Of Poetry and Medicine: Rafael Campo in Conversation
Interviewer's Note: I’d read, admired, and reviewed the writings of Rafael Campo for many years but never met him in person until recently, when he was the keynote speaker at a medical conference in Boston and I was in the audience. His topic was poetry, a stark contrast to the weekend’s other sessions, the likes of gene therapy, cardiology, and advances in neurology. I wondered how this clinical audience, accustomed to scientific methods and proofs, would respond to Campo’s thesis: that caregiving and writing poetry shared the attributes of witnessing, healing, naming, and bringing about, if not cure, then wholeness. This conversation grew out of that initial meeting.
Cortney Davis: I’m interested in poetic beginnings, so I’ll first ask how old you were when you began to write poetry? Do you remember the trigger that made you first put pen to paper?
Rafael Campo: I began writing poems early in childhood. Poetry as a vitally important medium of expression was not at all unusual to me—as the child of immigrant parents, I was read poems by such greats as Pablo Neruda and José Martí, in the effort to preserve a sense of connection to my ethnic heritage. I suppose it also isn’t all that surprising that the first poems I wrote were responses to my perceptions of my mother’s mood—I wanted to make her feel happy when I sensed she was depressed, to console her with musical language. So from the beginning, poetry and healing were linked for me, from my earliest self-conscious engagements with words.
CD: Stanley Kunitz has suggested that “key images”—the sense memories he carries with him from childhood—influence and recur in his poetry. So much of your poetry comes from your work as a physician, images of the body both in pain and in ecstasy. Do you also have key images from your childhood that surface or influence the more contemporary images in your writing?
RC: For me, the key images I keep returning to have to do with injury and repair—having lost in such an incontrovertible way my homeland, that insatiable trauma, I often feel myself trying to restore the loss, to repair the fracture between Cuba and me. In a similar vein, I knew at an early age that I was gay, and so poetry has also been a place to heal the wound of being made, by society, to feel so painfully that difference. The poem, I’ve always felt, is an opportunity for me to create an integrated whole from so many broken shards. I suppose that may be why I’ve been drawn so irresistibly to so-called received forms, to meter and rhyme—to my mind, they are physical touchstones that provide a kind of entrée into the arduous imaginative journey back to my lost, decrepit island, to inhabit the beautiful but forbidden body of my desire. So I try to rewrite the sonnet, pushing against its narrow walls, asking it to contain a not-so-different love; beneath the scaffolding of a villanelle, I imagine I might rebuild the fanciful architecture of crumbling Havana.
CD: Many young writers today do their poetry apprenticeship in MFA programs—but it seems yours has been an apprenticeship forged of loss, alienation, and the longing to create healing or wholeness through the “ordering” power of language. What else has been a part of your poetic apprenticeship?
RC: Though I earned an MFA at Boston University with some wonderful mentors, including Rosanna Warren, Robert Pinsky, and Derek Walcott, I think my apprenticeship was really at the physical body itself, which I encountered in all its complexity during my medical training—a poetic education I imagine might register especially with you, given the way your own poetry is permeated by those inescapable rhythms amplified by our stethoscopes. I was stunned by the kind of drama enacted by those stubborn iambs resonating within a heart’s broken vessels, between the astonishing dignity of my patients and their incomprehensible suffering. This harrowing, lovely music, I soon realized, was the same one I’d always found in poetry. What other medium could accommodate all the struggling physicality and cognitive determination of this drama, and offer at the same time the prospect for peace, for resolution, for healing? I believe the indigenous Americans and the ancient Greeks in their great wisdom, before the advent of so many distracting technologies, knew that in poetry, in performative language, in catharsis, body and soul could indeed briefly be joined, and that in this union was a chance to abet healing.
CD: Earlier you mentioned the body, the body’s rhythms, and how in poetry we might find beauty in the flawed world. All these connect intimately with your work as a physician. What led you to medicine, especially when your early interest in poetry and language seemed to suggest you might follow a different path?
RC: I went through a difficult period during my late adolescence, when in the context of trying to conform to the standards of American teenage masculinity, I rejected the power I knew poetry possessed—I didn’t want to speak a strange language or be a sissy, and since part of poetry’s power was its honesty, its demand that I speak truthfully, I had to find some other occupation that would allow me to hide from my ethnicity and my gayness. Medicine seemed perfect: the white coat could help me be whiter, covering up my brown skin, and the machismo of the profession might straighten me out. Of course, these were ridiculous fantasies, but at the time they seemed plausible. I think on some level I was also drawn, in a naïve but self-important sense, to the possibilities of caring for patients—but I saw then more a chance to have power over others, to neutralize the kind of power I feared others might exert over me if I remained a conspicuous “minority.” Ironically, it was in the abjection of my patients’ suffering, in their courage in the face of suffering, in cleaving to their own narratives of their illnesses in the face of arrogant biomedicine’s efforts to subsume them in its own, that I was able to discredit the lies I had told myself and rediscover the peerless power of the voice, of bearing witness truthfully.
