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A Syllabus For Empathy — Or Why Health Care Workers Should Read Poetry

A doctor reflects on the power of poetry to help better understand a patient's struggles. (Natalie Collins/Unsplash)
A doctor reflects on the power of poetry to help better understand a patient's struggles. (Natalie Collins/Unsplash)
This article is more than 3 years old.

In Jane Kenyon’s short poem, "The Sick Wife," the narrator stays in the car while her husband buys groceries, and the poem plunges us into her world. It’s a world where things move slowly; where the poet -- ill with leukemia -- notices what she missed when she was well and able to rush around like everybody else. Each detail feels tinged with regret.

Dry cleaning swung and gleamed on hangers

in the cars of the prosperous.

Even these inanimate objects have more ability to move and shine than she does. When the cars on either side of her “pulled away so briskly,” she is left behind, “sick at heart.”

Sitting in that car with the sick wife, we glimpse the sluggish world of the ill, where the well get around with oblivious ease.

That’s what this poem does so well: It pulls us into the experience of illness through the prism of the mundane. Sitting in that car with the sick wife, we glimpse the sluggish world of the ill, where the well get around with oblivious ease.

One can imagine that the narrator’s doctor might think she’s doing great — she can still go for car rides, after all. She’s not bed-bound yet! But the poem presents a different and subtle reality of her suffering.

If doctors really don’t understand what patients are going through during those most quotidian of moments, how can they help heal them?

A few years ago, when I used to make home visits, I sat with an elderly man at his small kitchen table cluttered with newspapers and pill bottles. My patient was overweight, he’d smoked for more than 50 years, and he was on oxygen. I really wanted him to get a little exercise. He explained that he couldn’t take his wheeled walker outside because his apartment building didn’t have a ramp.

"OK," I said to him, "then how about walking up and down the hall outside your apartment?" It seemed so straightforward. But he feared getting to one end and finding himself either so out of breath or lightheaded that he might never get back.

"Then go 10 feet and turn around," I said. I couldn’t understand why he couldn’t see that my advice made sense.

Then he said, "I wish you could understand what it feels like to be me."

I was floored. Didn’t he know that I was trying my hardest to do just that? I was in his home. I could watch how he maneuvered, awkwardly, between the couch and the end table. I could imagine how difficult it was for him to shower while sitting on a flimsy bath chair in a narrow stall. I thought was doing a pretty good job, that I had a decent sense of his life. I thought I was being empathic.

Empathy — a term we toss around all the time in the medical field — is a tough nut to crack, however. Some of us can draw on the memory of difficult or painful moments in our own lives to try to glean a patient’s experience of living with an illness, but it’s not easy. Often, those raw moments callous over, and we’re left with a memory that’s more intellectual than emotional. We can try to imagine what a patient is going through, but it’s hard to actually feel a similar emotion.

And then I came across Hayden Carruth's poem "Notes on Emphysema," which consists of 48 stanzas, most of which are a sentence or two. Each is a quick reflection on how emphysema tinges every tiny moment of daily life. The poem begins:

1. Smudgie, my beautiful white cat, lies curled on the bed beside me. She doesn’t know she’s breathing.

Empathy -- a term we toss around all the time in the medical field – is a tough nut to crack.

Carruth is hyper-aware of breathing, noting how the cat and other living beings make it look so easy. In the fourth stanza, he captures what I think my patient was trying to tell me: For him, physical exertion and misery were one and the same.

4. Climb the stairs. Lie down. Stare at the water stain on the ceiling, at utter familiarity. Slow your heart and still the gasping. Gradually, gradually. Notice the rise and fall of your diaphragm, the diminishing pressure against your stomach. After five minutes take one deep breath. A great exhaustive sigh. Now fall asleep.

Poems about illness — or metaphorically about illness — can slow down those mundane moments of real life. These poems can help health professionals better understand what it might be like to live with a disease, to receive good news (Jo McDougall’s "Mammogram"), or bad (Raymond Carver’s "What the Doctor Said").

Poetry can help doctors and other health care professionals remove our blinders, at least for one slowed-down moment. And that can make all the difference.

Related:

Anna Reisman Twitter Cognoscenti contributor
Anna Reisman, MD, is an associate professor at Yale School of Medicine, where she runs the Program for Humanities in Medicine.

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