Reading Medicine as Poetry

Artificial rupture of membrane. Shoulder dystocia. Vacuum-assisted delivery. Amnioinfusion. Scalp electrode application . . .

The poet and literary non-fiction essayist in me tingle with the desire to lineate, detail, and introduce enjambment: to weave metaphors, to delicately and precisely extend into lyric or narrative.

The social scientist in me wants to ask questions about histories and grids of power underpinning who administers such procedures, who endures the pain or accesses the services (and where), and what kinds of external or discursive forces structure and discipline such fascinatingly named traumas and practices.

The medical educator in me turns back to two exhausted and rather fragile-appearing second-year family practice residents worried about an upcoming rotation, their obstetrics competencies, and the demands on them to complete a scholarship project.

Behind each of my reactions rests the book I have just finished reading (twice, it must be said! I loved it that much!): Poetry in the Clinic, by Alan Bleakley and Shane Neilson. I muse about the book as I work with the residents. Because what Neilson and Bleakley have offered the world, brilliantly and poetically, is a peek into ways for each of my responses to be generatively in conversation with each other, forming a kind of dialectical synergy, a refusal of siloed, dichotomized, either/or ways of knowing and being in the world. After all, as the central thesis of Poetry in the Clinic goes, “Medicine=Poetry” (xix).

This is of course not always the case, as Bleakley and Neilson are quick to point out, because “the more reductive medicine becomes, the less poetry shows” (xix). What Neilson and Bleakley are fundamentally arguing for is a poetic imagination: a way of knowing and being in and of the world that simultaneously embraces, and is nested within, medicine, clinical practice, and medical cultures and imaginations. Poetry and poetics are less temporal than they are spatial—this appeals deeply to the geographer in me—and are thus sites and places both within medicine and everywhere all around it. Poetic imagination is both a beating heart within medicine that keeps it alive and a means of bringing to vibrant and full potential all that medicine might one day be. Again, medicine=poetry.

With that equation in mind, this is a book that kicks to the curb powerful disciplinary conversations circulating around the world, in both medicine and the humanities, about poetry’s utility to medicine. Breaking with linguistic tendencies of far too many an academic textbook, and using refreshing and ebullient language that includes puns, guffaws, wincing, bristling and (channelling Emily Dickinson) looking at things a/slant, Bleakley and Neilson shamelessly assert poetry need not be useful to medicine. Who wants mechanistic reductive utility when beauty and epiphany are at stake? To argue for an instrumental utility of poetry to medicine, according to Neilson and Bleakley, is to miss the point entirely: poetry should not be restricted to decorative function, therapeutic value, pedagogical potential, or the prospect of soothing and enlightening clinicians or patients. Bleakley and Neilson’s central argument is that medical work, replete with its many and powerful metaphors and creative languages, needs to be defamiliarized, made—once again and to both insiders and outsiders—strange and beautiful (86). Art (and by extension poetry) is not out there and somewhere else vis-à-vis medicine: medicine is poetry and art, just as surely as science, is artful and creative.

Nor—and here Bleakley and Neilson are blunt nearly to the point of abrasiveness—should poetry be enfolded into the cozy, mostly uncritical, and increasingly corporate corpus of narrative medicine. Oh, no, no . . . narrative medicine misses the lyric in efforts to lasso into form an interpretable arch of linearity and knowability. There’s a kind of mechanistic utilitarianism to the growing industry of narrative medicine. Narrative medicine focuses on and reads for a quasi-temporal storyline, usually with no hint of criticality or knowledge of long-standing formalist literary criticism. All in all, and at the same time, corporatized narrative medicine erroneously exalts much bad writing while also enfolding poetry into its lyrically naive sphere of narrative-ego. What an insult to the poetic arts, cry out Neilson and Bleakley! What a missed opportunity to rigorously uncover and celebrate the fine and carefully defined art of poetry.

Poetry in the Clinic is a theoretically rich, empirically comprehensive, joyfully pragmatic battle call: be prepared to fight for your right to claim that medicine is poetry, science is art, and the humanities are everywhere there are humans and a quest to care for humanity humanely. Poetry in the Clinic offers clear and grounded examples of both how medicine is poetry and how one, clinically and conceptually, might work to make this a recognizable reality. The book is a much-needed antidote to the scholarship, curations, curricula, and professional-development opportunities springing up in health care education around the world, which promote a kind of “art as accessory” mentality. Similarly, Poetry in the Clinic is a remedy for all the humanities scholars, creative writers, and (especially!) poets out there who feel just a little bit cringy when called upon to run yet another workshop for doctors wanting to take a break from “real world” and “important” practices by relaxingly jotting down a few broken-up sentences over a glass of wine.

