It’s poetry week in New Zealand, in the run-up to National Poetry Day on Friday 25 August. Here Auckland poet Johanna Emeney talks about the writing of her second poetry collection, Family History, which contains poetry written in response to her mother’s illness. Many of Emeney’s poems in this collection document the behaviour and language of healthcare professionals, and the impact of that on the quality of care received.
Family History grew from the creative component of my PhD. My thesis was essentially a study of autobiographical medical poetry written from the points of view of doctors, patients, carers and parents.
I knew that I wanted to explore constructs of identity and family in my own collection – how they are affected by illness and medical treatment. I also knew that I wanted to write about how it felt to be close to someone who was not being well cared for by medical professionals, and conversely, how it felt when a person in a healthcare role acted compassionately. In particular, I wanted to highlight how important the job of anyone in healthcare is, whether that person is a physician, hospital nurse, district nurse or liaison officer. Their warmth or coolness, their dedication or dispassion, makes a huge difference to the experience of the patient and his or her family.
When Angela Andrews and I go once a year to talk and read poetry with Mike Hanne and Elisabeth Kumar’s third-year medical students at Auckland University’s Faculty of Medical and Health Sciences (FMHS), one of the short poems I share is “Lines overheard at the teaching hospital” from Family History.
Today I learned that heartstrings
are called chordae tendineae.
I touched them.
In fact, I got to cut them
This is very much a found poem. As soon as I heard the lines, they spoke to me of the experiences and decisions that lie ahead for young medical professionals. First, they gain a specialised knowledge outside the bounds of the layperson. Next, they wonder at the proximity they are granted to the human body, to another person. Next comes the transition to enacting the mechanical skills that characterise much of medical practice. Although we are no longer in the days when medical students were urged to avoid irrational emotionality, there still must be some separation of emotion and performance implicit in the act of “cutting”.
I hope that those FMHS students manage to hold onto their intentions – sincere ones which, happily, Angela and I hear every year: to place the patient-as-person at the forefront of their minds; and to see each one as an individual, resisting the blunting effects of time and repetition, or the temptation to make the separation of emotion and performance spill over into consultations, thinking that distance might protect their emotions or make them more effective clinicians.
Certainly, courses in the medical humanities give students like these many opportunities to realise that they must minister not only to the bodies of patients to relieve suffering, but to their emotional and existential aspects, too. Reading poems like Glenn Colquhoun’s “Communion”, about a young doctor visiting an elderly rural wife and husband, can only cement in their minds the wider duties of a doctor:
She will provide bacon, eggs, sausages and chips with scones and
I will be given a glass of Fanta because I am a boy. We will talk
about high cholesterol, ischaemic heart disease, a recent blood
test. She will tell me it is marvellous what my tests can tell.
I will tell her three things remain:
And a cup of tea,
but the greatest of these
is a cup of tea. (Glenn Colquhoun, from Playing God, 2002)
In Family History, there are a few poems that refer to my job as a senior school teacher, as I was at the time of my mother’s illness. It occurred to me, back then, that there were a number of similarities between the vocations of teacher and physician. My mother’s surgeon drew an analogy between the two when I asked him if he might explain the chances of Mum’s cancer recurring after the first operation. However, his comparison was not really along the same lines as those I had been contemplating:
He asks me which students in my class
will get an A, which a D. Can I tell
with any degree of certainty?
Well, I can be pretty sure.
Same here, he says. Same here. (from “Understanding”)
What I had thought about was how accountable I felt for my students’ happiness, and how, when I left school at the end of the day, very often, I took their disappointments and upsets home with me. I would often lie awake, thinking about my mistakes that day, my failings, the things I didn’t notice – and, sometimes, my awe for young people’s vast capacity for compassion.
to blink back
tripped by something
I can’t put a finger on.
The line’s dumb slack
is taken up
by a girl at the back.
her dad died.
She knows the sudden
need to cry.
under two dropped iambs.
It was not that I felt that teachers and surgeons had commensurate work-loads or levels of responsibility for human life; it was more that I felt that the onus for dedication and empathy pressed upon both vocations. I had a voice in my head that said to my mother’s specialists and GP, “I don’t find this difficult. Why do you?”
The treatment my mother received made me angry, because she was a very good-humoured, undemanding person. She was no trouble. She did not deserve a breast surgeon who dismissed her questions about reconstruction because she was fifty-nine, and in his opinion, should have been concerned only with the excision of the tumour. She did not deserve an oncologist who was resistant to considering personalised treatment for her aggressive cancer once it had metastasised to her ribcage and arm.
He was offering her the same chemotherapy regime he would offer anyone else, even though it was not suited to her type of tumour. This was the 1990s. Research was hard to find online, but I was more motivated than he was. The way I saw it, the only way I could save my mother further suffering was by learning the language of the thing that was killing her, and then learning the language of the things that could help her while causing least damage to her body and mind.
Suspecting that the high grade, combined with the oestrogen and progesterone receptor status of my mother’s tumour would make her a likely candidate for Herceptin, I pressed him to test and see if her cancer was Her2-positive. It was. So, it was decided that when things progressed, she would be started on Herceptin. No more sickness or hair loss. A chance with a new drug targeted to her type of tumour. Also, bisphosphonate therapy for her bony lesions.
Five months later, Mum was killed instantly in a car accident.
A number of the poems in Family History describe aspects of my reaction to my mother’s sudden death. I’m not sure any number of books could describe life for my father afterwards. His was a complicated grief. I can recall telling my PhD tutors, as they helped me with my manuscript, that the next two years for Dad involved being diagnosed with bowel cancer and then Parkinson’s. They kindly (and sensibly) suggested that there was only so much tragedy readers could put up with in one book of poems.
One of the last poems in the collection, “Resting Tremor”, is an amalgamation of three “last” images: One of my mother, which we found on the film in my camera a few months after her death; one of Dame Chris Cole Catley, my first publisher, having a drink of champagne at my house when she was only months away from her own death from cancer – the photo of her is blurred as she laughs and says “Cheers!” – and the enduring mental image I have of my father’s Parkinsonian tremor, always inexhaustible, tapping away on his knee. He died in 2011, of a cardiac arrest.
are blurs –
the swift sweep
of head and neck
of one hand
on your knee,
when the rest
Johanna Emeney is co-facilitator of the Michael King Young Writers Programme with her friend Ros Ali. She is also a tutor of Poetry and Creative Writing at Massey University. Her first book of poetry is Apple & Tree (Cape Catley, 2011). Family History (2017) is published by Mākaro Press. She will be reading at the Depot Artspace, Auckland, at 5.30 pm on the August 25 for National Poetry Day and appearing with Sarah Laing at Going West Books and Writers Festival in “Mansfield and Medicine” on Saturday, September 9.