Recently, I had the opportunity to take a Saturday environmental writing workshop at the University of Washington’s wonderful Burke Museum. I signed up for it when I found out that our Washington State Poet Laureate Claudia Castro Luna was teaching a session. Two out of three of the sessions—including Luna’s—were centered around the practice of close observation. We were instructed to go outside the UW Observatory (coolest old building!), stand or sit in one place, observe and write down as many sensory details as possible for ten minutes. It was raining softly so I stood in the shelter of a doorway to conduct my observation. I was reminded of the truism that the art of paying attention comes through the practice of attention and close observation. These are essential skills for many aspects of life, and most definitely for the provision of good human-centered health care.
And yes, included in my observation and note-taking of details, was this sweet, tenacious dandelion stuck between a rock and a hard brick wall, yet managing to thrive and bloom. An apt metaphor for oh so many things. But dandelions were on my mind since I had just run across a historical document on Seattle pioneer Catherine Maynard. Catherine was second wife to our famous Doc Maynard and she was Seattle’s first official nurse. She is credited with introducing dandelions to the Seattle area. Dandelions were (and still are in certain circles) an important medicinal plant used to treat scurvy and other ailments.
After observing this dandelion, I wrote this poem. Happy Earth Day.
“come celebrate/with me that everyday/something has tried to kill me/and has failed.” Lucille Clifton, “won’t you celebrate with me” from Book of Light (Copper Canyon Press, 1993).
Poetry heals. Is it any surprise that at times of crisis, illness, grief—or joy and celebration—we turn to poetry to help express what straight word prose cannot?
I have been reminded of this over the past week while simultaneously holding the joy of a family milestone birthday with the sudden serious illness of a dear friend. I have been thrown into the arms of poetry.
Poetry heals. Our first responders are poets, as are artists of all kinds. Cherish our poets and artists. Their work is essential for our existence, for our survival. Listen up you curmudgeonly naysayers who proclaim that poet laureates of our cities, states, and nations are a waste of taxpayer dollars—that the money would be better spent on sweeping away our human waste, on filling the potholes in our roads. You too—but perhaps too late—will be thrown into the arms of poetry.
“There are times when people have experiences that don’t fit neatly into a storyline, a narrative of what happened. Especially within the context of trauma, suffering, and oppression, our ability to arrange bits together into a coherent narrative is overwhelmed. Yet these experiences, beyond the reach of narrative, can be formulated, conveyed, and communicated through metaphor, poetry, art, photography, and gesture.” (From my essay, “Witness: On Telling” in Intima: A Journal of Narrative Medicine, Fall 2017.)
I end this, as I began, with the words of Lucille Clifton. Here is a powerful video recording of her talking about and then reading her poem, “The Killing of the Trees.” In her opening statement, she says, “There seems to be very little reverence for life. I think there is a thing which bothers me about people not having reverence for life that doesn’t look like themselves. And I think that is a great mistake.” As a gifted poet, Clifton can “see it all with that one good eye.”
“Pause there while the sea lights a candle” Josephine Ensign/2018
“…when people say that poetry is a luxury, or an option, or for the educated middle classes, or that it shouldn’t be read in school because it is irrelevant, or any of the strange and stupid things that are said about poetry and its place in our lives, I suspect that the people doing the saying have had things pretty easy. A tough life needs a tough language—and that is what poetry is. That is what literature offers—a language powerful enough to say how it is. It isn’t a hiding place. It is a finding place.” p.40
This is one of my favorite quotes from one of my favorite authors, Jeanette Winterson, from her memoir (with one of the best titles ever) Why Be Happy When You Could Be Normal?(New York: Grove Press, 2011). The book’s title comes from an admonishment her abusive, Fundamentalist Christian adoptive mother frequently gave her growing up. Jeanette was frequently locked in a coal cellar and then locked out of her house by her mother (for being “sinful and gay”) before she ran away from home permanently at age 16. In short, she had a tough life as a child. Poetry and literature saved her.
