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This is a collection of 91 poems on medical topics by medical students, physicians in training, and attending physicians; two are Canadian and the rest American. The poems are organized by six traditional groups of medical training and advancement in the profession: Medical Student, First Year; Medical Student, Second Year, Medical Student, Clinical Years; Intern; Resident; and Attending. There are no sections for pre-meds, retired doctors, or other programs (naturopath, chiropractor).
The editors have done a good job of picking well crafted and evocative poems. A dozen have been previously published. For the most part, the poems are short, easily fitting on one page. Almost all are in free verse, although there is one group of haiku, one prose poem, and an impressive sequence of ten Shakespearean sonnets “Breughel at Bellevue” by Anna Reisman.
Many poems treat dramatic moments in training: the anatomy lab, first gynecological exams, physician-patient relationships, especially when a patient is gravely ill or dying. Several poems in the first three sections comment on the differences between the normal social world and the intense medical world of the hospital. Throughout there are references to the pressures of high-tech, unfeeling medicine. Indeed Jack Coulehan sounds this theme in his introduction; he writes that "steadiness and tenderness" are both needed in medical practice.
Dr. Pauline Chen is a transplant surgeon and hence highly trained in the surgical care of desperately ill patients. She found, however, that although she had intensive and first rate training, time and again the message she received from her mentors and peers encouraged a distance from frank discussions about dying with patients who were clearly dying. Dr. Chen successfully suppressed her urges to reflect on the meaning of illness and death. Years into her training, she finally witnessed an attending surgeon stay with a patient and the patient's wife until the patient passed away. The widow sent a thank you note to Dr. Chen for allowing a "dignified and peaceful death." (p. 101) Chen notes that observing her attending stand with the patient during death changed her profoundly: "...from that moment on, I would believe that I could do something more than cure. This narrative, then, is my acknowledgment to him." (p. 101)
Final Exam chronicles Chen's journey from medical student to attending surgeon and examines her experiences with death and serious illness - of patients, family members, friends. The memoir contains three parts: Principles, Practice, and Reappraisal - each with three chapters. The book is chronologically arranged, beginning with anatomy dissection at the start of medical school and ending with Chen as an attending arranging for hospice, thus honoring a patient's desire to die at home rather than in hospital. Chen skillfully weaves her stories around commentary on the social, cultural and philosophical issues surrounding death and the medical response to death. An introduction and epilogue bookend the text and 46 pages of extensive notes and bibliography complete the book.
Although Chen claims to have slowly and painfully awakened to the fact that patient needs extend well beyond good technical care, in fact one sees Chen emerge as a caring physician even from her initial patient contacts in medical school. Chen speaks more to her role as an Asian-American than to being a woman in a male-dominated field, but she clearly has what it takes to succeed in this extremely competitive field, including a good dose of compulsiveness and an incredible work ethic.
An already depressed second year medical student, Deborah, finds herself even more confused about the meaning of life after her aunt sustains a head injury and is in critical condition. Auntie Jenny’s convertible car collides with a utility pole and the impact ejects the woman (who was not wearing a seatbelt) onto the concrete road where she smacks her head. Five days later, Jenny remains in a vegetative state and connected to a ventilator. Deborah’s mother and Auntie Sal keep vigil over their unresponsive younger sister.
Deborah has been slacking – missing classes, sleeping a lot, and uninterested in most activities she formerly enjoyed. Previously she has suffered from insomnia and has fifteen barbiturate sleeping pills remaining. She questions the medical librarian as to how the drug works and the physiologic effects of an overdose. In the seventh grade, Deborah was hospitalized and out of school for one month with unexplained abdominal pain. In retrospect, her mother now admits that Deborah was likely suffering from depression as a child but no diagnosis was made and no treatment provided.
Jenny’s medical status remains unchanged. Deborah’s mother gives her an ultimatum: “You’ve got to make up your mind. The living or the dead” [p 119]. Deborah envies Jenny. No more worries about finding answers to important questions. Survival itself seems to be out of her control. Jenny’s fate rests in the hands of her close relatives who confer with the doctor about whether to continue artificial life support or “pull the plug.”
Summary:A collection of short stories loosely connected to each other by centering on the experiences of four people from their first encounters during medical school and continuing into young middle age.
A saxophone-playing, divorced psychiatrist, Dr. Denis, is baffled by the unexplained arrival of a new patient in his mental hospital. The highly intelligent newcomer, called Rantes, has extraordinary gifts and spends long hours in the yard facing southeast, where he claims to receive communications from his home planet. He is visited by the saintly Beatriz, who works in a church, and Denis asks her questions about Rantes.
