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  • Writer's pictureJan Carroll

But, What Does It MEAN?

I go to Urgent Care early on a Monday morning, concerned that the irritated, possibly allergy-induced skin around my right eye has swollen considerably overnight. I explain the history, that I’d clearly felt some bug bite me just under the lower edge of my big blue sunglasses on that side—LAST summer—and how the area would flare up and then calm down every once in a while since then. I am taken to a holding room, told, “If you need anything, push that red button. But don’t come through this door (into Emergency).” I wait. A woman comes in, quickly tells me her name, says she is a nurse practitioner, listens to my story briefly and says she will prescribe an antifungal cream and a steroid cream, concluding that I must have gotten something from the garden inside the bite. She is confident it will clear up everything in two or three days. Then she hurries out the door, on to presumably more dire cases.

I used to host a poetry circle at my place of worship. I’d put together a packet of two or three poems by two or three established poets, make photocopies, and place them on the table by the church office for anyone interested in preparing ahead to stop by and pick up. The degree of interest in doing so ranged from one person who passionately and thoroughly studied the packet, going into further background research on the authors than I had done, and making extensive notes in the margins of her copies to those who sauntered into the room the day of the meeting, a few yet unaware of the purpose of the gathering, just looking to fill some time, to shoot the breeze. The majority of them somewhere in between.

I dutifully use the creams as instructed. But waking Wednesday morning, I now have pain in more or less of a circle around the whole eye socket, though not the eye itself—that, thank goodness, seems fine. The kind male nurse asks what number I’d give it on a scale of one to ten. “Four, maybe,” I say. I’d seen him earlier out in the waiting room, crouching down in front of a distraught woman who was having a really hard time and gently ask her, “It seems like you’re not feeling well. What’s going on?” And she told him, crying—some would say venting. He took that all in stride, saying, “I’m sorry you’re going through that. We’ll get you some help soon, ok?” And she thanked him, calmer now.

Once I was in another poetry circle where one particular woman regularly raised her hand and asked the teacher if a certain line in the poem might be a reference to some detail she was aware of in that author’s life. Did the reference to wine reflect his own battle with alcoholism? Does the phrase about a stranger’s glance refer to his affair with the department secretary? “Maybe,” the teacher would reply. “But poems are works of the imagination. Though, of course, pieces of ourselves do tend to sneak in.”

The urgent care provider who sees me on Wednesday is an ER doc, as he is the one most available at that moment. This guy asks me questions that show he read my chart. He asks for clarification. He asks related questions. He is building a case in his head, and it’s not long before he decides it is a bacterial infection and he’ll prescribe me two antibiotics. “Ah, ok,” I think, “so THAT’S what’s really going on. Now I’ll get some relief.”

In the poetry circle, I don’t believe there was ever a time when everyone there liked all of the poems we read. Some felt a kinship, a resonance, something calling them in, while others either couldn’t make any sense of it or just felt no spark. Some group members pointed out a line or two that rang true for them.

Friday morning I return to Urgent Care. The antibiotics DID quell the pain, within two hours of taking them, but now the inflammation around the eye seems worse, and my grown son who lives with me strongly suggests I go in to have them check it once again. This time I get a physician’s assistant, garrulous and friendly. She starts going on about antihistamines. I say, “But isn’t the swelling a normal characteristic of what the ER doctor said it is and it just needs time to dissipate?” She looks at me somewhat astonished, says, “But we don’t KNOW that’s what it is! That was just his best guess. I figure if one thing isn’t working, why not try something else.” But I’m still thinking about the ER doc, how, yes, I guess he’d be primed to address the most acute possibility the most efficiently and effectively, and that’s what he did, as the condition he thought it might be could, if untreated, become much worse and threaten one’s vision. The PA, who had a more maybe-it’s-this perspective, sends me off with instructions to take an antihistamine, which I already am, and prescribes me another cream, which, after waiting for the third time at the pharmacy, I learn my insurance doesn’t cover.

Some poetry is intentionally opaque, a little opacity seen as another means through which to express an experience, emotion, or situation. Some poetry is intentionally straightforward, that route hopefully clearly delivering the intended meaning. But both of these approaches—and the array stretched between—still result in various interpretations, still can take readers in different directions. Even a supposedly only-the-facts-ma’am journalistic account can’t keep the human mind from drawing a range of conclusions.

On the fourth visit, the provider’s focus is on securing me an appointment with dermatology, which he does, in three weeks instead of the six months it would have taken had I made the appointment myself. I’m grateful. At the fifth and final visit, the fifth provider surprises me, diagnosing it as something usually only infants and toddlers get. I’m doubtful. But she also prescribes me oral steroids, and they, after a few days, do the trick.

How interesting, I ponder later, how each of these caretakers met with me, looked over my irritated, inflamed skin, and had a conversation with me, though each of them came to a separate, completely different conclusion on how best to address it. Each of them had a different answer to my question: What is this and what does it mean that this is happening to me? And, I wonder, what will dermatology say?

People often ask me how we can know what a poem means. In one poetry circle, I remember (though I don’t recall the poem), as I opened up the time for discussion, one person said, exasperated, “Oh! This is exactly what’s going on at my work!” Before I could respond, another person piped up, “Really? To me, this speaks so eloquently of me and my difficult relationship with my daughter.” A third said, “The poem makes me think of our move here. We liked it where we were, but due to circumstances, we had to uproot our lives and now are trying to start over.” Others added their experiences with how the poem touched them, with a few saying it didn’t do anything for them. Then, we got down to the work of trying to figure out HOW the poet did that, how the poem—the SAME poem—reached many of us in our own stories, just as each of those medical personnel who saw me and read my face, my skin, my condition, interpreted it in their own way, saw it through their own lens, responded with what they thought best.

I think this phenomenon is really cool in poetry, one of the reasons I love it. The same phenomenon in the practice of medicine? Frustrating, but probably the best we have, it not being an exact science much of the time. In both cases, I think it helpful to consider the context the poem or medical condition was created in AND how our own stories and lenses influence the ways we interpret them, the way we get at what it means, the way we decide what the poem or the medicine does for us.

It's possible all the caretakers were right in part. Also possible they were all, in part, wrong. It’s possible the “truth” was some combination thereof. I’ll probably never know for sure. I’m thankful for each of their efforts, each of them working under a fair amount of pressure, interacting with me with a fair amount of good will.

When you read or hear a poem, sure, it can be helpful to examine where the poem may have come from, what tools the poet is using toward what effect, what broader, universal message it might be speaking of. But my advice? Be aware of, first and foremost, be tuned into, what is says to you, what it does to you, how it affects you, this particular read through. Take that as a gift given just to you and carry it with you as a little bit of soul food to get you a little bit further through.

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