Towards the end of her memoir, Winterson writes eloquently of the complex relationship between madness and creativity. She admits that she often hears voices and realizes “…that drops me in the crazy category” but doesn’t much care. “If you believe, as I do, that the mind wants to heal itself, and that the psych seeks coherence not disintegration, then it isn’t hard to conclude that the mind will manifest whatever is necessary to work on the job.” Then she writes of the part of herself that acted out from her childhood trauma—the acting out in rage, self-harm (including suicidal ideation), social isolation, and “…sexual recklessness—not liberation.” She questions whether this madness could be the creative spirit. But she answers emphatically: “No. Creativity is on the side of health—it isn’t the thing that drives us mad; it is the capacity in us that tries to save us from madness.” pp. 170- 171.
Within the profession of nursing, we have a long and distinguished line of sick nurses who write. There was, of course, the mother of all sick nurses, Florence Nightingale, who, after the Crimean War, took to her bed with a mysterious illness that lasted for the last thirty years of her life. It was during this time that she wrote prolifically–letters and missives to the War Office, health care and social reform reports, and her now famous book Notes on Nursing.
Was her illness neurasthenia (nervous exhaustion, an actual medical diagnosis until the 1930s)? Was it a clever ploy to draw sympathy and support for her zealous cause of reforming nursing, hospitals–indeed, all of health care? Was it a clever ploy to have more protected time for writing and reflecting on the state of the world in need of her reform? Was it–as was taught to nursing students as late as the 1970s–the effects of tertiary syphilis? Was it–as current medical historian Philip A. Mackowiak postulates–a combination of bipolar disorder, PTSD from the horrors of the war, ‘Crimean fever’/brucellosis contracted from contaminated milk while in Turkey–and finally, the most likely cause of her death at age 91, Alzheimer’s Disease? (From his book, Diagnosing Giants: Solving the Medical Mysteries of Thirteen Patients Who Changed the World, Oxford UP, 2013.)
As Lytton Strachey puts it in his wonderfully intelligent short biography of Florence Nightingale in Eminent Victorians (Bloomsbury Press, 1918): “Her illness, whatever it may have been, was certainly not inconvenient. (…) Lying on her sofa in the little upper room in South Street, she combined the intense vitality of a dominating woman of the world with the mysterious and romantic quality of a myth.”
Lady with the Lamp. Ministering angel. Pious Christian woman relieving suffering in the world. Nursing as a religious calling. These are the nursing myths we still live with. The nursing myths we as nurses–and especially as nurse writers–still perpetuate.
That’s what I kept thinking today as I read nurse and poet Cortney Davis‘ new book When the Nurse Becomes a Patient: A Story in Words and Images (The Kent State UP, 2015). Her book is part of the ‘Literature and Medicine’ series that includes the wonderful short story collection What’s Left Out by physician writer Jay Baruch. (Baruch’s book also happens to have one of my favorite book cover designs–check it out here.)
Cortney Davis is a seasoned nurse practitioner and a talented poet. I especially like her poem “What the Nurse Likes” included in the now almost classic book, Between the Heartbeats: Poetry and Prose by Nurses (edited by Davis and Judy Schaefer, U of Iowa Press, 1995). But over the past decade or so, Davis’ work has become stridently religious (Catholic) and proselytizing (anti-abortion among other matters). The fact that her latest book was published by a reputable (and secular) university press, and has just received the Book of the Year Award (for the category ‘Public Interest and Creative Works) by the American Journal of Nursing combined to make me look forward to reading the book.
When the Nurse Becomes a Patient tells thestory–through pictures and words–of her experience with life-threatening complications of what was supposed to be routine day surgery in 2013. She had an extended hospital stay and then convalesce at home. Davis, a life-long writer, found that writing had ‘left her’ but that she was able to paint images of her illness experience.
