Skip to main content
SpringerLink
Log in
Book cover

Perspectives on Human Suffering pp 227–244Cite as

To Suffer With: The Poetry of Compassion

  • Chapter
  • First Online:

Abstract

Suffering is the experience of distress or disharmony caused by the loss, or threatened loss, of what we most cherish. Such losses may strip away the beliefs and symbols by which we construct a meaningful narrative of human life in general and our own in particular. The vocation of physicians and other health professionals is, insofar as is possible, to relieve suffering caused by illness, trauma, and bodily degeneration. However, since suffering is an existential state that does not necessarily parallel physical or emotional states, to relieve suffering physicians cannot rely solely on knowledge and skills that address physiological dysfunction. Rather, they must learn to engage the patient at an existential level. However, medical pedagogy discourages such engagement and, instead, promotes psychological detachment, or “detached concern.” In practice, medical education favors a process of progressive detachment from patients that devalues subjectivity, emotion, solidarity, and relationship as both irrelevant and potentially harmful. Such sought-after detachment (fortunately not achieved by most students and physicians) almost ensures that practitioners are unable fully to appreciate and respond to human suffering. The term “compassionate solidarity” summarizes an alternate model of the physician’s response to patients and their suffering. Compassionate solidarity begins with empathic listening and responding, which facilitate objective assessment of the other’s subjective state; requires the physician to develop reflectivity and self-understanding; and is in itself a healing act. Going beyond compassionate solidarity, the physician may in some cases also understand the disharmony in the patient’s symbolic world and, thus, be able to further relieve suffering through symbolic healing. Reading and writing poetry, along with other imaginative writing, may help physicians and other health professionals grow in self-awareness and gain deeper understanding of suffering, empathy, compassion, solidarity, and symbolic healing.

This chapter is a revised and expanded version of J. Coulehan, ‘Compassionate Solidarity: Suffering, Poetry, and Medicine,’ originally published in Perspectives in Biology and Medicine 52(2009):585–603.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Notes

  1. 1.

    These orthodox beliefs have recently been challenged by an upsurge of moralization that tends to blame patients for their illnesses. In the pre-scientific era, diseases were often attributed to moral depravity. This theme has reemerged in the recent tendency to blame patients for the ‘bad’ behavior that causes, or contributes to, their disease (e.g. smoking, drinking alcohol, eating trans-fats, not exercising).

Bibliography

  • Akhmatova, Anna. 2004. The word that causes death’s defeat. Poems of Memory. Trans. N.K. Anderson. New Haven: Yale University Press.

    Google Scholar 

  • Balint, Michael. 1972. The doctor, his patient and the illness. New York: International Universities Press.

    Google Scholar 

  • Basch M. F. 1983. Empathic understanding: A review of the concept and some theoretical considerations’. Journal of the American Psychoanalytic Association 31:101–126.

    Article  Google Scholar 

  • Becker, Howard Saul, Blanche Geer, Everett C Hughes, Anselm Strauss. 1961. Boys in white: Student culture in medical school. Chicago: Chicago University Press.

    Google Scholar 

  • Bennett, M. J. 2001. The empathic healer: An endangered species? New York: Academic Press.

    Google Scholar 

  • Berger, John, and Jean Mohr. 1967. A fortunate man. New York: Pantheon Books.

    Google Scholar 

  • Bloom, S. W. 1989. The medical school as a social organization: The sources of resistance to change. Medical Education 23:228–241.

    Article  Google Scholar 

  • Blum, L. 1980. Compassion. In Explaining emotions, ed. Amélie Oskenberg Rorty. Berkeley: University of California Press.

    Google Scholar 

  • Blumgart, H. L. 1964. Caring for the patient. New England Journal of Medicine 270:449–456.

    Article  Google Scholar 

  • Bolton, G. 1999. Stories at work: Reflective writing for practitioners. The Lancet 354:243–245.

    Article  Google Scholar 

  • Cassell, E. J. 1982. The nature of suffering and the goals of medicine. New England Journal of Medicine 306:639–645.

    Article  Google Scholar 

  • Cassell, E. J. 1991. The nature of suffering and the goals of medicine, 1st ed. New York: Oxford University Press.

    Google Scholar 

  • Cassell, E. J. 1995. Pain and suffering. In Encyclopedia of Bioethics, ed. W. T. Reich, 2nd ed. New York: Simon & Schuster.

    Google Scholar 

  • Cassell, E. J. 2004. The nature of suffering and the goals of medicine, 2nd edn. New York: Oxford University Press.

    Book  Google Scholar 

  • Charon, Rita. 2001. Narrative medicine. A model for empathy, reflection, profession, and trust. Journal of the American Medical Association 286:1897–1902.

