Guest Post: Medicine and Poetry, an Art and a Science

By Irene Planchard Mathieu, a writer and medical student at Vanderbilt University

Being a medical poet has often meant poetic isolation, immersed as I am in the intense educational world of medicine. I have felt very isolated jotting down lines between patients during busy days in the hospital or writing in my apartment after long nights of studying. Last summer, I had the opportunity to attend my first poetry workshop, a two-week immersive experience in Rhode Island. It was like opening the door to the little closet in which I’ve been writing alone and seeing that my small room is part of a sprawling, underground mansion where so many beautiful souls live, each one in a different room, who decorate the mansion’s rock walls with studded jewels and feathers and scraps of cloth.

On the last night of workshop a fellow poet asked me about the parallels between medicine and poetry. I began with the response that I have explicated elsewhere, but as I spoke I realized that my answer had evolved significantly as a result of the past two weeks. It isn’t just that poetry and medicine both offer a window into the totality of human experience, an intimacy with the human condition that few other professions offer.

Just as there are an “art and science” of medicine, there are both art and science in poetics. I often describe the role of science in medicine as analogous to the role of language in human communication. The point of learning another language usually isn’t simply for the love of language itself (although certainly that love is real and important and can be part of the motivation). Usually the primary purpose of mastering language is for communication, just as a deep understanding of science allows us to use medicine in the service of other people. The memorization of medications and amino acids does not a competent physician make. But this fund of knowledge is the language we use to navigate disease and to describe health and illness. Similarly, strong vocabulary, understanding of literary symbols and devices, and grammatical knowledge are the tools of meaning-making in poetics.

There are systematic ways to approach reading and writing poetry. I can dissect a poem in order to understand or edit it. There is basic anatomy that must be grasped before we can understand poetry or create great work. In poetry, anatomy consists of form, literary devices, symbols, and metaphors. These and other components provide the framework for the poem’s content. As physicians, we must understand the parts of our patients’ bodies – how individuals’ organs do or don’t function, what is “normal” for each person. But we also must remember that a person is not simply her or his body. A person has a body. Who a person is is analogous the content of the poem.

In medicine and poetry, in order to break the rules effectively we have to learn them thoroughly. Learning medicine in a classroom and practicing medicine in a clinic or hospital are two very different things. In the classroom we learn basic rules, mechanisms, and protocols. But rarely do patients fit our textbook definitions. And when they do, their diseases rarely occur in isolation. In clinical settings we have to account for patients’ other ailments and medications, medical history, age, sex, body weight/size, psychosocial conditions, values and goals, etc. Given this, what are the chances that we can do exactly the same thing the same way for every patient with ostensibly the “same” disease? Good physicians learn the textbook rules so they can understand when and how to adapt the knowledge to individual circumstances. Good poets learn the rules of poetry – about structure, form, use of literary devices, grammar – before they can break them to great effect.

Poetry and medicine are both a practice. They must be done consistently to be done well and require lifelong learning. In order to become a better poet you have to become a better reader. In order to improve as a doctor, you have to keep studying and learning about developments in the field. This is the duty of the committed poet or physician. It’s one aspect of professionalism. Professionalism also requires love of the field – a commitment to the evolution of scientific knowledge or of poetics. It requires being a team player – as a medical colleague, an editor, or a mentor to trainees in medicine and in poetry. It requires integrity; in both fields, this means checking our egos frequently and thoroughly.

Of course, poetry and medicine have many differences. I do believe poems have the power to heal and that poetry can be a matter of life and death; why else would so many brutal governing regimes around the world exile prominent poets time and again? Why else would words be censored in times of unrest? But poems are not people. Art imitates life, or vice versa, but art isn’t synonymous with life, and relating to patients is a completely different experience from relating to poems. While I have spent the last several years learning how to do the former, my poetry workshop was an intense course on how to do the latter. For a physician, patients must always come first. For me, poetry happens to come second. I believe the discipline, objective analysis, commitment, integrity, and heart required in each field can fortify my practice of the other.