Is the pen mightier than the stethoscope?
Neil M. Paige and Thomas Alloggiamento aren't sure, but they believe both have a place in the doctor's bag.
Now first-year medical students, the young men were premed English majors at UCLA when Paige conceived of a book of poems by doctors and medical students.
The newly published result is "Vital Signs: The UCLA Collection of Physicians' Poetry," a paperback anthology of more than 70 poems by men and women working in the tradition of such notable poets with medical training as John Keats and William Carlos Williams.
As the late Norman Cousins, who gave moral and financial support to the project, pointed out in a brief foreword to the book, "Some physicians whose writing on prescription pads may be difficult to fathom have done rather well in advanced literary forms, whether poetry or fiction."
Cousins' list includes, besides Keats and Williams, Francois Rabelais, Anton Chekhov, Louis-Ferdinand Celine, Arthur Conan Doyle, Gertrude Stein, W. Somerset Maugham, A. J. Cronin, Walker Percy and Richard Selzer. "Their books," Cousins comments, "bear witness to the ability of some doctors to know at least as much about the totality of a human being as they do about a disease."
Editors Paige and Alloggiamento, who graduated from UCLA last year, became friends after taking several of the same literature courses. Premed English majors were a distinct minority at the university, they recall, and the project gave them a chance to explore the relationship between literature and medicine.
"Both poets and doctors see life bare," said Paige, 23, who grew up in Encino and is now in medical school at Georgetown University in Washington. In their introduction to the book, the editors discuss some of the other similarities between doctors and writers, including their common need to use language with precision and delicacy.
Selzer, a surgeon and writer, once observed that "a doctor/writer is especially blessed in that he walks about all day in the middle of a short story." The UCLA editors agree. "Doctors have a unique experience poets don't usually have," Paige said. "Patients are a nonstop source of inspiration."
Some of the most powerful poems in the book deal with the daily drama of the curtained-off hospital bed. As physicians, the men and women represented in the book use such shorthand terms for tragedy as "carcinoma" and "failure to thrive." But as poets they write about their suffering patients with all the passion the clinical setting forbids. A recurrent theme is the pain of the physician, unable to ease the patient's anguish with skill or technology, able to salve the suffering only with language.
In "Lullaby," one of Paige's favorites, poet/physician Jon Mukand writes:
Old man, listen to me:
Let me take you in a wheelchair
To the back room of the records office,
Let me lift you in my arms
And lay you down in the cradle
Of a clean manila folder.
In the introduction the editors note that writing poetry is often a healing process for the physician/artists, whose professional lives are filled with stress and frustration. Paige and Alloggiamento quote Mukand, the medical director of a rehabilitation ward, who writes: "Scars are a natural response of the body to a wound. A healing response that remains to remind the body of what it has been through. Poems form like scar tissue on a physician-poet's wounds." Mukand argues that scars are better than callouses.
Initially, Paige and Alloggiamento, 22, and now a medical student at UC San Francisco, solicited poems from the UCLA medical community. Encouraged by both the medical and English faculty at the university, they then broadened their search to include literary doctors and medical students nationwide. JAMA, the Journal of the American Medical Assn., gave them free ad space inviting contributions.
Ultimately, more than 1,000 poems were submitted. Paige and Alloggiamento did a rough cut, and a committee of faculty and graduate students from the UCLA School of Medicine and the English department made the final selection.
Alloggiamento says the poems he read for the book gave him "a peek into the front lines of patient care" and helped solidify his decision to become a doctor. "I can't say I decided to go into medicine because there were poets in medicine, but it certainly made it more comfortable for me as an English major."
UCLA funded the project. Campus faculty and staff were extremely helpful, the editors say, particularly Cousins, who wrote eloquently on the limitations of traditional medicine and was an adjunct professor in the department of psychiatry and behavioral sciences until his death Nov. 30.
Cousins gave the neophyte editors tips on dealing with the literary community and also helped them clarify their thinking about medicine and art. Cousins also helped pay for the book's distribution, although he did not live to see it.
Largely because of "Vital Signs," Paige and Alloggiamento were named outstanding seniors at UCLA.
Proceeds from the book, which sells for $10, will be used to establish a scholarship for a UCLA medical student with an interest in the arts. The book is available at the UCLA bookstore and several other local stores and by mail.
Like Cousins, Paige and Alloggiamento say they think the humanities should be part of every physician's education. As Paige points out, you can lose touch with larger human issues when you are preoccupied with mastering, say, biochemistry and the other essential but narrowly focused subjects of the medical curriculum.
The arts, they say, are the great reminder.