Dr Lesley Morrison
You who read..
May you seek
As you look;
May you keep
What you need;
May you care
What you choose;
And know here
In this book
That will change
You and be yours.
Gael Turnbull, from There Are Words: Collected poems (Shearsman Press, 2006), by permission of the author’s Estate.
This was and is very much our aspiration for this project, to enhance the experience of being a new doctor, and to provide a comforting, supporting and illuminating friend.
The seed of the idea was sown in conversations between myself and my colleague Dr Pat Manson in Hawick in the Scottish Borders. We both had longstanding interest in the arts and humanities in health care and medical education, and in the need to nourish the creativity of medical students and young doctors. Pat was a committed, compassionate and very kind doctor, dearly loved by his patients and his many registrars. When he died, I decided, as a tribute to him, to make the idea a reality and contacted the Scottish Poetry Library, a wonderful institution sited in the ancient heart of Edinburgh and committed to bringing people and poems together.
I spoke with Robyn Marsack, the then Director of the Library, to ask her for her support. I had scarcely finished explaining when she said yes. Dr John Gillies, then chair of the Royal College of General Practitioners in Scotland, and Revd Ali Newell, Associate Chaplain at Edinburgh University, joined Lilias Fraser from the Library and myself on the editorial group and the difficult but very enjoyable task of choosing poems for the book began.
The criteria were that the poems spoke to the experience of being a junior doctor and that they were short. Our final selection of fifty poems included some by doctor poets, Glenn Colquhoun, Iain Bamforth, Martin MacIntyre and Gael Turnbull, some by well-known poets, and some by less familiar names. The title, Tools of the Trade, is from a poem by the same name by Martin MacIntyre, a Gaelic-speaking poet, novelist and doctor, who wrote it especially for the collection.
New doctors will be empowered by poems
in the pockets of their metaphorical white coats.
There at the ready:
on early, sweaty, scratchy ward rounds
to deploy while waiting patiently for the consultant’s late appraisal;
give filing, phlebotomy and form-filling an edge and depth;
sweeten tea-breaks as if with juxtaposed Jaffa Cakes
to answer that persistent bleep ̶ while sneaking a pee,
to travel to the manic crash and flat-lined emptiness of cardiac arrest
thole the inevitability of the inevitable…
Excerpt by permission of the author.
Dundee students receiving copies of Tools of the Trade at graduation in 2014 – © University of Dundee
We fundraised for the production among friends and GP colleagues and every Scottish medical graduate in 2014 and 2015 received a copy. In the foreword, we said, ‘Use the poems to connect with your patients, your colleagues, yourself’. We recognised, however, that some of the recipients might, instead, recycle it. Poetry does not appeal to everyone but the feedback we received was appreciative and positive. After ordering a copy for her son, a new junior doctor in a large teaching hospital, one person wrote: ‘I have just spoken to my son, he had a difficult weekend. I wasn’t going to mention the book but under the circumstances I did. I explained its purpose and how it might help, half expecting him to laugh at me. Much to my surprise, he thanked me. I think it will help a lot of people. The anthology is such a brilliant, thoughtful idea, which I am sure will be appreciated by many junior doctors or others working in caring professions. We all need help, encouragement, inspiration, understanding – thank you to everyone involved.’ And as Dr Richard Smith wrote in his BMJ blog on the book, ‘I think that if just one in 20 is turned on to poetry, the whole exercise will be worthwhile. For me, you cannot be a good doctor without some appreciation of, and infusion, of poetry’. Dr Richard Smith: A book of poems for medical graduates, June 2014.
Mentions in the Sunday Times and on BBC Radio 4 brought in many more orders and inquiries, and we quickly sold out of the small stock of copies set aside for sale: orders came for batches of books, from addresses at hospitals and medical practices in the UK and further afield, as well as individuals who wanted copies for family and friends.
Encouraged by this, by feedback from senior Royal College of General Practitioners members, from other doctor writers and from various reviews, we decided to produce a second edition. This time we successfully sought funding from RCGP Scotland and MDDUS (The Medical and Dental Defence Union of Scotland) for which we are extremely grateful and which enabled us to print enough copies for three more years of graduates.
Kate Hendry joined the editorial group and this time we invited suggestions of poems from a wide range of medical colleagues, either recommending other’s poems or their own. This made the task of choosing even more daunting and difficult, many poems from the first edition were retained and many new poems made their first appearance. We introduced a different format in this edition with poems being grouped in five sections, “Looking after yourself”, “Looking after others”, “Beginnings”, “Being with illness”, and “Endings”. Mini-biographies of the doctor poets were included along with notes about individual poems written by the poets. Again, the gift of this little pocket book of poetry has been much appreciated by new graduates. At a launch at RCGP Scotland, Miles Mack, Chair, said that Tools of the Trade ‘emphasises how at the heart of every medical consultation sit people,’ and that ‘[t]he compassion these poems represent will, I hope, underpin every medical career’. Dr Brendan Sweeney, author of the seminal James Mackenzie Lecture in 1997, ‘The place of the humanities in the education of a doctor’ (British Journal of General Practice 48, 998-1002) and now Chairman of MDDUS, said in his Preface to the book that ‘If you add to the scientific method and evidence-based medicine the stimulation and nurturing of the moral imagination by reflecting on poetry, we will have doctors who will not only have highly-tuned clinical skills, but also a more profound understanding of the human condition, and of the psychological and moral subtleties that illness reveals’.
At a time when the importance of kindness and compassion in health care is being more recognised, we hope that Tools of the Trade can make a useful contribution. Last year we shared a platform at Dundee Book Festival with Professor Sir Kenneth Calman, author of A Doctor’s Line: Poetry and prescriptions in health and healing (Sandstone Press, 2014). This year we are participating in a session at the Edinburgh International Book Festival, ‘A dose of verse’, with Gavin Francis, author of Adventures In Human Being (Profile Books, 2016), Martin MacIntyre, and poet Valerie Gillies. In another session, John Gillies, lead of the Edinburgh University Compassion Initiative, is discussing ‘The compassionate neurosurgeon’ with James Doty and Gavin Francis.
We are making some very exciting connections in the world of medical humanities and the arts in medicine and open to ideas about how to extend our initiative as widely as possible. At a time when scientific medicine is making such rapid advances, and the pressures on young doctors can be so intense, promoting and nurturing their empathy, compassion and creativity is much needed. As two new doctors themselves wrote in response to the book: ‘There is an important emphasis … in this book around thinking of patients as human beings – not only treating ‘diagnosis’ but also the person and being considerate of patients’ thoughts and feelings’. ‘Overall, the poetry made me think about caring for patients in a holistic manner with more compassion’. ‘I felt that the book motivated me to go into the wards and do a good job for patients … but also that my challenges are not unique and there is a great support network within the profession’. Navya Bezawada, Neil Craig, in Education for Primary Care 2015;26 (6): 431-2.
Sincere thanks are due to Dr Pat Manson, whose compassion and love of medicine inspired the book, to Robyn Marsack, inspirational Director of the Scottish Poetry Library whose enthusiasm allowed it to happen, and to all the young doctors who read and absorb some of the poems, use them as tools to enhance their clinical practice and become the caring and compassionate doctors of the future.
For further information on Tools of the Trade, or to contact the editors, please email email@example.com
To buy a copy for £6 + £2 p+p, visit the Scottish Poetry Library’s online Shop.
Dr Lesley Morrison: Lesley Morrison is a GP in the south of Scotland, is interested in the arts and humanities in medical education and health care, and is one of the editors of Tools of the Trade.