From the 2017 Northwest Network for Narrative Medicine Conference, Portland, Oregon
Recently, in a writing workshop on social justice issues, I was given a copy of Terry Tempest Williams’ essay “Why I Write” and in response to the reading of that brief essay, was given the writing prompt, Why do you write?
A simple enough (and in some ways too simple, as in a middle school level) writing assignment, but one that I happily took on. Beside my desk at home hangs an excerpt of George Orwell’s 1946 essay, “Why I Write.” In this essay he includes a list of “four great motives for writing” and they include (here in abbreviated form):
“Sheer egoism. Desire to seem clever, to be talked about, to be remembered after death, to get your own back on grownups who snubbed you in childhood, etc., etc.. It is humbug to pretend that this is not a motive, and a strong one.
Esthetic enthusiasm. Perception of beauty in the external world, or, on the other hand, in words and their right arrangement. (…) Desire to share an experience which one feels is valuable and ought not to be missed.
Historical impulse. Desire to see things as they are, to find out true facts and store them up for the use of posterity.
Political purpose—using the word ‘political’ in the widest possible sense. Desire to push the world in a certain direction, to alter other people’s idea of the kind of society that they should strive for.” pp. 312-313 in, A Collection of Essays by George Orwell, London: Harcourt, Inc. 1946.
So here is my prose poem, “Why I Write”:
I write because my fingers are ink-stained. I write because if I don’t, my pen will explode.
I write to make sense of the world. I write to court chaos.
I write until the rivers of my mind run clear. I write until glyphs are superfluous babble-brook praise.
I write unless there are enough reasons not to. I write unless it is unsharable, and then it stays inside, inscribed, worm-tracing scars.
I write journals, research proposals, reports, patient chart notes. I write poems, blog posts, essays, chapters, books, and marginalia.
I write personal mission statements. I write to humanize health care for patients, providers, and communities.
I write my name. I write my different names beneath the kitchen cabinet of my childhood.
I write because I was here. I write because I am here.
I write to remember. I write to forget.
I write. I am a writer.
I opened this post with a reference to the social and environmental justice writing of Terry Tempest Williams. I close with one of my favorite passages of her writing that I stumbled upon this summer. It is from her book An Unspoken Hunger: Stories from the Field (Vintage, 1995). It reminds me of why I write; it reminds me of the importance of women writers in our world:
“As women connected to the earth, we are nurturing and we are fierce, we are wicked and we are sublime. The full range is ours. We hold the moon in our bellies and fire in our hearts. We bleed. We give milk. We are mothers of first words. These words grow. They are our children. They are our stories and our poems.” p. 59
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….
JOSEPHINE ENSIGN 