This transcript has been edited for clarity.
Neil Skolnik, MD: I'm Dr. Neil Skolnik. As clinicians, we have a unique vantage point on the human experience, but we don't always have time to reflect on our experience. Involvement in the arts gives us the opportunity to create meaning, find meaning, and sometimes forge meaning out of what we do. When I talk about the arts, I like to think about it broadly: poetry, stories, song, dance, paintings, drawings — anything that we as people, as friends, as colleagues can come together and enjoy experiencing with each other and use as a means of finding meaning in what we do and in life.
Tonight we are privileged to have Dr Seema Yasmin join us. Dr Yasmin is the director of the Stanford Health Communication Initiative and a clinical assistant professor in the Stanford Department of Medicine. She's also the author of four books, including a really wonderful recent book of poems, If God Is a Virus. Seema, welcome.
Seema Yasmin, MD Thanks for having me, Neil.
Skolnik: Seema, can I ask you to read the poem that we had talked about for our audience?
Yasmin Of course. This is a poem called "Anamnesis."
My patient is the same age as me. 27.
Same complexion: golden brown.
Same postcode: E8.
Chief complaint: patient presents with 5-week history of intermittent blurred vision, neck pain, headaches, and vomiting.
My patient is a DJ. Spins lovers rock, dancehall, sometimes a little bit of house 'n' garage in clubs in Hackney and Essex.
Past medical history: Unscarred. Fine, too. Grew up in the ends without getting stabbed or shot.
Ordinarily, I would ask you for your digits, he says, straightening a pretend collar on his diaphanous white hospital gown.
Ordinarily? I think. What a word. What a world.
But since we are here—
Ordinarily we would meet somewhere near the DJ booth (who am I kidding, we would meet behind it).
Ordinarily I would let you drape your arm
around my neck.
Ordinarily we would dance to a Beres Hammond tune and hold hands.
(Did swims at the Reebok gym tone your frame up?)
Family history: Ordinarily he would live to 87 like his grandpops, the one in Kingston, the one on his mum's side. The one who Amber Rudd sent back on a reverse Windrush but said he went of his own volition, said he would not be buried in dirt that could not sprout mango trees.
I drape my stethoscope around my neck, fiddle with the diaphragm, finger the metal bell, scroll up and down the CT scan. Up and down. We wait.
Family history: His mother loves him. She loves him so, so much. Right now she is driving through the congestion zone to find out what is wrong with her baby boy.
Why did he wind up in accident and emergency on a Tuesday morning?
We wait for his mother and when she walks onto the ward I say the thing the five-syllable thing and she collapses onto my pinafore, brown goddess locks spill onto my face, over my right shoulder, and from his bed he says Mum, Mum. So I too say Mum, Mum.
In the doctor's lounge I brew tea because
this is what we do.
Brits, doctors—at times of crisis
War Divorce Brain tumors in brains as young as our own.
His mum collapsed on me I tell another doctor.
Like on me, on me.
I sip tea because
this is what we do
You look sad? the male doctor says
Stirring
Then
Perhaps you're not cut out for this job, not cut out for clinical medicine.
Perhaps you're not cut out for this job, you fucking robot
I say.
But not really
Really I sip tea because
this is what we do
when the word, the world is ending
and there is no more ordinarily.
Skolnik: Seema, that's an amazing poem. Can you discuss for us the meaning of this poem for you?
Yasmin: I wrote this a decade or so after that encounter, and I think I almost needed that much space and distance and time afterward just to give myself permission to reflect. It had been so ingrained in me that during encounters like the one in the poem, we are always reminded to be robotic.
Poetry gave me an opportunity and license to reflect in a way that I could not back then. And I'm glad we have language now for some of the problems that we face, some of the challenges we talk about in medicine — compassion fatigue, moral injury, and burnout. I didn't have that language back when I was 27 and first practicing, so I just thought I was inadequate in some ways and didn't realize that actually, I was fully adequate and competent. The system was broken, and the system was asking me to be detached in a way that I don't think made me the best advocate or best carer for my patients.
Skolnik: The origin of medicine comes out of empathy, right? We want to help people because we care about them. And then traditionally, we've had to be detached from that care in order to provide it. Can you talk a little bit about what the arts in general and perhaps writing and reading poetry might provide for us — the promise it holds for us as clinicians?
Yasmin: The arts, literature, storytelling — all of those are really powerful ways to reconnect us with those foundational sentiments and motivations that pushed us to be doctors, PAs, nurses, or techs and put us in the role of caring for people and meeting people at their most vulnerable. I remember when I was in medical school, my mom (a very atypical South Asian parent) said, "What a strange profession you are choosing, where you want to have autonomy over people when they are so vulnerable." And I was like, Well, yeah, that's one way of thinking about it.
And so much of what we do is counterintuitive. We don't always get to have conversations about that or feel like there's permission to talk about these things. Literature opens that door — whether it's losing yourself in a book, a poem, a piece of music, whether it's opening a journal and writing something that no one's ever going to read, or whether it is publishing something and encouraging these public discussions like you and I are having, I think it's really important that we bring humanities and the arts into medicine.
Skolnik: I love that. Hearing your poem helps me refine that caring. I think it was Francis Peabody who said, "Patients don't care how much you know until they know how much you care." And using literature as a way of refining that core meaning about what we do. As I'm listening to you, I am leaving this discussion inspired.
Yasmin: Oh, good, I'm glad. We've done a really strange thing over the centuries in terms of this artificial divorcing of the humanities and arts and literature from medicine. And I hope we're now recognizing how that doesn't serve us. It doesn't help us have fulfilling careers. It leads to burnout and is not necessarily the best for our patients, either. So here's to more literature, more humanities in medicine.
Skolnik: I agree with you. It's a pleasure talking with you. Thanks for joining us at Medscape, Seema.
Yasmin: Thanks, Neal.
Skolnik: And for Medscape, thank you all for joining us to talk about medicine and the arts. I'm Dr. Neil Skolnik.
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Cite this: A Doctor, a Poem, and a License to Reflect - Medscape - May 05, 2022.
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