Syracuse, NY 13210
Written by Andrea Asprelli, Editorial Assistant, 2008.
- In the third paragraph of Bromberg’s “Poetry and the Creative Healing Process” (p.31), the author discusses the relationship between community and healing. In what ways can writing about illness be therapeutic? What difference does it make to write for an audience?
- The speakers of “Puzzled” (p. 81) and “After a Mastectomy” (p. 32) both express yearnings to be made “whole.” How do physical changes in the body affect self-perception and identity? In what ways do the speakers seek help from others to work through these feelings?
- Several authors reflect on the inevitable deterioration of the body when talking about death and dying. Frost’s “Mercy Killing” (p. 3) refers to “a body broken by time”, illustrating the inescapably temporal nature of the body. By concluding the poem with the body returning “as precisely as leaves in fall, to earth”, what kind of comfort is the speaker taking in nature? In what ways do the authors of “Degeneration” (p. 72) and “Late Summer on the Hill” (p. 82) also utilize this imagery?
- Writings on Alzheimer’s shed light on the link between identity and memory. Bartley (p. 94) writes that memory is “the draught that wakes / us to ourselves. / Stir and the past comes alive.” Friends and family members of Alzheimer’s patients often struggle to understand the changing mental states of loved ones who appear outwardly the same. In Garrett’s “The Brooch”, she writes “sometimes she wished she could forget who mother had been and treat her as someone new” (p. 23). In “The Brooch” and Kanter’s “Meditation on Caregiving” (p. 83), how does the memory of their loved ones help friends and family members to cope, and how does it create more obstacles for them?
- In “Lessons” (p. 49), Calagiovanni writes “I do believe that the gall bladder is green… / --because I saw it today.” In what ways do we shape our ideas of health and the human body around what we can see? How could this view be problematic? Contrast the different experiences of the speakers in Johnson’s “Plastic Surgery Phase II” (p. 40) and Kirkpatrick’s “Physical Therapy” (p. 34). In what ways can visible scarring help validate experiences of illness? Alternatively, what effect does this have on patients who have minimal or no visible signs of illness or past illness?
- In “When These Things Happen,” Oliver writes in the September 30 journal entry that she wept in the cereal aisle: “my insides turned outside for the entire world to see, and I didn’t care” (p. 70). Considering your answer for question 5, how do our notions of visibility and validation of disease or illness affect the experiences of people with mental illnesses?
- Bob Dylan wrote, “Let me die in my footsteps before I go down under the ground.” In what ways do the speakers of “Let Me Breathe” (p. 14) and “A Good Day” (p. 35) share similar ideas of what characterizes death with dignity?
- Stern’s “Faulty Armor” (p. 16) explores the complexities of the physician-patient relationship through the eyes of a fourth-year resident. What about this particular patient makes the speaker feel uncomfortable? In the opening paragraph, he writes that the “empathic link is plastered so firmly in the foreground that we as diagnosticians usually force ourselves to focus beyond it in order to treat our patients.” As this student trains himself to suppress empathy, what kind of effect will this have on his future practice? Why does the speaker struggle between seeing the patient as a person and seeing the patient as a case or disease? Does he see the physicians struggling in the same way?
- In “Dependence Day” (p. 9), the speaker refers to the “home health aide du jour” on several occasions. What kind of statement is she making about hired home caregivers? Does this affect the quality of care she receives?
- Both “Faulty Armor” (p. 16) and “Disorder” (p. 50) use militaristic images to portray different aspects of illness and treatment. What examples can you find of this in these works? Thinking about how we talk about illness more broadly, phrases such as a person’s “battle with cancer” are frequently used. What other examples of these images can you think of that are commonly referenced in our culture? What aspects of illness are highlighted by such an image, and what aspects are overlooked? What are the advantages and disadvantages of thinking of illness and treatment as metaphorical warfare?
- In “Diagnosis 1972” (p. 89), Roney recalls a book on diabetes that portrayed a diabetic as a “form without face.” What effect did isolating the disease from the patient have on the speaker? Reflecting on your readings of The Healing Muse, discuss one or two works that have helped you to put a new “face” to patients, friends and families of patients, and/or health care professionals. What about these works was most surprising to you?
Educator's Guide - Bioethics
Written by Andrea Asprelli, Editorial Assistant, 2008.
THEORIES, PRINCIPLES, AND APPROACHED IN BIOETHICS“Let Me Breathe” Susan Hazen Hammond (p. 14)
- What kinds of ethical concepts, if any, does this poem touch upon?
- What kind of response from the reader do you think the author might be striving for in the first stanza?
- Who is the speaker addressing in the second and third stanzas? What does s/he want from them?
- Why do you think the speaker refers to his/her body as a separate entity in the final stanza?
PERSON-CENTERED CARE“The Other Mothers” K.B. Kincer (p. 56)
- This poem describes the intimate and delicate nature of patient care. Patient care has several components, including personal, physical, and emotional. How is the patient in the poem receiving care that addresses these various needs? Describe the importance of such care from the perspective of the patient and his family.
- How would the absence of such care affect their experiences?
- Do you think it would also have an effect on the patient’s health? Why or why not?
THE PHYSICIAN-PATIENT RELATIONSHIP“Faulty Armor” Adam Philip Stern (p. 16)
- The physician-patient relationship seeks not only to balance ethical and legal obligations, but also to fulfill these compassionately and humanistically. In the first paragraph of “Faulty Armor,” Stern writes, “every so often the medical gods send you someone who reminds you to read between the HIPAA lines and see the humanity of the patient before you.” Find instances in the poem where the speaker sees the interaction from the perspective of his patient.
- Why does the speaker describe this encounter as an anomaly?
- Do you think that these thoughts and feelings are a disruption or a contribution to his practice?
AUTONOMY AND PATERNALISM“Puzzled” Kathleen Grieger (p. 81)
- In the third stanza of “Puzzled,” the speaker writes “when I come / to see you, / I bring / the pieces / I do not / understand why / I cannot be / put together.” Reflect on how disorienting the experience of illness can be. What aspects of receiving care can be overwhelming for a patient?
- How has the physician behaved paternalistically to the patient? What duty does the physician have to the patient, and do you think it was neglected? How did the patient respond?
- Discuss the relationship between the duty of physicians to their patients, and the expectations patients hold for their physicians. In what ways do patients expect more from their doctors than can be given? In what ways do patients receive less from their doctors than they deserve?
INFORMED CONSENT“Physical Therapy” Kathryn Kirkpatrick (p. 34)
- There was once a time when it was expected that physicians chose treatment options for their patient without regards to the patient’s wishes. For example, many surgeons chose to perform mastectomies on breast cancer patients, even when survival rates were equal to treating with minimally invasive surgery and radiation. Construct a list of the pros and cons of performing a mastectomy from the perspective of a surgeon and from the perspective of a patient.
- Would your reading of the poem be different if you found out that her physician had mandated the mastectomy?
DECISIONS NEAR END OF LIFE“Slipping Away” Jack Coulehan (p.4)
- What kind of authority has the author given his speaker by writing from the perspective of a “brain-dead” patient?
- What assumptions about the nature of death has he made?
- What kind of importance does he give to the sister’s decision about maintaining life-support for the speaker?
GLOBAL HEALTH AND JUSTICE“Not Ready to Die” Andrea Shaw (p. 92)
- What aspects of the patient’s experiences of illness could be attributed to injustices in her country’s social structure? How are the patient’s feelings towards health care affected by social experiences outside of the hospital itself?
Neilen D, Garden R, eds. The Healing Muse. Volume 9. Syracuse, NY: SUNY Upstate Medical University, 2008.