Great physicians of the past warned their students about the emotional and spiritual dangers of medical practice.  The chief quality of a healer, one wrote, is “the sensibility of heart that makes us feel for the distress of our fellow creatures and which, in consequence, incites us to relieve them.”1  Physicians were well aware that daily exposure to suffering made them vulnerable to developing coldness of heart.  A professor cautioned students to cultivate “an affectionate, sympathizing spirit” to counteract medicine’s “manifest tendency to harden and corrupt the heart.”2

Contemporary medicine has largely forgotten these lessons. In fact, we now glorify toughness and promote detachment, rather than sensibility, as medicine’s ideal.  However, while the profession celebrates its technological success, a specter of emptiness and loss of purpose haunts the revelry.  A growing number of voices call for the return of compassion and virtue.  And a proliferation of physician poets speak eloquently of their pain and ambivalence, insights and epiphanies.  Like Maria Basile, these poets write for their lives.

However, the author of Minimally Invasive: poems on a life in surgery is not just another physician who writes poetry; she is an exceptionally strong poet who also happens to practice medicine—surgery, in fact.  Surgeons typically cut to the heart of the problem and fix it, if they can.  They don’t take detours, or beat around the bush.  Likewise, Maria’s poems offer a unique combination of precision, lyricism, and honesty that immediately cuts to the heart of the reader.  Consider her precise images drawn from practice: the panoply of surgical clamps, “the rabbit hole” the surgeon plunges into, the “fatty curtain,” “the clap of steel on rubber glove,” and “good guts” slid “to quiet corners.”  Consider also the extraordinary lyricism of poems like “So Good,” “Euterpe,” and “Goodnight Womb,” with its evocation of a well-loved children’s story.

The transparent honesty of Maria’s work is perhaps its most striking characteristic.  In this day of glib emotion and flim-flam poetry, her integrity shines through every line.

In the poem “To Sylvia” she writes:

The surgeon at 2 a. m. is

stroking sunset blood on college-ruled

canvas, breathing blue

abandonment between lines,

drenching gauze decay in bleach

With the publication of her compelling collection of poems in Minimally Invasive: poems on a life in surgery, Maria Basile joins the thriving cadre of doctor-poets.  As a surgeon, her poems form an elegant counterpoint to the essays of Richard Selzer, and take us closer to the heart of a life in this challenging specialty.

Basile's chapbook carries us along the arc of her career, beginning with her moment as a 10-year-old when she knew she would become a surgeon in the poem "Anastomosis."  In the poems that follow, she guides us through the surgeon's world, sharing the culture and vocabulary which sparkles in her work: monocryl, Metzenbaum, Bard-Parker.  In "Midnight Rain" she also initiates us into the lonely intensity of a surgeon's life and the forces that haunt all of us in the dark of night.

While surgical practice and language hold a strong place in these poems, Basile also reveals her love and nurturance for her children.  The feel of a tuft of her child's hair, or finding her child back in her bed after many years in "Love Poem" take us to the center of the poet's heart.  At the same time, Basile also lets us know something about the sexual passion that can brush against a doctor's skin in "Professional Courtesy."

Three of the poems, "Goodnight Womb," "Bed Rest," and "Vacation" take us on the journey of the poet's own encounter with illness and recovery.  "Goodnight Womb" is written in the style of Margaret Wise Brown's classic children's book "Goodnight Moon, and this device is both poignant and effective as the poet brings the image of her children into the horror of impending surgery at the same time she soothes herself with the hushed cadence of poetic form.

Like her colleagues in medicine and poetry, Basile is unflinching in her willingness to engage "the bruising storm."  With great compassion, insight and grace, Basile gives us a work of profound inspiration.  She tells us she has hoped that "finely crafted form" might rescue her.  This fine collection is healing for both the reader and the poet.

Richard M. Berlin, M.D.

Author of How JFK Killed My Father and Secret Wounds

~ ~

John Keats said that “A poet is the most unpoetical of any thing in existence; because he has no Identity — he is continually . . . filling some other Body.”  Although this new chapbook by Maria Basile, MD, is poetical, in the best sense of the word, in her poems she does continually “fill some other Body,” thereby not losing her identity but in fact finding it.

Like a good physician contemplating the nature of a patient’s illness, Dr. Basile sees life’s situations from many points of view: in some poems, “Anastomosis,” she might be the child, newly enchanted with the idea of being a surgeon; in other poems, “Nick” and “Calling for the Knife,” she is the surgeon, clamping, ligating and learning; in still other poems she is the patient “Late Summer Chemo,”, the widower, “The Widower’s Lament,” the mother, “So Good,” or the lover, “Euterpe.”.

