and how they are able to endure. So, Ten Patients and Another, and I'll read just some of these for you this evening.
Mrs. G. The patient is a sixty-odd-year-old white female who presents with fever, cough, and shaking chills. No further history could be elicited. She doesn't speak. The patient's social history was non-contributory: someone left her here. The intern on the case heard crackles in both lungs. An EKG was done, which showed a heart was beating in the normal sinus rhythm, except for an occasional dropped beat. An intravenous line was placed. The intern found a bruise behind her ear. She then became quite agitated, and began to sob without producing tears. We think she's dry. She's resting quietly on Haldol, waiting for her bed upstairs.
Jamal. The patient is a three-year-old black male, the full-term product of a pregnancy that was, according to his grandmother, unplanned and may be complicated by prenatal alcohol exposure. Did OK, developmentally delayed but normal weights and heights, until last week when he ingested what's turned out to be cocaine, according to the lab results. His grandmother had said she'd seen him with some baby powder on his face and hands before he started seizing and they brought him in. The vital signs have stabilized. The nurse is getting D.S.S. involved. The mom she left it on the kitchen table. That's he--the one who sings to him all night.
Kelly. The patient is a twelve-year-old white female. She's gravida zero, no STD’s. She'd never even had a pelvic. One month nausea and vomiting. No change in bowel habits. No fever, chills, Malaise. Her school performance has been worsening. She states that things at home are fine. On physical exam, she cried but was cooperative. Her abdomen was soft with normal bowel sounds and question of a suprapubic mass, which was non-tender. Her pelvic was remarkable for scars at six o'clock, no hymen visible, some uterine enlargement. Pregnancy tests positive times two. She says it was her dad. He's sitting in the waiting room.
S.W. Extending from her left ear down her jaw, the lac was seven centimeters long. She told me that she slipped and struck her face against the kitchen floor. The floor was wet because she had been mopping it. I guessed she'd had to wait for many hours since the clock read nearly midnight; who mops floor so late? Her little girl kept screaming in her husband's thick, impatient arms: he knocked three times, each time to ask when we'd be done. I infiltrated first with lidocaine. She barely winced and didn't start to cry until the 16th stitch went in and we were almost through. I thought my handiwork was admirable. I yawned, then offered her instructions on the care of wounds. She left.
Manuel. In trauma one, a gay Latino kid--I think he's seventeen--is getting tubed for respiratory failure. “Sleeping pills and Tylenol,” I translated for him as he was wheeled in. His novio explained that when he’d told his folks about it all, they threw him out. Like trash. They lived together underneath the overpass of highway 101 for seven weeks, the stars obstructed from their view. For cash they sucked off older men in Cadillacs; a viejita from the neighborhood brought tacos to them secretly. Last night, with eighteen-wheelers roaring overhead, he whispered that he'd lost the will to live. He pawned his crucifix to get the pills
F.P. Another AIDS admission. This one's great: they bring him in strapped down because he threw his own infected shit at them--you better bring your goggles!--and a mask, we think he's got TB. He's pissed as hell. Apparently, he wants to die at home but somebody keeps calling 9-1-1. A relative back home in Iowa, or some damn place. Just keep him snowed with Ativan-- believe you me, you do not want to get to know this fucker. Kaposi’s all over, stinks like shit—incontinent, of course. How long before you get down here? Because his nurse is driving me insane. Of course we got blood cultures…yeah, a gas—OK, I'll stick him one more time. the things you do for love.
Maria. This G2, P1 gives us a confusing history. It sounds like she's been pregnant approximately thirty weeks, although she can't recall her LMP. No pain, but bleeding for about two days. Of course she hasn't had prenatal care, and God Only knows where the father is. She works two jobs that keep her on her feet all day. She's been in the united states six months, and doesn't speak a word of English. Bet you she's illegal. Cervical exam is unremarkable, the os is closed. I think we need an ultrasound to tell us more. Besides a look at her placenta, we need some confirmation of her dates. her uterus can tell us more than she can.
