“Grappling This Present Moment”

A Poem and Conversation with Ron Louie, MD: Part 1 of 3

This is part of the Medical Humanities Series on Op-Med, which showcases creative work by our members. Do you have a poem, short story, creative nonfiction or visual art piece related to medicine that you’d like to share with the community? Send it to us here.

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Matter of Fact

Her face was matter of fact when she heard the pronouncement.
The neuropsychologist was her colleague; he remained professional,
but slipped in some sympathy with the data, which I could not appreciate.

She didn’t display a mask of depression, or Parkinson disease.
Her face remained pliable, not pleased, but neither terribly pained,
no exhibition of perplexity, or petulance, or surprise, a pensive look,
retaining its complex grace, a quiet reserve, a solemn alertness,
the beauty of humane consciousness, with no further expectations.

In her own practice, she had encountered early Alzheimer disease first hand:
that wonderful younger woman, whose baby she had delivered,
working in accounting until the numbers became exotic, then alien;
she had told me about that patient, with shock, sadness, and resignation.

But I didn’t understand this. I wouldn’t. It was the guy, his tests, the setting.
At home, I made her try to draw a clock, count backward, recite words, and
copy intersecting rectangles. She tried, this good doctor who had always
bested me in calculus, organic chemistry and marriage. She wasn’t angry.

So how could I be mad? She was setting the example, as she had done
her whole life, her whole career, without pessimism or regret, or fanfare,
just ready to go on, even though her words and steps might mutate,
unpredictably, ever aware of the possible endpoints, with each of us
now grappling this present moment, trying to recognize its identity.

Dedicated to IRJ, MD; suggested by Meryl Comer

Citation: Louie R: Matter of Fact, Neurology 2018; 90:139.

http://n.neurology.org/content/neurology/90/3/139.full.pdf

DOI:10.1212/WNL.0000000000004841

A Conversation with Dr. Louie

On the inspiration

These poems were each inspired by specific medical encounters, not that different than the daily work of every health professional. It’s a privilege just to be present at certain interesting moments, and some lend themselves to this kind of “alternative documentation.”

On poetry as contrast

Poems take advantage of word choice and prosody (the technology of poems, if you will) to create a certain density of meaning. The telegraphic style used in the medical record is usually spare and clipped, reflecting convenience and utility, also dense with meaning, so poetry offers both a complementary shorthand and a nice contrast.

On poetry and medicine

I have been reading poets and writing poems since high school; in college I studied with the poet Robert Wallace. Writing poems helps me step back and try to understand my practice from a different viewpoint.

On the art of medicine

My view is that excellent medicine itself still requires the deft skills of an artisan, despite all the incursions and obnoxious expectations surrounding contemporary practice, and the age-old under-appreciation of art.

Ron Louie, MD is a Clinical Professor of Pediatrics at the University of Washington, Seattle. He can be reached at ronlouie@u.washington.edu.

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