Can fairy tales and poetry help us heal?

#MedHumChat №1

Every fourth day in the ICU, I stayed on through night, caring for patients until the sun came up again. Perhaps by some effect of darkness, or the cognitive distortion wrought by exhaustion, it seemed the greatest tragedies struck during those long nights. Three deaths that month left me grief stricken. I hadn’t known these patients well—each was teetering on unconsciousness when we met. But in each case, I had had to tell their family members that we couldn’t fix their broken bodies.

Sleep-deprived to the point of delirium, I would stumble home, get into bed, and sob in my husbands arms. My recollection of this grief is that it lacked particulars. It was grief at the human condition, at death itself.

Weeks after that ICU rotation ended, those nights in the ICU still rested heavily on my heart. I turned to a collection of poetry by Mary Oliver, and stumbled upon a poem called “The Rabbit.”

This haunting poem is about a dead rabbit, decaying in the elements. The narrator longs for the rabbit to heal, to see him “leaping in the moonlight.” In beholding him, her own woundedness is apparent. Nature is cruelly unconcerned: “the rain… won’t help / the wind… can’t seem to do a thing.” Though her hands are “like fire,” she brings herself to bury his open, boiling body. The next day, she finds a bird’s nest made of his fur.

Sitting up in bed, alarm set for clinic early the next morning, I read this poem some dozen times. It was the interruption in the final two stanzas—“Are you listening, death?”—that I most needed. The fur of the rabbit woven into the chicks’ nest is defiance against death.

Reading stories and poetry helps me make sense of the seemingly senseless suffering and heartbreak I witness daily as a doctor. In sharing poetry with fellow resident physicians I’ve found I’m not alone in this. Stories and poetry foster personal reflection, deepened empathy, and when shared with others, a sense of community. Words have healing powers.

This year, I’m trying something new: bringing my love for stories and poetry in medicine to a Twitter chat that I’m calling Medical Humanities Chat, or #medhumchat. Each chat is guided reflection around a few short texts. After the chat, I’ll share the readings, questions, and a few comments from participants here. These blog posts will function as discussion guides that anyone, anywhere can use to foster reflection, empathy and connection in healthcare. It’s #FOAMed (free open access medical education) for the medical humanities.

#MedHumChat №1 | January 2nd, 2019

Theme: medical humanities, an introduction

Poetry: Intensive Care by Jane O Wayne

A loved one is critically ill and sedated in the ICU. The narrator communicates her the uncertainty and endless waiting through the metaphor of a ship out at sea.

Prose: Practicing Medicine Can be Grimm Work by Valerie Gribben

A young woman loves fairy tales, but when she goes to medical school, she leaves these stories behind, focusing instead on biochemistry and anatomy. When she enters the hospital, she realizes fairy tales had taught her far more about medicine than she had realized.

Take a few minutes to read the texts and then return to the questions. You might try writing down your responses, as writing forces us to slow down and reflect.

Question 1: How did you react to Wayne’s poem? What did it stir up in you?

Question 2: Wayne uses a metaphor of a ship lost at sea. What does the metaphor capture that an objective, medical description of the ICU would miss?

Question 3: How do you interpret the title of the poem, Intensive Care?

Question 4: How did you react to the essay by Dr. Gribben? Did it resonate with your experience?

Question 5: Dr. Gribben left her fairy tales behind when she went to medical school. What parts of yourself have you left behind when entering the hospital or clinic? As a patient? As a family member? As a clinician?

“But when I started medical school… I reordered my bookshelf, moving my well-thumbed but now irrelevant Brothers Grimm stories behind a biochemistry textbook.” —Dr. Valerie Gribben

Question 6: The gritty details in this essay are what make it so haunting, so powerful. Which specific descriptions captivated you?

“Fairy tales are, at their core, heightened portrayals of human nature, revealing, as the glare of injury and illness does, the underbelly of mankind. Both fairy tales and medical charts chronicle the bizarre, the unfair, the tragic.” — Dr. Valerie Gribben

#ThisIsOurLane is a reference to physician advocacy against gun violence

Question 7: Dr. Gribben returns to stories as a way of coping and making sense out of suffering and tragedy. Have stories helped you make sense of your experiences with illness and healthcare? How so?

“But what happens when the door to Bluebeard’s horror chamber opens, and the bloody secrets spill onto your aseptic field of study? How do you process the pain of your patients?

I found my way back to stories.” -Dr. Valerie Gribben

Huge thanks to Nick McKenzie for helping to get the #medhumchat blog started, and to all the participants.

I hope you’ll join me for the next @medhumchat!