IIn an unremarkable lecture hall on a rainy Monday afternoon, Cândida Pereira talks passionately about the intricacies of a poem by the Portuguese politician-poet Vasco Graça Moura. Her classmates listen closely as the second-year university student enthuses about lyric form, poetic voice and Moura’s use of “perceptual imagery” and “sensual tone”. Nothing unusual for a standard poetry module, perhaps. But once the bell rings, Pereira will repackage her well-thumbed poetry anthology and replace it with more prosaic textbooks on neuroanatomy and pharmacology. The 19-year-old is one of around 20 trainee doctors at Porto University’s medical faculty who are taking a new elective course on the fundamentals of modern poetry.
In today’s increasingly transactional health care culture, the initiative indicates a belief in the priority of person-centered care and old-fashioned notions of a doctor’s “bedside manner”. As the course creator João Luís Barreto Guimarães explained, poetry has a unique ability to help students connect holistically with their future patients, instead of viewing them as a medical problem to be fixed.
“For this reason, I get them to look at poems that talk about empathy, compassion, solidarity and other similar humanistic values that doctors should strive for when they are in front of a patient,” he says.
The 56-year-old Guimarães, a graduate of the university’s medical department, has been a practicing breast cancer surgeon for three decades. However, when he’s not in theater performing life-saving surgeries, he’s back at his desk crafting his own poems. The author of 10 published collections, he was awarded Portugal’s Pessoa Prize in 2022 in recognition of his contribution to the arts.
On the surface, his twin passions have little in common. Indeed, his search for a literal link leads him to resort to metaphor: cutting out words during editing, he thinks, is “a bit like how I cut out a tumor with my scalpel”.
Similarly, the structure of the course seems relatively conventional, covering basics such as images, sound, tone and rhythm. Yet, with his audience in mind, Guimarães mined his collection of anthologies by the British poetry publisher, Bloodaxe Books, to ensure that each class has at least a handful of poems that link to medicine. The course reading list includes a number of notable poet-physicians, including Júlio Dinis (a Portuguese surgeon), William Carlos Williams (an American pediatrician), Gottfried Benn (a German pathologist), and Miroslav Holub (a Czech immunologist). Its didactic intent is sometimes not too subtle, Guimarães admits. Poems about doctor-patient scenarios or famous healthcare settings, for example, provide students with an easy bridge to their everyday studies.
Take the example of Wendy Cope‘s poem Names, quoted in a module on the depictions of the human body in poetry. The short single-stanza poem describes the life of a woman christened Eliza Lily, but who in practice goes by a variety of different names – Lil, my darling, Mrs Hand, Nanna. But when she finds herself in the hospital at the end of her life, alone and friendless, the medical staff know nothing about her except the clinical contents of her medical file. So, as Cope’s heartbreaking poem concludes: “For those last confused weeks / she was Eliza again.”
The lesson? To remember the person behind the patient, Guimarães says: “These days, doctors often don’t have time to stop and think, so everything is quickly reduced to the technical and mechanical. What I try to convey to the students is that, like a poem, each of their patients is unique.”
In a similar way, the classes can help open up conversations about the emotional roller coaster involved in being a doctor and help students consider how to handle the job. Take John Stone‘s poem Talk to the family. In a few short lines, students come face to face with the pain, confusion and stress of the unpleasant but inevitable task of delivering bad news.
“… I will tell them.
They will put it together
and take it apart.
Their voices will buzz.
The severed ends of their nerves
will curl.
I will take off the coat,
drive home
and replace the light bulb in the hall”
Guimarães’ lore does not remain only with the most accomplished poets. He is especially a zealous advocate of exposing students to the “evils” of excessive sentimentalism; a habit he is determined to avoid once they hit the halls. Nor does the course avoid poetry of a more abstract or complex nature, something he sees as an invaluable tool for elucidating the capacity of speech to conceal and reveal.
It is not just poets who try to disguise their full meaning behind clever wordplay and literary devices, he argues. For reasons of fear, mistrust or simply embarrassment, patients do too (“And your estimated units of alcohol per week, sir?”). Good doctors, he thinks, know how to “read between the lines”. “In our lessons we often talk about decoding, because the use of illusion or symbolism or enigma is something that many poets do to convey their message in a hidden way.”
Guimarães quotes his own poem, História Clínica (Clinical History), in this connection. While ostensibly about a woman undergoing a double mastectomy, beneath the surface lies a darker story about her experience of domestic abuse. The poem plays with the double meaning of the Portuguese word medal, which can mean “medal” (here used in reference to the woman’s breasts) or, less commonly, “bruise” (linked in the text to the “bad mood of her husband”). The ambiguity surrounding the word is maintained until the final, devastating line. The woman is now cancer free thanks to the operation, but due to the loss of both breasts, her husband leaves her. Finally, Guimarães’ poem ends, she is livre de perigo (“free from danger”).
Since starting the course, Guimarães has received several requests to teach at other medical faculties Portugal. He is not alone either. Barcelona’s Pompeu Fabra University, for example, recently introduced a course in literature for its second-year medical students. Cândida Pereira, for example, understands the appeal. Like poets, doctors must be in touch with their feelings, she argues. Although a further step is probably required of them. “As doctors,” she thought, “we also have to be in touch with the feelings of our patients.”
