Dr. Jack Coulehan, the distinguished Emeritus Professor of Preventive Medicine and Senior Fellow of the Center for Medical Humanities, Compassionate Care, and Bioethics at Stony Brook University continues to write more palpable and prescient poems.

Bursting with Danger and Music offers his compassionate eye for witnessing the inherent beauty and darkness in the daily rounds of medicine and life. In an e-mail to me he revealed, ” I think mostly in terms of medical incidents or images that strike me and the “theme” only arises as the poem develops. If you look at my work as a whole, there is a lot of overlap. Nowadays, a larger percentage of my poems arise from non-medical experiences.”

Coulehan’s poems and stories have appeared in major literary magazines and medical journals in the United States, Canada, England, and Australia; and his work is widely anthologized. His collections of poetry include The Knitted Glove (1991), First Photographs of Heaven (1994), The Heavenly Ladder (2001), and the celebrated Medicine Stone (2002).

I am also an admirer of his earlier anthology, Blood & Bone with contributions by other physicians. This specific collection added measured validation that poetry and medicine have been linked by metaphors.

Dr. Pauline Chen in a New York Times blog, “The Doctor as Poet,” asserts that ” Poetry has long been linked to medicine; in mythology, the Greek god Apollo was responsible for, among other things, both healing and poetry. And poets like John Keats, Olver Wendell Holmes Sr. and William Carlos Williams were all trained as doctors. For them and other physicians of their time, reading or writing poetry required skills not that dissimilar from those employed in daily clinical work–an ability to connect emotionally with the subject, as well as careful attention to rhythm, wheter it was in the form of verse or heartbeats and breathing.”

For sure, Coulehan knows that doctors are immersed in stories. Like William Carlos Williams, he also discovers in the ordinary, a plethora of extraordinary images; an abiding interest in other lives and generous acts of kindness.

Dr. Coulehan and his publisher, Plain View Press, have kindly granted me permission to post this poem, “The Act of Love” from his latest anthology. For those of us engaged in teaching courses in Literature and Medicine, Coulehan’s poems never disappoint since they always demonstrate his engagement with life.

 

The Act of Love

 

How foolish Celia must look

to the Haitian cab driver

on the Medicaid run!

 

She wears a white communion dress

the week before Easter, a sign

she brings me something more pressing

 

than the pain in her shoulder

and the son who doesn’t talk to her

because his wife is embarrassed.

 

Her hips creak in conversation,

her knees grind, but even crepitant joints

are modestly silent and stand aside

 

when Celia hands me a potted plant

for my office—an act of Christian love,

she says, not a sign of being personal.

 

As for me, I’m stunned

out of the ordinary anger

at failing to help her

 

by the waxy-leaves of her gesture

and I receive this wafer of the season,

heartbroken for no reason.

 

 

 

 

These days it’s easy to see why we need more clowns and laughter in our daily life. This is especially true for those who are ill and confined to hospital beds. Last semester at the University of South Carolina Sumter campus, I taught a course in illness narratives and introduced the class to “Patch Adams,” that is, my students viewed the film about the doctor who continues to reach so many patients through the associated therapeutic benefits of laughter at his Gesundheit Institute.

Dr. Howard Carter, an adjunct professor in the Department of Social Medicine at UNC School of Medicine, has recently authored Clowns and Jokers Can Heal Us. His book examines humor in clinical settings and in popular culture. The subject matter ranges from ER humor, taboo breaking humor, jokes about sex, aging and even death. His book certainly draws upon his own work as an ER volunteer and as cancer survivor.

Carter quickly credits the contributions of Adams and Norman Cousins on the subject of humor in medical treatment. In a recent e-mail Dr. Carter reveals his rationale for the book.

” Hospitals and medical care (and especially academic attention) are often serious, rational, even grave, not to mention task-oriented, materialist, and tightly focused on issues… My book looks at the humor in clinical settings and in popular culture,” claims Carter.

