A Book of One's Own

I love lists. They’re concise, reductive, easy to absorb. That’s one reason I was drawn to Thomas Mallon’s, A Book of One’s Own—People and Their Diaries.  In it he devotes a chapter to each of seven types of diarist and gives examples of their work. By and large these diaries are not crafted or written with the benefit of reflection. But, he says, they continue to attract readers down through the decades.  There are the

·        chroniclers whose writing is rooted in the idea of dailiness and is meant to preserve impressions

·         travelers who record the sights and sounds of places they want to remember

·         pilgrims whose destination is inward, who want to realize their full potential

·         creators in whose private pages imagination comes to life through notes and sketches

·         apologists: the idealists, propagandists, and spurned lovers who want the world to sit up and take notice

·         confessors, animated by secrecy, who hold private conversations with God or some other embodiment of conscience

·         prisoners—the jailed, the invalid or otherwise incapacitated who are given voice in this medium

The big reason I dove into Mallon is that I, too, write my life.  Which of these diarists am I?  Except for one year in which I made a regular effort to explore my professional role (chronicler, pilgrim, apologist), I have not been a collector of days.  Nor have I adopted a consistent form.  Here’s my list of the molds into which I’ve poured my experience:

·         commonplace book (to-do lists, stray jottings about what I’ve read or thought, observations about events, places or people, numbers I want to remember)

·         journal (reflections on my life, musings from my imagination)

·         sketchbook (though I’m not a gifted artist, I often sketch or paint when I travel)

·         visual journal (a mix of words, collage, mandalas, headlines or illustrations torn from periodicals, drawings, photographs, interesting scraps paper or fabric)

·         pocket notebook with uncharted lines gathered from patient encounters, random observations from my professional life

·         this slowly evolving blog, Veneta’s Notebook

Letters to the future

Recently I found myself in the grip of Paul Monette’s 1994 book, Last Watch of the Night, a collection of passionate autobiographical essays about his last years with AIDS—before long term survival became the norm.  He addresses his own coming out, gay life, the impact of AIDS on the gay community and his own relationships, the importance of activism and the consequences of silence.  “It is simply not enough to be an artist, unengaged,” he writes.  “I consider the work I’m doing…as a kind of letter to my gay and lesbian children in the future…”

Letters.  I, too, compared my poems to letters in the preface to Clinician’s Guide to the Soul.  Literature in the guise of direct personal communication can do useful work in the world.  It can inform, challenge, heal, entertain, and create and sustain community. It can take distressing themes like illness and death and, rather than repel us, draw us to them.  Not only does it form a vital part of the record of human experience, it’s a seedbed for insights, ideas and action.

The One Book I Carried

I’ve heard Brian Turner speak eloquently about his time as a soldier in Iraq and I’ve read many of the poems it inspired.  In the British litmag Port he writes about the one book he carried in his assault pack the whole year he served there, an anthology titled  Iraqi Poetry Today.

I could take my last breath in this land, he observed. And, were that to be the case, I wanted to try my best to understand the deep history of where I was in the most nuanced and meaningful ways possible…by living with the poems and the work of poets…

 In a less dramatic but nevertheless powerful way, my work as a nurse brought me into contact with illness and death on a daily basis, so Turner’s choice of books made me think about what I carried—or might have carried—in my uniform or lab coat pocket for enlightenment and comfort.  While there are many poems, essays, memoirs and stories that were intensely meaningful to me during my clinical years, there is only one I clearly remember carrying into “combat.”  It was a 4x6 inch blank notebook.  I’d step out of an exam room or hallway, fish around in my pocket for the book and quickly record what had seized my attention.

Even now, when I open to a hurried scribble, the hush that falls as my fingers hesitate over the left breast, I am swept back to an encounter with a specific patient in an exam room at the women’s clinic.  I remember what this experience meant to me as a clinician and a woman whose sister had just died of breast cancer.  That phrase never found its way into a poem but it is still among the things I carry.

