IIn an inconspicuous lecture hall on a rainy Monday afternoon, Cândida Pereira passionately explains the intricacies of a poem by the Portuguese politician-poet Vasco Graca Moura. Her classmates listen attentively as the second-year student raves about the lyrical form, the poetic voice and Moura’s use of “perceptual images” and “sensual tone.” Nothing unusual for a standard poetry module perhaps. But once the bell rings, Pereira will repackage her well-thumbed poetry book and replace it with more prosaic textbooks on neuroanatomy and pharmacology. The 19-year-old is one of about 20 trainee doctors at the University of Porto’s medical faculty who are taking a new elective course on the basics of modern poetry.
In today’s increasingly transactional healthcare culture, the initiative demonstrates a belief in the priority of people-centered care and outdated views of a physician’s “bedside manner.” As a course creator João LuÃs Barreto Guimarães explains that poetry has a unique ability to help students connect holistically with their future patients, rather than seeing them as a medical problem to be solved.
“For that reason, I have them look at poems that are about empathy, compassion, solidarity and other similar humanistic values that doctors should strive for when they are in front of a patient,” he says.
The 56-year-old Guimarães himself graduated from the university’s medical department and has been a practicing breast cancer surgeon for thirty years. However, when he’s not in theater performing life-saving operations, he’s at home at his desk composing his own poems. The author of ten published collections, he was awarded the Portuguese Pessoa Prize in 2022 in recognition of his contribution to the arts.
At first glance, his twin passions have little in common. His search for a literal link causes him to resort to metaphors: omitting words when editing, he thinks, is a bit like how I remove a tumor with my scalpel.
Likewise, the structure of the course looks relatively conventional, covering basics such as imagery, sound, tone and rhythm. Yet, with his audience in mind, Guimarães has mined his collection of anthologies from the British poetry publisher, Blood Ax Books, to ensure that each class has at least a handful of poems related to medicine. The course reading list includes a number of notable poet-physicians, including Júlio Dinis (a Portuguese surgeon), William Carlos Williams (an American pediatrician), Gottfried Benn (a German pathologist), and Miroslav Holub (a Czech immunologist). Its didactic purpose is sometimes not too subtle, Guimarães admits. For example, poems about doctor-patient scenarios or familiar healthcare settings provide students with an easy bridge to their daily studies.
Take the example of Wendy Cope’s poem Names, cited in a module on the depictions of the human body in poetry. The short one-stanza poem describes the life of a woman named Eliza Lily, but who actually goes by different names: Lil, my darling, Mrs. Hand, Nanna. But when she ends up in hospital at the end of her life, alone and friendless, the medical staff knows nothing about her, apart from the clinical contents of her medical file. So, as Cope’s heartbreaking poem concludes: “For those last bewildered weeks / She was Eliza again.”
The lesson? To remember the human behind the patient, Guimarães says: “Nowadays, doctors often don’t have time to stop and think, so everything is quickly reduced to the technical and mechanical. What I try to convey to the students is that, just like a poem, each of their patients is unique.â€
Likewise, the lessons can help spark conversations about the emotional rollercoaster that comes with being a doctor and help students think about how to handle their jobs. To take Johannes Steen‘s poem Talking to the family. In a few short lines, students are confronted with the pain, confusion, and stress of the unpleasant but unavoidable task of delivering bad news.
“… I’ll tell them.
They will put it together
and take it apart.
Their voices will buzz.
The severed ends of their nerves
will curl.
I’ll take off the coat,
driving home,
and replace the light bulb in the hallâ€
Guimarães’ teaching is not limited to the most talented poets. In particular, he is a strong advocate of exposing students to the “evil” of excessive sentimentalism; a habit he is determined they should avoid as soon as they enter the department. The course also avoids poetry of a more abstract or complex nature, something he sees as an invaluable tool for illuminating speech’s ability to both conceal and reveal.
It’s not just poets who try to hide their full meaning behind clever puns and literary devices, he argues. Patients do the same out of fear, distrust or simply shame (‘And your estimated number of alcohol units per week, sir?’). Good doctors, he thinks, know how to “read between the lines.” “We often talk about decoding in our classes because the use of illusion, symbolism or enigma is something that many poets do to convey their message in a hidden way.”
Guimarães quotes his own poem, História Clínica (Clinical History), in this connection. Although it is ostensibly about a woman undergoing a double mastectomy, beneath the surface lies a darker story about her experiences with domestic violence. The poem plays with the double meaning of the Portuguese word medalha, which can mean ‘medal’ (used here in reference to the woman’s breasts) or, less commonly, ‘bruises’ (linked in the text to her husband’s ‘bad mood’). The ambiguity surrounding the word persists until the final, devastating sentence. Thanks to the operation, the woman is now cancer-free, but due to the loss of both breasts, her husband leaves her. Finally, Guimarães’s poem ends: that is her livre de perigo (‘free from danger’).
Since the launch of the course, Guimarães has received several requests to teach at other medical schools across Portugal. He’s not alone either. For example, Pompeu Fabra University in Barcelona recently introduced a literature course for its second-year medical students. Cândida Pereira, for example, understands the call. Like poets, doctors need to be in touch with their feelings, she reasons. Although there is probably one more step required of them. “As doctors,” she says, “we also need to be in touch with our patients’ feelings.”