Jane Doe #2. They found her unresponsive in the street beneath a lamplight I imagined made her seem angelic, regal even, clean. She must have been around sixteen. She died who knows how many hours earlier that day, the heroine inside her like a vengeful dream about to be fulfilled. Her hands were crossed about her chest, as though raised up in self-defense; I tried to pry them open to confirm the absence of her heartbeat, but in death she was so strong. As resolute as she was beautiful. I traced the track marks on her arms instead, then pressed my thumb against her bloodless lips, so urgent was my need to know. I felt the quiet left by a departing soul. (pause)
I thought I would read a poem that I think in some ways illustrates how patients writing about the experience of illness can be so empowering and healing. It's a poem called Hospital Writing Workshop. I sometimes lead writing workshops for for medical students but also patients in the hospital where I work. and I try to bring poems to share to serve as kind of prompts for us to write together, and I always try to do my own assignments myself, whatever they might be because I think that's what a good teacher should always try to do. If I'm going to make someone else do with this assignment, I should do it myself. So this poem actually was a response to one of my own assignments that, actually my patients’ poems I think were much much better, much more compelling, but I'm gonna share my poem with you tonight. It's called Hospital Writing Workshop.
Arriving late, my clinic having run past 6 again, I realize I don't have cancer, don't have HIV like them, these students who are patients, who I lead in writing exercises, reading poems. For them, this isn't academic, it's reality: I ask that they describe an object right in front of them, to make it come alive, and one writes about death, her death, as if by just imagining the softness of its skin, its panting rush into her lap, then she might tame it; one observes instead the love he lost, he's there, beside him in his gown and wheelchair, together finally again. I take a good, long breath; we're quiet as newborns. The little conference room grows warm, and there before my eyes, I see that what I thought unspeakable was more than this, was hope. (pause)
I wanted to read one more short excerpt from an essay and then one last poem. I was going to read a short excerpt from The Fairest College, another one of my essays, but I know it's, I don't want to go over too long, and I want to make sure I have time for your question. So, this is a very, very short excerpt from an essay called Aids and the Poetry of Healing, and then one last short poem. I hope I've given you a sense of the connections between poetry and healing that are so central in my work, and I hope that this next few paragraphs perhaps makes that connection a little bit more explicit or perhaps a little bit clearer if I haven't enacted it well enough through the poem. So, again, this is a couple of paragraphs from an essay called Aids and the Poetry of Healing.
In poetry are present the fundamental beating contents of the body at peace, the regularity of resting brainwave activity in contrast to the disorganized spiking of a seizure, the gentle ebb and flow of breathing or sobbing in contrast to the harsh spasmodic cough. The single-voiced ringing chant of a slogan at an act-up rally, in contrast to the indecipherable rumblings of AIDS funding debate on the senate. The poem is a physical process, is bodily exercise. Rhymes become the mental resting places in the ascending rhythmic stairway of memory. The poem perhaps is an idealization or a dream of the physical, the imagined healthy form, yet it does not renounce illness. Rather, it reinterprets it as the beginning point for healing. I wonder then whether poetry might also be therapeutic. Many of my friends, especially some of my colleagues in medicine, have teased me for believing in the curative power of words, joking that I should write some doggerel on my prescriptions instead of the names of medications and directions for their use. If poetry is made of breath or the beating heart, then surely it is not unreasonable to think it might reach those places in the bodies of its audience, however rarefied. Moreover, I joke back, I have never seen a poem cause fulminant liver failure or bone marrow toxicity, even a really bad one. Putting the mouth to words and by incantation returning regular rhythms to the working lungs, these were the principles by which ancient healers in Native American cultures practiced their art. The Egyptians gave their dead a book full of charms and spells to be used in the afterlife. Might not poetry then facilitate the passing to another realm? Poetry is a pulsing, organized imagining of what once was or is to be, what life once was, what life is to be. It is ampoules of the purest, clearest drug of all,the essence and distillation of the process of living itself.