The print version is a children’s picture book size and the printing quality of Davis’ twelve paintings depicting her illness is quite good. Favoring Davis’ poetry over her prose, I was disappointed to find that it was plain prose descriptions that accompanied each full-page image of the corresponding painting. Two of the prose/painting combinations, “On a Scale of One to Ten” and “My Husband Cares for Me Tenderly” are both quite powerful and effective at evoking important aspects of her individual-yet-universal illness experience. But most all of the remaining ten prose/paintings were over-the-top religious, what with Dark Nights of the Soul (parts one a two no less), last rites (with a priest figure), and and “Angel Band” with–yes–nurses as angels and the figure of a nun in full habit by the patient’s bedside. And, of course, there was the requisite redemptive suffering bit in “I Offer My Suffering.”
Davis, like everyone else, is free to have and write about their own personal religious beliefs. People who are ill are typically driven to face existential crises, which can lead them to deepen (or abandon) a personal faith. But books like this make me despair of nursing ever breaking free of its overly-pious Victorian roots. It’s something that I suspect even Florence Nightingale herself (pre-cognitive decline) would have wanted for nurses and for the profession of nursing. We are not angels and suffering is not redemptive.
Mural by a student in the Henderson South Studio MPHS (after-school art program for young people ages 9-18). Photo credit: Josephine Ensign/2015
“Art is the outward manifestation of human experience in the world. Art is necessary for survival. To be human and alive is to be an active art maker. Everything that humans create in their act of living is art.” -Tamati Patuwai, MAD AVE ‘Healthy and Thriving Communities’ Glen Innes, New Zealand
It was a happy accident, an unintended yet very welcome consequence of studying ‘how the Kiwis’ do community health from the ground (literally) up, from the community members’ perspectives. The recent experience has changed how I think about community health, has deepened my respect for the power of art (and libraries) to change lives, and has even altered how I view my own community back home in Seattle.
First, a brief recap of the experience to provide some perspective. What I’m referring to here is the recent University of Washington Study Abroad in New Zealand 5-week immersive program I co-led with Jim Diers, a social worker and internationally-acclaimed community development expert. Here is what our course description said about the study abroad program:
“Empowering Healthy Communities is an interdisciplinary Exploration Seminar in New Zealand, focusing on how various communities organize and advocate for overall health and wellbeing. In this seminar, we will combine community-engaged service-learning, community case studies, readings, reflective writing, student independent projects, and immersive living experiences, to challenge students to think more broadly and creatively about participatory democracy, civic engagement, sustainability, and the social determinants of health. This course is grounded in an international, community-engaged, service-learning format aimed at creating opportunities for transformational student learning. We will address the meanings of ‘diversity’ within global and local communities; issues of power and privilege; social justice; what it means to be civically engaged at the local and global levels; and the tensions and differences between tourism vs. travel, and community service vs. engagement.
“The Oarsmen” wall mural on K-Road by Miriam Cameron, 2006. Part of the ‘Visual Artists Against Nuclear Arms’ series. “The idea is we’re all in this together.” Photo credit: Josephine Ensign/2015
New Zealand is an ideal location for this Exploration Seminar. The country has a unique blend of indigenous and immigrant cultures, and its people have a rugged, “number eight wire” can-do, and highly creative approach to solving individual and community problems. In 2014, New Zealand ranked number one in the Harvard Business School’s Social Progress Index for overall wellbeing, while the U.S. ranked number sixteen, just above Slovenia. New Zealand spends one-third less per person on health care than we do in the U.S., yet they have much better population health outcomes. How do they do it? That is one of the main questions we will ask and explore through our work and study in New Zealand. In addition, as New Zealand is a world leader in environmental sustainability efforts, we will challenge ourselves to go ‘as green’ as possible: living in youth hostels, recycling, walking and taking public transportation, and eating a mainly vegetarian diet for our group meals.”
As we discussed with the students at the beginning of our program, New Zealand slipped somewhat in the 2015 Social Progress Index, but is still in the top tier/top ten of the 133 countries with sufficient comparison data to include. In 2015 for the ‘Health and Wellness’ category, New Zealand ranked 9th and the U.S. ranked 68th. And somewhat ironically in light of our study abroad program, the U.S. ranks first world-wide in the Access to Advanced Education category, and is weakest in Health and Wellness and Ecosystem Sustainability. I tried to remind students of this fact, especially when some of them grumbled about the vegetarian meals and relying on public transportation.