No matter the Body her poems inhabit, the author presents them in minimalist language that is both clinical and strangely familiar, and with a wry humor so subtle that it may take a reading or two to appreciate.  She uses words to dissolve the boundary between the clinical and the personal, allowing her poems to lead to, and fulfill, what seems to be the poet’s credo, stated in the ultimate couplet of the poem, “Truant,”  “I have been a truant from Medicine / a grateful refugee in humanity.”

Let’s first consider Basile’s use of language.  Caregiver-poets have at their disposal a wonderful lexicon of exotic, musical and sometimes frightening words, and Dr. Basile is not afraid to use them—words like “Metzenbaum,” “Bard-Parker,” “tumors,” “trochar,” and “monofilament” — in ways that enhance the meaning and the muscle of a poem.  One of my favorite poems in this collection is “Minimally Invasive,” a poem that, in itself, becomes a metaphor for the poet’s economical and rhythmic use of language, a language that mirrors the perfectly spare and synchronized workings of the body.  Here are a few lines from the first stanza:

Blot away and cauterize

skin edges, then bring close to hide

the scar with monofilament.  This port

a tiny window, the rabbit hole

we plumbed to search for silent sickness

in the belly.

The “rabbit hole,” the small opening in the patient’s belly created by the trochar, is both real and mythic — think of Alice in her Wonderland and understand how this doctor poet chooses to enter and plumb language, selecting words both dangerous and enticing in order to better honor and understand her patients, the humanity she recognizes behind the machinery of “Medicine.”

In some poems, Dr. Basile abandons the clinical in favor of the colloquial, using words so familiar they bring the situation of the poem eerily close to home.  Consider “The Bottle,” and the conversational, human cadence of these lines:

Now living in filth, in someone’s basement

plus or minus a phone, plus or minus hot water

broken glass on the floor, and lodged

in the pad of his foot.

No, he didn’t give up.

He walked into my office,

smelly and bleeding, in pain, with cancer.

In this poem and others, the author uses language and imagery that recognize the push / pull of dichotomy, the yes / no, the this / that of real life.  “Bedrest” examines “rest that is not / really rest at all,” and in “To Sylvia,” we learn that “The surgeon at 2 a.m. is not where you think she is.”  In “Calling for the Knife” we learn that the word “there” might be spoken when you really mean “oops.”  In “I Didn’t Hear,” we learn a patient’s sad story through all the things the doctor-poet did not hear, and in “Truant,” we learn that the “rumbles” of a patient’s “gut” really contain “symphonies.”  In the same poem, we come to understand that we are hearing the language of a poet who “made rhymes / for ‘pain’ and ‘suffer’” and somehow, in these poems, that seems exactly right.

The other hallmark of these poems is their humor — wry, tongue in cheek, cheeky and rogue.  The reader must be alert, because a serious poem might end in humor or a last line turn the poem on its ear.  Sometimes the humor is more evident, as in the ending of the poem, “Nick.”  The

call and response of two surgeon’s movements, the fully

There are few vocations that delve into the heart of the human condition as deeply as medicine and poetry, and when these two worlds converge, they present an avenue for physicians to convey their personal and professional experiences.  This writing is often profound because the literary canvases available to these poets is as vast as the human condition itself.  Such were the canvases of Minimally Invasive: poems on a life in surgery and its author, surgeon-poet, Maria Basile, M.D.

Poetry that rises from a foundation in medicine often draws from the deep, personal feelings of a physician's intimate encounters with patients and their families.  It is the nature of physicians who began their lifetime commitment to the service of others to do so with optimism and innocence.  With time though, the very nature of the environment begins to take its toll on not only the psyche and will of the physician caregiver but also on the care given.  It begins as a subtle, emotional distancing from each new encounter when sensitivities become dulled following the constant, repetitive exposure to pain and suffering and to the onslaught of the physical and emotional demands placed on the time and endurance of physicians.  They build protective, emotional shells to shield their spirits from the assaults of human agony, and as their shells thicken, their reactions to suffering diminish.

This is why medical poetry does not always follow the convention of the first person poetic narrative of intimate poetry.  Rather, the poetry is often conveyed through the voice of a third person observer as if to distance the narrator from these very personal moments, much like the practice of medicine in the past where students were taught to distance themselves emotionally from their patients so as to remain objective in their care.  It is rare then to encounter a physician caregiver who not only seems to be able to maintain close bonds with her patients, but also holds to the optimism with which she first began her professional journey.  Fortunately, this collection of poems was penned by just such a physician, Maria Basile, M.D., a surgeon whose poetry delves deep into the heart of not only the human condition, but also just as deeply, the heart of a caregiver.

As the collection unfolds, we find the poem, “Anastomosis,” a poem of reflection, where, as a young surgeon, Dr. Basile is shown a diagram by her mentor of a procedure that is rarely performed today.  The poem

conjures up memories of when, as a child, she observed her surgeon-father draw a similar diagram on a paper

napkin as he prepared to perform the same procedure for the first time, and how that moment in time set her on her course to pursue a career in medicine.

