In this second book of poems, oncologist Marc J. Straus addresses the hopes and the tragedies of his profession. The work is a commentary on his experience in the medical field and a collection of rich, vivid monologues written from the points of view of both doctor and patient. These poems show a rare sensitivity not only to those who are suffering but also to the details that distinguish each life.
|Publisher:||Northwestern University Press|
|Product dimensions:||5.50(w) x 8.50(h) x 0.40(d)|
Read an Excerpt
By MARC J. STRAUS
TRIQUARTERLY BOOKSCopyright © 2000 Marc J. Straus
All right reserved.
Chapter OneSand Crab
I walked along the bay with my five-year-old nephew. What are those little holes with bubbles coming out? he asked. Sand crabs, I said. They hide under a thin layer of sand to protect themselves.
Have you ever seen one? he wanted to know. Yes, I said, thinking of my first day at the Washington V.A. Hospital. A young man, age twenty-two, was hidden under a white sheet. He was pale as a moonbeam,
and his mouth puckered in and out with each breath. He had returned from Vietnam with acute leukemia. His name was Howard, I said out loud. You're making it up, my nephew laughed.
Red Polka-Dot Dress
I can't decide what to do, her husband said, the X-ray films still on the screen. He pulled out a picture. This is us in 1963, standing near the stone parapegm
built by the Greeks around 400 B.C. On it they engraved the ruler's laws and proclamations. That's Athena with an eroded nose and worn-out hands. Mildred's in a red polka-dot dress.
See how beautiful her auburn hair looks in that morning light pulled up in a bun above her neck. And that's me holding her hand. I see, I said.
From thirty-three thousand feet it looks like odd-shaped farms are pocketed between deep green octopus ills, pudgy tentacles coursing out. Justyesterday the antibiotics were stopped. One antifungal drug blistered my mouth when the white count dropped. I agree, the smallest thing is loss of hair, but the woman to my right fidgets nervously. I want to say, My eyebrows are bushy, the hair on my chest's like baby silk ... The hills are folded up now in long vertical ridges, and the few towns are tucked alongside. I don't see how anyone gets across.
I sighed this morning, a slow deep inspiration that dragged the air into the recesses of my lungs, portions I imagine had been forgotten in the last few months. And then for a second or two I felt the life pass out of me. As if it were a prelude, a taste for the sake of recognition, to diminish my anger. As if it were a gift to make me more accepting, so that when the angel lifts my hand onto her atomless sleeve I will have no animosity. She is so like my physician. He has no tolerance for remonstration, his head is so cluttered with obligatory data. I might articulate my pain but he is filled with dying and I'm obliged to keep the sigh inside.
A man's cough bounces down the hallway like pick-up sticks. Three rooms away an IV machine beeps constantly. I know the distance by now. I know Mrs. Mandelkorn was discharged today and Mr. Singer died. Not just the overhead intercom blaring Code Blue, or everyone running to his door. It was the stillness afterward, the leaden walk of the nurses. They've seen it before, but death fills their shoes. They pass the pills in silence and at the station their conversation is muted. I asked Angela. She said he was old and frail and his kidneys failed. It is more than she should say, but she is kind to differentiate is circumstance from mine. I am here now two weeks.
There is a chapel downstairs. I passed it twice on the way to radiology. No one was inside. There are twelve wooden benches, a large crucifix and stained glass above the altar. A note in the elevator says "religious services for Jews available on request." Today a priest came in and offered me absolution. I think you have the wrong room, Father, I said. He checked his notes, laughed courteously, and replied, Now that I'm here.... A few minutes later I was sorry. What harm is there to accept is prayer? I could borrow his God for a while.
Synesthesia, metaplasia. Before that my language was acquired on the corner of East Tenth Street, Alice Singletary lip-synching every song, Archie Grover starting every sentence with hey. Somehow an occasional three-syllable word entered my vocabulary. My tenth-grade paper was on Hemingway and Mrs. Clara Mann wrote across the top in bold red "needless to say you missed the symbolism entirely in A Farewell to Arms-C minus." For the next exercise she asked us to write a poem in class. I sat the hour and angrily penned a dark and pessimistic verse. God had disappeared in fear (and this was a religious school). "This is an A plus," she wrote in red in the margin, "but you must pay more attention to Yeats." That may have been asking too much, but soon I had found Rilke, Bishop, William Carlos Williams, and Stanley Kunitz, who wrote about a slap his mother gave him across the face when he was five that still stung sixty years later. Words were pistols and fireballs lined up like dominoes. Words etched out the cilia in my throat and held my ankles down. Later, in college and medical school, language stretched on an unending yardarm. It became convoluted and specific. Sometimes I yearned for simplicity-Joe Applebaum tapping the top of a garbage can-do wop, do wop; hey everybody, just do the hop.
