Transcripts

text | pdf |

---

TOM CRANN: It's All Things Considered. From Minnesota Public Radio news, I'm Tom Crann. We all know that ill-chosen words can hurt. But can well-chosen words actually heal or at least give us insight into the healing process? Poetry is an emotional outlet for patients and caregivers alike. In fact, the highly technical Journal of the American Medical Association publishes a new poem in each weekly issue. April is National Poetry Month. And today, we're talking medical poetry with Dr. Jon Hallberg.

Each year, he brings in some of his favorite medical poems to talk about. Jon is a physician in family medicine at the University of Minnesota. He's also the director of the Center for Medical Humanities and the Arts at the University of Minnesota. And it's a pleasure once again to have you here. Thanks, Jon, for coming in.

JON HALLBERG: Thank you, Tom. It's great to be here.

TOM CRANN: Let's start with the first one that you brought. It's called Pandora, and it's by Kelley Jean White. And what do we know about Kelley Jean White?

JON HALLBERG: Well, Kelley Jean White is an inner city pediatrician in Philadelphia. She went to Harvard Medical School. There's an allusion in the poem to working at the Massachusetts General Hospital, or Mass General as it's called. So I'm guessing this is a little bit autobiographical. I don't know that about the poem, but I'm guessing that she's going back to an experience that she herself had as a student.

TOM CRANN: And where did you come across this one?

JON HALLBERG: This is actually from Garrison Keillor's Writer's Almanac. I should get that as an email every day. And this one absolutely caught my eye.

TOM CRANN: All right. Pandora by Kelley Jean White. If you could read it for us, Jon.

JON HALLBERG: September, 2nd year medical student. An early patient interview at the Massachusetts General Hospital. Routine hernia repair planned, not done. Abdomen opened and closed, filled with disease, cancer. The patient is 56, a working man. Irish. I sit with him, noticed the St. Christopher medal around his neck. Can't hurt, can it? He laughs.

I have become his friend. I bring him a coloring book picture that shows this thing, this unfamiliar organ that melted beneath our hands at dissection, pancreas. Leaving his room crying, avoiding classmates, I take the back stairs. I find myself locked, coatless in the courtyard outside.

TOM CRANN: It's Pandora by Kelley Jean White, who is a physician. And Jon, does that experience of the medical student actually ring true to you?

JON HALLBERG: It sure does. In fact, just last week, I had two different groups of students, each with five students in them, kind of doing a reflective exercise. And I was surprised at the degree of emotion that came from these third and fourth year students, describing things that they really hadn't got a chance to describe before. And that's really the sense I get here, that these students experience things that most of us can't even imagine.

And how do you make sense of that? How do you process that? And I really think that this poem kind of captures that nicely, that processing, that looking back, that trying to sort through this horrible outcome.

TOM CRANN: So the raw and new emotion of that for a medical student of dealing with that is captured there, and captured succinctly, it seems to.

JON HALLBERG: Yeah. I like the spareness of it. And I think she does a very nice job with that.

TOM CRANN: Well, speaking of spareness, the next ones are not poems. You brought me a set of little, in a way, really short stories or prose poems, as you can call. These are 55 words. It was an assignment for doctors to write 55 words here.

JON HALLBERG: Yeah. This collection appeared in a journal that I get every month called Family Medicine. And within that, there's a section called literature and the arts and medical education. And this particular article describes this assignment that some family physicians had at a faculty development workshop. They're looking at care of the underserved.

And I think that these prose pieces read like poetry. So this little piece is by Tapan Kant, who was a faculty development fellow there in Pittsburgh, and he's a family physician in practice there right now.

TOM CRANN: It's called 9th and Carson, and it's 55 words long. 12 patients in a waiting room small enough for four. A young man whispers his sexual history, while a makeshift partition away, another man tries hard not to listen. A free medicine cabinet, expired lidocaine, a psychiatry consult in a closet, falling plaster. The United States spends over $1.7 trillion on health care. And there, I think in 55 words, we have a succinct indictment or certainly strong criticism of the economics of health care in our country.

JON HALLBERG: Well, I've got a number of colleagues who do provide care to the underserved and work in a homeless clinic. And it's just this crazy dichotomy of, on the one hand, doing a consultation in a closet because that's the only quiet space, private space, you can find. And then looking at the reality of what we spend in health care, there's just such a huge disconnect.

TOM CRANN: Well, if the first two give us a perspective of physical health, this next one gives us a little perspective on mental health. But certainly, I'm sure physicians can relate to this, too. Who's Hal Sirowitz who wrote this?

