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NINE: In the Middle of Life’s Journey
- Johns Hopkins University Press
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Nine in the middle of life’s journey jack coulehan, md 92 In the middle of the journey of our life I found myself astray in a dark wood where the straight road had been lost sight of. when, as a young man, I first read the opening stanza of Dante’s Inferno, I probably raced right passed it without thought because I was so anxious to delve into the nitty-gritty of hell. However, when I took up Dante again in the mid-1980s, the same three lines jumped up and hooked me. Dante’s experience hit home. At the time I found myself in Pittsburgh following a variety of roads that seemed irreconcilable . I was a primary care internist in an academic medical center, an epidemiologist studying cardiovascular disease in Navajo Indians , and a nascent student of doctor-patient communication. I had plenty of energy. It was exhilarating to jump from crunching numbers to talking with patients to making rounds in the hospital. Yet something was missing, not only a piece of the puzzle, but the piece that I yearned for. I felt very much “astray in a dark wood.” In this essay I reflect upon the e¤ects of psychiatric treatment on my creative writing, especially poetry. Before I can do so, however, I need to explain that when I found myself in the dark wood, I was not writing poetry and hadn’t been for at least twelve years. I believe psychotherapy allowed me to seize an unexpected opportunity that arose when a patient o¤ered to become my poetry teacher. This led to my becoming a writer, which I think saved my life. For me, poetry was the path I was looking for. Much later, during another spell of psychiatric treatment, I began to take medication that had an additional influence on my life and work, as both a poet and a physician. Thus, this story has three parts: a prepsychotherapeutic prelude; psychotherapy, fol- lowed by a long span of poetic development and synergism between medical practice and poetry; and, finally, the addition of antidepressant medication and its e¤ects on my writing. prelude Ever since I sent maudlin poems to my girlfriends in high school, I fancied myself a creative writer. At St. Vincent, a Benedictine college known best for its proximity to the home of Rolling Rock beer, I wrote a poem for a freshman English assignment. It was an elegant pseudoEliot a¤air with internal rhymes and classical references. Father Maynard called me into his oªce after class and told me in no uncertain terms that I was a plagiarist. “You picked the wrong teacher to mess with,” he said, with the tone of a hawk descending on its rabbit. “There’s no way you could have written a poem like this.” “I did, Father,” I sheepishly told the crucifix behind his left ear. “Really.” Benedictines were very existential in those days, and Maynard was one of the most exceptionally existential of the lot. I wrote him poem after poem filled with angst and being-for and references to Sartre. Because of this, he took me aside and suggested that I major in English and concentrate on writing. But I turned him down. “Biology,” I said. “I want to help people. I want to be a doctor. But I can still write, can’t I?” I completed college totally naive about the medical life; never volunteered in a hospital or nursing home or even had a local physician role model. When growing up, I was rarely sick. When a cold or sore throat did develop, my mother’s prescription was inevitably aspirin and juice. On occasion I did venture into old Doc McGee’s oªce. He lived in a huge yellow house near our church and intimidated me because he was a parish big shot and a cigar smoker as well. In addition, his smartass son was my nemesis. Given this record of naiveté and noninvolvement , a medical school admissions committee today would never even grant me an interview, but things were di¤erent in 1965. So why choose medicine? My role model was Albert Schweitzer, who at that time was the Great Humanitarian of the World. He appealed to me as a Renaissance man—philosopher, theologian, musicologist , musician, physician, and missionary. As a teenager in southwestern Pennsylvania, I visualized myself at Schweitzer’s side treating elephantiasis in the jungles of Gabon and, in the evening, listening to him...