CD: It’s true that in healing and witnessing our patients, we are often healed ourselves. When you consider the interaction of these twinned pursuits, medicine and literature, does one come first? Do you consider yourself a doctor who writes poetry, or a poet who is also a doctor?
RC: In my experience of poetry and medicine now, I see them as inextricably interrelated—so I can’t call myself one before I am the other. I want to elaborate on what I was saying in response to your previous question. I think there are two competing narratives of the body, of suffering: the first is the one that comes from the lived experience of ecstasy or pain, the stories my patients tell me when they describe their symptoms, when they allow me to examine their bodies; the second is the biomedical narrative, which I construct with biopsy reports, CT scan results, CD4 cell counts and blood pressure measurements. In our current moment, in our rampant fascination with science, this latter “just the facts” narrative claims, arrogantly, to be the more important one, the more valuable one—so we remunerate physicians lavishly for tests ordered or procedures performed. And yet at the same time, what most patients seem to feel is most lacking in medicine these days is compassion, the sense that their doctors listen to them, that their own unique voices are heard—in short, that what I think of as their more “truthful” narratives matter. So to be a healer in the most meaningful sense, I think that of course one must be able to synthesize all those important facts and perform all those technical competencies but at the same time, be able to warm the hand of the patient dying in the ICU despite all the IVs and ventilator settings, or share the stories of a life well-lived at the hospice bedside when one more round of chemo isn’t going to help. I don’t want to live in a world where these two pursuits are pushed further and further apart, where all the mysteries of our humanity are explained by deciphering the human genome, where we have billion-dollar pharmaceuticals for even the soul’s ailments. As a humanist and a scientist, I think it’s a kind of hubris to even suggest we might someday “solve the problem” of human suffering. May we instead always honor—through art, through poetry, through music, through all our imaginative engagements with what is ultimately unknowable—the humanity of those who suffer! Here is where we must feel awe, and be humbled. Not by some rocket we send up into the air, or some drug that helps us live a little longer.
CD: You mentioned before that the body can sometimes seem like a “confined space”—a space within which exists the push and pull of the breath, the blood flow, the pulse of hormones and the waxing and waning of a life. And you said that in poems you push against the boundaries of received form in order to rebuild and reimagine what you’ve lost. In The Enemy, you have a sonnet sequence, “Eighteen Days In France”—and you’ve featured sonnets in other collections. Can you speak a bit more about how and why the formal impulse influences your writing and why the sonnet calls you?
RC: For me, it’s mostly a matter of hedonism. It’s so pleasuring to recapitulate the body’s innate rhythms in the sounds a poem makes—it’s almost like listening attentively to the heart beat and not just making a diagnosis but knowing that you are hearing a life being sustained. These structures, these patterns are just so utterly compelling—I could cite some scientific studies on the dramatic effects on our brainwaves or on our breathing rates reciting iambic hexameter can have—but I resist validating something any of us can feel ourselves with p-values! I guess it’s akin to how we feel on the dance floor and we move our bodies to the music’s beat—it’s primal, at once liberating and a potent reminder that we reside in physical, flesh-and-bone bodies. The sonnet, with its special emotional reference points and more extreme concision, in particular does that—I can’t help but feeling I’m making love with the millennium, that I’m whispering Spanish and English at once to my lover in some cramped hotel room with a view of the Mediterranean!
CD: Your poetry is revelatory and sometimes wonderfully subversive—sexually, clinically, and culturally. Has this honesty ever been misunderstood or criticized by your healthcare peers?
RC: Yes, I think it has, sadly. I’ve been dismayed to discover that what to my mind is an occasion for empathetic connection is sometimes perceived as threatening. Whether it’s an aversion to my critique of biomedicine’s self-aggrandizing but false claim to omniscience, or just the same old less inspired homophobia or anti-ethnic bias, or even an antipathy toward poetry bred by simple unfamiliarity with it, I have felt discouraged by some of my colleagues’ reactions to my work. But I hasten to add that I’ve had countless more positive responses, not only from fellow doctors, but also from allied healthcare workers such as nurses and chaplains and social workers. So I’m hopeful in the end that we’ll have room for all the storytellers in medicine—not just the Nuland’s and Sacks’s and Remen’s but also those who speak honestly and openly from outside of the mainstream.
CD: When I read your poetry, I find intelligence, rebellion, passion, honesty, the empathic depiction of suffering, music, love, the celebration of the erotic and often, as a base note, the tension of ritual, the awe of the mysterious, a familiarity with despair and, frequently, a hint of God. Am I correct in finding in your work a focused spiritual awareness?
RC: Writing a poem to me is a sacred act. It is a moment of profound reverence for the mystery of our humanity, in all its unfathomable complexities, feeling the hair on the back of my neck stand up as I realize what I am trying to do. It’s also an act of humility and service—another way it’s like healing—in which I give myself over to the power of narrative itself, the acknowledgment that no poem or story is owned by one person but instead belongs to us all. I don’t feel the fabled isolation of the creative act at all—alone, scrawling my lines out by candlelight, against the all-encompassing dark—but, on the contrary, am aware of all the possibilities for communion and sharing that poetry at its origins must have had. I want my poem to join me to “the other,” to satisfy not just a need in me to speak out, but also that need in another consciousness to recognize himself in another human being’s creation.
