This originally appeared in The Lancet, Medicine and Creativity Vol 368 December 2006 2006 in a special issue focusing on creative physicians. The Lancet is a British medical journal and is considered one of the world’s “high impact” medical publications along with the Journal of the American Medical Association and the New England Journal of Medicine. Here is the text from the article (some of the spellings look odd – they are in “English”):
Richard Berlin is a poet and psychiatrist who practises in a small town in the Berkshire hills of Massachusetts, USA. Current projects include a second book of poetry, Secret Wounds, and editing a collection of essays by 23 contemporary poets describing how their own psychiatric treatment influenced their creativity.
The paper “Hidden conceptual models in clinical psychiatry” by Aaron Lazare (N Engl J Med 1973; 288: 345-51), because the author makes explicit the hidden psychological, behavioural, social, and biomedical models that underlie psychiatric assessment and treatment.
The corporatisation of medical care and research.
My relationship with my patients.
Serving on committees, where my mind tends to drift to the Leonard Cohen song, First We Take Manhattan, which begins with the line, They sentenced me to 20 years of boredom, for trying to change the system from within”.
Miss Athey, my tenth grade English teacher. Her goal was to convey her love of literature to her students, and she succeeded. Without her influence, I would never have become a poet. Garrison Keilor dedicates his anthology Good Poems to English teachers everywhere, “especially the great ones”. Miss Athey was one of the great ones.
No matter how much you know, no matter your level of technical expertise, all your patients will die, so first be sure you do everything possible to relieve their suffering.
On my first day of psychiatry training, my supervisor, Dr Tan told me that patients would approach me on the locked inpatient unit to ask questions about medications, discharge, unit rules, etc. His advice was to respond to all questions I couldn’t answer easily by saying, “I’ll have to think about that”. I am happy to report this response has continued to work well for me in a variety of professional and personal situations.
Only in the way we live on in other people.
The Catcher in the Rye by J D Salinger. I have read this book countless times, and for years I identified completely with Holden Caulfield and his adolescent world view. But on my most recent reading, I realised I had finally grown up; now I responded to Holden with parental feelings of worry and concern, and imagined how l would treat him if I were his psychiatrist. How had I always missed the fact that he is writing from a mental hospital? Since I couldn’t reach Holden any other way, I wrote him a poem.
What would be your advice to a newly qualified doctor?
No matter how much you know, no matter your level of technical expertise, all your patients will die, so first be sure you do everything possible to relieve their suffering.
My sense of humour and a few clean jokes I can tell to my teenaged patients. And I also believe every doctor carries a black bag filled with the poetry of medical practice.
My wife is a physician and health-care reform activist. My main political activity is to support her efforts as she works to create a universal, affordable, Canadian-style single-payer health-care system in the state of Massachusetts.
My stepbrother Jernigan Pontiac (his pen name) has written about his life as a taxi cab driver. In the introduction to his second book Hackie 2 he quotes Philo of Alexandria who said, “Be kind, for everyone you meet is fighting a great battle”. I continue to try to make kindness my ethical outlook.