As we move forward, Dr. Basile reveals how her different worlds carry into and influence each other as her poems transition back-and-forth between surgery and patient, surgeon and family, and how sometimes, the differences between her worlds are too meager to measure when they merge into one.  At other times, the poems convey her struggles to steel herself so as to not allow one world to sway the other while at the same time recognizing that these worlds bleed into each other.

In “Calling for the Knife,” Dr. Basile reveals the coded, conversational language spoken between surgeons, and in “Minimally Invasive,” the title poem, she introduces us to the unique language of medicine, with its precise observation and terminology, yet in all her poems, she speaks with the sensitivity of a poet's heart.   Like a considerate medical practitioner, who, when speaking to her patients about their conditions, uses everyday, common words and injects humor, wit, and personal experiences into the conversations to help ease her patients’ anxieties, Dr. Basile’s poetry is understandable, conversational, and revealing.  It is personal, and it is sprinkled with her wry sense of humor.

You will find poems about mothering like “So Good” and “Love Poem,” and there are the poems, “Goodnight Womb” and “Bedrest,” about being a woman patient, but the poems that reveal where there is convergence between worlds are the most striking.  In “The Widower’s Lament,” “Truant,” “I Didn’t Hear,” “Late Summer Chemo,” “Euterpe,” “Midnight Rain,” “Professional Courtesy,” and “To Sylvia,” you will learn how surgeons contend with the many aspects of both their personal and professional lives to allow them to focus on the immediate while guarding their reserves for whatever may come next.

Maria Basile goes beyond offering her readers a glimpse into the life and worlds of a surgeon.  Rather, she meets the challenge head on as she portrays the stark realities of some of the most intimate details of the human experience, and she does so with sensitivity, honesty, and humor.  Minimally Invasive: poems on a life in surgery is not only a must read for anyone who has ever been a patient or a caregiver, it is also a necessary resource for members of their families and their close, personal friends.

O.P.W. Fredericks, Editor

and lye.

She is writing

for her life.

Here the sentiment, the scene, the meaning are utterly convincing.  Likewise, this stanza from “The Truant” strikes the reader as revelatory, a metaphorical truth beyond doubt:

I have found poetry in the hands of

a patient, read history by the lines

on his face, heard symphonies in the

rumbles of his gut.

In a letter to his publisher, Anton Chekhov famously wrote, “Medicine is my lawful wedded wife, and literature my mistress.  When one gets on my nerves, I spend the night with the other.  This may be somewhat disorganized, but then again it’s not  boring, and anyway neither loses anything by my duplicity.”3 I’ve always felt that Chekhov’s catchy aphorism was a bit dishonest because his commitments to medicine and writing were not only equal, but, in fact, aspects of the same calling.  They were not separate bedrooms.  Alternatively, William Carlos Williams wrote of medicine and poetry that “they amount for me to largely the same thing.”4  That hits the nail on its head.  Perhaps, in one sense Maria Basile does experience herself as “a truant from Medicine / a grateful refugee in Humanity,” but in a much deeper sense, her poetry continues and expands her calling as a healer.  Minimally Invasive: poems on a life in surgery, Maria’s first chapbook, offers the reader a therapy of delight.  It proves that she is indeed a “scribe of wonder.”

Jack Coulehan, M.D., author of Medicine Stone and Bursting With Danger and Music

_______________

meshed working of their hands as they operate, calls to mind “movements like the gears / of an old German clock.”  This leads one surgeon, the poem’s narrator, to ask the other surgeon “Nick, have you ever been to Germany?”  In the last line, Nick replies “No, looking up, why?”  But in the penultimate line he calls for a particular type of scissor called a “Metzenbaum,” named after the American surgeon with the German name who invented this instrument.  And if one wishes to delve further into Basile’s word choice, the Metzenbaum’s blades can be either curved or straight, like language; and the scissors use, like poetry, is for delicate cutting.  And isn’t “Nick” the ideal name for a surgeon?

In the poem, “Minimally Invasive,” the clinical (serious) language continues until the ultimate lines: “More stapling, then it’s / Monocryl for everyone.”  As readers, we expect the phrase to be, “More stapling, then it’s / done,” but the author plays with those expectations, offering “Monocryl for everyone” as if passing out cookies as a reward for surgery well done.  There’s also the interplay of “mono” (one) and “everyone,” and if you look up “Monocryl” on line, you’ll find that it “has a high degree of memory, and it’s slippery,” two qualities of the poems that Basile offers in this collection — poems that are enhanced by memory, and poems that are slippery in their ability to be both this and that, both clinical and conversational, both serious and humorous.

