In an unremarkable lecture hall on a rainy Monday afternoon, Cândida Pereira is expounding passionately on the intricacies of a poem by the Portuguese politician-poet Vasco Graça Moura. Her classmates listen closely as the second-year university student enthuses about lyric form, poetic voice and Moura’s use of “perceptual imagery” and “sensual tone”. Nothing unusual for a standard poetry module, perhaps. Yet once the bell goes, Pereira will repack her well-thumbed poetry anthology and replace it with more prosaic textbooks on neuroanatomy and pharmacology. The 19-year-old is one of 20 or so trainee doctors at Porto University’s medical faculty taking a new elective course on the fundamentals of modern poetry.
In today’s ever more transactional healthcare culture, the initiative signals a belief in the priority of people-centred care and old-fashioned notions of a doctor’s “bedside manner”. As the course creator João Luís Barreto Guimarães explains, poetry has a unique capacity to help students connect holistically with their future patients, as opposed to viewing them as a medical problem in need of fixing.
“For that reason, I get them to look at poems that talk about empathy, compassion, solidarity and other similar humanistic values that doctors should strive for when they are in front of a patient,” he says.
A graduate of the university’s medical department himself, 56-year-old Guimarães has been a practising breast cancer surgeon for three decades. When not in theatre carrying out life-saving operations, however, he is back home at his desk crafting his own poems. The author of 10 published collections, in 2022 he was awarded Portugal’s Pessoa prize in recognition of his contribution to the arts.
On the face of it, his twin passions have little in common. Indeed, his search for a literal link leaves him resorting to metaphor: cutting out words when editing, he reflects, is “a bit like how I eliminate a tumour with my scalpel”.
Similarly, the structure of the course looks relatively conventional, covering basics like imagery, sound, tone and rhythm. Yet, with an eye to his audience, Guimarães mined his collection of anthologies by the British poetry publisher, Bloodaxe Books, to ensure every class has at least a handful of poems that link to medicine. The course reading list includes a number of notable poet-medics, including Júlio Dinis (a Portuguese surgeon), William Carlos Williams (an American paediatrician), Gottfried Benn (a German pathologist), and Miroslav Holub (a Czech immunologist). Its didactic intent is sometimes none too subtle, Guimarães concedes. Poems about doctor-patient scenarios or familiar healthcare settings, for instance, offer students an easy bridge over to their everyday studies.
Take the example of Wendy Cope’s poem Names, cited in a module about the depictions of the human body in poetry. The short, single-stanza poem describes the life of a woman christened Eliza Lily, but who, in practice, goes by an assortment of different names – Lil, my darling, Mrs Hand, Nanna. Yet when she finds herself in hospital at the end of her life, alone and without friends, the medical staff know nothing about her bar the clinical contents of her medical file. So, as Cope’s heartrending poem concludes: “For those last bewildered weeks / She was Eliza once again.”
The lesson? To remember the person behind the patient, says Guimarães: “These days, doctors often don’t have time to stop and think, so everything quickly gets reduced to the technical and mechanical. What I try to convey to the students is that, as with a poem, each of their patients is unique.”
In a similar vein, the classes can help open up conversations about the emotional rollercoaster involved in being a doctor and help students consider how to cope with the job. Take John Stone’s poem Talking to the Family. In a few short lines, students come face to face with the pain, confusion and stress of the unpleasant but inevitable task of breaking bad news.
“… I will tell them.
They will put it together
and take it apart.
Their voices will buzz.
The cut ends of their nerves
will curl.
I will take off the coat,
drive home,
and replace the lightbulb in the hall”
Guimarães’s teaching does not just stick to the most accomplished poets. In particular, he is a keen advocate of exposing students to the “evils” of excessive sentimentalism; a habit he is adamant they should avoid once they hit the wards. Nor does the course avoid poetry of a more abstract or complex nature, something he sees as an invaluable vehicle for elucidating the capacity of speech to hide as well as reveal.
It is not just poets who look to disguise their full meaning behind clever word play and literary devices, he argues. For reasons of fear, distrust, or just embarrassment, so too do patients (“And your estimated units of alcohol per week, sir?”). Good doctors, he thinks, know how to “read between the lines”. “In our lessons, we often talk about decoding, because using illusion or symbolism or enigma is something many poets do to get across their message in a hidden way.”
Guimarães cites his own poem, História Clínica (Clinical History), in this regard. While it ostensibly deals with a woman undergoing a double mastectomy, beneath the surface lies a darker story about her experience of domestic abuse. The poem toys with the double sense of the Portuguese word medalha, which can mean “medal” (used here as a reference to the woman’s breasts) or, less commonly, “bruising” (linked in the text to the “bad mood of her husband”). The ambiguity surrounding the word is sustained until the final, devastating line. The woman is now free of cancer courtesy of the operation but, as a consequence of losing both breasts, her husband leaves her. Finally, Guimarães’s poem ends, she is livre de perigo (“free of danger”).
Since launching the course, Guimarães has received several requests to teach at other medical faculties across Portugal. Nor is he alone. Barcelona’s Pompeu Fabra University, for example, recently introduced a course in literature for its second-year medics. Cândida Pereira, for one, understands the appeal. Like poets, doctors need to be in touch with their feelings, she reasons. Although arguably a further step is required of them. “As doctors,” she reflects, “we also need to be in touch with the feelings of our patients.”