Using connections through the amazing New-Zealand group Inspiring Communities, we focused our time on a variety of local community groups working to empower and improve the places they call home. The Central Business District/ Karangahape Road in Auckland. The Avondale and Henderson communities on the outskirts of Auckland. Devonport and Waiheke Island, both more affluent communities. The Ruapotaka marae in Glen Innes. Then south to the Wellington area communities of Porirua, Bromphore School, and Epuni. Consistent through all of these communities was an emphasis the community members placed on the use of the arts to catalyze positive change and to enable community wellbeing. That and public libraries, which community members treasured as being the heart and soul and ‘mind food’ of their communities. Places where true democracy happens. Places to “dream up and enact crazy ideas.” Places that nurture “the freedom to change.”
Mural by schoolchildren at the true ‘community-building’ Berhampore Primary School, Wellington. Photo credit: Josephine Ensign/2015
Art, including literary art, was literally everywhere we turned in these communities. And not just the typical government-sanctioned commissioned public art we are used to seeing in the U.S., but also much more grassroots , low barrier, “anybody can participate” community art shown in my photos in this post.
A new version of “Girl with Balloon” street art by Bansky. On building on Karangahape (“K-Road”) Road, Auckland. Photo: Josephine Ensign/2015 First photo is of poetry by young people at the Te Oro youth community arts center in Glen Innes. Second photo is a ‘cast off’ (in the trashcan) poem by a rough sleeper/Auckland Central Library ‘Poetry Corner.” Photo credit: Josephine Ensign/2015
This sort of art not only beautified the communities, it also built community identity and promoted wellbeing. Walking around my hometown of Seattle this past week, I’ve been searching for similar sparks of community wellbeing through art and have had a hard time finding them. Yes, we do have some great bus shelter artwork, as well as some building and wall murals–and our public library system has been one of the best in the country (and hopefully will remain so despite a very silly rebranding effort), but I cannot find the same level of empowering healthy communities through art. Perhaps this is an important ‘take home’ message, one we could use to improve community health and wellbeing in the U.S. More art, less guns.
Harborview Medical Center, Seattle Photo: Josephine Ensign/2015
What do art and poetry and Seattle’s largest public hospital have to do with each other? My colleague, poet Suzanne Edison, and I set out together this week on a mission to find possible answers to that question. We spent a half day doing our own art walk through the lovely and eclectic collection of public art at Harborview Medical Center in downtown Seattle. Then we sat in one of the hospital’s street-side cafes facing the Medic One emergency bays, sipped coffee amidst the occasional swirl of red lights and sirens, and wrote Ekphastic poetry in response to pieces of art that particularly moved us.
Our wonderful King County-based arts and culture organization, 4Culture, has a useful webpage with links showing photographs and describing some of the major pieces of art at Harborview. As they state:
“The Public Art Collection at Harborview has been growing since 1977 and is based on the belief that the arts can counterbalance the emotional, psychological, technological and institutional intensities of the medical center by reducing stress and conveying a sense of individual dignity and worth upon all who enter its doors.”
In choosing the artwork for display in public spaces–busy hallways, specialty clinics, and the numerous waiting room areas–careful consideration is given to things like inclusion of a diversity of artists, artistic styles, and themes. Peggy Weiss, who directs the art program at Harborview, explained to me that they have to try and balance having art pieces be interesting and healing across the wide range of patient populations they serve. (See my previous blog post “A Photo Ode to Harborview” from 1-31-15 for another ‘take’ on Harborview and for photos of its outdoors View Park artwork).