Let’s first consider Basile’s use of language.  Caregiver-poets have at their disposal a wonderful lexicon of exotic, musical and sometimes frightening words, and Dr. Basile is not afraid to use them—words like “Metzenbaum,” “Bard-Parker,” “tumors,” “trochar,” and “monofilament” — in ways that enhance the meaning and the muscle of a poem.  One of my favorite poems in this collection is “Minimally Invasive,” a poem that, in itself, becomes a metaphor for the poet’s economical and rhythmic use of language, a language that mirrors the perfectly spare and synchronized workings of the body.  Here are a few lines from the first stanza:

Blot away and cauterize

skin edges, then bring close to hide

the scar with monofilament.  This port

a tiny window, the rabbit hole

we plumbed to search for silent sickness

in the belly.

The “rabbit hole,” the small opening in the patient’s belly created by the trochar, is both real and mythic — think of Alice in her Wonderland and understand how this doctor poet chooses to enter and plumb language, selecting words both dangerous and enticing in order to better honor and understand her patients, the humanity she recognizes behind the machinery of “Medicine.”

In some poems, Dr. Basile abandons the clinical in favor of the colloquial, using words so familiar they bring the situation of the poem eerily close to home.  Consider “The Bottle,” and the conversational, human cadence of these lines:

Now living in filth, in someone’s basement

plus or minus a phone, plus or minus hot water

broken glass on the floor, and lodged

in the pad of his foot.

No, he didn’t give up.

He walked into my office,

smelly and bleeding, in pain, with cancer.

In this poem and others, the author uses language and imagery that recognize the push / pull of dichotomy, the yes / no, the this / that of real life.  “Bedrest” examines “rest that is not / really rest at all,” and in “To Sylvia,” we learn that “The surgeon at 2 a.m. is not where you think she is.”  In “Calling for the Knife” we learn that the word “there” might be spoken when you really mean “oops.”  In “I Didn’t Hear,” we learn a patient’s sad story through all the things the doctor-poet did not hear, and in “Truant,” we learn that the “rumbles” of a patient’s “gut” really contain “symphonies.”  In the same poem, we come to understand that we are hearing the language of a poet who “made rhymes / for ‘pain’ and ‘suffer’” and somehow, in these poems, that seems exactly right.

The other hallmark of these poems is their humor — wry, tongue in cheek, cheeky and rogue.  The reader must be alert, because a serious poem might end in humor or a last line turn the poem on its ear.  Sometimes the humor is more evident, as in the ending of the poem, “Nick.”  The call and response of two surgeon’s movements, the fully meshed working of their hands as they operate, calls to mind “movements like the gears / of an old German clock.”  This leads one surgeon, the poem’s narrator, to ask the other surgeon “Nick, have you ever been to Germany?”  In the last line, Nick replies “No, looking up, why?”  But in the penultimate line he calls for a particular type of scissor called a “Metzenbaum,” named after the American surgeon with the German name who invented this instrument.  And if one wishes to delve further into Basile’s word choice, the Metzenbaum’s blades can be either curved or straight, like language; and the scissors use, like poetry, is for delicate cutting.  And isn’t “Nick” the ideal name for a surgeon?

In the poem, “Minimally Invasive,” the clinical (serious) language continues until the ultimate lines: “More stapling, then it’s / Monocryl for everyone.”  As readers, we expect the phrase to be, “More stapling, then it’s / done,” but the author plays with those expectations, offering “Monocryl for everyone” as if passing out cookies as a reward for surgery well done.  There’s also the interplay of “mono” (one) and “everyone,” and if you look up “Monocryl” on line, you’ll find that it “has a high degree of memory, and it’s slippery,” two qualities of the poems that Basile offers in this collection — poems that are enhanced by memory, and poems that are slippery in their ability to be both this and that, both clinical and conversational, both serious and humorous.

While there are many other poems that highlight Dr. Basile’s subtle use of humor, one in particular should be noted, “Goodnight Womb.”  The title, immediately, seems silly, a play on the popular children’s book, “Goodnight Moon,” and the poem itself is told in irregular rhyme and repetition, the stuff of nursery tales; the last stanza is an imitation of the goodnight ritual of the children’s story.  But the subject matter — surgery to remove a uterine mass — is  anything but laughable.  Is the poem funny — or is the poet saying that sometimes the only way she can say what really happens between doctor and patient is to examine those moments through a poetic lens?

In Minimally Invasive: poems on a life in surgery, Maria Basile gives us such poetic lenses, permitting us access into her private world, both medical and personal, and offering us both tension and release.  Reading her poems, we are grateful that she has declared herself a “refugee in humanity” and invited us along on her journey.

Cortney Davis, A.P.R.N., F.C.P., author of

Leopold's Maneuvers and

The Heart's Truth: Essays on the Art of Nursing