Surrounded by pain, doctors turn to poetry, writing to cope with loss

MINNEAPOLIS — The details of the day have not left Dr. Michael Shreve, even after a decade: The blood gurgling into his infant patient’s lungs. The medications he sprayed to try to stop the bleeding. The manual pump he used to keep baby Rose breathing until her family came to say goodbye.

Rose died that day, and Shreve felt utterly helpless. “I did nothing for this child,” he said. “I did nothing for this family.”

Years later, he poured that day into a poem, memorializing Rose in verse: “Red returns/ Heart rate stumbles/ Monitors warn/ Tiny lungs stiffen/ Too much.”

Shreve, a pediatric pulmonologist in St. Paul, Minn., is not alone in turning to poetry to help him cope with the emotional burden of work as a physician. So many health care professionals write verse that it has become its own genre, with distinct literary journals and prizes. Monday is the deadline for one such competition, the international Hippocrates Prize, which honors amateur poetry about medical subjects, with a special category for verse written by employees of the United Kingdom’s National Health Service.

In the US, the flagship publication for fiction writing about medicine is the Bellevue Literary Review, founded in 2000 by physicians with offices in the country’s oldest public hospital. The journal receives so many submissions, it has a lower acceptance rate than the New England Journal of Medicine.

The genre has blossomed as doctors have become more comfortable acknowledging their humanity and vulnerability through prose, said Dr. Paul Gross, the founder and editor in chief of the online journal Pulse, which carries the tagline “voices from the heart of medicine.”

Doctors deal with so many difficult situations each day, Gross said. “How do you process it? And how do you remain whole as a person?” Writing helps them work through those issues by forcing reflection, said Gross, who also teaches in the family medicine department at the Albert Einstein College of Medicine.

Dr. Danielle Ofri, the editor in chief of the Bellevue Literary Review, said writing can allow doctors to slow down and revisit situations that seemed to race by in the moment.

As a resident, Ofri barely got a break. “A patient died, and the bed was filled in 30 minutes,” she said. But when she wrote, she could slow things down.

“You can stretch time in the past. You can speed up time. You can reframe it,” said Ofri, an associate professor at New York University’s School of Medicine. “You couldn’t change what happened, but there are so many ways in which one can write about it.”

For Dr. Marilyn Mellor, a retired emergency pediatrician who lives in a suburb of Minneapolis, poetry is a chance to remember the lives she couldn’t save, such as that of a baby born four months premature:

600 grams of baby,
           a little more than a can
           of soda in weight,
delivered in a bathtub
           by wide-eyed medics.

The baby died seven hours after arriving at the hospital.

Mellor also wrote of another patient:

Sapphire,
why did you stop breathing
at nap time?

Did you forget
its simple rhythm
or did you follow whispers
about a place free from sorrow?

“It’s so hard when a child dies in the ER,” Mellor said. “And she was so beautiful. She was one of the most beautiful babies I have ever seen.”

Both Mellor and Shreve have been writing for many years. Mellor holds a master’s in fine arts and recently published a short book of poems; Shreve took a handful of writing classes in college and keeps notebooks of handwritten ideas. He comes from a literary family, too: His sister, Ginny, was nominated last year for a Pushcart Prize, a prestigious literary award, and a bar in Bozeman, Mont., hosts a baseball-themed poetry reading named after his late brother.

After Rose died, Shreve jotted down some of his thoughts in one of his notebooks. About a decade later, he saw a notice in the professional journal Minnesota Medicine for a poetry contest — and decided to write about Rose.

The poem was inspired in part by a card he received from Rose’s parents soon after her death.

“Thank you for saving my baby’s life so I could hold her when she went to heaven,” the card began.

That note helped Shreve realize that even though he’d felt like a failure in that case, he had helped the family by keeping Rose alive long enough for them to say goodbye. He came to accept the fact that he did not have control over Rose’s life.

“You think you are about to be in control,” Shreve said. “That’s what you want to be. But you realize what you really are is spending a lot of time just picking up the pieces.”

Poetry is one way Shreve has found to express that feeling. The poem “Rose” ends:

In her mother’s arms now
Comforted, comfortable
My turn ends
Slip out unnoticed

“…when she went to heaven.”