Additionally, Dr. Carter is almost evangelical about finding a place for humor in all Medical Humanities curriculum. ” Humor affirms the humanity of patients, no matter how sick or injured they are. It’s part of the old fashioned term bedside manner,” adds Carter.

It appears that more academics and physicians are embracing the notion of the intersection of comics (humor) and medicine. Just this morning, I received this Medical Humanities list serve announcement from Professor Rebecca Garden, Associate Professor of Bioethics and Humanities at SUNY Upstate Medical University.

Read on.

Comics and Medicine–Navigating the Margins July 22-24 2012

The third international interdisciplinary conference* on comics and medicine will continue to explore the intersection of sequential visual arts and medicine. This year we will highlight perspectives that are often under-represented in graphic narratives, such as depictions of the Outsider or Other in the context of issues such as barriers to healthcare, the stigma of mental illness and disability, and the silent burden of caretaking.

The conference will feature keynote presentations by comics creators Joyce Brabner and Joyce Farmer. Brabner, a comics artist and social activist, collaborated with her late husband Harvey Pekar on the graphic novel Our Cancer Year (1994), which won a Harvey Award for best graphic novel. Farmer is a veteran of the underground comics scene who nursed her elderly parents through dementia and decline as shown in her graphic memoir Special Exits (2010), which won the National Cartoonists Society award for graphic novels.

We invite proposals for scholarly papers (20 minutes) or panel discussions (60 minutes) focusing on medicine and comics in any form (e.g., graphic novels, comic strips, graphic pathographies, manga, and/or web comics). In particular, we seek presentations on the following—and related—topics:

• Graphic pathographies of illness and disability
• The use of comics in medical education
• The use of comics in patient care
• Depictions of the illness experience from the perspective of loved ones and family caregivers
• The interface of graphic medicine and other visual arts in popular culture
• Ethical implications of using comics to educate the public
• Ethical implications of patient representation in comics by healthcare providers
• Trends in international use of comics in healthcare settings
• The role of comics in provider/patient communication
• Comics as virtual support groups for patients and caregivers
• The use of comics in bioethics discussions and education

We also welcome workshops (120 minutes) by creators of comics on the process, rationale, methods, and general theories behind the use of comics to explore medical themes. These are intended to be “hands-on” interactive workshops for participants who wish to obtain particular skills with regard to the creation or teaching about comics in the medical context.

We envision this gathering as a collaboration among humanities scholars, comics scholars, comics creators, healthcare professionals, and comics enthusiasts.

300-word proposals should be submitted by Friday, 28 February 2012 to submissions@graphicmedicine.org. For more information contact s.wall@utoronto.ca.

Proposals may be in Word, PDF, or RTF formats with the following information in this order:

• author(s)
• affiliation
• email address
• title of abstract
• body of abstract

Please identify your presentation preference:
• oral presentation
• panel discussion
• workshop

While we cannot guarantee that presenters will receive their first choice of presentation format, we will attempt to honor people’s preferences, and we will acknowledge the receipt of all proposals submitted. Abstracts will be peer-reviewed by an interdisciplinary selection committee. Notification of acceptance or rejection will be completed by 14 March 2012.

Please note: Presenters are responsible for session expenses (e.g. handouts) and personal expenses (travel, hotel, and meeting registration fees). All presenters must register for at least the day on which they are scheduled to present.

poet Tish Pearlman

It’s early into the New Year and I am busy compiling an anthology entitled, The Art of Medicine: Poems & Stories. It’s abundantly clear that all illness poems and stories share a common ground: they enable us to document how illness has affected our lives and the lives of those closest to us.

  1. I recently received an e-mail from Tish Pearlman originally from Southern California and now in Ithaca, New York, where she hosts and produces an award winning radio program, Out of Bounds, a weekly public affairs and arts interview format. She’s a veteran broadcast journalist and poet who has published widely, including in The Healing Muse, an annual journal of literary and visual art, published by SUNY Upstate Medical University’s Center for Bioethics and Humanities.