    Article  Google Scholar 

  • Clark, M. M. 2004. Art and suffering in two late poems by William Carlos Williams. Literature and Medicine 23:226–240.

    Article  Google Scholar 

  • Coles, R. 1989. The call of stories: Teaching and the moral imagination. Boston: Houghton Mifflin.

    Google Scholar 

  • Connelly, J. 1998. Emotions, ethics, and decisions in primary care. Journal of Clinical Ethics 9:225–234.

    Google Scholar 

  • Coulehan, J. 1991. The word as an instrument of healing. Literature and Medicine 18:111–129.

    Article  Google Scholar 

  • Coulehan, J. 1992a. May I walk in beauty. Humane Medicine 8:65–69.

    Google Scholar 

  • Coulehan, J. 1992b. On medicine and poetry. In Life on the line: Selections on words and healing, eds. S. B. Walker and R. D. Roffman. Mobile: Negative Capability Press.

    Google Scholar 

  • Coulehan, J. 1995. Tenderness and steadiness: Emotions in medical practice. Literature and Medicine 14:222–236.

    Article  Google Scholar 

  • Coulehan, J. 2002. Being a physician. In Fundamentals of clinical practice. A textbook on the patient, doctor, and society, eds. M. B. Mengel and W. Holleman, 2nd ed. New York: Plenum Medical Book Company.

    Google Scholar 

  • Coulehan, J. 2009. Compassionate solidarity: Suffering, poetry, and medicine. Perspectives in biology and medicine 52:585–603.

    Article  Google Scholar 

  • Coulehan, J., and P. Clary. 2005. Healing the healer: Poetry in palliative care. Journal of Palliative Care 8:382–389.

    Google Scholar 

  • Coulehan, J., and M. R. Block. 2006. The medical interview: Mastering skills for clinical practice, 5th ed. Philadelphia: F.A. Davis Company.

    Google Scholar 

  • Coulehan, J., F. W. Platt, R. Frankl, W. Salazar, B. Lown, and L. Fox. 2001. Let me see if I have this right: Words that build empathy. Annals of Internal Medicine 135:221–227.

    Article  Google Scholar 

  • Coulehan, J., P. W. Williams, S. V. McCrary, C. Belling. 2003. The best lack all conviction: Biomedical ethics, professionalism, and social responsibility. Cambridge Quarterly of Healthcare Ethics 12:21–38.

    Google Scholar 

  • Daudet, Alphonse. 2002. In the land of pain, ed. Julian Barnes. New York: Knopf.

    Google Scholar 

  • Engel, G. L. 1977. The need for a new medical model: A challenge for biomedicine. Science 196:129–136.

    Article  Google Scholar 

  • Farber, N. J., D. H. Novack, M. K. O’Brien. 1997. Love, boundaries, and the patient physician relationship. Archives of Internal Medicine 157:2291–2294.

    Article  Google Scholar 

  • Frankel, R. M., T. E. Quill, and S. H. McDaniel, eds. 2003. The biopsychosocial approach: Past, present, future. Rochester: University of Rochester Press.

    Google Scholar 

  • Frankl, Viktor. 1997. Man’s search for meaning, rev. ed. New York: Washington Square Press.

    Google Scholar 

  • Gunderman, R. B. 2002. Is suffering the enemy? Hastings Center Report 32:40–44.

    Google Scholar 

  • Hafferty, F. W., R. Franks. 1994. The hidden curriculum, ethics teaching, and the structure of medical education. Academic Medicine 68:861–871.

    Article  Google Scholar 

  • Halpern, J. 1993. Empathy: Using resonance emotions in the service of curiosity. In Empathy and the practice of medicine, eds. H. Spiro, M. Curnen, E. Peschel and D. St. James. New Haven: Yale University Press.

    Google Scholar 

  • Hauerwas, Stanley. 1990. God, medicine, and suffering. Grand Rapids: Eerdmans.

    Google Scholar 

  • Hoffman, M. L. 1984. Interaction of affect and cognition in empathy. Emotions, cognitions, and behavior, eds. C. E. Izard, J. Kagan and R. B. Zajonc. Cambridge: Cambridge University Press.

    Google Scholar 

  • Hunnert E. M. 1996. Characteristics of the informal curriculum and trainee’s ethical choices. Academic Medicine 71:624–633.

    Article  Google Scholar 

  • Inui, T. S. 2003. A flag in the wind: Educating for professionalism in medicine. Washington: Association of American Medical Colleges.

    Google Scholar 

  • Kassirer, J. P. 1998. Managing care—Should we adopt a new ethic? New England Journal of Medicine 339:397–398.

