Imagination and Healing

JAMA’s new poetry editor discusses the healing power of the arts

Rafael Campo

Rafael Campo

Rafael Campo, MD ’92, believes in the power of imagination to make sense of suffering, to heal, if not the body, then the heart.

As a physician, he has been dedicated to this idea for nearly 25 years. As a poet, though, Campo’s been writing to heal for a good deal longer.

His dual approach has been newly recognized: On Jan. 1, he became editor of JAMA’s Poetry and Medicine section.

Campo, an associate professor of medicine at Harvard Medical School and a primary care physician at Beth Israel Deaconess Medical Center, has published nine volumes of poetry and received numerous poetry awards.

In addition to his clinical duties, he teaches medicine and writing to Harvard’s medical students and serves on the executive committee of the HMS Arts and Humanities Initiative.

Harvard Medicine News interviewed Campo at Beth Israel Deaconess. Campo, lively and with a warm smile, seemed comfortable and ready to express his cascading and expansive thoughts on poetry and medicine and his plans for JAMA’s poetry section.

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You’ve been JAMA’s poetry editor for a couple months now. How is it going? What are you finding out about submissions and how do you choose what to publish?

We get thousands of submissions, and we can only publish 50, more or less, per year. One per week, roughly. That’s maybe the hardest thing about being the editor, because there are just so many wonderful, worthy poems, and I can’t publish them all. I’m seeing and reading poems about empathy, about cultural difference, about end of life, about, really, the nature of human suffering.

I feel that there’s this worry that poetry that responds to illness is always going to be depressing. Nobody likes to see someone else’s pain. It’s hard. But these poems are in some ways just so transcendent. They are inspiring in how they seek a kind of response, a kind of healing in the face of dire situations, dire health issues.

I’m learning a lot as poetry editor of JAMA about how care providers, doctors in particular, are making use of narrative to respond to some of the pressures that we continue to experience in medical practice and in medical education as well.

Much of the poetry speaks to the brokenness of our systems in medicine. I’m seeing so much poetry that is really trying to make sense of a system that unfortunately isn’t serving our patients or us, as healers trying to work within the system.

That’s not to say writing a poem fixes all the problems we face in medicine. But I think it does provide a space or an opportunity to give context to the challenges we’re all facing in this changing system and this changing profession.

That’s something I hope people will understand about this work: it’s actually uplifting. We can’t always cure the disease, but I think, in even the worst of situations, there’s always an opportunity to find healing.

Who submits to JAMA?

Mostly physicians but also, increasingly, people living with illness. And other care providers, whether they be in the health professions, like nurses, physical therapists and pharmacists, or family members of people who are living with illness or who have confronted illness. For me, receiving poems from physicians is really gratifying. It gives me hope for our profession that there are docs out there who are engaging in this way.

Another thing I see, which is gratifying, is that doctors are, in a way, rediscovering what called them to medicine in the first place through these poems, and again, those basic gestures of empathy, of compassion, of really hearing another’s voice, someone who perhaps doesn’t have a voice in the larger culture. I see poems that are very moving and, I think, potentially life changing for the poets and for those who read the poems.

JAMA has history of weaving the humanities in with the science of medicine. So how can reading and writing poetry help physicians and scientists in their work?

Poetry’s never going to take the place of many of our medical interventions, but surely it exists alongside of what we do in terms of the science of medicine. It helps us be better scientists. I think the best science is born of the kind of creative, out-of-the-box thinking that we see in the humanities. Those leaps of metaphoric language and metaphoric thinking—the best scientists, that’s what they do. That’s how they invent. That’s how they create new paradigms. That’s how they understand a problem, an old problem, an unsolved problem, perhaps, from a different perspective. So there’s actually much more in common between the two than we often realize. It’s a way of thinking or a habit of the mind.

Some of the more practical ways poetry can help us is to be more attentive, more empathetic listeners. There are some studies that show that medical students and physicians in training who are exposed to poetry are considered by their patients as more empathetic in providing care. There are other studies that show that the attention to detail and the focus that comes with close looking, whether it’s the imagery in a poem or what we see in a painting, can help physicians be more observant and better reporters on, for instance, what a rash looks like or what the findings are on an chest x-ray.

