Having the diabetes

Getting a handle on this diabetes thing is no joke mate

it’s as slippery as a bloody eel, or a big pot of boiled brisket.

Sure, you can take away those cakes and biscuits and crap

I’d rather have a tin of peaches any day. What? But it’s fruit, man!

I don’t think eating too much of that rabbit food

can do a bloke much good either – don’t know how

the cattle eat all that green stuff and still put on the beef.

Must have a different kind of guts somehow.

Pretty astonishing to be told that spuds and bread get turned

into sugar inside the belly. Find that one hard to swallow, eh!

Give away the fizzies? Yeah, fair enough, they’re just lolly water

but the beer’s a different story, eh – like an uncle who

puts an arm across your shoulders when you’re taking things hard.

He asks no dumb questions. Yeah, the beer’s family, it’s gotta stay.

Hey, if these pills are any good, can’t they take care of it all

and let me get on with normal life? Why pay twice?

I really don’t know about this diabetes fella, who gate crashed

my life and looks like he’ll never leave. Does a bloke’s head in.

Poetry and Medicine VII: Sarah Broom

Hospital Property

Because I am alone in this cold room,

because the Siemens Somatom EmotionDuo

CT scanner is about to talk to me again

and tell me, of all things, to breathe normally,

because I cannot hear right now the wind

in the pines just behind the beach, the way

it runs at night so high above your head,

because my gown says HOSPITAL PROPERTY

all over, and because someone said

BUT WE CAN GIVE YOU TIME

and someone else said WELL, YOU SEE,

IT’S NOT MY KIND OF CANCER,

and because just one fist, held close enough,

was enough to block out the light

from the giant white window where the traffic

kept travelling over and over the bridge,

and because they stuck my heart

to its lining and my lung to its lining

to stop up the gaps, and because right now

I cannot hear the wind as it probes

the gaps in the roof, rattles the corrugated

iron, and because I am about to move again,

to look at the red light circling, to be told

again to take a deep breath, again

to breathe normally, because of all this

I am not quite the same as I used to be.

No, but wait. Watch what happens now.

Sarah Broom, from Tigers at Awhitu, Auckland University Press.

Sarah Broom was emerging as a talented poet and literary academic when she was diagnosed with an incurable cancer during her third pregnancy.

Poetry can be taut and philosophical, it can be beautifully lyrical, it can be witty and amusing even as it addresses issues such as ageing. By contrast, I find this poem, Hospital Property, gut-wrenchingly moving.

The narrator is alone and cold, the huge machine mesmerising as it goes through its programmed routines, dehumanising even as it talks to her, telling her to breathe normally, unaware of the irony when it is her lungs that are invaded with tumour. She longs for the comforting sound of wind in the pines, wind rattling the roof, the freedom of air movement that wind represents.

What does the ability of one fist, held close, to block out the light, mean to the narrator in this poem? A simple observation to pass the time in hospital, or the menacing symbolism of a fist held close to the face, the threat of light being extinguished? When our patients use language like that to describe their symptoms, their fears, it is so easy for us to miss the emotional punch behind the words – to not appreciate the possible meaning of those words to the patient in our quest to extract our own meaning from the ‘history’ we are being told.

Then there are the words that so casually spill from our mouths as doctors, stamped in capital letters into our patients’ minds and memories. BUT WE CAN GIVE YOU TIME. Sentences which may be revisited and reinterpreted and repeated to family, and come to form in their own way part of the sentence that follows the verdict.

Sarah concludes this free-flowing poem with an awareness that she is not quite the same as she used to be, and a curiosity as to what will happen next. Writing a poem enables the writer to step outside the storm of events which have engulfed her, to reflect and find meaning and temporarily occupy an observer’s seat.

Poetry and Medicine VI: Emily Dickinson

Tell all the truth but tell it slant –

Tell all the truth but tell it slant –

Success in Circuit lies

Too bright for our infirm Delight

The Truth’s superb surprise

As Lightning to the Children eased

With Explanation kind

The Truth must dazzle gradually

Or every man be blind –

Emily Dickinson

The 19th Century language in this poem appears quaint to us now, as does the liberal use of capital letters, but a careful reading of this poem reveals a very interesting point of view which comes into focus in the last two lines.

Note the classic rhyming pattern at the end of every second line, but also the internal rhyming of “bright,” “Delight,” and “Lightning,” best appreciated when the poem is read aloud. Don’t be bothered by the use of “every man” to mean all humanity – that was a convention of the era in which Emily Dickinson lived.

Throughout the history of thought and language, there runs a pervasive metaphor linking truth and light. Light is revealing, both of what we were seeking and also the streaks of dirt and imperfections which we would rather not be made aware of.

Dickinson does not use the word ‘light’ in this poem, but many references to this metaphor run through it.

In some ways, this instructional poem reads like a little sermon or lecture, urging the reader to tell the whole truth but to do so kindly, from an angle (slant), and to dazzle gradually. Most, if not all, of our cultural traditions contain parables and allegories and fables – colourful stories which contain a truth, but which tell that truth on the slant, making them more palatable as well as memorable.

Always tell the truth. That was a core principle in my upbringing. But when breaking bad news to a patient, for instance, how can we know how much of the truth to tell up front? Some patients ask for the worst-case scenario, others initially retreat into a protective cocoon of denial. That is where the principles and skills of a patient/whanau-centred approach to consultations are so important – to be constantly seeking and responsive to the words and unspoken cues from the patient.

The key message I take from this short poem is that it can take time for the iris of the soul’s eye to accommodate to the sudden glare of truth, and in medical practice it is helpful to be aware of this.

It is still however, the truth we are communicating “With Explanation kind,” not some falsity or obfuscation arising from a misguided desire to avoid causing any distress.

This essay was originally published in NZ Doctor, 2022.