Book Review

The Healing Art: A Doctor's Black Bag of Poetry

N Engl J Med 2003; 349:2576-2577December 25, 2003

Article

The Healing Art: A Doctor's Black Bag of Poetry
By Rafael Campo. 209 pp. New York, Norton, 2003. $22.95. ISBN: 0-393-05727-5

Painting is silent poetry, and poetry is painting with the gift of speech.

Simonides, 556–468 B.C.

Other physicians who are writers provoke readers with dramatic scenes from the vantage point of the bedside, but Rafael Campo uses a palette of poetry to provoke the reader to philosophical, even existential thoughts about the ways in which illness and death define human experience.

With poetry by accomplished poets — Marilyn Hacker, Alicia Suskin Ostriker, Lucia Perillo, and William Carlos Williams, among others — Campo, himself a poet, constructs the basic tenet of his book, that “curing and healing are not the same, and it is possible to achieve the latter without succeeding in the former.” Poetry is his means to those ends.

Campo signals his intent in the story of “Daniel,” a depressed and suicidal patient who did not respond to psychotherapy or treatment with antidepressant drugs. After trying, and failing, to commit suicide, Daniel appeared in Campo's office with a bundle of poems that recounted sexual abuse by a priest and the humiliation and pain that rendered Daniel unable to mention this dreadful experience. Poetry, however, released him, brought him joy, and gained him freedom. Campo observes that, for Daniel, “his poetry seems in retrospect like a prerequisite, fundamental condition to his healing, because without it, his abuse experience almost surely would have remained unaccounted for, unmarked, as though it never happened, leaving only his intractable symptoms in its place.”

In this book, both patients and practitioners use poetry to heal the “disease” caused by physiological and sociological illnesses and “the postmodern deconstruction of the body and community.” Narrative provides more than a bridge between patient and doctor; it is also a diagnostic and therapeutic tool. Carried in the black bag, it is part of the physical examination, an internal ultrasound. Campo writes that “poetry locates us inside the experience of illness, demanding that we consider it from within, as attentively as we do from without.”

Campo presents and palpates poems as he might present the symptoms and palpate the body of a patient during teaching rounds. He teaches how to feel the pulse of the meter or elicit the reflex of the metaphor, all the while keeping his refractory light focused on humanity and, sometimes, questioning the humaneness of it all. This book may serve as the course in great poetry one missed in college. Campo offers remarkable insights and interpretations as he places the phonographic needle on the page, playing each poem like a symphony.

Tory Dent, a poet and a patient who has human immunodeficiency virus infection, writes of her experience in the doctor's office in “Apology to the Doctor”:

The two leather chairs of community and isolation: / the desire to heal — a drilling for water; a searching for the doctor.

The body a given, a gift, a limitation, also a mystery / of which there be no end to the cruel suspensions of its mystery.

Over my interiority as if, paradoxically, outside myself / how powerful am I, Doctor? You who know and do not know the body,

how powerful are we? . . .

It is not surprising that the sharing of poems by patient and physician nurtures the relation between creative self-expression and healing. Unfortunately, the reality of today's 15-minute office visits with patients may preclude such exchanges. Nevertheless, reading this book is an experience in and of itself. The book offers a reflective moment similar to what one might feel while sitting in a place of worship. It is an afternoon by a waterfall or at the sea's edge for the busy practitioner, in which to stop and listen to the rhythms of life.

Of “Famine Relief,” by Marilyn Krysl, about feeding a starving girl in Calcutta, India, Campo writes, “We see laid bare in poetry the complex intersection of biological and cultural forces; in the face of the most profound physiologic deprivation, the delicious mystical sustenance of empathy abounds.”

Explain, please, this wonder, this / creaturous pleasure,

this ruby of feeling / while I feed another being: tell me why

when Hasina opens her mouth, / it's as though the world in its entirety

opens, the lotus of the Buddha unfolding / its jewel. Veil of skin, draped over

bone: Hasina's fourteen, so thin / she can't walk, sit up,

hold a cup. Eyes a single beam / scanning for food, even when

she's full. She's the mouth / of the soul. . . .

Campo invites readers to take part in this therapeutic dance of words. The reader may feel an urge to recite or reread a favorite poem. He writes, “Let us pull ourselves away from validating science, and open our minds to the music of the poets themselves.” Campo acknowledges that even the best iambic pentameter cannot replace important medications such as pegylated interferon for his patients with hepatitis C. But he believes that poetry serves where medicine remains notoriously inept, as in exploring and accepting death, “the greatest human drama of all.”

Audre Lorde, an activist for social justice who died of breast cancer in 1992, wrote in “A Song for Many Movements”:

Nobody wants to die on the way / caught between ghosts of whiteness / and the real water

none of us wanted to leave / our bones / on the way to salvation . . .

Campo uses Lorde's poem to conclude that “in poetry, that most valuable effort against the dark, we might all just live and love forever.”

Campo successfully weaves such threads of philosophy and psychotherapy into his reflections on patients and society. His is a gallant mission, to use poetry to “reclaim medicine as the art it truly remains” — a healing art.

Teresa L. Schraeder, M.D.
Editorial Fellow,