The bond between the three people begins to transgress the ordinary boundaries between doctor and patient, and culminates in an excursion to a concert in the park. Charmed by Beethoven's "Song of Joy," Rantes instigates generalized waltzing and takes over from an inexplicably obliging conductor. Back in the asylum, the other patients feel the vibrations emanating from Rantes' concert and engage in a good-humored romp. The doctor is reprimanded for the embarrassing situation, and begins to doubt the integrity of the psychiatric enterprise. A weakened Rantes dies after electroshock therapy and the film ends in ambiguity.
Canadian surgeon Norman Bethune, 1890-1939, (Donald Sutherland) journeys 1500 miles into China to reach Mao Zedong's eighth route army in the Wu Tai mountains where he will build hospitals, provide care, and train medics. Flashbacks narrate the earlier events of his life: a bout with tuberculosis at the Trudeau sanatorium; the self-administration of an experimental pneumothorax; the invention of operative instruments; his fascination with socialism; a journey into medical Russia; and the founding of a mobile plasma transfusion unit in war-torn Spain.
Bethune twice married and twice divorced his wife, Frances (Helen Mirren) who chooses abortion over child-rearing in her unstable marriage. By 1939, Bethune had been dismissed from his Montreal Hospital for taking unconventional risks and from his volunteer position in Spain for his chronic problems of drinking and womanizing. As his friend states: "China was all that was left." Even there, Bethune confidently ignores the advice of Chinese officials, until heavy casualties make him realize his mistake and lead him to a spectacular apology. The film ends with his much-lamented death from an infected scalpel wound.
This strong, powerful poem of grief for the death of an infant son in an intensive care unit is written by a poet who lost two of his five children. The rhythm of the poem is jazz, pulsing and pulsating, with well-controlled rests. Some words are run together: " . . . mamaborn, sweetsonchild / gonedowntown into researchtestingwarehousebatteryacid" which evokes (among other things) the frenzied atmosphere of a neonatal intensive care unit and the seemingly inevitable rush towards death.
Much of the poem deals with the distrust of the medical community, which is emphasized by the divide of race: the white doctors and nurses in white uniforms versus the African-American patient and family. The frustration of dependence on others is painful for the father during the nightmare of his baby’s dying. However, the poet reaches a higher level of understanding about his pain and grief; he acknowledges that the baby did receive all that medicine had to offer and he recognizes the complicated responsibilities one acquires by experiencing a loss.
Poet Donald Hall writes of his vigil over wife Jane (poet Jane Kenyon), gravely ill with leukemia. To him, the hospital where he spends his days with her is a ship whose huge pounding engines keep the propellers turning so that the voyage to harbor can safely be made. The ship passengers "wore masks or cannulae . . . but I believed that the ship / travelled to a harbor / of breakfast, work, and love."
Hall writes about what he wrote at the time: " ’. . . bone marrow restored . . . I will take my wife . . . home to our dog and day.’ " After weeks of treatment, wife Jane is discharged, months pass, and now, at home, Hall re-reads his own words as he listens anxiously "to hear Jane call for help," and prepares to "make the agitated / drive to Emergency again," knowing that there is no safe harbor and that the ship is going nowhere, a " . . . huge / vessel that heaves water . . . / without leaving / port, . . . / without arrival or destination . . . . "
In this nine-stanza, sixty-three line poem, the speaker articulates her process of recovery from surgery in terms of the image of "excitable" tulips that interrupt her "winter" sojourn in the hospital where she has "given [her] name and [her] day-clothes up to the nurses / And [her] history to the anesthetist and [her] body to the surgeons." The images in the poem link one stanza to the other (the nurses like "gulls," her body "a pebble," her family "little smiling hooks," herself "a thirty-year-old cargo boat").
The image of the eye appears throughout the poem as well. The speaker is herself the pupil of a huge eye whose lids are the pillow and the sheet; in another stanza she finds herself existing between the "eye of the sun" and the "eyes of the tulips," herself without a face, but beginning to see beyond her own pain.
The speaker has wanted only quiet and emptiness and is agitated by the presence of the tulips, whose "redness talks to [her] wound" and "weigh [her] down" as she is being "watched" and nearly suffocated ("The vivid tulips eat my oxygen") by them. The tulips, dangerous as "some great African cat," remind the speaker of her heart, a "bowl" that blooms red "out of sheer love of me," and realizes that the tulips call her, ultimately, back to "a country far away as health."
Summary:As editor Judy Schaefer writes in her introduction, this collection provides "the rare opportunity to read both the poem and the poet's commentary." It is somewhat like a good poetry reading, where we get to hear about the events, thoughts, feelings and contexts that have stimulated the poem. Often the writer's commentaries have a richness of their own, complementing the poetry but not necessary to it. Also the commentaries describe some of the writing process the nurse poets go through in creating the poem. The fourteen nurse poets in this volume have all published their work in journals and anthologies, but this is the first collection to include commentaries along with the poems.