CD: I know that you sometimes show your poems, and the poems of others, to your patients, often slipping poems in with clinical information. Does this sharing of your poetry, of yourself, change the doctor / patient relationship?
RC: Very much so. I think my patients are surprised sometimes to find a poem together with patient education pamphlets or scientific articles—and yet so often that’s what they want to discuss at the next visit. A poem says to a patient that I want to know more than just my own biomedical narrative of her illness—that I want to take care of her as a whole person, with attention to both the blood sugar results and also her struggles to maintain them in our target for treatment—that slice of birthday cake she couldn’t eat at her child’s party, the sting each time she must administer her insulin, are just as important. Such an approach, I think, not only has practical value—because the patient who trusts me will confide in me the detail of a symptom that helps me reach the correct diagnosis more expeditiously—but also is more rewarding on a personal level. So many docs these days feel alienated from their own work and from their patients. I think that’s largely due to all the obstacles to caring for patients, really caring for them, that poetry can help short-circuit: the burdens of such a rapidly expanding knowledge base, the constraints imposed by managed care on the time we can spend with our patients, the challenges of caring for increasingly diverse, multicultural patients. Poetry gets us past all the machines, literally to the heart of the matter; poetry expands the interaction with a patient to a space without time limitations; poetry bridges those cross cultural gaps by speaking in the most elemental and mutually understood form of language we have.
CD: In her praise of one of your earlier collections, Landscape with Human Figure, Marilyn Hacker called you “a writer engaged in several of the pivotal struggles and issues of our era.” What struggles and issues do poets and poetry face today?
RC: In so many nations, poets are seen as the conscience of society. Poets are frequently involved in politics, and they give readings in stadiums. In Native American traditions, shamans are often among the most important members of the tribal community. I think poets must be engaged in the struggle for social justice for all, because the empathy our craft evokes in readers demands it. I’m skeptical of those who argue that poetry is only art—this stance seem to me to come from privilege, writers who have the luxury of imagining language as a plaything, merely an opportunity to exercise the intellect. Such poets perhaps have never felt the utter necessity of language. Witnessing whole life histories being extinguished by the AIDS epidemic in San Francisco, an entire community’s history in the process of being wiped out, convinced me of the absolute urgency of poem making, of telling stories.
CD: In poetry, much is made of the idea of “witnessing.” But as caregivers, you and I witness, close up, the most elemental and profound suffering. Can a poet, especially one who is also a caregiver, truly honor and witness another’s suffering?
RC: I’m glad you asked that—you must have also felt at times what we might characterize as a “pitfall” of empathy. What I think you’re implying is true—that it is impossible to know entirely the experience of another person’s suffering. To suggest otherwise, even in a discussion of the great empathetic medium of poetry, is another kind of hubris. So if I write a poem about my deaf patient, I don’t become deaf myself, nor do I even approximate the experience of deafness. It’s the gesture toward that possibility of mutual understanding that is so necessary, the reaching out, especially coming from the perspective of biomedicine, which so actively imagines the opposite—that there is no value whatsoever in contemplating deafness, just get the sign language interpreter or adjust the hearing aids and move on. I think instead poetry asks how we can all be implicated in an individual’s experience, and thus how can we best be of service, how we can best be present, mindfully, emotionally, at this difficult moment but stops short of saying glibly “I feel your pain.”
CD: If you had a crystal ball, what would it show you about your future? How do you see your poetic self evolving or changing in the years to come? Now that The Enemy is about to be published, do you see yourself taking a poetry break and returning to non-fiction or perhaps even fiction?
RC: I hope I’ll continue to write, but better poems, poems that do more of the work of creating community and engendering empathy. We’re living through some dangerous times, obsessed with our differences and convinced that strict adherence to some specific belief system—not just science as God, but for others only my God as God, or the self as God, or the dollar as God—will resolve our increasing number of conflicts. I think we need to get away from this idea that we are hopelessly fragmented, that there is no possibility of repair after Auschwitz, or Rwanda. I think we need instead to return to the ancient wisdom that in great works of the imagination lie our best chance to survive as a species, and that in the sum of our diverse stories especially, which are essentially synonymous with our humanity, is the only truth. I want to be helping to tell that truth.
Cortney Davis is a nurse practitioner in women’s health. Her poetry collections include Leopold’s Maneuvers, winner of the Prairie Schooner Book Prize in Poetry, Details of Flesh, and The Body Flute. Her memoir, I Knew a Woman: Three Women Patients and Their Female Caregiver, won the Center for the Book Non-Fiction Prize. She is co-editor of two anthologies of poetry and prose by registered nurses, Between the Heartbeats and Intensive Care.