Tribute to Nurses (Winter 2007)

Poems and Essays in RATTLE:   Poetry for the 21st Century

Issue #28; Vol. 13, #2

Editor-in-Chief, Alan Fox

Editor, Timothy Green

Nursing rating		Rating guide: excellent = 4 stars; good = 3 stars; fair = 2 stars, poor = 1 star
Artistic rating

Unusual access to us

May 16, 2008 -- The Los Angeles poetry magazine RATTLE has placed a remarkable "Tribute to Nurses" in its Winter 2007 issue. The 45-page tribute includes only work by nurses: 24 poems and four essays. The essays discuss the relation between nursing and poetry, and how the writer has come to pursue both. Calling this material a "tribute" almost does it a disservice. You might think that approach would lead editors right to the traditional angel image, and some of the retro cover art isn't far from it. But RATTLE offers well-crafted, irreverent poems that capture modern lives and deaths, without sentiment. Perhaps that is because nurses "have unusual access to us," as noted by Joanne Trautmann Banks (quoted by Madeleine Mysko). Many of these poems address clinical settings, especially older patients in extremis. The poems suggest the scope of patients' lives through their physicality, their frailties, their suffering. To some extent we also glimpse the inner lives of nurses who, as Shawna Swetech suggests in "Midwifing My Father," have "delivered soul from body many times." Several of the nurses point to the healing power of poetry in their own lives. There are also lots of cigarettes. But there are not many physicians, a stark contrast to the overriding theme in the popular media that health care consists of the physician-patient interaction. The issue also identifies each writer with appropriate credentials (e.g., BSN, PhD, APRN), giving readers an idea of nursing education. Because the focus of the clinical poems is so much on the patients, there is less sense of nurses as health experts and life-savers, with the exception of Anne Webster's "Dry Drowning." It may be that the poetic form in general does not lend itself to conveying that type of information. But the tribute does present nurses as keen observers, and courageous workers who help us in our darkest hours.

The focal point of the issue's cover art is an illustration of a 19th or early 20th century nurse in a nun-like uniform with red crosses. In the jumble of old-timey objects, ads, and memorabilia, we also see a smaller retro illustration of a matronly nurse attending a patient. This graphic also appears at the start of the "tribute" section inside the magazine. On the back cover, a small illustration shows a nurse, perhaps from the first half of the 20th century, applying some ointment to a little girl's injured knee, while the girl's mother watches. A nearby tray has a bandage the nurse will presumably place on the girl. These images have a certain charm, and there's nothing particularly wrong with them if you're going to use imagery from a century or more in the past. But this kind of imagery really does nursing no favors today, linked as it is to the traditional idea of nurses as noble but low-skilled female handholders who are peripheral to serious health care, rather than modern professionals of both genders with college-level educations.

In fact, the vast majority of the essays and poems that actually comprise the magazine's tribute focus on the last two decades, and they give readers some reasons to reconsider traditional views of nursing. The four essays address the relation between writing poetry and practicing nursing. All the authors are veteran nurses with an obvious connection to the profession, yet here, most seem to present themselves as poets first--poets who also happen to be nurses. Of course, very few people today can make a living as a poet.

(Full disclosure: in connection with this issue, RATTLE also published "Nursing Our Beer Back to Health," an online essay on nursing and language by Truth staff.)

The first essay is Mysko's overview "Introduction: When the Poet Happens to Be a Nurse." Mysko says that unlike, say, "businessman-poets," nurses tend to write about their working lives. Their poems are often narrative, sense-focused, attentive to the human body. Mysko explores what makes nurses' poetry special: in addition to the "unusual access to us," nursing entails "an intimacy with human suffering the likes of which no other profession requires." Mysko explains that nurses must be empathetic, yet somewhat removed in order to be effective. Nurses' poetry therefore consists of "professional barriers to emotion dismantled out of poetic necessity," which suggests that nurses must allow themselves more feeling in their poems than they can afford while nursing. You could argue that the poems would actually require a similar balancing of empathy and clearheadedness. Mysko seems to acknowledge this, concluding that these nurses have found "the discipline to make something beautiful out of what a nurse knows."

The other essays are more in the nature of personal histories, but they also provide valuable insights into the relation of nursing and poetry. "Nursing and the Word," by Cortney Davis, describes how Davis gradually moved into nursing after taking a job as a nurse's aide when she was a struggling young mother. Later, as an oncology nurse, Davis renewed her earlier interest in poetry after a favorite patient died. Davis suggests that writing poems helps her capture something of her patients' lives and deaths, and in some way heals her. She actually compares her poems to nurses.

T.S. Davis, in "A Kind of Gift," says he got into nursing as a "day job" to support his real profession, poetry. But nursing changed his poetry, making it more intense. Nurse poets, he says, are "like rubberneckers passing a wreck on the highway, voyeurs with a job to do." Davis also discusses connections between health care and poetry generally. He quotes Walt Whitman (who cared for the wounded during the Civil War) and William Carlos Williams (a physician), and argues that nurses and poets share a desire to "get down to the fundament of existence."

In "A Split Personality," Anne Webster suggests that she has spent much of her life with two divergent sides: a practical one, which she appears to associate with nursing, and an artsy humanities-oriented one, which she associates with advanced education and learning. Webster describes her early years in nursing like this: "Nursing school in the late fifties was little more than indentured servitude"; "The girl who had dreamed of college, of becoming an artist or a doctor, railed against her existence as the busy, low-rung practitioner she'd become."

