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Poet and Physician: A Chat With John Coulehan, MD

— Coulehan wears three different hats: physician, ethicist, and poet

Last Updated August 10, 2016
MedpageToday

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"I have a background in internal medicine, and for my whole career I have worked in a teaching hospital," said , who also happens to be a poet with six published collections to date.

Coulehan, who is a professor at , attended medical school at the University of Pittsburgh. In the past, he served as the director of the ethics and humanities program at Stony Brook Medical School. Coulehan was also the chair of the university hospital's ethics case consultation service.

He has received prestigious awards for his work as a physician, an ethicist, and a poet. His newest collection of poems, , was released this past June. Coulehan recently talked with ֱ.

1. How did you first begin writing poetry? How many of your poems are based on personal experiences?

It is peculiar how some people who are poets seem to be drawn to poetry. I was always interested in poetry, even going back to high school and college. As I look back now, I really have no idea as to why -- sometimes I wrote poems for my girlfriends, and though that it would impress them

As I got into medicine and began my medical training, poetry got away from me. I really got into writing regularly in the early to mid-1980s, when I was close to 40-years-old.

I really owe it to a patient of mine who was a poet and a university professor who stimulated my interest. I told her I had written poems before, and she encouraged me to start again. I did start again, and for one reason or another it just took hold and became a regular part of my life. I think there is a kind of therapeutic aspect to writing poetry, which was helpful for me.

To answer the second part of the question, I think that the large majority of my poems are based on my own personal experiences. The medical poems are based on my experience, but in many cases I change or combine things, so they are not what you might call "non-fiction" but they rise out of my experience. The same goes for poems about my family or about places I have visited; I sometimes write poems based on historical fictional characters, but in a way that is also my own experience because it is my response or interpretation.

2. The Wound Dresser, which is your sixth collection of poems to be published, is divided into four sections. Tell us about each of these sections.

First of all, when I write these poems, I am not thinking about where I am going to put them -- I just write them.

I recall a few things that came to mind when I put this book together: It is very late in my career, I am no longer practicing, only teaching, so I wanted the book to pass time, beginning from the early part of my life and continue on, which explains some of The Wound Dresser's structure. The very first poem in the book is about when I was a medical student/intern, and the very last poem is a retrospective piece that looks back on 40 years in practice.

In terms of the four sections, the first one includes all poems dealing with medical subjects and primarily my own experiences and patients.

The second section deals with historical or mythical topics.

The third section focuses on looking at different places around the world -- there is one poem in there about seeing the museum in Ho Chi Minh City, and another about visiting Cambodia and Istanbul. Not all of these are medical, but they all have themes related to healing, illness, or the sickness of the world.

The fourth section's poems are more personal and detail myself and my family. The section also includes some poems about when I was a teenager and even a young boy.

3. We understand that much of your inspiration comes from the work of Walt Whitman. Tell us more about that.

First of all, I have always liked Walt Whitman as a person because he was very counterculture because he spoke up. He was actually a journalist as well as a poet, and was a very individualistic person who stood up for what he believed in.

I liked his poetry because it was inclusive: it dealt with all aspects of society. When you think of those days when people were writing strict meter poems that rhymed and were usually about love and abstract matters, Whitman was writing about everyday things, and about normal people and their activities.

The idea that he volunteered his time during the Civil War to work in a hospital tending to wounded soldiers appeals to me. I thought that even though only a couple of the poems in the book are explicitly about him, I thought his philanthropic actions would be a nice theme for the book.

My interest in Walt Whitman also stems from his time as a nurse in the civil war. He inspired me to [see] a tension that exists in medicine between tenderness/compassion and steadiness/objectivity. I think that this tension is at the core of medicine, and that is another idea I tried to put into this book. I think readers will understand that there is an acceptance of compassion and also a stepping back from compassion in the book.

4. When did you write "Metamorphosis at Starbucks"? You write of a man who has become a woman, "She's not like those miracles in the paper; she's real." Is that a comment on recent events involving the transgender community?

The poem is at least 2 or 3 years old, so it antedates the great bathroom debate.

I used to go to Starbucks every morning, where I would read the paper and drink coffee. This person came in regularly. Since she was also there almost every day, we naturally acknowledged one another.

As I wrote in the poem, I had the opportunity to watch her transition -- at least partially -- over a period of time. I think since this was an older woman the ability to transition was not as easy as it would be for a younger woman.

Here is a person who had the courage and integrity to go through this process, which must have been very difficult.

On the other hand, when you read the newspaper, there is something about a new treatment published every single day, which get people's hopes up. Many of these are really just a flash in the pan; and most of these new treatments turn out to be phony. Despite the phoniness of these developments, they still get covered by media because our society is gullible, and is also very interested in medicine, and then people believe in these things.

What I wanted to say was that here was somebody who was so committed to her personal identity that she was willing to go through this process, and I really admire her for that because she was a real medical miracle -- she's the real thing whereas what you read in the paper is usually hyped up.

5. In your poem "He Lectures" at the Heritage Association Dinner, the subject of the poem sparked conversation about the "distinction between letting a patient die and killing" but does not actually voice an opinion of his own. Is that a comment on the effectiveness of these sorts of gatherings?

To give background the "He" in this poem is me. I am putting myself in the third person here, which I do in a few other poems of mine.

Part of my work as an academic was as a medical ethicist and an ethics consultant, so I often gave lectures to different groups about topics related to medical ethics.

This particular poem has to do with end-of-life care and I guess what the poem is about is that even if you arrive at a function with a prepared speech, and provide all kinds of logical reasons with specific legal/ethical doctrines to support them, you might receive pushback. When you are dealing with a topic so many people have very personal and emotional responses to, they are likely to interrupt, and start to ask questions or make comments, thereby generating discussion within the group.

Rather than actually give the talk you prepared, you end up just listening to all of the back and forth and the different opinions the people have.

The poem is a little bit of an exaggeration because usually I get to give at least part of my talk; however, it is an exaggeration to demonstrate that those of us in medical ethics see these topics as subject for intellectual discussion that require rational decision-making. On the other hand, most people who are not clinical ethics' physicians see these topics as very personal and emotional, which is why they only want to express their opinions.

The poem is ironic because if you took it literally you would think "He" stood up, and then everybody immediately started talking. The audience then emphatically thanked him for his wisdom, which he did not actually give.

6. Is there a seventh collection in the works?

Yes. I am not consciously saying 'Next year I am going to put out another book,' but I am still writing, and I anticipate that if I remain healthy and able to write then I will do another book. At some point I would like to do a collection in which I would include poems from many of my books.