And I have one last poem to share. It's a newer poem that's part of a series of poems called Modern Medicine. They each are addressed to one of the medical specialties as a way of trying to critique how we compartmentalize what we do in medicine in many respects, but I think this last poem, which is entitled Pathology, I think in some ways summarizes much of what we've talked about earlier today and also this evening. So, I'll share that, but before I conclude, I want to thank Professor Judy Frank for hosting me, Professor Amelia Worsley for also bringing her students to our discussion earlier today, and of course all of you for coming to hear me tonight virtually. I hope this format wasn't too disconnected. I can see some of your faces which makes me feel connected to you. So, this is, again, a poem called Pathology. The body quantified at autopsy. It's always on its back. Looks up at me. Lips puckered tight as if it would refuse one last kiss. How much the liver weighs. How heavy is the heart? How large the brain? The body, hungerless. All that remains reminds us we are objects, absent souls. I try to animate them, nights alone, when human company seems necessary. The lab surrounding us, imaginary as Frankenstein's. Any thing’s possible. I talked to this one like she's only ill and might pull through, remembering my friend who died of stomach cancer, face so drawn and bloodless she was almost only breath. I was among those thankful for my health who'd visit but not have to stay. We'd tell her stories while she winced in pain. Meanwhile the clock kept warning us no time was left. How mute the open thorax, how bereft the empty bowl of pelvis, how I wish our fables in the end were more than this. Thank you very much
Thank you. Thank you, Rafael. You know, there are worse things than being at home listening to poetry at night. It's not just bad that we can't all be together, for those of us who maybe don't like to leave the house at night, this is extremely pleasant to be at home. What kinds of questions do people have? I'm going to ask you to either put them, you can put them in the chat if you'd like, you can also raise through the little raise hand icon if you'd like to which is under, I don't know, what is that under? Under reactions? Under the participants list, under participants, thank you, on the participants list. You all know how to do that. Yes, I welcome your questions, comments, also screams of horror or outrage
We have Gregory. I can see his hand up. Oh okay, now I'm, so sorry, oh yes, he's got his actual hand in the air, not the little not the icon
I just want, i just wondered, sort of exploratory, I’m a retired psychologist so I can really relate to the mechanisms we use to distance ourselves a little bit and protect ourselves a little bit from sometimes the horrors in front of us, or the ones we hear about. But getting off the clinical side for a minute, the only, and I haven't read a lot, but the only poetry that is, the only poet-physician I know of is William Carlos Williams and I wondered if you had any comments on his work. Oh yes, absolutely. No, he's certainly one of my heroes for many reasons. I think his poetry, and I talked with some of the students earlier about him and his work, so they will know a little of my response, but I think his poetry really reflected his work with patients through his very democratic approach to poetry, the use of vernacular, of common language, of universal language, diction that was unfussy and was really, sort of had this kind of immediacy to it. I think some of his impulse to, in a sense really invent such an fundamentally American poetry also had to do with the modernist moment in which he was writing, and at a time when you know science did in some ways promise a kind of answer to the never-ending question of human suffering. I think he was in some ways perhaps writing from that sense of a kind of hope about us as human beings that we could be joined in this fundamental way through language and perhaps really be healed, both through science and through the human connection possible through poetry. So I think unfortunately the modernist moment disappointed us in many ways and we are still unfortunately, I think, perhaps too enamored of science and its power. I mean it is extraordinarily powerful but on the other hand, Williams's poetry endures and speaks to us still in a very direct, very immediate way about our experiences of suffering. and so those are a few thoughts about Williams. I teach his work all the time of course to my medical students, and I share it with colleagues all the time as well, and I do think he continues to be an urgent voice for again that kind of democratic hope of ours as a country, as Americans. Yeah, he's extraordinary. For those of us old enough to remember house visits, home visits, yeah I don't know how many there are here but there's a few of us. That's what he did. He had a private practice and he made house calls. Yes, absolutely, and some of his best poems, I mean one of his best poems, a poem you may know called Complaint, is the sort of tableau of visiting a patient in her home as she's laboring to give birth and it's just an awe-inspiring poem. The intimacy of it, and the sort of the vastness of it in terms of this central human experience shared in this, in this you know incredibly immediate way, is just, it's an incredible poem. It's very instructive for my students who again are learning most of the time about distancing and disconnecting and we have actually attending to a patient in her own home as she gives birth is is just this unbelievable idea for them, so it's… Not to mention the malpractice insurance phase. (laughs) That's right, that's right. One of the many challenges we face in medicine today that contribute to that distancing, unfortunately. Yeah, thank you very much. I'll mute myself now. Thank you. Thank you for your question. Rafael, do you see raised icon hands now? Yes, I do. So, why don't we go with Jordan? I just had a comment to make. In your poem, Manuel, that final line--he pawned his crucifix to get the pills--that's just one of my favorite lines that I've happened upon in poetry. So thank you for that. Thank you. Thank you for your comment, Jordan. Thanks for coming to hear me tonight.