Her communication to me was precipitated by the knowledge of our simultaneous heart surgeries in June 2009. Despite medical evidence they we were excellent candidates for surgery, we experienced a harrowing journey into the dark abyss following surgery. Although Pearlman claims she has no memory of those first five days following her surgery, she wrote her first poem about the ordeal as soon as she was released from the hospital and has not stopped writing.

Like me, she also was compelled to assiduously read her entire 500 plus page hospital medical history. For sure, the need to understand what happened is grounded in most illness narratives and often rendered in graphic metaphors. I recall reading what the poet doctor, Rafael Campo wrote, “that poetry locates us inside the experience of illness, demanding that we consider it from within, as attentively as we do from without.”

In the preface to her published collection of poems, The Fix Is In, she painfully writes.

” On June 1, 2009 I had open-heart surgery for a congenital heart valve problem. I was told it would most likely be a fairly routine surgery…as I was being brought out of the anesthesia my blood pressure crashed to zero. Routine turned to nightmare.”

Like so many others who have had their near brush with death, she also discovered the need, to make sense of her heart event and to chronicle the anguish, pain and recovery as part of a patient’s journey. Acclaimed Narrative Medicine evangelists like Dr. James Pennebaker and Dr. Rita Charon, have written extensively about the corresponding health benefits associated with forming a story or writing a poem.

Below is one of Pearlman’s poems included in her anthology. I publish it with her permission  and that of the publisher, Finishing Line Press.

Critical

by Tish Pearlman

She knows well that

they were in a panic

because she was falling   steadily

drowning

into darkness.   Zero means

her heart stopped,

her pulse was nowhere.

Did she see the ending?

Did she see the sky, trees

against the light?

Did she arrive just in

time at their beck and call

and call and call?

Did they twist her into

shape- dance around her

final breath?

Did they scream, no, come

back, come back!

Did the tunnel reveal a

light?

Did she rise

swiftly from free fall?

Did they say, yes, yes, she

is alive, she’s come from

the darkness, she’s surfaced,

the spark of her caught fire

she arrived back

she arrived back,  here.

Did she say anything about

the return trip?

Did she?   Did she?

Did she ask, was she asked

can you ask, did you ask?

Was her awakening by consent?

Did she sign the papers?

Did she have enough info?

Did she meet with you before with a

question?

Are you pleased that she came

through your revolving door of

drugs and panic? Is this

a save? Yours? Hers?

In due time will she ask many more

questions?  Will she see the

evolution

the devolution

the sinking, the stirring

the god damn,

the fuck, the idiot,

the dropped soul

upon the table in the sterile

light

wheeled away

in critical but stable condition

wheeled away

in critical but stable condition

connected to the idea

of reprieve?

 

But the heart heard the

whispers. The heart. Heard.

The. Whispers.

August 14, 2009

 

 

Poet Joan Baranow

Poet Joan Baranow and her husband, Dr. David Watts have been engaged in collaborative projects on the power of healing through words for years. Joan Baranow’s poem, “Lumpectomy” was recently recognized as one of the winners (Honorable Mention) in a recently held Medicine & Metaphors writing event coordinated with support from the South Carolina Humanities Council and the Sumter County Cultural Commission.

Baranow, an English professor teaches at the Dominican University in San Rafael. Her poems have appeared in The Paris Review, The Western Journal of Medicine and elsewhere.

She was a producer along with her husband and others of Healing Words: Poetry and Medicine, an inspiring program on the poetry of illness and recovery. From that site, the producers write, ” poetry serves to remind us of the spiritual mission of medicine.” In the more than 100 prose and poetry submissions received in our Medical Humanities event, I am more than convinced of the efficacy of metaphors in medicine.

Below is Joan’s poem.

