A Physician-Poet Bears Witness to the Pandemic's Lost Voices

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Dr. Rafael Campo is a practicing physician at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston. He's also a poet, the author of five books. He’s the current poetry editor of the Journal of the American Medical Association.

Campo has found that during times of great illness, such as the AIDS crisis and the COVID-19 pandemic, writing verse helps him personally grieve, and offers a lasting remembrance to those who die. I spoke with Campo about how he both treats the physical body and explores the non-corporeal world through words.

This transcript has been edited for brevity and clarity.

Shannon Henry Kleiber: So, Rafael, how are you? How are you doing right now with being a doctor through this entire pandemic?

Dr. Rafael Campo: It’s been such a challenging time for so many of us, and I think for me as a doctor and for other doctors, it's been particularly cruel because the pandemic and the isolation and distancing that it has imposed on all of us has really alienated us in many ways from our patients.

It's kept us more than 6 feet away in settings like the ICU. Even in the clinic where I spend most of my time caring for patients, we are masked, we are gowned, we are removed from the presence of one another in ways that I think really can interfere with empathetic care, the kind of care that I think is so important. 

I have to say that my connection to poetry and through poetry to my patients has really been the most sustaining thing in my life as I've continued to work with folks who are ill with COVID-19 infection.

SHK: I read that you're writing poems for those who have lost their voices in a literal sense, those who've died, which I thought was so powerful. Is that your way of grieving?

RC: Yes. You know, that's one way I think poetry helps us. Probably the oldest poems that we know were elegies — expressions of grief. We're called to grieve through language. And that language allows us, I think, poetic language in particular, allows us to create a kind of container for our grief. Or if not a container, a way of making sense of our grief.

Death comes for all of us. And poetry, I think, makes some kind of sense of it by narrating it, at least. I think it helps ease our own pain as we confront death.

SHK: Were there many poems written after other times of great death and illness?

RC: Yes, absolutely so. I think of the AIDS pandemic and I remember so clearly when I was training to become a doctor. I was an intern and a resident at the University of California, San Francisco at the height of the crisis. And I remember activists in the street chanting: "Silence equals death, silence equals death."

And those voices, those poems that came out of that moment actually were sustaining, I think, in a very real sense. Not only did they help us bear witness to the tremendous suffering in communities that were most impacted by HIV and AIDS, but also I think they actually spurred scientific research that led to some of the medicines that we have now that are effective in treating the infection. That poetry really saved lives, and in some very real sense saved my own life.

SHK: How did it save your own life?

RC: Well, I felt so hopeless then as a gay man and a member of the Latinx communities — two communities that were particularly impacted by HIV and AIDS. I felt that it could be me, and that hopelessness was really dangerous.

And so discovering voices and engaging with those voices helped me think about what I might do to be a healer, to stay on this path of becoming a doctor and not give up, not allow this dread disease to take me too. And so in that sense, poetry really did save my life.

 It also helped me to become a better doctor. It helped me preserve my humanity as a doctor.

SHK: It seems like we have a lot of deferred grief that's happening right now. I lost someone early on from Covid: my best friend's mother, who was really my second mom growing up. And I just feel like I haven't seen her for a long time and I haven't seen my friend for a long time either. And I just haven't grieved.

RC: It's interesting what you say, Shannon, about that sense of a kind of deferred grief, because so often we can't be present with our loved ones when they're facing the end of life because of the fear of contagion and that immediacy is lost.

So I think poetry for me is a way of revisiting those lost moments, or projecting myself imaginatively into those moments where one can still, create a sense of connection and allow oneself to feel what wasn't allowed in that actual moment.

I think that also goes back to what elegy does. Since the beginning of human history, it enlivens, it brings back the lost loved one in a way that's really almost alchemical. And the person that we've lost, in some ways, I think lives again.

SHK: When you feel despondent during this time, do you sit down and write a poem? How does your writing process work? Do you just try to write and it makes you feel a little better, even if the poem doesn't come right away?

RC: Sometimes I'm so exhausted I can't actually write. But, being in the clinic with patients is itself like being inside a poem in so many ways. And so the poems are being written all the time as I'm present with my patients.

And so when I do finally have 10 minutes to sit down, usually late at night and I'm not so exhausted that I can't keep my eyes open, I feel compelled to write, to prepare myself for the next day. And writing is healing. I almost can't resist. I can't imagine not writing. I think of the two things that I do as really inextricably interrelated. I can't imagine doing one without the other.

SHK: You're giving some of these patients more voice, or a voice that they otherwise won't have.

RC: I hope I am able to do that. I don't want to — in a glib or presumptuous way— say, "Oh, I know this other person's experience and I can articulate it for them." But at the same time, I definitely have a sense that many patients of mine have been literally silenced by that endotracheal tube being placed through the vocal cords when they go on a ventilator. And so, who can speak to their pain and who can be a witness to that suffering?

SHK: I wanted to ask you to read your poem "Vaccination." And if you could also just tell me first a little bit about when you wrote this and if anything got you to think about writing this poem.

RC: Yeah, this is actually a very, very recent poem. And it was inspired by the story of one of my patients whose sister was dying of COVID. And he said to me, he just wanted to see her in the ICU. And the doctors said it was impossible. He couldn't see her. She was dying essentially alone in the ICU.

He said, "I just wanted to smash the glass wall. I could see into the ICU, but I couldn't see my sister. I couldn't visit her."

So that resonated with some of my own experiences in caring for patients and feeling that kind of distance and wanting to get through it. So this is a poem, again, I just wrote a couple of weeks ago.

Vaccination

Immunity, supposedly, through pain.

I see their faces like I'm there again.

The ICU, it’s brightness crystalline,

controlled fragility. I want to smash

the panes of glass, break through, tear off my mask.

Somewhere, the nurses’ station maybe, Bach

plays, like a memory, like someone dying,

like viruses, artfully multiplying.

I still remember how hard I was trying

to not let one more die, but it was AIDS

back then, and so instead we busily made

quilts. Dreams, supposedly, or grief, betrayed

us to ourselves and let us hope again.

I see their faces and I'm there: their pain

is mirrored in the sink’s metallic drain

as once again I wash my hands, my eyes

above my mask same blur I recognize.

Immunity, elusive, still contrives

to make us think we might live long enough

to find the cure. Across my latex gloves

his skin feels alien, but still craves touch,

at least as I imagine it. So keen

this interplay of notes, the major key,

and minor fall; the prick of the vaccine.

SHK: Wow, that's really beautiful. And you feel like you're there. I mean, you just brought me right into that spot. I feel like I could hear it and see it.

RC: Oh, well, if that happened, then I think that's what poetry can do for all of us, bring us into that space where we're told we can't go in. We can't go into the ICU, but yet, we can. And I think poetry helps us transcend those distances and those barriers.