August is divided into two sections: "On the Corner of Fourth & Irving" and "To Marie Curie." The narrator, on a street corner in San Francisco near the teaching hospitals and medical school of University of California, San Francisco, meditates on the recurrence of lymphoma in a patient. Evening is approaching, fog blows in from the ocean, and the city pigeons are unsettled--landing and taking flight.

The meditation includes a tribute to Madame Curie and her discovery of the effects of radium. The patient had had a good chance of cure by radiation treatment--unfortunately, this patient is in the twenty percent who are not cured. The narrator, probably a physician-in-training due to the load of textbooks, had read the patient's chest x-ray as negative (normal) previously.

By the end of the poem, we learn that the physician had felt enlarged lymph nodes in this patient's neck today and he bluntly states: "I have failed. He has not been cured." The poem closes with the sound of the wind and the "beating and beating of wings."


This is a lovely poem, full of complex imagery, time shifts, and emotion. The colors of the evening--the greys and blacks of the street, pigeons, fog and sky--are likened to the greyscale and ghostliness of x-ray imaging. Likewise, the failure to cure the cancer in this patient is reflected as physician failure. There is a hint of "what-if"--what if I (the narrator-physician) had seen an early trace of cancer on the x-ray?

This self-doubt, as well as the sense of failing the patient by failing to eradicate the cancer, leads to a complicated mix of emotions and ruminations. This poem eloquently acknowledges that the burden of doctoring in this era of expected cure and technological advances is far greater than the burden of a load of textbooks.

Primary Source

North American Review 285/6 (Nov/Dec): 26-27 (2000)