The artist as a person who decides

I found so much fodder for reflection in Kim Stafford’s book, “Early Morning—Remembering My Father, William Stafford,” that I feel compelled to capture a bit of it here.

William Stafford, poet and, for over thirty years, a teacher at Lewis & Clark College in Oregon,   tells his son,  “A student comes to me with a piece of writing, holds it out, says, ‘Is this good?’  A whole sequence of emergencies goes off in my mind.  That’s not a question to ask anyone but yourself.  Others may be able to accept standards from another.  But an artist is a person who decides.”

Counseling students, he would say,  “Once you decide to write in your own voice, for your own purposes, in your own way—then the act of writing is your teacher.”

My training and years of experience as a nurse have taught me a great deal but I believe that a regular practice of keeping  journals and writing poems and essays inspired by my work has made me a more astute and resilient clinician, compassionate caregiver and enlightened observer of the health professions. In that way, my writing is good.  I have become an artist, a person who decides.

The Way It Is

I love reading William Stafford, the plain-spoken but so evocative chronicler of the daily and the extraordinary.  In fact, I think of two of his poems as bookmarks in my own story as a nurse.  I first read “Strokes” back in the 1960s.  I clearly remember being on a bus, crossing the Oakland-Bay Bridge from my apartment in Berkeley to my classes at the University of California Medical Center in San Francisco.  The first line was, for me, an early epiphany about the nature of illness:

The left side of her world is gone—
the rest sustained by memory
and a realization: There are still the children.

At 22, I’d acquired the technical skills I needed to nurse a stroke patient but had little sense of what life was like after the victim left my care.  A powerful and startling revelation.

I came upon “The Way It Is” somewhere around 2000, when my career path had taken many a turn and brought me out of clinical practice into the realm of writing and medical humanities: 

There’s a thread you follow. It goes among
things that change. But it doesn’t change.
People wonder about what you are pursuing.
You have to explain about the thread…

The phenomena that illuminate our lives are many and various—advice from a mentor, a seminal event, a memorable dream and so on.  For me, poems also serve this purpose.  The poets who make them help me distill meaning from experience and sharpen my vision of the world I inhabit and what may lie beyond it.

Pen in Hand

Finally, years after buying it in the Florence Nightingale Museum at St. Thomas’ Hospital in London, I’ve read “Suggestions for Thought,” a heavily edited version of the 800-page manuscript Nightingale wrote in her thirties.  It was often a tough slog, even with the editors’ help, which accounts for my previous false starts,  but I come away impressed with her intellect and views on everything from women’s place in the family (she’s bitter about it) to God, universal law and life after death.

As I writer, I was taken with her observation that, “Few, except Descartes, ever thought without a pen in their hands.”  At first, I was puzzled by the reference to the philosopher, even read a bio and his “Discourse on the Method” in an effort to understand it.  Maybe she’s referring to his statement that he had abandoned scholarship, “resolving to seek no knowledge except what I could find in myself or read in the great book of the world.” In another place, he says he “often found that something that seemed true when I first conceived it came to look false when I tried to write it down.”

As a nurse I, too, have spent many years studying the great books of the world but have to side with Nightingale about the value of thinking with pen in hand.  Whether it’s on a post-it note, a yellow pad, the rough draft of a manuscript or an entry in this notebook, that’s where I find out what I’m thinking and (like Descartes) what’s true and what isn’t.

On Hindsight and Vision

Some food for thought from jazz pianist and teacher Kenny Werner:  “Once I was asked, ‘What is the next stage of evolution in music…?’  My answer was that the evolution of music is not the issue.  It is the evolution of the musician that’s most important.  The artist must take his rightful place in society as a teacher, metaphysician and visionary.”

How does that apply to those of us who practice the art of writing?  I can speak for myself.  My early poems and essays told stories of my patients and my own experiences as a nurse clinician.  Later, I began to write on themes that recurred in my work: birth and death of course, but also subjects ranging from guilt over poor clinical outcomes to the presence of computers in the exam room.  These days, I’m taken with what I think of as heresies, my deviations from orthodoxy.  I approach heresy as a health professional but also as a rational and spiritual being.  My poem, “Reference Range,” questioning the value we place on lab tests and screening exams is one example.