I took photographs of pieces of art and of particular spaces inside and outside the main Harborview (old) hospital, being careful to exclude any people in order to respect patient (and staff and patient family member’s) privacy. Here are some photos of art that I found most engaging and moving:
Artist: Dempsey Bob “The Wolf Helper” 1999 cast bronze and horsehair location: atrium in main hospital. Photo: Josephine Ensign/2015.Artist: Sultan Mohamed “Royal Family,” 1997 oil on canvas The placard explains that he was inspired by the saying by Ethiopian elders, “Religious beliefs are an individual right but the country belongs to everyone.” Location: in hallway outside entrance to cafeteria Main hospital.Artist: Peggy Vanbianchi “Journey: Hands” Mixed Media Location: waiting room of Radiology/outpatient, second floor of main hospitalArtist: Peggy Vanbianchi “Journey: Journal” mixed media Location: waiting room of Radiology outpatient department second floor of Main hospital.
This piece, ‘Journal,’ with its collection of enigmatic words, such as ‘refuge,’ ‘passage,’ ‘quest,’ ‘search,’ and ‘restore,’ lent itself to our first writing prompt: Take a word from the journal and write from it. I chose ‘refuge’ and wrote a free form poem that took me in surprising directions. The other writing prompts that we came up with were: 1) Write as if two pieces of art are in conversation, 2) Take one piece of art and write from its perspective, and 3) Have a figure in a piece of art be in conversation with the artist.
My main poem that came out of our art walk/Ekphrastic poetry writing day is titled “Harborview Refuge,” and has somehow manifested itself back into its own piece of art of the same name. Using my black and white photographs on various photo transfers (packing tape and acrylic gel medium), along with bits of my poem written on strips of bandage tape, here is my work-in-progress:
As you can see from these three photographs included in my mixed-media art piece, I am taken by the Art Deco architecture and details of Harborview’s main hospital, which opened in 1931. The almost Gothic gargoyle-looking figure on the right adorns the top of the pillars at the main entrance to the ‘old hospital,’ next to the emergency department.
Harborview Medical center has a tradition of ‘poetry happens.’ Seattle-based writer Wendy Call was a Harborview writer-in-residence in 2010/2011. She worked on a project Harborview Haiku and American Sentences. As part of her project, Wendy shared her poetry with patients and staff and also encouraged them to write their own haiku/American Sentences.
And for anyone who wants to read some recent examples of ekphrastic poetry (and perhaps be inspired to write/submit your own poem in response to a photograph), take a look at Rattle‘s Ekphrasis Challenge.
This week I have been immersed in both the history and present state of the health care safety net in my home town of Seattle, especially as it is ’embodied’ (or ’em-building-bodied’) by Harborview Hospital/Medical Center.
Harborview is the largest hospital provider of charity care in Washington State. It serves as the only Level 1 adult and pediatric trauma and burn center, not only for Washington State, but also for Alaska, Montana, and Idaho, a landmass close to 250,000 square kilometers with a total population of ten million people. In addition, Harborview provides free, professional medical interpreter services in over 80 languages, and has the innovative Community House Calls Program, a nurse-run program providing cultural mediation and advocacy for the area’s growing refugee and immigrant populations.
Here is my photo–simple ode–to Harborview and its adjacent Harbor View Park:
What poetry does: inspires, transforms, moves, agitates, articulates, imagines, disturbs, delights, and mystifies.
What poetry does (according to Emily Dickinson): “If I read a book (and) it makes my whole body so cold no fire can ever warm me I know that is poetry. If I feel physically as if the top of my head were taken off, I know that is poetry.”
Poetry happens. All around us. Every day. Even if we aren’t fully aware of the fact, the muses are whispering subliminal sweet everythings in our ears.
Poetry needlessly intimidates; poetry is relegated to the shelf labeled ‘inaccessible.’ At least that is the case for most adults; children seem to be born poets and we educate them out of it. Goodnight Moon, along with most other popular children’s books, are really illustrated poems.
Along with Cicero so long ago, pragmatic people proclaim that poetry and art are dead. Not true.