Let’s see. How about Robin next?
Hi. First I wanted to say that I actually came to one of your readings during my freshman year and now as a rising senior or like a senior taking time off, I feel like I've kind of come full circle and hearing or reading again here as a senior, so I just want to say that, but I was just wondering, also sorry about the clock noises in the background, but I was just wondering, what's been moving you as a writer as of now especially during these unprecedented times? Yes, yes. Well, you know, unfortunately they are unprecedented, unprecedented in many ways but also very, very deeply reminiscent of the height of the ADIS pandemic which I lived and worked through as a very young doctor, intern, and then resident at UCSF in San Francisco, and so I have been really writing to try to make some sense of what we're experiencing now and also that that kind of just juxtaposition of these two pandemics where sadly, I think, we are seeing some of the same kinds of impulses to stigmatize, to blame the other, to I think you know these, in some ways, very human kinds of responses that have to do with fear and lack of understanding of the disease itself. So there's similarities in that sense as well, and so, yes, I, in fact, I just coincidentally, I had a poem on the pomodae series from the Academy of American Poets that speaks to that issue of how these days are so reminiscent of what was happening then. That's really been central to what I've been writing about currently, and I will also say that as a poetry section editor for JAMA. we're getting so many poems. I mean, we are often inundated with submissions, but I would say the number of submissions coming in that that similarly are trying to grapple with COVID- 19 and the current pandemic is just two to three times more than what we typically see, and so it's really remarkable how people turn to poetry to try to make sense of these moments where science isn't able to explain it all and isn't able to answer all of our questions about what's happening. Poetry does have that very important function for us now as it did then. I think it really can sustain us in profound ways, so thank you. Thank you. Thank you for coming for more poetry.
Let’s see. How about Professor Cobham-Sander? (pause) Hi there, Professor. It makes me feel like (inaudible), but it's wonderful to see you. I was hoping that you'd read a piece of The Fairest College because I teach that essay every chance I get in classes, especially to beginning students, and it still always surprises me how completely how… it has not dated at all, the way in which there's always a student in the class who says that's exactly what my parents did or that's exactly how I speak, and it seems to transcend, even though the narrative is so much about the experience of coming out, it's also this experience of coming into one's own, intellectually, and all that sort of stuff. And I wondered how looking back at it now, how you feel about it, whether you still use it. You decided not to read it tonight and I was really sad but I know some of my students are here and I knew they read it, so I wanted to ask you. Oh, well, that's a wonderful question. Yes I do, I still do often read it and, or read from it, and I think what what you say is true of my experience of it, also that it's really a story, an essay, about coming into one's own sort of intellectual life and discovering one's own powers of imagination, and how liberating that can be and how liberating in particularly it felt at a place like Amherst College which, back when I was a student, if I can sound like that, I apologize to the current students, seemed in many ways at once very traditional and in many ways kind of distant and guarded and reserved, but also was this incredible opportunity to learn and to see these boundaries if you will between disciplines in away, interrogated and questioned and broken down and have professors who encouraged me to major in English even though I was thinking I wanted to go to medical school. It was also that kind of place, and so all of those paradoxes of of Amherst at that moment I think really only heightened that sense of it was really ultimately up to me. And I was of course encouraged and nudged to do it, but it was up to me to fulfill what my imagination told me might be possible in relation to these sort of twin passions I had. So I feel very, very grateful to have been at Amherst, even all those years ago. Now I’ve returned to Amherst, I served as a trustee, recently completed my service, and every time I return to Amherst, I'm just so gratified to see how those fundamental values of the college around liberal, around the liberal arts, around exploring one's passions, identity and diversity is so manifest, is so evident and expressed in the current students and just seeing their faces gives me such joy. I felt like I was the only one when I was a student at Amherst, and I probably was in some ways. Now it's such a different and such a better place for that kind of discourse and dialogue across so many different kinds of people, and their voices and perspectives. That just gives me such great joy to be still part of the Amherst community and so yes, I do still read that essay, especially if my parents are in the audience because then my dad gets up and says, “No, that's not how it happened, and when you met Jorge it was,” (laughter) you know, he has his own story about the whole thing. So, that one particular part of the essay, I like to particularly share if he's in the audience. All right. Thank you, thank you (pause)
There's some questions. Sophia, I'm sorry.
