Register Monday | June 17 | 2019

Complete Physical

I have a book of medical poems coming out with the Porcupine’s Quill in the Spring of 2010. As usual, I had trouble coming up with a title (this will be my fifth book, it doesn't get any easier.) Titles always come late with me, as I find it difficult to sum up an entire collection in just a few words. For a year I debated White Coat, Black Bag: it had the right ring to it, the white coat suggesting all that is good in medicine, as if the coat were the white hat of a good guy, and the black bag suggesting black art. Indeed the book has two personalities: the first section would make my residency professors at Memorial University proud, for it is empathetic and supportive. The second section is more circumspect, wondering how people contribute to their illnesses, and is overtly frustrated. But the provisional title came to ground when my editor warned me of a CBC Radio program of a similar name, and for several months I experienced the anxiety of an author without a title. I debated the default position, naming the book after a favourite poem, but that seemed inadequate. Luckily, my publisher came up with a simple and elegant title: Complete Physical.

I think that title does say it all: physicians must be thorough, their assessments “complete.” And every office visit is an opportunity, in being complete, to seek the truth. My physicals are divided into half: the first part is history gathering, learning what transpired in the past year, how the new is new and the old is the same or changing. The second part is leveraging that information against the patient’s own body, seeking quickly for clues (the symptom of chest pain leading to the finding of a heart murmur) but also checking out the parts that the patient is not complaining of.

How do the poems do this? Well, there is the trick of the anecdote: certainly some patients have struck me more than others, and their predicaments worth a poem. Medicine is a means of knowing a person, and some of the poems try to take on the patient’s raiment. Yet they are written from my perspective, and so have a dual life. There are other poems that take on certain diseases, sly poems that try to terrify, although the image of the doctor tempers that terror. And other poems display my misgivings about medicine, about being privileged in the way that we are, to see so much suffering, nobly and ignobly borne. Nobly and ignobly witnessed!

My favourite poems are not ambiguous and interpretable in myriad ways; they are ambivalent, the equivalent of cherishing and despising a thing simultaneously. The most interesting part of a physical exam is a social history, the part where I learn how patients live their lives, and often discover information about how they will end them. The poems in the book freight complicity with beauty, they tend my flock not with judgement but with rueful wonder. During the “cpx”, as my day sheet nicely abbreviates, I am a seeker, trying to find out information. The poems are exercises in answering the most important question the cpx begs: how are we to live in this world? The poems make that question tangential, they throw in details to make the poem fastenable, real, but they are always answering in earnest.