Poetry in Medicine

by Danielle Ofri

When I make rounds with medical students and interns, I’ve often tried to sneak in a poem at the end. It’s not always the most well-received bit of medical teaching, but it can help convey the parts of the medical experience that don’t make it into textbooks. It can also help foster creative thinking—something that’s often in short supply in medicine.

I’ve handed out poetry on and off to medical personnel over the years, but I’ve always wanted to give poetry to patients. Unfortunately, English is not the first language for most of the patients in my hospital, so this has been challenging.

But there is one set of patients that seems to consistently speak English—the alcoholics. The Bowery-type alcoholics aren’t necessarily the favorite patients of the medical teams. These patients are frequent fliers, they are clinically “uninteresting,” they are often malodorous and ornery, and their illness is perceived as self-inflicted. But they do speak English.

So one morning on rounds, our team went to examine a new alcohol-withdrawal admission. His condition was standard: alcohol-on-breath, speech slurred, fingers trembling, hair and beard disheveled, body odor a mix of unwashed socks and cheap bourbon. He was cranky and impatient. Our detailed medical questions were annoying and he made that clear. The team was equally anxious to move on.

But this patient was our only fluent English-speaker, so it was now or never. As the team was finishing up, I whipped out some papers from the pocket of my white coat—Jack Coulehan’s poem “I’m Gonna Slap Those Doctors.” Before anyone could protest, I handed a copy to the patient and pressed the rest into the hands of the resident, interns, and medical students. Ignoring the perplexed looks, I plowed forward and read the poem aloud.

I’m Gonna Slap Those Doctors

Because the rosy condition
makes my nose bumpy and big,
and I give them the crap they deserve,
they write me off as a boozer
and snow me with drugs. Like I’m gonna
go wild and green bugs are gonna
crawl on me and I’m gonna tear out
their goddamn precious IV.
I haven’t had a drink in a year
but those slick bastards cross their arms
and talk about sodium. They come
with their noses crunched up like my room
is purgatory and they’re the
goddamn angels doing a bit
of social work. Listen, I might not
have much of a body left,
but I’ve got good arms — the polio
left me that — and the skin on my hands
is about an inch thick. And when I used
to drink I could hit with the best
in Braddock. Listen, one more shot
of the crap that makes my tongue stop
and they’ll have something on their hands
they didn’t know existed. They’ll have time
on their hands. They’ll be spinning around
drunk as skunks, heads screwed on backwards,
and then Doctor Big Nose is gonna smell
their breaths, wrinkle his forehead, and spin
down the hall in his wheelchair
on the way to the goddamn heavenly choir.*

As I read the poem, I could feel the atmosphere in the room changing, ever so slightly. The focus shifted from the patient to the poem. Suddenly everyone was an equal neophyte, and that’s not necessarily something doctors enjoy feeling.

When I finished reading, some of the medical team looked uncomfortable with this divergence from medical protocol, annoyed at the time I was wasting, worried perhaps about what I was subjecting our patient to, or concerned that their attending physician was off her rocker. But the patient was smiling broadly. “This is great,” he said. “That’s exactly the way it is!” With his pronouncements, everyone relaxed a bit.

“You know,” the patient continued, seemingly happy to have an audience, “ I used to read some books, back in the day.” He sat up in bed, more animated now. “I like history stuff—ancient Greeks, ancient Romans. Real characters, those guys.”

He told us about his childhood in small-town New Jersey, how he cut classes in high school to putter around on the beach. How he picked up books at garage sales in the neighborhood. How he gradually migrated across the Hudson to New York City.

I’ll be honest—I felt just as awkward as my team as we closed out our visit with him and left the room to continue our rounds. It was weird reading a poem with a patient in the middle of a busy medical ward. But the atmosphere was somehow lighter. Our patient wasn’t just another irritable alcoholic drying out on the ward. He was someone. Someone a little different than the next someone we’d be seeing on rounds.

The poem certainly didn’t change the course of his alcoholism. It didn’t offer him the epiphany to suddenly quit drinking or to reconnect with his estranged family. His liver enzymes didn’t miraculously normalize. His platelets didn’t rebound back to proper levels. But it gave all of us a hint of human connection.

Throughout his four-day stay in the hospital, the patient was much more pleasant to the team. I noticed that the students and interns wandered in more frequently to say hello. We all felt just a bit more connected.

There’s no special magic in poetry, just as there’s no special magic in so much of our medical treatments. But sometimes I just want give an Rx and see what happens: Take two sonnets and call me in the morning.

(*from Medicine Stone, Fithian Press 2002. © Jack Coulehan, reprinted with permission)