JON HALLBERG: Well, Hal is a special ed teacher in New York City. He's a published poet. And this piece, I found in the Bellevue Literary Review, which arrived in my mailbox recently. And this is a wonderful little new review that's from New York city, from--

TOM CRANN: From the Bellevue Hospital.

JON HALLBERG: That's right. New York.

TOM CRANN: Big hospital there.

JON HALLBERG: Yup, NYU. And Danielle Ofri, who's a physician and writer, edits this. And there's always quite a collection of poetry within it. And the minute I read this one, I actually laughed out loud.

TOM CRANN: It's called Overblown by Hal Sirowitz. What's hopeful about your problems, my therapist said, is they're just typical anxieties. You don't have any that I haven't seen before. But what concerns me is your habit of enlarging them until they become almost unrecognizable. Luckily, you have me to recognize them. I'm familiar with all your anxieties. I can tell which ones are coming. In a few moments, we're about to be revisited by your worry of taking up too much of my time. But that's why I schedule my patients one after the other, so they can't.

And that's a really good poem. Very funny. And even though as a physician, do you deal with a bit of recognition there? Sometimes, that new patient is a bit of a relief from the one that's there.

JON HALLBERG: Well, yeah. I mean, in primary care, I think this is one of the things I love about it. So don't get me wrong. But one of the frustrating things is that much of my day is spent being a sounding board and listening and listening to things that I can't solve easily. So that rings rather true.

TOM CRANN: From the world of mental health and the analyst's couch, we moved to a poem that you brought in that both incorporates the experience of being a physician and a parent of a newborn, I'm assuming. Why did you pick this one, Jon?

JON HALLBERG: This is from the poetry and medicine section that appears each week in JAMA. And I think maybe as a parent and as a physician, this just resonated with me. Because just from the opening couple lines, you get the sense that there's something about the observer, the poet, who is a physician, and his ability to incorporate this wonderful feeling of being a parent, but also being a physician and the power of observation, the sense of the scientific background and training that he had. But it's just so tempered with this lovely observation that it just really captured it for me.

So it's entitled To My Daughter. What is this smell? Some oil, some ketones, some other chemical or combination of these leeching from your skin and breath and hair up to my nose. It smells like the press of your tiny forehead against my chest feels or the tickle of your fine hair brushing up to my chin. These feels and smells, they trigger love. They rest my restlessness, subdue exhaustion, goad me to hold you long after you fall back to sleep.

Transmitted by my shhh, my whispered lullabies. My rocking heartbeat pressing close to yours, double timed. These will sleep deep in your infant memory, insensate, until your daughter wakes you up late to cry and fuss, until your rocked embrace imparts the smell and feel and sound of love to her. And that's by Clayton Baker, who's a physician at the University of Rochester in New York.

TOM CRANN: And as both a parent and a physician, what is Dr. Baker getting at here? What's the nugget of the truth in that one for you, Jon?

JON HALLBERG: No matter how much we understand about the human condition, there's this mystery of life. And what is that baby smell? Well, there's some real reason for that. Some molecules of that baby are entering our nose and being picked up by the olfactory bulb and are incorporated in the brain someplace. But it's more than that.

TOM CRANN: So for all the scientific ways you have to diagnose and to describe and figure things out, there's still stuff that the poetry figures out better than the science?

JON HALLBERG: Oh, absolutely.

TOM CRANN: So people might be listening now and saying, well, that seems odd that medicine is this very scientific discipline. And what can poetry add or bring to it?

JON HALLBERG: I think there's this huge affinity between medicine and the humanities and arts. And in fact, one quote that I'm fond of saying is that medicine is the most humanistic of the sciences and the most scientific of the humanities that captures it for me. Or that in my own world, it's a way for me to express my training in the liberal arts in this very interconnected kind of way.

People who are in medicine, who are in health care, are there because just being a researcher wasn't enough. I mean, just answering questions isn't where it ends. It's the interactions, the messy stuff. It's the unpredictability of working with people, with patients. And when you do that, you've got to work through it. I mean, there's a lot of unpleasant stuff and, of course, some wonderful stuff that happens, too. And writing about it in a narrative way or writing about it in poetry is one way of getting at that and processing it and maintaining your humanness yourself.

TOM CRANN: Well, Jon, as always, it's been a pleasure. Thank you for bringing these poems in to share. I appreciate your eye for them, and your insight into them as well.

JON HALLBERG: Well, thank you, Tom. It was my great pleasure.