Poetry and illness



The black hair of my Chinese doctor
gleams like combed ink
as he leans over his desk,
with quick pen strokes writing my prescription
in the lingo of the I Ching,
characters so intricate and strange,
the page looks like a street
lined with sampans and pagodas,
rickshaws gliding through the palace gates
bearing Szechuan takeout to the king.

Daydreaming comes easy to the ill:
slowed down to the speed of waiting rooms,
you learn to hang suspended in the wallpaper,
to drift among the magazines and plants,
feeling a strange love
for the time that might be killing you.

Two years ago I was so infatuated
with my lady doctor, Linda,
I wanted to get better just to please her,
and yet to go on getting worse,
to keep her leaning toward me,
with her sea green eyes and stethoscope, asking
Does that hurt?

Does it hurt? Yes, it hurts
so sweet. It hurts exquisitely.
It hurts real good. I feel as if I read it
in some Bible for the ill,
that suffering itself is medicine
and to endure enough will cure you
of anything.

So I want more injury
and repair, an ulcer
and a migraine, please.
I want to suffer like my mother,

who said once, following a shot
– her face joyful as the needle entered –
that she felt a train had been injected
straight into her vein. Day after day,
to see her sinking
through the layers of our care

was to learn something delicious
about weakness:
as if she had discovered
the train was bound somewhere;
and the conductor
had told everyone on board
they never had to bear the weight
of being strong again.


Tony Hoagland  from Donkey Gospel (Graywolf Press, 1998)

I wouldn’t be without Tony Hoagland. I think he takes you to places in his poems which you knew existed but have absolutely never spoken about, places you have heard rumours of yet feel eerily compelled by, and places which, while seeming to appear from right under your feet, are transformed into something utterly new and strange. Much of the time he is doing all of these at once. ‘Medicine’ is a fabulous example of this.

You know this because where you end up is far from where you began. I first began trying this as a way of reading poems via a comment of Dean Parkin a few years ago in The Rialto. He was commenting on Dean Young’s comment that it can sometimes be instructive to say the first few lines/first line of a poem, quickly followed by its last.

In the case of ‘Medicine’ we therefore move from:

The black hair of my Chinese doctor
gleams like combed ink
as he leans over his desk


they never had to bear the weight
of being strong again.

At the most basic level of the sentence, we notice that new personal pronouns are being used. We have gone from ‘his’ (the doctor) to ‘they’. A shift has taken place. We have been taken from a consulting room to the question of ‘being strong’.

This is the kind of thing that Kim Addonizio and Michael Theune talk about in their wonderful Voltage Poetry blog. They refer to it as ‘the turn’: ‘a significant shift in rhetorical and/or dramatic trajectory’.

‘Medicine’ has more turns than an Alpine pass, and is just as breathtaking.

We begin with that marvellous image of the Chinese doctor’s hair ‘like combed ink’. We are in an office. There are papers (we assume), because there is a desk. But soon, as the confidence in the speaker’s riff grows, we are ‘bearing Szechuan takeout to the king’, an image that would be laughably over the top were it not for our implicit knowledge that we are here to talk about suffering.

As if to beg the reader’s forbearance, the tone shifts again, into a stanza of marvellous simplicity and directness:

Daydreaming comes easy to the ill:
slowed down to the speed of waiting rooms,
you learn to hang suspended in the wallpaper,
to drift among the magazines and plants,
feeling a strange love
for the time that might be killing you.

For me that is up there with Julia Darling and Beverly Rycroft. Just look at those verbs, each arriving in a perfect pair of submerged action and emotion: ‘daydreaming’ and ‘slowed down’; ‘hang’ and ‘drift’; ‘feeling’ and ‘killing’. It is a ‘strange love’ indeed.

But then we are off again, this time into the speaker’s memory of his ‘lady doctor, Linda’. I must admit to not feeling a great liking for the phrase ‘lady doctor’. We don’t say ‘lady teacher’ or ‘lady politician’. The more I read it, the more creepy it seems to me. Parallel to this is the creeping thought that this may be exactly what is intended, played out in the speaker’s desire to ‘please her,/ and yet to go on getting worse’.

Not many poets dare to risk merging overt sexism with covert sexual desire, let alone in the context of a serious subject like suffering. But this is the Hoagland way. Do I wince when I read it? Of course. Am I glad he did it? That is harder to answer, not least when the poem makes its next two turns, at the speaker’s imperative ‘I want more injury’ and ‘I want to suffer like my mother’.

On the face of it the latter is especially injurious. The reader may even be forgiven for wondering if the poet is not flirting with outright misogyny.

Critically, it is not just the subject which turns, but, once again, the tone. We are in the territory of real suffering now, both that of the speaker’s mother, and his own as he watches her sink ‘through the layers of our care’, an image which, tonally, is tender and a perfect rendering of helplessness. The ‘needle’ is all we need to know that we are also in the place of the final days, and thus the final questions.

In a neat summary of the poem’s own shifting language and perspectives the poem invites us to weigh up the oxymoronic ‘something delicious/ about weakness’. The metaphor of the out of control train which drives the poem’s final stanzas is, again, one which dallies with comedy, were the subject not so harrowing. This is, in part, because the symbol of the train takes its energy from outside of the speaker’s own invention, the only time this happens in the poem.

Finally, the speaker explicitly tells us, we are in a place of learning. It is possible to think of this sudden turn-within-a-turn as didactic. I have a theory that to English or British ears it may well be. The point is one you find in all great faith systems and philosophies, namely that you find yourself when you finally let go, that strength is achievable only in weakness. To our individualistic, Western minds this is of course an outrage. I wonder if the risks Hoagland takes to arrive here, making himself appear by turns whimsical, crestfallen, lustful, hard-hearted and helpless, are calibrated to undercut the notion that we possess any authority in the face of death, and our moral superiority with it.


I will be discussing poetry and illness with Beverly Rycroft at the Aldeburgh Poetry Festival on Saturday 8 November, at the Jerwood Kiln, 1.15-2.00 pm.


  1. I love Tony Hoagland’s poetry for precisely the reasons you articulate (thank you), but hadn’t come across this particular poem. It’s wonderful.


    1. Hi Mandy, thank you! I’m so pleased to know you are a fan also. It’s from the first book of his I bought. Many favourites still in there. You’d love it of you don’t already know it.
      As ever with best wishes


  2. Tony Hoagland is a revelation. He seems to dig deep for each word and to encapsulate what you’re conveying in your post – wisdom and weakness vying and co-existing. Fantastic stuff


  3. Tony Hoagland is a genius and isn’t frightened to say the unsayable – his poem ‘Lucky’ also in Donkey Gospel, is uncomfortable and brilliant


    1. Hi Victoria. Yes, you are absolutely right. I have been rereading it this week. Lucky is certainly up there, as is Mistaken Identity and Laying with a Man. Uncomfortable and brilliant: how brilliant! As ever with thanks


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