Listening to Understand in Medical Poetry

One essential beauty of art rests in its ability to express its creator’s internal self. Medicine similarly involves an opening of unseen worlds—through history-taking, laboratory results, and imaging, clinicians can access scientific dimensions of patients that are shielded from view, which can sometimes lead to inadvertently appropriating the illness narrative. Patients also offer physicians other intimations of themselves that go beyond chief concerns and data—their feelings. How clinicians have personally coped with or been trained to receive these glimpses into a patient’s emotional world is complex. Yet Sir William Osler is reported to have said, “Listen to the patient. [They are] telling you the diagnosis.” Perhaps the value of listening lies not only in solving diagnostic problems but also in more deeply understanding who a patient is. The poem “If She Has to Go” portrays a grandmother candidly sharing her inner thoughts about the end of her life. With “legs uncharacteristically exposed” as hospital discharge approaches, her embrace of death contrasts sharply with the medical team’s reassurance of restored health. The tension builds ironically, as it is the patient diagnosed with dementia who so clearly insists on the ultimate medical futility of her case, while the physicians (however patient-centrically) blithely urge continued temporizing care. As the poem concludes, all understand exactly what this patient wants despite her dementia, a “shroud with dancing opacity.” With a “sense of/contentment” and as “her shroud thin[s],” poetry ushers in a metaphorical unveiling of mutual acceptance of mortality: “if she has to go, she has to go.”