Lumpectomy

by Joan Baranow

The moon is a little dented tonight
on the right side
where an arm would be
pressing,
and that’s natural
to the moon
as well as certain situations—
a word gets slivered off,
a cup chips its lip—
and accidents,
like standing up into
a harder substance
than your head.
Soon, though, the moon
regains her whole,
there’s repair
to blood and hair
where force
asserted its fact,
and bone builds
within its cracks
denser deposits.
Every form exhibits
the seams of what was
torn or taken or lost.
Lovely
the life left
with its stitches.
Even this night
tucked between granite peaks
receives from a surface
slightly skewed
a bruised
yet no less emphatic
radiance.

I am pleased to introduce another one of the award winning submissions for the Medical Humanities Writing event held last week at the University of South Carolina Sumter campus. Debra Daniel’s writing confirms that all patients and those of us who are witness to illness, require new story lines, different plot structures and fresh metaphors as we examine human troubles and expectations gone awry. As a triple bypass heart former patient, the poet’s narrative appeals to me.

Debra A. Daniel is the author of, AS IS, a chapbook published by Main Street Rag. She was twice named SC Arts Commission Poetry Fellow and won the Guy Owen prize.  She has also won awards from the Poetry Society of SC, the Piccolo Fiction Open, the SC Fiction Project, and was nominated for a Pushcart. Her work has appeared in Smokelong Quarterly, Kakalak, Pequin.org, Southern Poetry Review, Tar River. She lives in Columbia, SC, with her husband Jack McGregor with whom she sings and plays mandolin and cardboard box percussion in an eclectic acoustic band.

What Happens in the Chambers of Our Hearts

1. Megan

When her Father’s goes into A-fib from the myocarditis that fevered him and caused the clot lurking in his atrial chamber, she drives home from vet school to sit vigil. As the string of doctors enters, alarming us with each new medication or each different complication they must eliminate from the dangerous possibilities; she enters data into her log: descriptions, dosages, prescriptions, and procedures. She recognizes names, reasons, side effects for injections and capsules and tests.

Her Father, confused about Amiodarone and Coumadin, beta blockers and ace inhibitors,
asks Megan to explain. She pats his arm. “You’re like a golden retriever,” she says.
“We treat dogs exactly like your doctors treat you, only the dogs aren’t grumpy. They don’t complain about Jello or refuse to wear hospital gowns.”

Megan helps her Father put on his shoes, stands beside him while he brushes his teeth.
Then she walks him down the corridor, the pole rolling between them, his IV tube like a leash.

2. Sara

She’s staying at the house since I’m sleeping at the hospital. She waters the plants, turns on lights, feeds Emma, our cat, and Otis, our golden doodle. Everyday she runs errands and stops by the hospital.

Each day, Sara presents some little treat. A blueberry tart. A chocolate éclair. A hothouse orchid. Something, anything to distract him from the tubes and needles.

Her job is to save him from cubes of green Jello, from unsalted potatoes, from lukewarm broth. They talk of mango chicken paired with a playful Chardonnay and reminisce about the crème brûlée in Paris, the best they ever tasted. They chat about spices: cardamom and cinnamon, tarragon and cloves.

She says, “We’ll take that class taught by the real French chef when you get home.” They talk until the nurse comes in with the nightly meds.

3. The Wife

I rush home for a fast shower, a change of clothes. Otis meets me at the door, but his tail hardly wags. He doesn’t follow me upstairs carrying the ragged remains of his duck toy.

I’m not his favorite person. He hasn’t seen my husband in more than a week. His food bowl shows he isn’t eating much. Neither am I.

Downstairs, Otis is lying beside my husband’s chair. I sit on the floor next to him for a few minutes before heading back to the hospital.

