Poetry in Medicine

When I make rounds with my students and interns, I always try to sneak in a poem at the end. I think poetry is important because it helps convey the parts of the medical experience that don’t make it into textbooks. It’s important because it teaches creative thinking—something of immense value to doctors.

It’s important because interpreting metaphors is a critical clinical skill in diagnosis; patients’ symptoms often present in metaphorical manners and we doctors need to know how to interpret our patients’ metaphors. Last but not least, there is a therapeutic value to introducing beauty into a situation that is not commonly associated with aesthetics.

I’ve been giving poetry to my medical team for a few years now, but I’ve always wanted to give poetry to my patients. Unfortunately, English is not the first language for most of the patients in my hospital, so this has been challenging.

But there is one set of patients that seems to consistently speak English—the alcoholics. The Bowery-type alcoholics aren’t necessarily the favorite patients of the interns. These patients are frequent fliers, they are clinically “uninteresting,” they are often malodorous, and their illness is perceived as self-inflicted. But they do speak English.

So one morning on rounds, our team went to examine a new alcohol-withdrawal admission. His condition was standard: alcohol-on-breath, speech slurred, fingers trembling, hair and beard disheveled, body odor a mix of unwashed socks and cheap beer. He was cranky, and impatient with the detailed questions we asked.

As the team was finishing up, I whipped out some papers from my pocket—Jack Coulehan’s poem “I’m Gonna Slap Those Doctors. I gave a copy to the patient and distributed the rest to the resident, interns, and medical students. Asking their forbearance for this slight divergence from medical protocol, I plowed onward and read the poem aloud.

I’m Gonna Slap Those Doctors

Because the rosy condition

makes my nose bumpy and big,

and I give them the crap they deserve,

they write me off as a boozer

and snow me with drugs. Like I’m gonna

go wild and green bugs are gonna

crawl on me and I’m gonna tear out

their goddamn precious IV.

I haven’t had a drink in a year

but those slick bastards cross their arms

and talk about sodium. They come

with their noses crunched up like my room

is purgatory and they’re the

goddamn angels doing a bit

of social work. Listen, I might not

have much of a body left,

but I’ve got good arms -- the polio

left me that -- and the skin on my hands

is about an inch thick. And when I used

to drink I could hit with the best

in Braddock. Listen, one more shot

of the crap that makes my tongue stop

and they’ll have something on their hands

they didn’t know existed. They’ll have time

on their hands. They’ll be spinning around

drunk as skunks, heads screwed on backwards,

and then Doctor Big Nose is gonna smell

their breaths, wrinkle his forehead, and spin

down the hall in his wheelchair

on the way to the goddamn heavenly choir.

(from Medicine Stone, 2002. © Jack Coulehan, reprinted with permission)

As I read the poem, I could feel the atmosphere in the room changing, ever so slightly. The focus shifted from the patient to the poem, and everyone was an equal neophyte with this particular poem.

When I finished reading, some of the medical team looked uncomfortable, but the patient was smiling broadly. “This is great,” he said. “I love it!” With his pronouncements, everyone relaxed a bit.

“You know,” the patient continued, seemingly happy to have an audience, “ I used to read some books, back in the day.” He sat up in bed, more animated now. “I like history stuff—ancient Greeks, ancient Romans. Real characters, those guys.”

We ended up having a conversation about his childhood in small-town New Jersey, how he cut classes in high school to putter around on the beach.

We left the room feeling awkward but also somehow lighter. Suddenly our patient wasn’t just another alcoholic drying out on the ward. He was a real person, someone who stood out in our minds.

The poem certainly didn’t change the course of his devastating disease of alcoholism. It didn’t offer him the epiphany to suddenly quit drinking or to reconnect with his estranged family. His liver enzymes didn’t miraculously normalize. His platelets didn’t bound back to health. But it gave all of us a sense of human connection.

Throughout his four-day stay in the hospital, the patient was much more pleasant to the team. I noticed that the students and interns wandered in more frequently to say hello. We all felt just a bit more connected.

Rx: Take two sonnets and call me in the morning.

If you are interested in poetry and medicine, check out this unique conference at Duke University on May 21-23. Life Lines: Poetry for Our Patients, Our Communities, Ourselves. (I will be giving a presentation there.)

Danielle Ofri is a writer and practicing internist at New York City’s Bellevue Hospital. She is the editor-in-chief of the Bellevue Literary Review. Her newest book is Medicine in Translation: Journeys with my Patients. View the YouTube book trailer.

You can follow Danielle on Twitter and Facebook, or visit her homepage.

Her blog, Medicine in Translation, appears on Psychology Today’s website.