I love poetry and have been a mostly closeted writer of poetry. My first (and so far, my only) published poem at age nine (in my elementary school newspaper) was a haiku: “A hurt cricket limps/helplessly and hopelessly/into the forest.” At the time, I wanted to be an entomologist, or a veterinarian, or a writer. I most definitely did not want to be a nurse, but when I re-read this haiku, I see the empathy and compassion that later led me to nursing. Several years ago when my mother was dying of cancer and in home hospice, I found that I could only read poetry. Poetry has a magical quality.
I use poetry in my teaching. For nursing students, I’ve found that it helps to use a healthy dose of poems written by nurses. They resonate more closely for the students, and also make poetry less frightening to students who equate poetry with totally inaccessible, frustrating writing. For instance, I often use the powerful poem by Cortney Davis, “I Want to Work in a Hospital” “where it’s okay/to climb in bed with patients/and hold them—” to spark a discussion on empathy and the murky realms of professional boundaries and burnout. I love the moment in class when I read that opening line, hear a dampening of background noise, and look out over the sea of faces suddenly fully attentive. Poetry is magic.
I use poetry writing in my teaching, but I often sneak this in by not announcing it as poetry writing. For many years, in my health policy undergraduate course, I had students write an American Sentence of their take-home message for that class session. (See my previous blog post “Nurses and Writing the American–Healthcare–Sentence.”) An American Sentence is an ‘Americanized’ version of haiku and is a sentence consisting of 17 syllables. With a class of 150 students, this assignment did double or triple duty: it reinforced their in-class learning of concepts; it forced them to focus and hone their writing skills, and it helped me to read all of their writing before the next class session. Here are a few of my favorite student American Sentences about health policy: “US healthcare: purposeful opacity in service to the rich.” and “Sticks and stones will break our bones, but prevention is the way to stop it #nopoetryskills.” OK, so obviously the student who wrote that last one had figured out the poetry part. Good use of humor and Twitter.
In the final class session of the narrative medicine course I taught this summer, I had the students write either a haiku or an American Sentence to sum up their overall take-home message from the course. Here are some they came up with in 10 minutes of writing time: “Words, poems, artwork/Express the unspoken pain/We need to release.” “Prompted to write, to my surprise, the narrative created healing.” “So close yet so far/More questions raised than answered/ Curiosity.” “Healing is an art/in this class/that is what I get.” (This last one is technically a Lune/American Haiku, but I like it.)
I continue to search for ways to sneak more poetry into not only my teaching, but also into my writing life and into my life. The photograph here is from the Te Papa Museum, New Zealand’s amazingly wonderful national museum in Wellington. They had a ‘make a poem’ board with those little magnetized words in both Maroi and English that adults and children could play with and change around into ephemeral poetry: word art (or toi kupu, which I think literally translates to ‘speak art’–lovely!). When I was there this past February I stopped and wrote a poem mixing English and Maori words, using the Maori words by instinct since I don’t know more than a few words of Maori. Here’s what I came up with (translated into English, and I suppose this counts as my second published poem. Move over hurt cricket!) Poetry happens; let it happen to you.
Last week in my narrative medicine course I had two local authors come to class to read some of their writing and lead class discussions. The first guest speaker was Suzanne Edison, a poet and psychotherapist. She also leads Seattle-area workshops
on therapeutic poetry writing with parents of children with chronic illness, as well as with adolescents with chronic illness—at Seattle Children’s Hospital
and at Odessa Brown Children’s Clinic. Suzanne read poems from her two poetry chapbooks Tattooed With Flowers (2009) and What Cannot Be Swallowed (2012). In our first class session this quarter we had done a close reading of her powerful poem “Teeter Totter.” Students had questions about some of the metaphors and lines in her poem, so last week they were able to ask Suzanne about them directly. (“Teeter Totter” also appeared in Ars Medica, Fall 2009).