    Article  Google Scholar 

  • Kearney, Michael K. 1996. Mortally wounded. Stories of soul pain, death and healing. Dublin: Marino Books.

    Google Scholar 

  • Lawrence, D. H. 1947. Selected poems, introduction by Kenneth Rexroth. New York: New Directions.

    Google Scholar 

  • Levertov, D. 2003. Selected poems. New York: W.W. Norton.

    Google Scholar 

  • Lief, H. I., and R. Fox. 1963. Training for ‘detached concern’ in medical students. In The psychological basis for medical practice, eds. H. I. Lief and N. R. Lief. New York: Harper & Row.

    Google Scholar 

  • Manson, A. 1994. The fate of idealism in modern medicine. Journal of the Medical Humanities 15:153–162.

    Article  Google Scholar 

  • Meier, Diane, Anthony L. Back, and R. Sean Morrison. 2001. The inner life of physicians and care of the seriously ill. Journal of the American Medical Association 286:3007–3014.

    Google Scholar 

  • Morris, D. B. 1998. Illness and culture in the postmodern age. Berkeley: University of California Press.

    Book  Google Scholar 

  • Novack, Dennis H., Anthony L. Suchman, William Clark, Ronald M. Epstein, Eva Najberg, and Craig Kaplan. 1997. Calibrating the physician: Personal awareness and effective patient care. Journal of the American Medical Association 278:502–509.

    Google Scholar 

  • Novack, Dennis H., Roland M. Epstein, and Randall H. Paulsen. 1999. Toward creating physician-healers: Fostering medical student’s self-awareness, personal growth, and well-being. Academic Medicine 74:516–520.

    Google Scholar 

  • Orr, G. 2002. The caged owl: New and selected poems. Fort Townsend: Copper Canyon Press.

    Google Scholar 

  • Ozick, C. 1989. Metaphor and memory: Essays. New York: Knopf.

    Google Scholar 

  • Petersdorf, R. G. 1992. Are we educating a medical professional who cares? American Journal of Diseases of Children 146:1338–1341.

    Google Scholar 

  • Pololi, L., R. M. Frankel, M. Clay, and A. Jobe. 2000. One year’s experience with a program to facilitate personal and professional development in medical students using reflection groups. Education for Health 14:36–49.

    Google Scholar 

  • Reich, W. T. 1989. Speaking of suffering. A moral account of compassion. Soundings 72: 83–108.

    Google Scholar 

  • Rumi, J. 1995. The Essential Rumi. Trans. C. Barks and J. Moyn. San Francisco: Harper.

    Google Scholar 

  • Sulmasy, Daniel. 1997. The healer’s calling. Spirituality for physicians and other health care professionals. New York: Paulist Press.

    Google Scholar 

  • Sontag, Susan. 1978. Illness as metaphor. New York: Farrar, Straus and Giroux.

    Google Scholar 

  • Sontag, Susan. 1988. AIDS as metaphor. New York: Farrar, Straus and Giroux.

    Google Scholar 

  • Spiro, H. 1992. What is empathy and can it be taught? Annals of Internal Medicine 116:843–846.

    Article  Google Scholar 

  • Suchman, A. L., K. Markakis, H. B. Beckman, R. Frankel. 1997. A model of empathic communication in the medical interview. Journal of the American Medical Association 277:678–682.

    Article  Google Scholar 

  • Williams, William Carlos. 1951. The autobiography of William Carlos Williams. New York: New Directions.

    Google Scholar 

  • Wispe, L. 1986. The distinction between sympathy and empathy: To call forth a concept, a word is needed. Journal of Personal and Social Psychology 50:314–321.

    Article  Google Scholar 

  • Zinn, W. 1993. The empathic physician. Arch Intern Medicine 153:306–312.

    Article  Google Scholar 

  • Zoloth-Dorfman, L., and S. Rubin. 1995. The patient as commodity: Managed care and the question of ethics. Journal of Clinical Ethics 6:339–356.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Medical Humanities, Compassionate Care, and Bioethics, Stony Brook University, Stony Brook, USA

    Jack Coulehan

Authors
  1. Jack Coulehan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jack Coulehan .

Editor information

Editors and Affiliations

  1. , School of Philosophy - Private Bag 41, University of Tasmania, Hobart, 7001, Tasmania, Australia

    Jeff Malpas

  2. , School of Philosophy - Private Bag 41, University of Tasmania, Hobart, 7001, Tasmania, Australia

    Norelle Lickiss

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media B.V.

About this chapter

Cite this chapter

Coulehan, J. (2012). To Suffer With: The Poetry of Compassion. In: Malpas, J., Lickiss, N. (eds) Perspectives on Human Suffering. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2795-3_18

Download citation

Publish with us

Policies and ethics

Search

Navigation