The Talking Cure: New and Selected Poems

Book Title: The Talking Cure: New and Selected Poems

Author: Jack Coulehan

Publication Information: Austin, TX, Plain View Press, 2020, 212 pp., $17.95, paperback

Narrative-based medicine and reflective practice of medicine are part of a long tradition recognizing our patients as complex people with interesting stories to tell, rather than as collections of lab values and symptoms. We know that we should be more humanistic in our dealings with patients, but remembering how to do that, in the thick of things, requires practice. Knowing how to engage with our patients in a deeply human way can also be daunting, requiring the courage to be touched by their experiences. We struggle to connect while staying professional, while feeling safe. Reflective practice, done well, also honors our own humanity.

Jack Coulehan’s The Talking Cure: New and Selected Poems takes us right into the heart of narrative medicine. Dr Coulehan is emeritus professor of family, population and preventive medicine and senior fellow of the Center for Medical Humanities, Compassionate Care, and Bioethics at Stony Brook University.1 His career has been devoted to teaching humanism in medicine and medical interviewing,2 along with maintaining a robust research program. He also writes great poetry on the side.

A major focus in the book is the patient-doctor relationship, including many poems in which the poet inhabits the character of a patient, often with very funny and poignant results. These poems demonstrate deep compassion for patients who are difficult and demanding. “Isn’t” (p 49), and “I’m gonna slap those doctors” (p 65), immerse us in the anger, sorrow, and fear patients feel. Other works, such as “Virginia Ham” (p 96), explore how warm the patient/physician connection can be, and how sustaining.

Another theme has to do with imposter syndrome, particularly during internship. So many new physicians struggle with exactly that challenge, the fear of not being worthy. I especially like one poem from “The Internship Sonnets” (p 91), which begins:

Orientation. He appeared at seven,

welcomed by a voice, You don’t belong,

a repetitive warning that no one

heard but him…

“Sewage Treatment” (p 88) is another poem about medical education, that shows how time and reflection shape the process of moving from medical student to fully-fledged physician. As an educator, its wry humor made me laugh.

One my favorites in this collection is “The Talking Cure” (p 180), which examines friendship and intimacy and the power of words. In it, the poet describes a visit between old friends, both physicians, during which they discuss the power of words within medicine. Perhaps it is this unifying idea—that words matter, that thinking deeply about how we talk with our patients matters—that made this poem to be the title piece in the collection. A section reads:

We sip iced tea. They don’t teach the talking

treatment anymore. We used to be told

that words matter. Remember?

Another theme within this collection has to do with travel, and it becomes clear that Dr Coulehan loves exploring the world. His poems touch on the lives of people he meets in Ireland, Australia, Jamaica, Vietnam, Uganda, the Sinai desert, Denmark, South Africa, Turkey, and Egypt. In his travels and his medical work abroad, the poet displays an openness to be moved emotionally, and to listen to stories he encounters on the way.

Dr Coulehan was kind enough to allow me to interview him.3 We talked about how keen observation and compassion are essential in both poetry and medicine. I asked about his many poems that honor the rich tradition of physician-poets. Walt Whitman, William Carlos Williams, Anton Chekhov, John Stone… all are acknowledged, sometimes directly, sometimes by allusion, as in the repeated phrase “so much depends” in “All Soul’s Day,” (p 97). His poems reflect his interest in the lives of these earlier travelers on the journey. Some poems are larded with juicy tidbits—did you know that William Carlos Williams circumcised Ernest Hemingway’s first son on the Hemingway kitchen table (p 108)?

Both in person and in his work, Dr Coulehan is witty and warm. He has a generous and humble spirit that permeates his work. This prevents his poems, even the most profound, from being at all ponderous.

I have two guidelines for myself when it comes to judging poetry. First, does it stay with me long after I first read it? Second, is it worth memorizing? On both counts, Coulehan’s work gets a resounding yes. When you read this fine collection of poetry, take your time and savor it, the bitter with the sweet. It is rich and complex and satisfying.