Poetry is communication concentrated. A few words speak volumes. Concise communication is also a key part of general practice so why is poetry not widely recognised as a natural teaching medium in medicine?
After the arc of ECT
and the blunt concussion of pills,
they gave him lithium to cling to —
the psychiatrist’s stone.
This opening line from Robin Robertson’s Lithium1 is a great example of the power of poetry to impress the patient’s inner feelings on the reader. We see the jumping spark of electricity; we feel the confusion and trauma inflicted by the very medication we insist will help. We sense the desperation of the patient flailing in his sea of madness with medication his only point of stability and yet ... ? Surely that brilliant reference to lithium as the psychiatrist’s stone is also intended to bring to mind the legendary philosopher’s stone? That which not only turned base metal to gold but held the secret of eternal life and brought healing to the possessor. Just as that miraculous remedy was only a fantasy perhaps this ‘cure’ doesn’t work either? Is psychiatry mere alchemy too?
So many questions arise and doors into the patient experience can open up in discussion of just a single line of a poem. Lithium artfully goes on to describe three physical properties of the metal and how each of them induces memories of the patient’s previous triple failed suicides by drowning, self-immolation, and hanging. Some of lithium’s properties would have prevented such attempts but some would have facilitated them. Is lithium then a therapy, a threat, or both? All of this and more is conveyed in just 33 words. You have to look carefully to perceive these double meanings though. The link to the attempted suicides is rarely seen on a first or even second reading. The experience of light gradually dawning from a seemingly random text can help us as GPs to consider how often we miss important links in consultations; especially with those patients we consider to be ‘mad’.
It’s not just poems about experience of illness that are rich sources of teaching and learning. Poems about doctors and by doctors and other healthcare professionals, poems about medical procedures, the medic’s inner life and outer world, about birth, death and all the milestones in between, can feed lively and relevant discussion and learning.
A recent training afternoon with GP registrars confirmed this for me. I had originally been invited to talk about using humanities in medical training and planned to use mainly films but when both projectors failed, I was glad I had some photocopied poems as backup. I could see how the group was gripped by many of the poems and became increasingly skilled in bringing out their hidden meanings as the afternoon wore on. Our patients often bring their pains concealed in metaphor and allusion too and poetry can help us as GPs to identify and unwrap those concerns which can’t be voiced directly.
- © British Journal of General Practice 2014
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