JG

By Jeremy Groves, Council member

Poetry and critical illness. Each summer, in the leafy suburb of Sheffield where I live, we have a festival.  There are an eclectic mix of events: concerts, open gardens, a fete and this year a scarecrow competition.  One I always enjoy is organised by a friend, John Birtwhistle, who happens to be a poet.

Last year he read some of his own poetry from a new anthology, this year he took on the theme of death.  Not death in the sense of an elegy, but people writing about their own impending death or their feelings about the death of a loved one or patient.  The poetry spanned both time and continent.  The contrast between the factual brutality of a medieval European poem and sound bites from 17th century Japan was fascinating.

Most of the poems were from a time when death was part of everyday life.  The traditions, often encapsulated in a religious wrapper, were far from the experiences many people have in a 21st century developed, westernised society.  Except one.  This, and the poem really struck me, is reproduced below (with the kind permission of Bloodaxe Books).

 

Vigil.

Your eyes open, silver

For one second, close.

Your hand stops, falls still.

You send me no more messages.

The machine by your bed

Is saying prayers for you.

It keeps watch, tenderly interpreting

Your body’s needs.

It listens and records your every breath,

The turning of your blood, your heartbeat.

All night, all night, it pays close attention

To you. At dawn it stops.

I try to read its face.

The machine is blinking back

Its tears.

ImtiazDharker (2014), Over the Moon (www.bloodaxebooks.com)

The poem is about ImtiazDharker’s husband who died of cancer.  The imagery it portrays of the monitoring, watching over its ward, imbues the machinery with humanity.  It becomes a soulmate in Imtiaz’s vigil during the last hours of her husband’s life.

The situation in the poem is a daily occurrence for all those who work in intensive care.  We spend an inordinate amount of time, rightly, studying how to combat disease.  We perhaps spend less time studying or thinking about how to be better at empathy and compassion.  Our scientific rigor lends to the perception of our machines as just that, machines.  Perhaps reinforced when it becomes increasingly obvious that a patient is not going to survive and ongoing multi-organ support is, by some, deemed ‘cruel’.  Cruel is an emotive word.  It is diametrically opposite to the care the critical care team are aiming to deliver.  This, I think, arises from a view that the technical environment of a critical care unit can be depersonalising.  Using words to changing our thinking about the machines could, perhaps, alleviate this for clinical staff, relatives and patients.

Words are powerful things.  I think it would be helpful, when all seems desperate, to explain in comforting words what we see our machines as doing.  Words to give a relative something to think on during their vigil, maybe even to read to their loved one.  Not perhaps as in the poem above where death is the outcome, but one which emphasises the sentiment, expressed by ImtiazDharker, humanising the technology and aiming to give a message of hope for both patient and relative during those long bedside hours.

John Birtwhistle is keen to produce a poem to that effect.  If you know of other poems putting modern critical care into an accessible context, email them to me (jeremy.groves@nhs.net) and I’ll seek permission to publish them on a blog.  Who knows, those words may one day supplement, or ever supplant, the bland factual accounts of critical care found on our own site and many others.

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