The Husband

The doctors finally release him, but he must wear a heart monitor, which, if he passes out, will act as a defibrillator to buy time until the paramedics arrive. It isn’t comforting or comfortable. He can take it off for a shower, but only a short lukewarm one. A long hot shower could move the blood clot in his atrial chamber. At some point the doctors will try to shock his heart back into a normal rhythm, but first he must fully recover from the virus.

At home, Otis wags himself into frenzied delight. The cat appears. My husband pets them both. Before sitting down, he heads for the piano. It’s been eight days without piano or guitar. Eight days without tennis or the gym. Eight days without sex. His spirit is low.

My husband works to keep fit. Being sick is alien. He balks at meds he must swallow. He wants to walk with Otis. He wants to cook and sip a glass of wine or two. He wants his life back. All in good time, the doctor told him. Not yet.

At least, we’re home, where already we can feel the healing.

Continue to send me your stories.


Excuse my writing delinquency. My computer crashed a week ago. I am in mourning for the loss of all my files but remain hopeful that they might be repaired just like my broken heart, when all my blood spilled out after surgery.

This week I assembled a stellar cast of academics and physicians for a program aptly entitled, The Art of Medicine: Narratives & Metaphors held at the University of South Carolina campus. This event coupled with an awards ceremony for the best poems and prose on illness was generously supported by the SC Humanities Council and the Sumter Cultural Commission. In the late afternoon program, as the light streamed into our Arts & Letters Lecture Hall, a former church, located on Miller Road, I invited our distinguished speakers to address how and why Narrative Medicine answers the overwhelming challenge of understanding the patient’s unique illness story and at the same time expertly treating patients’ diseases. These speakers included: Dr. Charles Bryan, Dr. Joseph John, Dr. Lisa Adams Mount, Dr. Randy Spencer, Professor Lisa Kerr and Professor Sara Sanders.

Although Dr. Bryan offered an initial contrarian view that patients only want the cure and not a story, all other voices generously support the use of narratives since it connects individual illness stories and complements evidence -based clinical practice. Simply stated, it is through stories that we humans understand ourselves and our lives. And the story of illness that trumps all others is the medical narrative.

At a time when doctors have less and less time to spend with patients; stories matter now more than ever. Medicine treats disease more than it cares for the ill. Treatment is delivered; caring requires being with another, as two persons together in conversation. Fortunately, for us there are more and more medical schools teaching narrative.

At the conclusion of the symposia, I acknowledged the winners of the 1st annual South Carolina Medical Humanities Writing Event. I was compelled to add that every person who submitted a poem or story deserves recognition. My colleagues in the English Department, Mary Ellen Bellanca, Audrey Johnson, Ray McManus, Melissa Makala, who all served as judges, would agree that these submissions offer a prerequisite, if not fundamental condition to the healing process.

I was reminded of what Abigail Zuger, a doctor and regular contributor to the New York Times Health section wrote, “ I know one thing for sure: there’s no story out there that is not a great story. Every single one contains pathos, courage, comedy and surprise to power it right to the top of the charts.”

This is equally true for all these writers who also poured their hearts into these stories and poems.

The first place winner is Professor Gilbert Allen from Furman University, located in Greenville, South Carolina. His poem, “After Watching a Play about Cancer, He Learns Why He Hates the Theater” received a $200 award.

Allen has published several collections of poems, including In Everything (1982), Second Chances (1991), Commandments at Eleven (1994) and Driving to Distractions (2003).

2nd place went to Ed Madden, a poet and English Professor at the University of South Carolina (Columbia campus). His poem is entitled, “Thirteen Weeks”.

3rd place was awarded to Debra Daniel’s “What Happens in the Chambers of Our Hearts.”

Honorable Mentions include: Sam Watson’s “ Another Reason to be Pleasant.”

Joan Barranow’s Lumpectomy” and Cathleen Cuppett’s the surgeon’s art.

See below the winning submission. It’s my intention to establish a website for all of the submissions and to also edit an anthology. Look for more stories here.