Way back in 1995, humanities scholars, cultural critics, and postcolonial theorists W. J. T. Mitchell and Homi Bhabha had a long and wide-ranging conversation, published in the journal Artforum, about—among many other things—philosophical parameters through which to understand culture and the generative powers of rupturing and splitting. In the mid-90s, much ado was made about the concepts of inter- and trans-disciplinarity, both of which have much in common with contemporary institutional and clinical moves toward medical and health humanities. Bhabha and Mitchell offered a few blunt comments on practices of inter- and trans-disciplinarity that don’t account for power, moves that (much as Euro-colonialism set an ideological stage for land and resource theft across “territories”) involved encroachment upon and digestion of one disciplinary structure by another, especially if the latter held currency and authority while the former did not—think here of a Faculty of Medicine or a hospital in comparison to a Department of Poetics or a library. In their conversation, Bhabha observed the following:

The humanities live in an intertextual, transdisciplinary space. The academy is often organizationally unable to deal with this. I have the sense that over the past thirty or forty years, liberal institutions have been quite comfortable with one version of interdisciplinarity—let’s call it “Interdisciplinarity 1.” . . . Interdisciplinarity 1 is a way of framing or garlanding a particular discipline with another discipline’s insights or expertise . . . But there is a different interdisciplinary mode—“Interdisciplinarity 2”—in which our invocation of another discipline happens at the edge or limit of our own discipline. It is not an attempt to strengthen one foundation by drawing from another; it is a reaction to the fact that we are living at the real border of our own disciplines, where some of the fundamental ideas of our discipline[s] are being profoundly shaken. So our interdisciplinary moment is a move of survival—[a] formulation of knowledges that require our disciplinary scholarship and technique but demand that we abandon disciplinary mastery and surveillance . . . Interdisciplinarity 2 is fired with a desire to understand more fully, and more problematically, that it’s poised at the point of our disciplines’ liminality . . . it requires us to articulate . . . new and collaborative definitions of the [disciplines]. (82)

Poetry in the Clinic is a stern rebuke of poetry as a “framing or garlanding” of medicine: poetry is not medicine’s plaything, not a sweet, cute, friendly decoration medicine can exercise surveillance over while hanging it on its doorway for special occasions. Medicine, as anyone broadly adjacent to the discipline knows, is (again to paraphrase Bhabha) living at and confronting its own real borders, where some of its fundamental ideas are being profoundly shaken. Medicine in a time of planetary destruction; institutional racism, sexism, heteronormativity, and ableism, and wide-ranging cuts stemming from extractive capitalism and neo-liberalism, is most certainly looking for a means of survival. What Bleakley and Neilson are suggesting is that a solution rests not with medicine using poetry, but in medicine understanding itself as poetry: medicine is poetry is lyric line wild imagination rigour work beauty metaphor unownable epiphany craft care deep-reading open-ended enjambment a/slant curiosity turning newness. Medicine’s survival, again to borrow from Bhabha, requires all this and the fiery desire to (re)articulate itself as being poetry, as a poetic imagination.

As a medical educator and professor in a faculty of medicine, I’m all in. Yes! Yes, I say! Poetry in the Clinic is the fodder I need to produce more theoretically robust research in anti-colonial health humanities. It’s a text I’ll wholeheartedly be recommending to nursing colleagues, medical students, and graduate trainees in health science programs. It will also be the reference point for conversations I have in spheres like the Canadian Association for Health Humanities and the League of Canadian Poets.

I’ll end, however, with a tiny question I had upon exiting this otherwise fantastic text. As a poet, I couldn’t help but privilege poetry by flipping the equation with which the book began: if medicine=poetry, does that not implicitly mean that poetry=medicine? After all, the rather poetic and magical discipline of mathematics dictates that whatever sits on one side of the sign is, of course, equal to what lies on the other. Right? It is at this juncture that I start to feel a little unsure. Does poetry=medicine? Do poetics aspire to being medicinal? Really? And if not, then can medicine really, fully, equal poetry? I want to say yes . . . and yet. And yet.

I think ending with this question is really to end not with a critique but with an invitation: the world needs another book, this one entitled something like “Medicine in Poetics: Toward a Clinical Lyric.” I am not being entirely fanciful or flippant. Again, as a poet—but one who works all day every day with physicians and health care professionals —I do think the poets and artists with whom I also work might do well to embrace more of the scientific, clinical, and even medical in their (our) work. But that’s another story, maybe for another time and place. For now, I’m off to send my residents some books of contemporary poetry. They’ll know what I’m saying.

Work Cited

Bhabha, Homi. “Translator Translated.” Interview with W. J. T. Mitchell. Artforum, vol. 33, no. 7, 1995, pp. 80-84.