Suzanne led the class in a poetry-writing session that she has developed. First, she asked students to write about a time they had an interpersonal conflict of some sort. Then they went through their prose piece and circled four to five words that stood out to them. Suzanne had them do some other tasks in order to come up with an expanded list of words (a dozen or so). Finally, Suzanne asked them to write a poem (in any form) using all of their words. Several students wanted to share part of or the entire poem they had written, and one student commented on how powerful it was to ‘get it out there.’ Students pointed out that reliving the stressful, difficult interpersonal interactions through the poetry exercise brought on stress responses (sweaty palms or changes in heartbeat and breathing), but that writing the actual poem gave them some distance from it and left them feeling more peaceful. Suzanne explained that the poem is a way to create a container for these powerful memories and emotions. One student wrote of this
as “framing the event in the bubble of a poem.”
I prefaced this poetry-writing exercise by letting the students know that what
they wrote was for their eyes only—that I would not ask them to turn in this
writing to me. Suzanne and I had incorporated the same writing exercise last
fall in my undergraduate community health course, when I did ask students to turn in their poems to me. I got feedback from some students that they found this to be intrusive into their personal lives when they didn’t really know me. Duly noted, and very true since it was a class of 150 students (vs. 40 students in the narrative medicine course). So this time around I set the parameters upfront that they wouldn’t have to share their poems with me. Instead, the first writing prompt I gave them for in-class writing was to share a fragment of their poem, or a key word, and to reflect on what surprised them most about what came out of the poetry exercise. This seemed to work out much better. It probably also helped that this class is specifically on narrative medicine, and students expect to do more creative and personal writing in it than they typically do in a more traditional nursing course.
The second guest author was Mary Oak, author of Heart’s Oratorio: One Woman’s Journey Through Love, Death and Modern Medicine (Goldenstone Press, 2013). (see my previous post/book review “Heart’s Oratorio” from 3-24-13). She read passages from her book and answered student questions. As one of the selections she read was about her stay in the ICU and how disorienting it was, students had questions for her about this. They also asked her what motivated her to write the book and about her development as a writer. Since Mary writes about her genetic heart condition and is a mother, students also asked what the ramifications are for her children, and what that feels like now that’s she’s lived through serious cardiac complications. Much of Mary’s book is set in Seattle and she mentions specific hospitals (Northwest Hospital and University
of Washington Medical Center) and some medical personnel by name. This led to an interesting class discussion on the ethics and legalities of nonfiction medical-related writing. Several students mentioned recent ‘compliance trainings’ they’ve had to go through in their jobs as RNs in Seattle-area hospitals, where the message was that ‘they could never ever write about their work in any context whatsoever!’ They were concerned since they were asked to write about their work for class assignments (like for my course). We reviewed the basic parameters on this for academic writing: 1) no patient identifiers such as name, age, super-rare medical condition, etc.; and, 2) no specific names of providers, hospitals, clinics, care facilities—although I acknowledged this can lead to strange permutations, such as “a large Level-I Trauma Center in the Seattle area” (there is only one Level-1 trauma center in Washington State—in fact within a four state radius—and that would be Harborview Medical Center). And then I briefly discussed various legal and ethical parameters as designated by specific journals, differentiating what I was asking them to write about versus writing for publication. I got on my soapbox briefly to rant about how hospital administrators try hard to intimidate nurses (and others even lower in the food-chain) into not writing about their work—but the intimidation is real and nurses can and do lose their jobs over this stuff—and it is easy for me to rant from the relative security of my tenured academic soapbox.
Back off my soapbox, Mary read them a lovely poem by a nurse poet friend of hers, Lise Kunkel, who works in hospice nursing in New York State. The poem had to do with her hands while caring for a hospice patient. So for my last writing prompt I had students think of a significant patient-nurse interaction they had had and to write it from the perspective of their hands: Tell the story your hands could tell. Since I was really stuck back on my soapbox and hadn’t thought through the specific writing prompts I wanted to use for that class session, this one was completely made-up on the spot. I had no idea what students would do with it until I read through their writing this week.
Wow—just wow! That prompt worked, as nurses most definitely identify and
communicate with their hands. Some students wrote from the perspective of their hands: the punishing abuse from the frequent application of hand sanitizer; the uncertainty of where to place their hands during certain patient-nurse or healthcare team interactions; the patient assessment of skin warmth or clamminess or bulges where there shouldn’t be bulges—and, as one student stated, providing “a loving touch, not a medical touch.”
