Doctors, Bad Bedside Manners, and Poetry

In Margaret Edson’s W;t there is a doctor, Jason, who has taken her 17th century poetry class as a challenge.  As he puts it,

You can’t get into medical school unless you’re well-rounded.  And I made a bet with myself that I could get an A in the three hardest courses on campus.

He notes that his move pays off:

Professor Bearing was very highly regarded on campus.  It looked very good on my transcript that I had taken her course.  They even asked me about it in my interview for med school—

Studying John Donne proves hones the mental skills that Jason needs for doing high quality medical research.  But for Donne to function this way, Jason explains to a nurse he’s working with, he must separate out the poet’s tough thinking from sentiment.  Such poetry is not about softness, he says:

Susie: She [Vivian] is not what I imagined.  I thought somebody who studied poetry would be sort of dreamy, you know?
Jason: Oh, not the way she did it.  It felt more like bootcamp than English class.  This guy John Donne was incredibly intense.  Like your whole brain had to be in knots before you could get it.
Susis: He made it hard on purpose?
Jason: Well, it has to do with the subject.  The Holy Sonnets we worked on most they were mostly about Salvation Anxiety.  That’s a term I made up in one of my papers, but I think it fits pretty well.  Salvation Anxiety.  You’re this brilliant guy, I mean, brilliant—this guy makes Shakespeare sound like a Hallmark card.  And you know you’re a sinner.  And there’s this promise of salvation, the whole religious thing.  But you just can’t deal with it.
Susie: How come?
Jason: It just doesn’t stand up to scrutiny.  But you can’t face life without it either.  So you write these screwed-up sonnets. Everything is brilliantly convoluted.  Really tricky stuff.  Bouncing off the walls.  Like a game, to make the puzzle so complicated.
Susie: But what happens in the end?
Jason: End of what?
Susie: To John Donne.  Does he ever get it?
Jason: Get what?
Susie: His Salvation Anxiety.  Does he ever understand?
Jason: Oh, no way.  The puzzle takes over.  You’re not even trying to solve it anymore.  Fascinating, really.  Great training for lab research.  Looking at things in increasing levels of complexity.
Susie: Until what?
Jason: What do you mean?
Susie: Where does it end?  Don’t you get to solve the puzzle?
Jason: Nah. When it comes right down to it, research is just trying to quantify the complications of the puzzle.
Susie: But you help people!  You save lives and stuff.
Jason: Oh, yeah, I save some guy’s life, and then the poor slob gets hit by a bus!
Susie: (Confused) Yeah, I guess so.  I just don’t think of it that way.  Guess you can tell I never took a class in poetry.
Jason: Listen, if there’s one thing we learned in Seventeenth-Century Poetry, it’s that you can forget about that sentimental stuff.  Enzyme Kinetics was more poetic than Bearing’s class.  Besides, you can’t think about that meaning-of-life garbage all the time or you’d go nuts.
Susie: Do you believe in it?
Jason: In what?
Susie: Umm.  I don’t know, the meaning-of-life garbage.  (She laughs a little.)
Jason: What do they teach you in nursing school?

In this response to Donne, the puzzle solving is important, not the wrestling with salvation and death.  Jason is like those literature teachers who (sometimes defensively) argue that their discipline is worthy because it enhances critical thinking skills, which can be used in all walks of life.  Jason is not wrong to see improved critical thinking as a side benefit.  But by seeing this as the whole point, he doesn’t grapple with the meaning of life.

In fact, for all his brilliance, he’s missed a major point of Donne.  Donne wrestles with the gap between his desire to believe in God’s forgiveness and his inability to accept it.  Jason, on the other hand, doesn’t appear to be doing too much wrestling at all.  He easily dismisses metaphysical questions as so much garbage.  His dismissal of his mission to heal echoes a similar dismissal by Christopher Marlowe’s Doctor Faustus, who pooh-poohs his ability to heal whole cities of the plague because these people will die anyway.

As a result, Jason’s bedside manner leaves something to be desired.  Medical schools have become sensitive to the fact that their doctors need to be more than auto mechanics of the body, and Jason alludes to this development within medicine when he periodically reminds himself to consider the patient.  But this self-reminding is not sincere and indicates that he hasn’t internalized a deeper humanity.  Or as he says, “there’s a whole course on [bedside manner] in med school.  It’s required.  Colossal waste of time for researchers.”

This from a man who, at the end of the play, tries to override a “do not resuscitate” order after Vivian has (mercifully) died because he wants to get more test results from her. 

As one of Jason’s former teachers, Vivian takes some responsibility for his insensitivity.  She remembers being a cold teacher who rigidly insisted upon due dates, even if her students were undergoing hard times.  As she looks at Jason now, she wishes she had been different:

So.  The young doctor, like the senor scholar, prefers research to humanity.  At the same time the senior scholar, in her pathetic state as a simpering victim, wishes the young doctor would take more interest in personal contact.

She also realizes that she is responsible because she has focused more on Donne’s wit than on the issues he was wrestling with.  In other words, she is more interested in his virtuosity than in his human struggles.  She remembers saying at one time,

So we have another instance of John Donne’s agile wit at work: not so much resolving the issues of life and God as reveling in their complexity.

The irony of this is that medical schools want their students to take more literature courses (and other humanities courses) precisely so that they will be better able to handle the very human issues that accompany illness.  Watching my friend Alan Paskow interact with doctor after doctor in his own search for cancer treatment, I am struck by just how few of them have been able to speak to his humanity.  Highly trained specialists that they are, most (not all) of them seem more tuned into the technicalities of their field than to Alan’s internal state.

To be sure, one would probably choose a cold and competent surgeon over a sensitive and incompetent one.  But why not demand both, a surgeon who has depth as a human being as well as technical proficiency?

And with regard to the literature teachers who introduce future doctors (and others) to the works that can help guide them through the maze of life and death, can one also have both: a teacher who is sensitive to feeling yet rigorous in instruction?  I’ll write the day after tomorrow on how I work to achieve that balance in my own teaching.