“Immunology.” “Hospice Rounds.” “On Doctoring.” These aren’t topics that Rafael Campo, MD, has taught at Harvard Medical School (HMS) — they are poems he has written. And he has written hundreds of them, scores of which have been published in seven books, featured in journals like The Paris Review, translated into six languages, and honored with a range of prestigious awards.
Over the decades, Campo has repeatedly heard that poetry and medicine don’t mix. Yet he has no doubt that poems offer a gateway into the intimate stories and emotional connections that are vital to the art of healing.
That’s why Campo often conducts workshops in reading and writing poetry for his students and fellow physicians. He also serves as poetry editor of JAMA: The Journal of the American Medical Association, directs the writing program of the HMS Arts and Humanities Initiative, and likes to slip poems into information packets for his patients.
AAMCNews recently talked with Campo about what poetry means to him as a gay Latino man, as a primary care doctor who treats many patients with HIV and AIDS, and as someone who cares deeply about the future of medicine.
What first attracted you to poetry?
I first became interested in poetry as a means to explore the fracture I felt growing up here in the United States as a child of immigrant parents. My parents used to read me poetry as a way of connecting me to my Cuban heritage. Then I became aware of my sexual identity, so I felt another disconnect from the majority of my peers. But I found that through stories, through narrative, we can understand each other across differences. So poetry always was a source of healing for me.
What happened when you began trying to weave together medicine and the humanities?
In college, I had a liberal arts education in which science and the humanities didn’t seem that distant from each other. When I attended medical school, I had this hope that I would still be able to join these two ways of knowing about the human condition. But when I got there, the focus was really on the hard sciences. I remember attendings saying, “Just give me the facts.” There was little room for the patients’ stories that were flooding me in a powerful way. I was being taught, “We don’t spend a lot of time on social history. We are here to cure disease.”
That was really troubling to me, so I took a year off and earned my MFA in poetry. That year was transformative as I rediscovered the power of voices to heal.
As an intern in the early 1990s, you cared for many patients with AIDS. How did you see poetry at work then?
I did my residency at University of California, San Francisco, Medical Center during the height of the HIV/AIDS crisis. People were just dying everywhere, mostly men my age for whom we could do very little. At the same time, activists were out in the streets marching, chanting, “Silence equals death. Silence equals death.” It underscored for me that our voices indeed do matter. That outrage, that refusal to be silenced, often expressed in the poetry written about AIDS, spurred scientific discoveries that have saved countless lives. So there’s power in narrative and poetry that actually can heal in a concrete way. Of course, stories are therapeutic in that they connect us empathetically with individual patients, but they also can change the course of a whole epidemic.
the body’s workmanship, how perfect is
its service to the soul it shelters, each
soft hair along the shin enshrining touch,
this way we’re made to need each other’s care.
– From “On Doctoring”
You believe poetry can help make physicians better providers. How?
Even though we have all these amazing technologies at our disposal, there are limitations to what we can do with our scientific expertise and technical competence. When there isn’t another round of chemotherapy or another surgery to perform, poetry teaches us to be healers in a broader sense. It allows us to be more empathetic at a difficult time for patients when we can provide comfort and be present for them.
Sometimes physicians are so busy we can hardly keep our heads above water, and we are feeling so many pressures. Reading or writing poetry creates a space for empathy, for seeing another person, for bearing witness to our common humanity. Poetry, and the arts more generally, allow that chance to be human together with our patients.
You make time in your busy schedule to hold poetry workshops for patients. Why is that?
What we often do in medicine is write a medicalized version of a patient’s story in their chart, which means we, to some extent, appropriate their story. Giving patients back the power of telling their own stories is therapeutic in and of itself.
Poetry also brings people together into community and eases the isolation of illness, especially in a workshop setting. It helps patients see that they are not alone, that someone else has experienced this kind of pain. Studies actually show that patients who read poetry together experience decreased pain and symptoms of depression.
At times fellow physicians have said poetry and medicine don’t mix. How do you respond?
A lot of people — not just fellow physicians — say, “Poetry and medicine, really?” My response — and as poetry editor at JAMA, I see so many physicians who are making this point too — is it’s not far out. It’s actually central to the work we do in medicine. Poetry at its heart is this shared empathetic experience not unlike the clinical encounter, where we are often engaged in the very private experience of another person’s suffering.
Unfortunately, many of us were taught poetry in a way that wasn’t accessible. It was presented as coded language, very complex and very rarefied. But the best poems are highly accessible and reach us viscerally. When you listen to a heart with a stethoscope, you can hear the beating of the physical body. Poetry also has a rhythm, a meter. Poetry and medicine are both visceral and physical. If you dig a little deeper, there really is a profound connection between them.
O body, even as you age you sing,
you are tender in certain places, you
believe you could be dying. Body, please,
repair yourself once more, bleed and stink,
decay again until, beneath your fragile skin,
I see the outlines of the soul you shield.
– From “Primary Care”
How do you see poetry helping medical students in their training?
For years when I was a medical student, I was explicitly taught distancing, what was termed “detached concern,” and that still happens in many places. Or it sometimes may be taught through the hidden curriculum in which physicians model certain behaviors and create hierarchical ways of thinking about our relationships among ourselves and with our patients.
But poetry and other kinds of stories provide details that help us better understand some of the painful health disparities in our country. When I teach medical students about health disparities, the statistics can become just abstract numbers in some sense. But when you can contextualize them in the perspective of someone who has actually lived that experience of disparity, you can completely transform how we understand inequities, and we can be moved to act to change them.
I hope we see more required courses that integrate humanities into the patient care experiences of learners. A lot of my colleagues might say, “But I don’t know if I could teach a poem on rounds.” Luckily for medical schools, many are anchored in larger universities where humanities departments are eager to partner with their colleagues in the sciences. If we could draw on that potential synergism, it would be wonderful for the future of medicine — and the humanities.
Actually, as medical education is evolving now, we’re seeing more health humanities programming across the country. These kinds of efforts to really integrate the humanities into medical education bode very well for the future of our profession.