Hello. Thank you for the beautiful reading. I was sort of struck by this idea of like when you were reading the essay excerpt, you mentioned these conditions that didn't really have a way of being translated into English, and I'm sort of interested in kind of thinking about the idea of intranslatability, especially now that we are in this time where thinking about medicine and individuality and empathy becomes kind of overwhelmed by just the amount of tragedy and everything going on. I'm wondering if you might explore that a little bit. Sure. Sure. Great question. Thank you. So, yes, it seems like often times, and perhaps this is a another kind of consequence of the distancing that we've been talking about that occurs throughout medical training and is also, I think, enforced in some ways by some of the technologies that we rely on, but also can really kind of obstruct our connection with our patients. I think that yes, sometimes the patient's experience of illness becomes untranslatable in a very real sense because we are sometimes speaking different languages, sometimes quite literally, when I'm speaking English and my patient is speaking Haitian Creole and we have to figure out a way to bridge that kind of disconnect, in a sense, and so yes, I think that. Then also, of course, the medicalese that I alluded to before, is its own foreign language in many respects, and so how do we really translate and deliver all the incredible gifts of these medical advances and technologies to our patients who don't speak the medical language, and so there are, I think, many challenges in your question that one way perhaps to respond to them is again this notion of empathy that really I think in many respects short circuits a lot of these barriers. If we can really attune ourselves to what our patient's experience of illness actually is, I think we can transcend some of those barriers, and I think one of the most important aspects of being a poet that helps me in in my medical work is having that trained ear so that at least that aspiration, to always listen attentively and to really try to hear precisely what someone is saying to me, and also listening actually to the rhythms of their body as well through the stethoscope that amplifies those rhythms, I think in a very real sense how do we translate how the body speaks into a language that we can understand and diagnose and treat appropriately. So again, poetry through that trained ear has really helped me to be a better listener to even the visceral rhythms of my patients’ bodies. I don't know if that exactly answers your question but I do think that empathy and the way poetry calls us to that joining of voices, that touching of souls, can really again kind of get past some of those other kinds of barriers that interfere with our understanding of each other. Thank you
Let's see. Amelia has a question, Professor Worsley? Oh, thank you so much. I have learned a lot about your relationship with Eve Sedgwick today. I didn't know that Heart Grows Fonder was for Eve Sedgwick because I just saw “ for Eve” at the top and I was so moved by that final stanza when you talk about what you were reading together. I noticed, and probably I was especially alert to it because we are reading your work in a class called Amherst Poets, I noticed that you had that line from Emily Dickinson--after a great pain, a formal feeling comes. So I thought I'd just ask you, since we are reading your work in this context, about what it means to you to be in this tradition of Amherst poets and what it meant to you as a student to be in a place where Dickinson and Frost and Wilbur and Sonia Sanchez and so many others had been, and if there are particular poets amongst the Amherst poets, both that ones I just named and others, who are important to you. Thank you so much. Thank you, Amelia. Thank you and I actually I feel so humbled to be in any way associated with a notion or a tradition of Amherst poetry and poets. The poets you mentioned were really so much a presence me during my time at the College and I really felt that I was surrounded by this incredible sort of poetic imagination that's something, I don't know if it's in the water, if it's in that spectacular view of the mountains from Memorial Hill, if it's in the professors who taught me to think critically about poetry and to think critically about language, but absolutely that presence was very, very real to me, and ironically I remember taking many of my science courses in the Merrill Science Ienter and I was thinking always about James Merrill when I was going into the Merrill Science Center, when I was heading to my chemistry lab or what have you and again, that poetry data was just was omnipresent and really heartening actually for me as someone who on some very again sort of humble level, aspired to to make poetry, to make poems myself and at the same time was passionate about science. I think many of the Amherst poets that you mentioned, Frost had a particular interest in science as it relates to poetry. Emily Dickinson, actually a number of her poems also explore scientific concepts. We think of her not always as a poet of science but she was very much a scientist in many respects. I mentioned Merrill, and the Merrill Science Center which really doesn't have anything particularly directly to do with James Merrill but to my mind these were all poets who in some ways did bridge that gap between the two ways of knowing about the world that C.P Snow critiqued in his famous essay about sciences versus the humanities. I felt like I had these just extraordinary role models, and Eve was another such poet to my mind as well. I think that Amherst poets really do have, not only are they justgiants in terms of their poetry, but this particular sort of view world view that reaches beyond strictly poetry. I think the best poetry does that, asks those kinds of questions about how the natural world works and I think those poets all did that in their work and inspire me to do it. I don't know if I, again, would ever include myself in that kind of company but at least I went to Amherst College, so.
