A Prescription of Poetry To Help Patients Speak Their Minds

Doctors at several major hospitals are experimenting with poems as a source of psychological relief and connection. A Prescription of Poetry To Help Patients Speak Their Minds

Dr. Joshua Hauser approached the bedside of his patient, treatment in hand. But it wasn’t medicine he carried. It was a copy of a 19th-century poem titled “Invictus.”

It isn’t often that doctors do rounds with poetry. But Dr. Hauser, section chief of palliative care at the Jesse Brown VA Medical Center, and colleagues are testing it as part of a pilot study. He entered Mr. Askew’s room. The patient had asked for “Invictus,” a dark poem by William Ernest Henley that he remembered from his past.

Mr. Askew shielded his face with his hands as Dr. Hauser, leaning forward, slowly read the poem.

“I am the master of my fate, I am the captain of my soul,” the poem ends.

“Yes,” mumbled Mr. Askew, a 68-year-old who served as a Marine from 1969 to 1970 and was in the hospital for a broken collarbone and rib. He also suffers from metastatic prostate cancer.

The poem sparked a stream of consciousness from Mr. Askew. He talked about the Vietnam War, rich people, his deceased parents and, finally, his cancer. “I’m not gonna roll up in no ball and cry because I’ve got cancer. I’m just gonna keep going, keep moving. It is what it is,” he said.

“I’m not giving up. I’m tired, but it’s not the kind of tired where I’m giving up.”

Poetry may not be common in the medical setting. But more hospitals and medical schools are turning to the power of the written word, and poetry in particular, to help patients process their conditions and heal. The Northwestern doctors are studying whether it’s feasible for busy doctors to carve out time for poetry with inpatients. They’re examining how patients reflect on the process. They’re also interviewing patients after the reading to see if the poetry affects their quality of life and relationship with the physician.

Dr. Hauser says the poems often elicit patients’ memories about their youth or their parents, or reflections on their illness and mortality.

“By looking at a piece of text which has some uncertainty or ambiguity, I think they are able to reflect back on their illness in a way that direct questions might not get to,” Dr. Hauser says.

His team hopes to do a larger study and include other VA hospitals if it can secure funding.

Other hospitals around the U.S. are also using poetry. At Huntsman Cancer Institute in Salt Lake City, cancer patients can dictate poetry and reflective writing as they get chemotherapy.

At the Haslinger Pediatric Palliative Care Center at Akron Children’s Hospital in Ohio, the narrative medicine coordinator became a full-time job in May due to increasing requests for her services.

And at Beth Israel Deaconess Medical Center in Boston, Rafael Campo, an associate professor of medicine at Harvard Medical School and poetry section editor of the medical journal JAMA, holds writing workshops and poetry seminars with patients and staff.

“We don’t always have a cure in medicine, but poetry can actually heal in a broader sense, and so I think many patients feel healed even in the absence of a medical cure for their illness,” Dr. Campo says.

Dr. Hauser, an associate professor of medicine at Northwestern University Feinberg School of Medicine, says that poems often spark conversations that are more associative in nature, like the one with Mr. Askew.

For the study, Dr. Hauser and Nora Segar, another physician at the hospital, reached out to the Chicago-based Poetry Foundation. The nonprofit connected them to some local poets who helped curate three collections of poetry revolving around nature, Chicago and health.

Dr. Hauser and Dr. Segar have spent more than a year asking some of the patients in palliative care if they want to read poetry.

The pilot study consists of reading poetry with 22 patients to see if it’s feasible to incorporate it in the hospital setting and how long it takes. Now they will analyze transcripts of the sessions to see what topics arise when they read poems.

In addition to understanding its impact on patients, the doctors aim to see if reading poetry with patients has the potential to help alleviate doctor burnout. “This is a way of moving the clinician closer to their patients, being part of their experience and their world,” Dr. Hauser says.

Huntsman Cancer Institute writer-in-residence Susan Sample says that though she also works with other genres, poetry provides something special for patients.

“It’s like a different language,” says Dr. Sample, an assistant professor in medical ethics and humanities at the University of Utah. “I think that poetry works really well when people are writing about their innermost experiences, because those are experiences that are often unfamiliar, they are foreign.”

She visits cancer patients in the infusion suite when they receive chemotherapy. She gives them a writing prompt and then transcribes what the patient says. Often she reads the poem “Miracles” by Paul Hostovsky, which talks about letting something go, and she asks patients what they would let go of. She does similar work with inpatients at the hospital and does some home visits.

Right now she is working with a woman in her 70s with dementia who had breast cancer twice and was a computer engineer. “When I started, I would bring in pictures or just words,” Ms. Sample says. “She would start looking at those and they would prompt conversations. I would write down everything she said and then give it to her.”

The patient tells Ms. Sample she enjoys reading what she previously said because it helps her see how she thinks now. “She can critically look at her own writing and analyze her own thinking patterns, which is very amazing,” Ms. Sample says. “The more she reads about herself, she has more of a sense of self. She’s making memories now. Not recalling so much, but making new memories of herself that she can then draw on.”

At the Haslinger Pediatric Palliative Care center in Akron, narrative medicine coordinator Nicole Robinson says workshops and individual sessions typically involve reading and discussing a poem, as well as writing. “It provides patients and families and staff with the opportunity to see themselves in the poem,” she says. “And the poem can open up a space inside of them to access things maybe they didn’t have the language for.”

Brandon Johnson was the first patient Ms. Robinson saw at home. Mr. Johnson, now 23, has spinal muscular atrophy and has been a patient at the center for more than 10 years. “I kind of write about everything,” says Mr. Johnson from his hospital bed.

Due to his disease, Mr. Johnson can no longer move his arms, though he can type with his hands. He uses an electric wheelchair and depends on a ventilator to breathe. He is mostly immobile.

Mr. Johnson took two sessions in April to write a poem he calls “Scared.” He wrote the first stanza after he learned that a new treatment called Spinraza couldn’t be administered into his spinal fluid. The next day he wrote the second stanza of the poem, with each line responding to a line of fear from the first stanza.

“I love doing poetry. I really think it helps me kind of just process what’s going on in my life,” Mr. Johnson says. “With Nicole, I realized the healing process of poetry. It’s really helps me to find my way in life. Even when there’s been darkness, I’ve found light in poetry.”
A Patient’s Poem

Brandon Johnson wrote this poem, ‘Scared,’ while being treated for spinal muscular atrophy at the Haslinger Pediatric Palliative Care center in Akron, Ohio:

When I’m losing my strength, I’m scared

When I see my friends move forward with life, I’m scared

When I’m stuck in the same position as every day, I’m scared

When I see my mom cry, I’m scared

When I’m not feeling strong mentally, I’m scared

When I see my skeleton, I’m scared

When I think of my future, I’m scared

When I think of my loved ones’ futures without me, I’m scared

When you are loved, do not be scared

When you live in every second, do not be scared

When your body is unique, do not be scared

When you’re unsure of who you’re meant to be, do not be scared

When your loved ones worry for you, do not be scared

When you cannot move, do not be scared

When your friends move forward, be proud, do not be scared

Find your strength in music, art, and loved ones, do not be scared

Share Your Thoughts

Can you name a poem that helped you get through a difficult time? Join the conversation below. A Prescription of Poetry, A Prescription of Poetry, A Prescription of Poetry, A Prescription of Poetry, A Prescription of Poetry, A Prescription of Poetry



 

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