Addendum: I received an e-mail from hospice nurse Lise Kunkel with a link to one of her published poems, “Reading Aloud to Dad (for Jiggs)” in Oncology Times, 3-10-09, vol 31(5),p. 34. She also told me the name of the poem that Mary Oak read to my class last week: “The Hands of a Hospice Nurse.” She uses some of her poems in trainings she does for hospice volunteers through the Care for the Dying Cooperative in NY State. Lucky volunteers and lucky patients….
English: This is an image I took in Saigon, Vietnam last year (2008). (Photo credit: Wikipedia)
I promised my current cohort of community health nursing students the information in this blog post, but I wanted to offer it to other people—nursing or otherwise—who are interested in getting their writing in print (both traditional and virtual publication).
Here’s my advice for getting your health-related creative writing published. In follow-up posts I will provide specific resources for where to get published, as well as some ethical/practical writing guidelines specific to narrative nonfiction (true stuff written in an engaging, literary way). This information is mainly for writers of short-form (typically 6,000 words or less) fiction and non-fiction, and poetry. It doesn’t include advice for academic journal writing or book-length works. The following recommendations are based on my personal experience (mainly publishing narrative nonfiction in literary journals), as well as the collective wisdom of the wonderful people in my Seattle writing group—The Shipping Group.
Submit your best work. The most important self-editing advice I ever got was to read my own writing out loud to myself (to my always attentive and appreciative Corgi/don’t try this with cats as they bore easily). You can pick up a lot of things that don’t ‘sound right’ by reading your work out loud.
Have your writing (essay, poem, etc) vetted by other people besides your significant other/spouse/co-workers who may not be objective enough to provide you with kind but honest feedback.
If you are a student, take advantage of the writing support resources at your school for editing and feedback (mainly for essays, but they should also have resources for writers of poetry and short fiction).
Find a local (or virtual) writing group to provide support. Indie bookstores and public libraries are good sources to find local writing groups.
Balance the advice of ‘submit your best work’ with the equally important reminder that some people take this too literally and never submit their writing.
Do your homework to make sure your writing piece fits the current submission criteria for the journal/blog, etc you are targeting. Read their submission criteria descriptions. Read samples of their published work. Ask their contact person for clarification if you are unsure of something. The contact people are generally really nice and helpful so don’t be afraid of them!
Begin a daily practice of repeating the mantra, “Rejection only means I am submitting my writing. Rejection only means I am submitting my writing….”
If something you submitted gets rejected one place, immediately submit it somewhere else.
If something you submitted gets rejected, but the editor writes you a personalized note of encouragement, take it seriously. That means they took time to tell you something specific that was positive about your writing.
Celebrate any and all of your publications. Writing itself is a radical act. But since most writing is intended to have an audience, achieving that communication link with a wider audience through publication is truly a radical act. So celebrate your accomplishment.
Recently, I had the opportunity to take a Saturday environmental writing workshop at the University of Washington’s wonderful Burke Museum. I signed up for it when I found out that our Washington State Poet Laureate Claudia Castro Luna was teaching a session. Two out of three of the sessions—including Luna’s—were centered around the practice of close observation. We were instructed to go outside the UW Observatory (coolest old building!), stand or sit in one place, observe and write down as many sensory details as possible for ten minutes. It was raining softly so I stood in the shelter of a doorway to conduct my observation. I was reminded of the truism that the art of paying attention comes through the practice of attention and close observation. These are essential skills for many aspects of life, and most definitely for the provision of good human-centered health care.
“come celebrate/with me that everyday/something has tried to kill me/and has failed.” Lucille Clifton, 
First photo is of poetry by young people at the Te Oro youth community arts center in Glen Innes. Second photo is a ‘cast off’ (in the trashcan) poem by a rough sleeper/Auckland Central Library ‘Poetry Corner.” Photo credit: Josephine Ensign/2015
JOSEPHINE ENSIGN 