Reflecting on my decades as a nurse, family caregiver and writer, I can see how my thinking and practice have evolved.  Hindsight doesn’t make me a visionary but it does help me appreciate my journey through this life and the occasional clearings I stumble into where I can stop, catch my breath, and ready myself to take the next step along my path.

"The Habit of Art"

Four years ago I saw this play by Alan Bennett at Studio Theater here in Washington, D.C.  Next day I ordered a copy, read it hungrily and marked it up.  A few weeks ago I dipped into it again.  Why?  I wanted inspiration and, for me, “The Habit of Art” offers plenty.

It’s set in the poet W.H. Auden’s digs at Oxford University and centers around a late life meeting between him and the composer Benjamin Britten, once friends and collaborators, now estranged.  The theme it addresses is art and the artist. 

Britten asks Auden: Do you not work?

Auden replies:  Every day, but I do nothing.  I have the habit of art.

I love this line and feel I understand it entirely.  It expresses the writer’s consistent bent toward her calling—the stray observation, the words jotted on a piece of scrap paper then lost, the snatch of dream or conversation—all cached in memory, awaiting transformation or evaporation.  Reading.  Ruminating.  Idling, pen poised in thin air.  The habit of art.

A few more memorable lines in Auden’s voice:

Never underestimate the role of the will in the artistic life.  Some writers are all will.  Talent you can dispense with, but not will.  Will is paramount.

On writer’s block:  It’s not a complaint from which I’ve ever suffered…or entirely believe in…It assumes, too, that the natural condition of writers is writing whereas the natural condition of most writers is not writing.

In the end art is small beer.  The really serious things in life are earning one’s living and loving one’s neighbor.

 As a writer and a nurse with a good day job and circle of family and friends, I almost agree.

Stories because...

We are devoted to stories because that is how the mind works.
           E.O. Wilson

Got it in December.  Read it in May.  Am still thinking about it in July:  Edward O. Wilson’s book, “The Meaning of Human Existence.”  According to him, it’s “the epic of the species begun in biological evolution.”  I’m not entirely satisfied with his thesis.  For me an epic conveys meaning but is not the entirety of it.  Nevertheless,  it’s fascinating to consider that the mind works in stories.

Wilson, a renowned biologist, Harvard professor emeritus and student of ants, goes on to talk at length about the synergy between the analytic power of science and the introspective creativity of the humanities.  What does this mean for those of us in the health professions who see ourselves straddling a divide between the science on which our profession is built and the humanity that illuminates and guides our practice?  For me, it confirms the artist’s fundamental importance to the human endeavor.  It also makes me wonder whether the divide between science and art really exists.  

Wilson says, “The early stages of a creative thought, the ones that count, do not arise from jigsaw puzzles of specialization.” [Think about our health systems, our universities.]  “The most successful scientist thinks like a poet—wide-ranging, sometimes fantastical—and works like a bookkeeper.”  That observation should inspire us all—scientists, poets, tellers of stories and, yes, bookkeepers.

Journey On!

Get a good day job…one that puts your boat out in the river of life.
               Abraham Verghese

What I found in the Washington Post article by physician and writer Abraham Verghese (“The doctor as a patient writer,” 12/11/2011) was more than just advice to writers.  It served me as inspiration for a poem reflecting on my choice of nursing as a career and as a theme for a recent workshop with medical students who write about their work and their lives.

I offered the students a few prompts to stimulate their reflections and our discussion:

•    Sure, I’ll tell you something about my boat. The first thing that comes to mind is…

•    So far, for me, the river of life has been…

•    If I had to choose someone to guide me down this river (living, dead, imagined or mythical), it would be…

“So I write about life,” Verghese concludes.  “I plunge into the river every morning, let the current take hold. It is not the same river you stepped into yesterday.  Thank God for that.”  I, too, thank God for the work I’ve been given to do—and the sturdy craft that carries me.