I have long believed that poetry provides just such a means for coming to terms with harrowing stories of human suffering, and so I took comfort in the hard curved metallic seat back, the dim lighting, and the sight of the sickly looking poetry aficionados trickling in. Soon I would be immersed, along with these other people, in the voice of another. I hoped that the voice would be rhythmic and dynamic as a healthy heartbeat, and that all of us in the audience would be buoyed by the experience of empathetic connection. If we share anything, it is language, and the impulse to put our language to work in the service of truth-telling. I listen to poetry as some might hear gospel music: as a balm for the troubled soul.
I was ready to be transformed: from a passive observer, capable only of recasting knowledge of diseases into competent treatment plans, into an active, wise participant in the catholic drama of illness, with the power to heal the soul, if not always the body. I wanted to be given over to all the power of the elegy, from the Greeks’ catharsis to the sonorous consolation of Thomas’s “Do not go gentle into that good night.” I could prescribe any of a dozen antibiotics to cure endocarditis, or even a thrombolytic agent to stave off a heart attack; but what I yearned for was the elixir of poetry, which could heal the otherwise untreatable condition of my broken heart.
A tall woman with dyed raven-black hair and a nose ring abruptly sprung to the podium. The spotlight illuminated the spray from the can of Diet Pepsi she popped open. As she read her poems, which elicited faintly audible gasps of pleasure and hissed yeses from the approving crowd, I began to feel the opposite of what I had expected. Here was a poetry that was full of cynicism and rage; rather then the empathetic invitation to share in a vision of a better world, she was leading us into a hell of hostility and decay. Underlying her poems was a sneering disdain for the homeless people in her neighborhood, for the couple afflicted by violence and drug abuse in the apartment next door, and even for her own parents (which in one particularly memorable poem she imagined murdering in various heinous ways). It engulfed me like a foul cloud, her patter between the poems punctuated by the occasional rhetorically reassuring “Right?” or dismissive “Whatever.” It was akin to someone heedlessly conducting a brusque conversation on a cell phone in a quiet library while others were trying to study.
I walked out of the reading before she finished, under a starlit night that seemed like smashed glass. I seethed with self-righteous indignation, feeling that my one place of solace in poetry had been invaded and violated, the child of my imagination brutalized while I stood by, incapable of responding. Certainly I had experienced what in medicine were considered “violations of the health care contract” before: the drug-addicted patient who, in an attempt to get more narcotics, blatantly lied about a prescription lost in a suitcase stolen while visiting family in North Carolina; or the malingerer who demanded I fill out disability forms for back pain, and whom I observed by chance only a week later carrying heavy packages out of a department store. But never had I felt so betrayed in the realm of poetry by a fellow wordsmith. A serious engagement with language, I had bitterly discovered, did not guarantee a defense of the humane.
Thus it dawned on me that there were some unpalatable truths about empathy. The vehemence of my response to the reading was in some way, I had to admit, a refusal of another point of view. Was my notion of empathy, ironically, a self-serving one? My mind flashed back to some of my own poetry, especially those poems that addressed caring for patients. I wondered with discomfit if my espousal of empathy was an attempt to make myself the hero of these stories, the good-hearted doctor ministering to those who were always tragically less fortunate.
While I’ve always believed that I created these works of the imagination as a response to the silencing of those who are marginalized, maybe I was writing to deny my own misanthropic tendencies. Maybe I wanted to portray myself in the most flattering of terms. Or, worse, to assuage my own guilt over shortcomings and failures, real or imagined, revealed to me as I cared for my patients. I remembered my indignation years ago at the review of my book The Poetry of Healing in The Nation. The author criticized my zeal to identify with a patient of mine whose death from AIDS I had recounted; at least one other academic critic, whose paper had been forwarded to me anonymously in the mail, had raised a similar concern about my eagerness to become victim by proxy.
The empty streets and the late hour started conjuring other, more existential questions in my mind. By now the moon had risen, its bright, familiar beauty offering a kind of antidote to my dark ruminations. I had long agonized over my visceral reactions to liberal hand-wringing about how secular humanist Western democracies ought to respond to the threat posed by religious fundamentalist–inspired terrorism. (I shuddered a little at my own pleasure when reading in the newspaper that very morning of American troops in Afghanistan killing a group of Taliban fighters.) Whether it was the Christian or Muslim brand of radical extremism—one can discern little difference between the likes of Eric Rudolph and Osama bin Laden and their bloody expressions of enmity and hatred for those whose beliefs do not match theirs—I struggled to remain true to the values of mutual tolerance and respect that my parents had instilled in me. Yet I had felt unable to continue to care for a former patient of mine who left stacks of homophobic and anti-abortion pamphlets printed by his church in my clinic’s waiting areas, evidently unaware that his physician was a queer feminist. There were times when the more genuinely Christian credo of “turn the other cheek” seemed less persuasive than the vengeful Old Testament “eye for an eye, tooth for a tooth,” especially those moments when considering a response to those who would harm you and your loved ones.
