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 But dandelions were on my mind since I had just run across a historical document on Seattle pioneer Catherine Maynard.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.”
“…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.
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.
“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.
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.”
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.
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.
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:
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: