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.

Poetry and Medicine V: Rachel McAlpine

New Zealand writer and poet, Rachel McAlpine, recently celebrated her 80th birthday by publishing a book of poems, How to be Old.

Here’s one of my favourites from this collection, reproduced with Rachel’s blessing.

Getting old is not like getting pregnant

Preparing for old age is scary

scarier than getting pregnant

twenty thousand miles from home.

Now my body has to face

the prospect of extreme old age.

What scares me most is the unknown

and so I study hard. But hey

old age is not like pregnancy.

I’m carrying a void

and when I say I’m getting old,

nobody says to me, How lovely!

Congratulations!

Is this your first old age?

When is it due?

Oh no, they tell me,

you’re not old.

You’ll never be old.

It’s all in the mind.

Age is just a number.

Try homeopathy.

Note the sweet-sour flavours here! I love the way the poet has poignantly blended the scariness of ageing with humour.

What scares her most is the unknown. But she is also a keen observer of other people’s responses and comments, including the tendency of others to minimise the reality of her experience, in an attempt to be reassuring. ‘Oh no, they tell me, you’re not old, you’ll never be old…age is just a number.’ Rachel McAlpine is an astute listener, capturing commonly heard expressions, yet she does not feel well heard herself, when she dares to tell people she is getting old, and how scary that can be.

Poems vary tremendously in style and technique. Some make powerful use of metaphor, some produce a musicality from rhythm and repetition of sounds, but this very accessible poem takes strength from using everyday language to bring together two contrasting aspects of the human life cycle – pregnancy and ageing. This is reminiscent of James Baxter’s lines, discussed in a previous article: “Alone we are born/ And die alone.”

I read the last line of this poem, “Try homeopathy”, as an indirect way of stating that there is no cure for growing old, representative of a range of responses from others which are well meaning but futile.

That is where it ends, on an amusing note. It is one of the techniques of poetry to address a heavy theme with sufficient levity to keep the reader engaged, and in this case to leave them pondering their own mortality while demonstrating that it can still be approached with a sense of fun.

This essay was originally published in NZ Doctor, 2022.

Poetry and Medicine III: James K. Baxter

High Country Weather

Alone we are born

And die alone;

Yet see the red-gold cirrus

Over snow mountain shine.

Upon the upland road

Ride easy, stranger:

Surrender to the sky

Your heart of anger.

This is one of my favourite poems by New Zealand poet, James K. Baxter. It is short and compact, selecting a few powerful images for the reader to reflect on, and in doing so it conveys both beauty and truth about the human condition.

At one level, we may want to challenge the statement that alone we are born, and die alone, citing our own examples of these pivotal moments in life being wrapped in a loving family. Yet as a poet, Baxter is stripping away some of the trappings surrounding birth and death in order to highlight in a few words that there is an essential alone-ness in the arrival and departure which book-ends our lives.

Suddenly, the poem switches from this introspective mood to draw us out into a mindful awareness of the beauty in the world around. Instead of talking in prosaic generalisations about mindfulness being an awareness of the present moment as we experience it through our senses in an attitude of non-judgemental acceptance, Baxter presents us with one breath-taking example. We leap from morbid thoughts to a magnificent reminder of how wonderful the natural world can be if we open our eyes to it.

In the second stanza, the poet or the narrator of this poem addresses the reader as a stranger riding an upland road. Describing the road as upland, with mention of a mountain in the previous line, suggests effort is required, yet this stranger is encouraged to ride easy. With another dramatic leap, Baxter urges the reader/rider to surrender to the sky their heart of anger.

Reading this as doctors, we may want a more detailed history, more explanation of the background and context. But ambiguity in poetry creates space for the reader to respond to the written lines in whatever way they resonate. We may acknowledge that anger is a burden we carry that makes the journey harder, or we may identify more closely with other related concepts such as resentment or frustration or finding it difficult to reach forgiveness. Similarly, within the consultation, allowing space for the patient to respond to what has been said creates the opportunity for the patient to relate the generality of the conversation to their particular need and circumstances.

Letting go, no longer fighting, is portrayed in the poem as surrender to the sky, but here the sky may be a metaphor for the natural world, or for a God or other symbol of the faith and values held dear to the reader. Once again, metaphor permits a range of responses in the reader, which encourages a personalised interpretation.

This essay was originally published in NZ Doctor, 2022.