Poetry and Medicine XVI: Sarah Broom

There is only so much I can do, and must let go of the rest.

This poem is from NZ poet Sarah Broom’s second collection, Gleam, published by AUP.

I love a poem like this, short and simple, yet carrying far more weight on its shoulders than is apparent at first glance.

Of Necessity

This many birds

I will protect and nurture

and the rest I will release

to the wind.

This much earth

I will dig and water

and the rest I will abandon

to the sun.

This much sand

I will hold fast

and the rest I will cede

to the tumbling sea.

At the time she wrote this poem, Sarah had three young children and a cancer in her lungs.

The setting here of the outdoors, and the imagery of birds, wind and sea recur in many of her poems, with the Awhitu peninsula being of special spiritual significance – a place of retreat for reflection and renewal.

There is symmetry and form in this poem, not from rhyme or even line length, but from repeated words, themes and elements in common between corresponding lines in each of the three stanzas.

The theme that comes through most strongly for me is abandoning to the forces of nature, that which one instinctively seeks to protect. Abandonment of necessity, as the title makes clear. There is only so much that one can do, that one can nurture and hold onto, and of necessity the rest will have to take its chances in the world, at the mercy of forces represented by wind, sun and sea.

I sense here Sarah being acutely aware of her diminishing strength and of the uncertain time remaining, yet yearning to keep writing and spending time with family, among other goals. She is forced to prioritise. In the final stanza, the sand she holds onto seems to represent time trickling through her fingers. The last line describes the sea as a tumbling sea, evoking turbulence, a disrupting force that upends our lives and hopes.

Sarah could have written an essay reflecting on the tough choices forced on her by her illness, on the necessity to prioritise, but the images or word pictures she has created in this poem are an art more vivid to the reader.

As doctors, the constraints within which we practise, the need for us to prioritise and to accept the gap between what we long to achieve for our patients and that which we have to settle for, makes this poem very relatable.

Poetry and Medicine XV: Haiku

Haiku to capture a moment

Haiku are like snapshot pics to the video of a longer poem.

They are a great place to start when getting into writing poems, but there is more depth to haiku than first impressions.

she is an album

each time she visits she shows

me one more photo

This haiku demonstrates the classic structure of three non-rhyming lines, with five syllables in the first line, then seven and five syllables. A haiku does not have a title, but can be referred to by its first line.

Haiku should conjure a picture in the mind of the reader, traditionally one from nature, but in recent times social scenes are common subjects. Here the metaphor is of a patient or person represented by a photo album, and the doctor slowly getting to know her, one visit at a time.

when are you due

I ask she’s not

rapport aborted

Contemporary haiku often break away from the 5-7-5 syllable convention, but they must never be longer than 17 syllables. Also, they often dispense with punctuation marks and capital letters – in this haiku, the question mark is unnecessary, and the long gap in the middle of the second line conveys a pause, an embarrassed silence! I wonder how many of you have also been in this situation?

The picture is one of a misdiagnosed tummy, the theme is extreme embarrassment, and the use of the word ‘aborted’ to describe the loss of rapport, not only echoes the sounds in that word but also relates to early pregnancy.

masked depression

conspires with my sob conscious

prejudices

When this haiku formed in my head during a morning jog, I was thinking of both patient and doctor factors contributing to depression or emotional distress being missed as a diagnosis. I meant subconscious prejudice or bias, but when putting it on the computer today, I made a typo error. As I was about to correct it, I paused long enough to realise that one prejudice that can lead to a missed diagnosis, is the assumption that depression comes with tears, with sobbing. I hope that a reader will see both meanings in these words. Ambiguity, allowing a reader to discover more than one layer of meaning, is a common device in poetry.

the patient need waits

with bare feet and shod soul

for the space between

What do you see in this picture? I see a needy patient waiting patiently for a pause in the consultation, waiting for the doctor to stop talking long enough to speak from the heart. Note the gap between need and waits, suggesting a pause in time or a brief silence. The feet are bare, as in poverty, and instead the heart or soul is shod protectively.

Poetry and Medicine XIV: Rachel McAlpine

As if it was really simple!

After the Fall

After the bath with ragged towels

my Dad

would dry us very carefully;

six little wriggly girls,

each with foamy pigtails,

two rainy legs,

the invisible back we couldn’t reach,

a small wet heart and toes, ten each.

He dried us all

the way he gave the parish

Morning Prayer:

as if it was important,

as if God was fair,

as if it was really simple

if you would just be still

and bare.

Rachel McAlpine

New Zealand poet, Rachel McAlpine, recalls her childhood to capture a scene of fresh innocence, of joy and simplicity within the security of a loving family, with her vicar father carefully and earnestly drying his six young daughters after their bath.

The poem is in free form with irregular line length, but there is rhyme here to be discovered in unpredictable patterns. ‘Towels’, ‘girls’ and ‘pigtails’, followed by ‘reach’ rhyming with ‘each’ in the first stanza; ‘prayer’, ‘fair’ and ‘bare,’ and ‘simple’ paired with ‘still’ in the second stanza. But note that these lines that rhyme with each other are not consistently positioned within the poem, but they seem to wriggle around and end up in different places, like the girls. A more tightly structured and predictable format would be less well suited to the theme of this poem.

The picture the poem creates in our minds is delightfully cute, with wriggly girls and their foamy pigtails, but there is more depth to this poem than just cuteness.

The poem’s title refers to the creation story of Eve and Adam, where those first people were innocently unaware of their nakedness until disobedience and sin were said to enter the world, sometimes referred to as ‘the fall’ in Christian tradition.

When I read this poem I see us GPs in the girls’ father, as he tries to do his job very carefully, as if it is important and as if the world is fair.

The towels he is using are ragged, like many of the tools we use and the systems we work within.

He attends to the invisible backs, the areas of need our patients may not be aware of or able to reach themselves.

‘As if God was fair;’ speaks to me of the inequities in society, the unfairness of disparities in health outcomes.

‘If you would just be still…’ – surely it would be easier if the patient was more cooperative!

‘…and bare.’ Being bare suggests being open and transparent. It would make our jobs easier if every patient gave a straightforward history, telling it as it is, disclosing the abuse when asked, admitting when they’ve stopped using insulin.

Yes, our jobs could be so much simpler, yet I bet this vicar loved the task of drying his wriggly girls, as we still love caring for those patients who make our day more challenging.