The pantoum is a poetic form thought to have originated in Malaysia in the 15th century, and then popularized in Europe by the likes of Charles Baudelaire and Victor Hugo. The form’s repetitive, interlocking structure—the rhymed second and fourth lines of each stanza are repeated as first and third lines in the following stanza, and the poem’s last line is a repetition of its first—is entrancing, and thus well-suited to conveying generational wisdom and fostering reflection. More recently, writing in English, notable poets such as John Ashbery and Donald Justice have used the form to examine themes of history repeating itself and recurrent familial trauma. In “Cardiac Intensive Care,” these attributes of the pantoum are similarly enlisted to express both powerlessness and hope in the face of fatal illness. The speaker tells “the story of the mending of a heart” in terms both literal and metaphysical, aided by slight rewordings of the repeated lines so that the narrative plays out on both planes. The pantoum’s circularity is further harnessed to recreate both the feeling of intensive care unit rounds, especially familiar to clinicians, and also the sense of déjà vu that families may experience as they witness improvements and setbacks in their loved ones. Also in keeping with the pantoum form, the wisdom expressed in such repeated lines as “narrative for now is all we have” is soothing, as prayer might be. Ultimately, the pantoum form here abets healing by insistently joining “science and…art,” reminding us again and again that “healing is a most mysterious grace.”
As studies suggest empathy in medicine continues to decline, mirroring the trend seen in other societal realms, poetry remains an important medium for questioning why, and reclaiming it. In the poem “20 Marlboro Reds,” smoking, both a communal bonding ritual and noisome health risk, becomes a complex metaphor for our vexed attempts to connect with others. The desire to belong and the harmful effects of smoking are simultaneously evoked when the speaker first experiences nausea after trying cigars offered by a friend. Colloquial, almost irreverent language belies the speaker’s nagging aloneness: as the stanzas wryly move through his adolescence and young adulthood, two “black cigarillos” at parties (accompanied by “thick liquor,” another fraught social lubricant) seem a jaunty rallying cry for teenage rebelliousness; and later, smoking marijuana because “a girl wanted me to” and finding “nothing happened” suggests that genuine human connection remains elusive. The irony in the search for shared feeling deepens when eventually, we infer, the speaker becomes a physician and a patient with metastatic lung cancer is craving a cigarette, so the speaker offers to fetch some. With roles reversed and the speaker and would-be healer now supplying the cigarettes, long-sought empathy is never really kindled, as the request is forgotten and instead they watch a wholesome television show together. Any facile notion of empathy is critiqued, however, as in the final lines, the speaker ruefully smokes the cigarettes himself after the patient dies, ever alone in his frustrated quest, “while I contemplated what/was killing me.”