An appreciation of the arts and humanities can give us that larger human context. Rather than seeing our patient as a list of problems, we can reimagine our patient as a specific story in the context of a particular life. And we can then ask what does breast cancer, diabetes or any other condition mean in that particular person’s experience in that person’s community and in that person’s family.

I don’t think of poetry as an irrelevant diversion. I think it’s central to how we can best treat our patients. How we can heal.

We doctors, who deal with life and death every day, who look into the eyes of people who are in pain, who are dying, or who are giving birth and having one of the most joyous experiences of their lives, need the humanities to help us make meaning of those experiences for ourselves, and for our patients. That to me is what being a healer truly is.

What would you say to physicians, scientists and students who write, or want to write, poetry? How would you encourage them to keep writing—or take up the pen? What can you say to our readers to encourage them to submit to JAMA?

I would say, first and foremost, don’t fall into the either/or mentality that says, “Oh, the arts, the humanities. That’s a diversion. Or, that’s my hobby,” or, similarly, “Science is the real deal. That’s the important thing I do.” Look at them as joined, as complementary, as deeply connected. That would be my first piece of advice.

And then I would say, don’t let the science crowd out the humanities. Go to that film festival. In addition to reading all the scientific articles in JAMA, read the poetry in JAMA. Pick up the novel that you wanted to read. Go to the art museum with your kids, with your family. Those kinds of things will spark your impulse to create. The humanities mirror who we are, and so seeing ourselves is the first step in creating our own art, to tell our own stories.

Once you’re doing that, once you’ve begun engaging with the humanities, try keeping a journal. And then send me your poems. I want to read them. And the world wants to read them, because there’s so much interest in the perspective we have. We’re so privileged to have this front-row seat, in a sense, to human experience. So little of that experience is shared with the larger world. There’s this incredible hunger for these stories in the larger world.

For those who are not writers or artists—can you recommend a poem, a poet or collection to get them started as poetry readers?

There are several that come to mind. Some of our most consequential American poets have written from the experience of illness, from medicine. Walt Whitman is a quintessential American voice—democratic, inclusive, inspiring, physical. I think that some of the best poems of another seminal American poet, Emily Dickinson, speak to healing in a broader sense.

Some of William Carlos Williams’ poems are of particular interest to doctors and others interested in medicine, because he himself was a doctor. And he also wrote in a poetic language that’s very accessible, very democratic.

Several anthologies by physician poets are easy to find. One of these, Blood and Bone, is particularly good. Such anthologies can be great starting places for physicians and other care providers who are interested in poetry that comes out of their experience in a more direct way. And they’re written mostly by fellow docs.

In your poem “Tuesday Morning,” you say “words don’t cure.” But in the introduction to your latest book, "Comfort Measures Only," you talk about the power of imagination—as expressed in writing and other forms of art—as having the power to heal. How do poetry and other art aid in healing?

I think there is an important distinction between curing and healing. It’s not just a semantic one. I do think that while poetry may not cure—although there is some interesting evidence out there that for certain mental health conditions, poetry can actually be therapeutic—in the broader sense we’ve been talking about, poetry can heal. I can describe a couple of ways poetry heals.

One is through the rhythms in poetry. There’s actually some science to back this up. Much like meditation, when we hear rhythmic language, when we read poetry aloud, our breathing and our heart rates synchronize. So just as meditation might be beneficial for certain health conditions, the same can be said of poetry.

April is National Poetry Month

Another way is more metaphoric but very important. What we do a lot in medicine is take narratives from our patients. We appropriate them and we medicalize them and we put them in our patients’ charts. And then their stories become our story. What poetry and other kinds of writing can do is restore that narrative to the person who’s living it and give that person a sense of control and a sense of authority as the author of their own experience.

I think that can be powerful for patients. I’ve led writing workshops for patients with cancer and with HIV infection and it’s dramatic how, by reclaiming their stories and, really, authoring their experiences, they feel empowered—and they feel better. So, that’s another way I think poetry and writing can be healing.

Listen to the HMS podcast "Rx: Poetry" with Campo. Read Campo’s poetry and more about him in Harvard Medicine and on his website.