The Blue Hat
The Doppler was negative, I said. His son hugged him tightly
around the chest. I was about to say, It would have been better if we had found
a clot. Now I suspected the cancer had recurred. Outside, I could see
a yellow van. Its side lift lowered and three people were taken out
in wheelchairs. One middle-aged man with a blue wool hat was chattering constantly.
His left hand spiraled upward in wide semicircles like swallows
starting south. I remembered the lecture on hemiballismus. It was twenty-two years
ago and the professor mimicked its motion. I continued to watch until
the movements stopped. For an instant it seemed that a motionless and
was holding the sky, then suddenly it dropped, as if a bird had been shot.
Sometimes a word seems to fall into an inaccessible gyrus of my brain and is lost forever.
Then there are times it snaps back, coursing up from a hidden sulcus, bounding across thousands
of synapses. Adamantine recently did that. It was a word I had once read and never looked up.
Then this week-brindled, gibbous, Rift Valley fever, Gaucher's disease. In medical school I depended on
my excellent memory. I was quick. I gathered them in, each word a shibboleth to be placed
in its proper quarry. Again today, a patient I often see was in and I couldn't remember her name,
but then a girlfriend's phone number from tenth grade came to mind. That's the proof. It's all there
carefully tucked away. Everything is recoverable: agnosia, semaphore, von Hippel-Lindau disease.
for Douglas Maxwell
It's slipping by, tiny aliquots of DNA, memory scratched out like an old 78 RCA recording, tintinnabular, and rhonchal as a forty-year smoker. They play horseshoes, the men squatting slightly then heaving up the iron and letting go. One eighty-three-year-old plants it; it lands partway round the small post. He waits. You're still up, the aide says loudly. He lifts the iron again. The idea of the post and the horseshoe momentarily escapes him. You're ahead, another man offers. You can skip your turn. There was breakfast, or it's almost breakfast. The sun sits over the post and the metal is rusty. A bell rings in the background. It might be a telephone, it might be a son in California, a stockbroker wanting to sell AT&T (it went down for years). Your turn! someone yells. He crooks his elbow. The post comes into focus and he throws. The metal wraps completely around. You always win, Jessup complains. You must have been a professional, the aide says. The sun casts a long narrow shadow. It might be dinner. Green beans and a slice of meat.
Sunrise in Virgin Gorda
The sea, almost slate blue, a four-masted schooner slipping past Tortola. Who's out this early? What crew would work, and where are they headed in such a hurry? Next door a baby cries. I've never been an "early person." Back home I'm certain my mother's already eaten breakfast
and walked three miles. Last week I was in Peekskill by eight to cover an office. Nine patients were waiting at the door. They were there for chemo: a five-minute push, a thirty-minute drip, a four-hour infusion. It's always like this, the nurse explained. No matter when I start they are here before me. The boat pushes
south, each sail taut. Its large sleek hulk tacks at least ten degrees to port.
If I cut down on fatty foods, lose fifteen pounds, work out three times a week, will I avoid a heart attack?
If only every question were that simple. It's an opportunity to answer unequivocally, to give patients a sense of purpose
and hope, even if they've always been obese, refractory to treatment, unable to comply with a regimen. Still, just to say yes
is palliative, even though they know the answer isn't accurate. They don't want to hear statistics and vacillation.
Just to be like the surgeon who says, It's 100% curable-I got it all, omitting the possibility that a cell, a micro-
metastasis, may already be elsewhere. Say yes-a sliver of grace in an excoriated world. I must try it sometime.
I thought to delay the answer, camouflage it, by waiting until he asked another question. But he prefaced the question with
I know you 're not God. This is commonly said to me, second in frequency only to What would you do if it was your father, or wife,
etc. I accept this statement of my undeity to be rhetorical, a mechanism to permit me to be imprecise, to use phrases like "it depends
upon many factors" and "a range of." But lately I'm increasingly tempted to say, How do you know I'm not God? What gives you such certainty?
Do you say this to your lawyer, accountant, or mother-in-law? And, if I'm not God then why ask me a question that only God can answer?
Chapter TwoBanner Hopes
Tel Aviv, Winter 1996
Banner hopes, and the dusk edges along the wall like ghost beats. Who wants to know? What else is there to say? Ruminations are molecules stacked like pie plates in the brain. War,
warlords, terrorists, assassins-word grenades to disassemble. A boy who's seven, a girl from New Jersey, an old man with sixteen grandchildren, and the sallow face attached to the knapsack filled
with a homemade recipe: butter, bread, salt, and a thousand nails. What is there to say? Maybe if we kill his brother the next one will hesitate? His teacher? His teacher's son and daughter? If we ring the perimeter with absolute anger?