After Watching a Play about Cancer, He Learns Why He Hates the TheaterBy Gilbert Allen

1. Not the Play

which was a clever diatribe
against cleverness, albeit riddled
with Stage Four problems—the saintly
nurse; the clinical researcher
with the moral complexity
of Caligula slicing his unborn
child from his sister’s womb; the protagonist/
patient’s mute, nude apotheosis
from slow motion defibrillator paddles
as the set dimmed, momentarily.

2. You Get What You Pay For

the director says over her shoulder
to the young couples in the cheap seats
(stage right), while she faces the fogies
in the center section. His section.
But he didn’t pay for this.
The play’s over, and she’s doing her own
clinical trial, telling survivors out there
to share their stories. He’s nowhere
near an aisle. He doesn’t remember
signing the consent form.

3. If This Were a Book

he could stop reading. If this
were a movie, he could walk
out, and the screen wouldn’t
talk back. This is humanity
with a vengeance. Somebody
too convincing to be
convincing, seven rows behind, weeps out
the words of his wife’s death, eighteen
months ago, exactly
as it happened on stage.

4. They All Line Up,

the whole cast, in the lobby.
His wife walks on his inside
shoulder, shaking the right hand
of the dead, for both of them.

5. When Has a Parking Lot

been such a blessing?
Hail asphalt, full of grace!
“I hope that didn’t bother you
too much.” And he tells her
don’t worry, it’s fine, before he mutters
the rest of what I’ve told you.

Healing Icons sprang from South Carolina’s Heidi Darr-Hope’s personal journey through her life and her art. The mixed media artist’s exquisite website reveals that “creativity is her profound teacher, providing tools that enable her to dive deep into her life experiences, to wrestle with them over and over and finally to release them through the birthing process of the creative act. “

Her traveling exhibition, Sometimes Words Are Not Enough, displays color reproductions of artwork created by diverse cancer patients from a broad spectrum of life circumstances. This dramatic exhibition with support from the Sumter County Cultural Commission and the personal commitment of its director, Booth Chilcutt, will be displayed at the University of South Carolina Sumter Umpteenth Gallery at the end of September, just in time to be viewed at the October 4, Medical Humanities Program that I have been developing since May.

These are the words from Hedi Darr-Hope’s website.

The quality of the artwork is impeccable, a truly incredible achievement by individuals with no professional art training. Not only are the pieces visually and symbolically profound, the viewer receives an intimate glimpse into the frightening, disorienting world of living with a life threatening disease. When words are not enough, these works of art speak from the heart to the soul.

Each unique piece of artwork tells a story. Collectively, they spread the gift of hope and healing to cancer patients, their families, and the community at large. It is my hope that these works will not only inspire you, but give you insight into the world of healing. I hope you will open your heart to the wisdom and honestly that is shared by all of these courageous, resilient individuals.

It takes more than medicine to heal. From ancient times, art has been used by all cultures to cope with life’s tragedies. The artist takes emotional pain, gives it meaning, and transforms it into a healing experience. The joys in life are lived; the pain in life is expressed. Her program, Healing Icons is dedicated to helping individuals and their families cope with cancer by transforming incredible psychosocial and spiritual trauma into a healing experience.

Recently, Hedi Darr-Hope along the San Diego-based writer, Sharon Bray, led a creative collaborative workshop, mixing words and art in Columbia, South Carolina for a dozen women bravely facing their cancer. On Bray’s website, she writes poignantly about the “Metaphors of Illness.”

“A metaphor is a comparison of one thing to another, for example, “illness as a disturbed country.” It’s a powerful literary device. By comparing one thing to another, we see or understand it differently. Metaphors offer powerful ways to describe cancer and or other serious illness. They are a shorthand route to the way we experience and feel about illness. Metaphors take us deeper into our emotions and at the same time, allow the listener or reader to better understand our experience.”

Whether through words or art, more patients are discovering ways to find a voice and to give expression to healing.

Send me your stories.