As I passed by a shuttered health clinic, with its cheerful public health posters pitching good nutrition and prenatal care to none but the shadowy street signs and impassive cars lined along the deserted street, my mind drifted back again to some of my own patients. I reflected on how I read the poems and stories and letters that many of my patients wrote in the days after the 9/11 attacks; what once had seemed to me pure expressions of mourning and grief, natural attempts to narrate those terrible events and thus make them somehow human, suddenly seemed much more complicated. Poetry, and other acts of language, I seemed to have learned, were not simply advertisements for compassion. Poetry was not, and perhaps should never be, an infallibly inerrant gesture toward mutual care and comfort. Even if on some level the poems I personally most loved were deeply humane, perhaps calling attention to them as emblems of fundamental human goodness was wrongly expedient. Perhaps such poems sought to imprint their pain on us all, to demand that all of us bear the burden of what then could become a more manageable collective despair.
Or perhaps, on the contrary, such poems sought instead to displace the horror entirely with a representation that was easier to comprehend—to keep grief at a safe distance, or to project it on a screen to create a kind of beauty from it, the way the silvery moonlight was making the squat, circa 1970 brick apartment buildings around me seem strangely lovely. I thought of my mostly indifferently received efforts to introduce poetry and other literary writing to medical students, which I had hoped would model alternative responses to the unending traumas they would encounter—the inevitable deaths and irresolvable social ills. But perhaps my skeptical colleagues were right, and all these students could learn, if anything relating to empathy was even teachable, was to ape such humane responses and thereby feel complacent in having mastered another aspect of medicine, as it if were something they might later be tested on for their board exams.
I recalled one particular class discussion, for which I had assigned Virginia Woolf’s essay “On Being Ill” together with Audre Lorde’s “The Transformation of Silence into Language and Action” (the first chapter in her book The Cancer Journals). A few of the students had argued listlessly about these two works. One group praised what they saw as Woolf’s tour-de-force of language and metaphoric translation of suffering into witnessing, and derided Lorde for her perceived alienating stridency. A pair of female students defended what they regarded as Lorde’s rousing and courageous call to empathy for the suffering and grief of cancer patients across diverse identities, while criticizing Woolf for intellectualizing and prettifying the raw experience of illness. Yet another camp, the largest of the three, chided both authors for crying out so shamelessly about what they viewed as the intensely private and idiosyncratic experience of suffering, which sounded to me like a well-honed refusal of the call to witness, regardless of the form. The majority of the students remained totally silent, presumably because they hadn’t done the assigned reading in the first place. A few of them rolled their eyes.
As I led the desultory discussion, I had to wonder whether public language such as Lorde’s and Woolf’s really mostly served to construct a monument from anguish itself, so that it could then be viewed more objectively. Once mastered in this way, grief could become a mere topic of debate such as ours, something that one might teach rather abstractly in a classroom—a process that risked diminishing unimaginable pain to a photocopy of a few pages from an out-of-print book which a busy medical student could toss in the trash. Recalling the mostly blank expressions of my group of young gene sequencers and budding epidemiologists, I had to consider whether it served any relevant purpose at all, amid what ultimately seemed such a disheartening failure of engagement with two such powerfully lyrical writers.
Perhaps, I mused finally as an impatient wind rose up around me, the best that poetry can do is to contain, for some of us, our emotions. Perhaps, in this way, it could leave a record, a kind of document that some might cast aside but that others might encounter with relief, and hope, and gratitude. I remembered the way my grandmother’s abiding grief over her loss of her Cuban homeland had seemed tamed by the beautiful old Cuban songs she was always singing or humming, and how those songs seemed the only connection to my irretrievably lost homeland, to which I was told we could never return. I remembered how much I craved those melodies and would beg her to sing them to me (and how much I still miss them, how they seemed to sustain her voice, even as it drowned years ago in heart failure).
I began to hum myself, the chords of “Perfidia” arising in me unconsciously, consoling me in my loneliness and fear as I realized I was utterly lost again, this time more immediately in an unfamiliar neighborhood. Distant shouting followed by the piercing wail of a car alarm unnerved me. While I hoped that the music in my head might somehow help me to find my way back home, I also knew it could never really protect me.