Don't say this is war! War is (1) open armed conflict between countries and (2) military operations as a profession. I am worn out explaining this, while fragments of mitral valves, gastric
linings, nasal cilia, stain the pavement. I am worn out hoping, and if I am no here to hope then the pusillanimous will seethe out of this corner, and my banner
(which also has no writing) will be shredded. Maybe if I can diagram it someone else can carry it. Maybe if my hope is surrounded by perfect beads, a polymer that soaks up time, and blood, and misused adjectives. Maybe if my hope mutates and infects a little boy before he is told to put the knapsack on, the soldier who pushes an old woman down, the journalist who explains things didactically, the politician
who prevaricates. I would lay it out completely unfurled, colors and diagrams that would astound and each one would draw in a lungful of fresh air, then smile. Let me hold that baby awhile. I like its sucking sound.
Le Mas du Luberon
I stretch my legs after a midday meal: fresh morels, a succulent lamb ragout. As the sun slants over the square, Monsieur Bouchon opens the orange awning. One could cook bread on the cobblestones, he says. Across the square the general store lowers its slatted shutters.
At four the local women buy butter, vegetables, tins of pâté. Where I stay nearby, at Le Mas du Luberon, the rooms of the ancient farmhouse are filled with exquisite antiques. The owner, a dealer in Paris, rents it in July to those of us who seek reprieve in he countryside.
I cross miles of back roads of Provence by bike. I see farmers bent over small plots of cucumbers, women fattening geese. Today I stop for a dusty train headed east to Alsace, then Tuscany, a farmer who pulls up next to me explains. His name is Horowitz. That's impossible, I suggest. No, it's true,
he tells me. I discovered this only ten years ago. When I was five I was taken to the square. All my friends were there at the depot, each with a small suitcase. Behind the general store my parents push me into the arms of a farmer, Colvert. I'm brought here. I study in a nunnery. I go through catechism. I marry,
have five children, run the farm. What about your wife, your children? I ask. My parents boarded a train like that, he said, pointing east. We owned an elegant farmhouse near town. They collected antiques. I'm a farmer. I grow sweet corn and delicate peppers. My name is Horowitz, Abram Horowitz of Luberon.
First at breakfast, now next to me on the beach in Barbados. Maybe if I concentrate on the emerald water; nineteen sailboats in the bay, thirty-three windsurfers. I stop, realizing the symmetry. The numbers: a blue black tattoo, so clear
over fifty years later. And, when I talk to her, she swings the left suntanned forearm around-numbers in full view. She asks me what I do-where I live-about my children. I say: doctor-New York-two. There's the symmetry again. Such a low
number, meaning she was taken early. She tells me her age; captured at nineteen, I calculate. The forearm flashes again. Nineteen sailboats. She sees me staring. The world comes full circle, she says, pointing. Everything has meaning. This number was meant to survive.
Two men behind me playing steel drums ...
The Glass Museum of Murano is fifteen minutes by boat from Venice. Its most exquisite piece is a large fifteenth-century bowl. I looks as if a thin layer of crystalline water is miraculously held aloft. Here and there tiny portions are painted with scenes
of a royal event. The delicate features, the use of gold, citron, and light blue, remind me of Botticelli. One side of the bowl is missing. The guide explained that even the broken fragment would be priceless. Outside, awaiting the boat, a young Israeli man
was leaning against the piling. He was dark and thin. His right hand curled up and shook rhythmically. What? he asked his mother, as his face contorted in a grimace. His words coalesced and split apart like shards. It's your injury, she explained.
The war. What? he asked again, as saliva ran down his chin. As he turned to board, I saw a wedge of sun cross his cheek. His skin was streaked orange, cerise, and madder red-his blue eyes brushed with amber and green.
Excerpted from symmetry by MARC J. STRAUS Copyright © 2000 by Marc J. Straus
Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Most Helpful Customer Reviews
It was said that if we really wanted to know about the moon, we should send a poet. The same can surely be said about the intimate and often painful relationships that patients share with their doctors. Marc Straus, a Poet-Physician, has written a profoundly moving collection of poems, Symmetry, of which many works address this shared experience. As a physician myself, I was hard-pressed to recall any poetry which more clearly evoked the many overlying and conflicting feelings that I deal with every day. And, most certainly, the descriptions of patients and their complex moments of joy, failure, frustration, and victory were most beautifully rendered. The first poem, 'Sand Crab', hints at the inescapable intermingling of the public(professional) and private lives that physicians lead. Our most personal moments are often lived in a referenced way, spilling out long thought forgotten medical recollections. 'Not God' addresses the demand for Absolute Truth often made in desperation by our patients, our friends and often our own families. This poem was, for me , truly too close for comfort. This collection of poems is a powerful reminder of the need for expression of patients and their doctors. But it would be unfair and incomplete to not mention the lyrical and touching non-medical poems in this collection. Notable for me in this latter group were 'Le Mas du Luberon', a poem about lost identity and 'Butterfly, for Sarena', a very moving love poem. All in all, a beautiful cluster of poems.