Tender Fences

Book Title: Tender Fences

Author: Richard M. Berlin

Publication Details: Dos Madres Press, 2024, 122 pp., $21.00

Poetry has many purposes in medicine, medical education, and society. Dr Richard Berlin fully understands and embraces the power of poetry. In Tender Fences, his fifth collection of poems, he offers 59 poems that range from observations of medical training to lessons on writing; some are simply whimsical observations about topics as benign as listening to NPR or having trouble sorting socks.

Berlin is a psychiatrist who resides in western Massachusetts. He began writing poetry in his 40s. He is also the author of 60 scientific articles and has edited two books, including Poets on Prozac. ² While he began writing poetry later in life, he harnessed the craft and is a keen observer of people, life’s nuances, and all things medical. His poetry includes odes to cars, orchestras, and even bears, yet he is at his best when he invokes medical topics. For example, one offering is a series of house staff senyrus (Japanese style haikus) that captures the range of emotions and tasks from reflecting on long shifts to being pregnant during residency. Elsewhere, he engages our collective emotions about electronic health records and prior authorizations. For a psychiatrist, he really celebrates the breadth of medicine.

Like other doctor-writers, he uses graphic phrases and images to bring mundane moments to life. On one page he contemplates the power of Jolly Ranchers as bribery for children to cooperate in a pediatric setting, and on the next page he pivots to contemplate the ethics of profiting as a doctor-poet from the sickness of others. One of my favorites is a poem titled How a Psychiatrist Writes a Poem, which invokes everything from Freud to autumn and Earl Grey tea. In this poem we experience Berlin’s ability to be vulnerable, observant, and witty all in one set of stanzas. This collection is a place to be entertained and in awe. We realize that we are in the presence of a colleague who clearly loves doctoring. None is more obvious than a poem where he reminds us, maybe even chastises us, that the extraordinary moments in the lives of those who are homeless or infirm risk becoming ordinary to us. These are lessons that every health professional should pause to ponder: Who are we? Who are we caring for? Where do people come from? And what do they endure? Those profound questions are captured in the book’s creative constellation of words focusing light on people and places all around us.

For fellow writers, his first few poems will truly resonate. He is playful as he recalls the juxtaposition of writing progress notes alongside poetry. In Muses, he invokes not the writing gods but rather veterans and alcoholics to inspire us to put pen to paper. If this is not enough, he also has poetry about retirement, birthdays, and the COVID-19 pandemic. In fact, he includes a whole section titled “Sheltered in Place.”

Many of the poems are very personal. Berlin offers a poem about his mother, and the book is dedicated to his brother. He lovingly pays homage to his daughter as she completes medical school. He is haunted and enthralled by his Jewish ancestors and captures this in a poem called Immigrant. A few pages later, we are drawn into his father’s life as he looks back at his challenging summer labor in the poem Sweat.

And then there is the poem about socks. It’s my wife’s favorite. It is the perfect antidote for when life gets too serious. A chance to smirk and recall how silly we can be and how important it is to laugh at ourselves. Within one page, once again, he swings back to the more serious with the eponymous poem Tender Fences. Here he eschews the idea that, like cattle, we sometimes need a porous fence to allow for grace and flexibility: “barriers that create space for healing, . . . strong enough to hold tight before it bends” (p. 52). Medical students, residents, and clinicians can all find inspiration, entertainment, solace, and comfort within this short book. Berlin has a remarkable range and a keen eye for what is all around us, if only we take time to notice.