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The cancer surgeon incorporates poetry into medical training, recognizing the individuality of each patient.
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The cancer surgeon incorporates poetry into medical training, recognizing the individuality of each patient.

I

In a typical lecture hall on a rainy Monday afternoon, Cândida Pereira is energetically discussing a poem by Vasco Graça Moura, a politician-poet from Portugal. Her classmates are attentive as the second-year university student talks about the structure of the poem, the poetic voice, and Moura’s use of “perceptual imagery” and “sensual tone”. This is a common topic for a poetry course, but once the class is over, Pereira will put away her well-read poetry book and switch to studying textbooks on neuroanatomy and pharmacology. Pereira, who is 19 years old, is one of about 20 aspiring doctors at Porto University’s medical school who have chosen to take a new elective course on the basics of contemporary poetry.

In the current healthcare culture focused on transactions, taking initiative to prioritize people-centered care and a doctor’s personal approach is significant. According to João Luís Barreto Guimarães, the creator of the course, poetry has the ability to help students connect with their future patients on a holistic level, rather than simply viewing them as a medical issue to be solved.

He explains that he encourages them to read poems that discuss qualities such as empathy, compassion, and solidarity, which are important values for doctors to embody when interacting with patients.

56-year-old Guimarães is a breast cancer surgeon who graduated from the university’s medical department. He has been practicing for 30 years and also enjoys writing poetry at home when he is not performing surgeries. He has published 10 collections of poems and was honored with Portugal’s Pessoa prize in 2022 for his artistic contributions.

At first glance, his two main interests may seem unrelated. However, when searching for a direct connection, he often resorts to using metaphors. For instance, he compares editing by removing words to removing a tumor with a scalpel.

The course structure is fairly traditional, covering fundamental topics such as imagery, sound, tone, and rhythm. However, keeping his audience in mind, Guimarães carefully selected poems from Bloodaxe Books, a British poetry publisher, to ensure that each class includes several poems related to medicine. The reading list for the course includes notable poet-physicians such as Júlio Dinis (a Portuguese surgeon), William Carlos Williams (an American pediatrician), Gottfried Benn (a German pathologist), and Miroslav Holub (a Czech immunologist). Guimarães admits that the course’s main purpose is often not very subtle. Poems about doctor-patient interactions or familiar healthcare settings provide an easy connection to students’ everyday studies.

Let’s look at the poem Names by Wendy Cope, which is mentioned in a module discussing how human bodies are portrayed in poetry. The brief poem, consisting of only one stanza, tells the story of a woman named Eliza Lily who goes by various names such as Lil, my darling, Mrs Hand, and Nanna. However, when she is hospitalized towards the end of her life and has no friends or loved ones with her, the medical staff only know her by the information in her medical records. As the poignant ending of Cope’s poem states: “For those final weeks of confusion / She was once again known as Eliza.”

The main point is to keep in mind the individual behind the patient, according to Guimarães. In today’s busy medical field, doctors may not have the chance to pause and reflect, causing everything to become focused on technical and mechanical aspects. Guimarães emphasizes to students that each patient is like a poem, with their own distinct qualities.

Likewise, the courses can facilitate discussions about the intense emotions that come with being a physician and assist students in contemplating ways to manage the demands of the job. For example, John Stone’s poem “Talking to the Family” presents students with a brief yet powerful glimpse into the agony, disorientation, and tension that accompany the difficult but necessary duty of delivering negative news.

“I will inform them.”

They will assemble it.

Disassemble it.
They will have a buzzing sound.
The cut ends of their nerves
will curl.
and put it on

I will remove the coat and then put it back on.
drive home,

Replace the lightbulb in the hallway.

Guimarães’s teaching does not just stick to the most accomplished poets. In particular, he is a keen advocate of exposing students to the “evils” of excessive sentimentalism; a habit he is adamant they should avoid once they hit the wards. Nor does the course avoid poetry of a more abstract or complex nature, something he sees as an invaluable vehicle for elucidating the capacity of speech to hide as well as reveal.

According to the author, it is not only poets who use clever language and literary techniques to hide their true intentions. Patients also often do this out of fear, mistrust, or shame, as seen in the example of a doctor asking about alcohol consumption. The author believes that skilled doctors are able to interpret the underlying meaning behind these disguised messages. In their classes, the author discusses the concept of decoding, as many poets use illusions, symbolism, or enigmas to convey their message in a covert manner.

In his writing, Guimarães mentions his own poem, História Clínica (Clinical History), in relation to this topic. Although it appears to focus on a woman’s double mastectomy, there is a deeper story about her experience with domestic abuse. The poem plays with the dual meaning of the Portuguese word medalha, which can refer to a “medal” (representing the woman’s breasts) or, less commonly, “bruising” (connected to her husband’s negative behavior). This ambiguity continues until the final line, which is heart-wrenching. The woman is now cancer-free due to the surgery, but her husband leaves her as a result of losing her breasts. In the end, Guimarães’s poem concludes with the woman being livre de perigo (“free of danger”).

After starting the course, Guimarães has received multiple inquiries to teach at different medical schools in Portugal. He is not the only one, as Pompeu Fabra University in Barcelona has also recently implemented a literature course for their second-year medical students. Cândida Pereira agrees with the interest in this idea. She believes that like poets, doctors should be emotionally connected. However, she also believes that doctors have the added responsibility of being emotionally aware of their patients.

Source: theguardian.com