Webster starts writing poems, but still feels alienated. The physicians with whom she works evidently don't respect her as much as they would if they knew she was "a published poet," and her fellow nurses could not begin to comprehend her writing poems, if she were to grace them with that information. But over time, Webster comes to realize that poetry has helped her handle the emotional pain of nursing. Even though she quits nursing for a while to write full time, she itches to return to that "other part" of her. Ultimately, she comes to realize she has actually reached more people through nursing than her literary journals. By the end of her account, her two sides seem reconciled, and she claims to have "no regrets" about her "second-rate education," and her lack of a college degree, because her path led her into nursing and writing.

Parts of Webster's essay suggest no great respect for nurses as a group or nursing as a profession. It would seem she thinks that the uneducated nurses of the sixties, and perhaps beyond, could never understand the aesthetic merit of poetry. Physicians, on the other hand, are clearly held in the highest regard. And despite the length of the essay, the author does not get around to telling readers that nursing education now is rigorous college-level training.

However, Webster's poem "Dry Drowning" is probably the best in the entire issue at conveying nursing autonomy and skill. In a short but powerful evocation of an unexpected emergency department death from asthma, Webster gives readers a sense of the range of important things nurses do She casually describes the use of inhalers and epinephrine, CPR and defibrillation, dealing with distraught families. Of course, most readers would never imagine that nurses play a key role in these things, given the mass media's common presentation of them as the province of physicians. Webster does not ignore physicians, but simply presents them as part of the team:

                        ...   Ten minutes after
he arrives we pronounce him. His wife
and kid wait in the lobby, expecting
him to amble out with a birthday grin
ready for songs and cake. What they get
is me and some strange doctor, our faces
wearing the news. On the drive home
at midnight, I count each breath I take,
wondering if there will be another one.

The other clinically-oriented poems don't really bring out nursing skill and autonomy to this extent, but they do give a similarly striking sense of nurses as doing vital work on the front lines of human suffering and death. Curiously, there is little here on the wonders of recovery and redemption. Maybe it's more difficult to make a compelling, unclichéd poem with those themes.

Many poems explore what patients are going through and how nurses react. Judy Bowman's "At Four in the Morning" is a short but haunting look inside the mind of a nurse to a failing "old soldier" whose hands are "talons tearing the mesh of air," whose face is a "rigid tragedy," and whose son is not coming.

"Diagnosis HIV," by nurse practitioner Cortney Davis, explores the ambivalence of a nurse trying to figure out what to say to a patient who vacillates between guilt and hope ("I don't know why I always say / What I think she wants me to say").

Veneta Masson's "Conga! At the Rio" describes a nurse accompanying a patient to a show. The patient, who is undergoing chemo, embraces the dancing the audience is invited to join, but the nurse declines:

We head home in a haze of regret,
she, for the dance, over too soon,
me, for missing another chance.

And Maggie Greene's "All-Consuming" takes us inside the mind of a dying cancer patient who describes the "bugs eating you from the inside out." The patient speaker seems to blame the "pretty nurse" less for the feeding tube and restraints she does not want than for rubbing lotion on her, attracting the bugs to her skin:

They're moving with a mission now. Soon enough
I'll die, I guess, because they know what she did not.
Thanks to Florence Nightingale, my skin tastes just like pears.

Christine Wideman's long, Beat-influenced "Howlin' Moon" recounts an ICU shift ("...being sick brings out the very best and absolute worst in patients and their families and it all comes to a head in intensive care.") The poem conveys the intensity of dealing with difficult patients, and the array of high-tech equipment ICU nurses must handle. The nurse speaker finds one demented patient, "poor grandma," in the hallway trying to leave, with a "river of poop" running down her legs. There is also a "weak 90-year-old heart with a little old man attached to it," and his "poor terrified little wife." The nurse agonizes over how to, once again, "tell someone that a person they love is dying."

A few of the poems do take us to specific times and places in nursing's past, though not to the antiquity of the cover illustration. Nancy Kerrigan's "Ward 24: St. Patrick's Day 1966" describes a mental hospital in which patients are "overmedicated" with Thorazine, and the nurse-speaker offers cigarettes as "free admission tickets" to her group. The female patients receive green carnations for St. Patrick's Day: "The oldest patient / Lillian, who had a lobotomy, / watered the blossom with her drool." Tracy Klein's "Nursing Internship, LA County, 1990" contrasts the casual wellness of the staff with the sad condition of the patients ("As the cancer patients died you smoked").

Even many of the poems without a clinical setting focus on death. T.S. Davis' "The Gravedigger Thinks Of" offers a short meditation on the distance between the dead and the living, and more smoking, at a graveyard. Monica Groth Farrar's "Things They Save" seems to offer two perspectives on the death of a man--first a rumination from the man himself following his avoidance of a falling piano, then a short, wry message from his wife after he has died. And the speaker in Allan Nicoletti's "Open House" holds a hallucinatory, but possibly dangerous, party for his dead acquaintances.

RATTLE 's issue tells us something about the vital work nurses do for patients. But more fundamentally, it reveals the nurse poets to be thoughtful and articulate observers of the human condition. And that is a worthy tribute.

Review by Harry Jacobs Summers
Nursing Editor: Sandy Summers, MSN, MPH, RN
Reviewed May 16, 2008

The views expressed herein do not necessarily reflect those of the Board Members or Advisory Panel of The Truth About Nursing.