Thank you so much. Thank you, Amelia. That was a wonderful question.
It's getting a little late. Anyway there's a couple of good questions in the in the chat. I'm sorry. I don't think we can get to all of them probably, but I do want to ask Alison's question which was to talk a little bit about the process like do you, when do these poems get written, are they lines in the moment that you write down and build on later or do they come out in brief moments of downtime during a shift, and my follow-up to that is do you think you could be a novelist and a physician at the same time? Oh wonderful question. I don't know, I mean my experience is, I guess one thing I should say about my process is that it was sort of forged in this crucible of medical and pre-medical training, so not a lot of time and so I've ended up being or becoming more and more of a night owl. I somehow learned to survive on relatively little sleep which I don't recommend to everyone out there because it's not good for your health long term. We know more and more about how important it is to sleep and I sadly don't get enough because I'm, that's when I write, is when I should be asleep, I suppose, but yes, I do find that I write at sort of odd times. I do also find that when I'm in the clinical setting and working with patients, hearing their stories, really immersed in their narratives, that poems are getting written in that, in those moments, and when I do have time late at night to finally sit down with my journal or pen to paper that what I produce has been shaped by these sort of currents of language that I'm hearing throughout the day, when I'm listening to my patients and really again trying to attend to their stories and really hear them, listen to them attentively and closely and so then also I mentioned the sounds of the body that I hear amplified, unmistakably, in my through my stethoscope, those rhythms are also constantly shaping what I'm writing. I'm almost compelled to write in sort of more musical or metrical forms because of that proximity to the body and to the rhythms of the body. That's a little bit about my process. Gosh I mean there are wonderful novelists who have also been doctors so it must be possible. I don't know if I could do it because my sense of what it must take to write a novel is well beyond what I could ever accomplish in my writing time, but it must be possible. I know of course that people who have lived themselves directly with the experience of illness have written extraordinary novels and so that's got to be the most sort of time-consuming way of being in the body is to actually live the experience of illness and so yes, it must be possible and maybe that's some something for me to think about more and perhaps try at some point down the road. I'm just gonna, and I'm sorry, there are some really good questions here, some of them came to me privately, some are public, but I think it's probably time to close. But I did have somebody write to me and say that some of us wonder whether Rafael would be willing to read his poem Lost in the Hospital. Of course, I could do that, if it's not too late and people don't, others don't mind. I can. Why don't we? Why don't we end with it. I think that'd be a really wonderful ending actually. Thank you for that invitation. Let me see if I can find it. I have it in the chat so I can make it, I can make it public if I need to. Oh no, I have it here. Let's see. I do have it in front of me. Here it is. Lost in the Hospital.
It's not that I don't like the hospital. Those small bouquets of flowers, pert and brave. The smell of antiseptic cleansers. The ill, so wistful in their rooms, so true. My friend, the one who's dying, took me out to where the patients go to smoke, IV’s and oxygen in tanks attached to them--a tiny patio for skeletons. We shared a cigarette which was delicious but too brief. I held his hand; it felt like someone's keys. How beautiful it was, the sunlight pointing down at us, as if we were important, full of life, unbound. I wandered for a moment where his ribs had made a space for me, and there, beside the thundering waterfall of his heart, I rubbed my eyes and thought, “I'm lost.” Thank you very much, Rafael. Thank you again for having me, having you. It's such a joy to be back at Amherst. Thank you. Wonderful to have you. Thank you.