Creativity Outlets: The Clinician’s Battery for Recharging

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SPECIAL REPORT: CREATIVITY & PSYCHIATRY

Psychiatry is a unique field for many reasons, but largely because it deals with gray space. Compared with other fields, our diagnoses rely more on subjective measures. We cannot diagnose schizophrenia with a blood test or obsessive-compulsive disorder by imaging. Numbers can only tell us so much in psychiatry. On the other hand, that ambiguity naturally lends itself to a story, and creativity is all about telling a story.

In psychiatry, the diagnosis is always tied to the human element. It may be simple to be cut and dry (clinical) when addressing someone’s high blood pressure, but it is different when a patient tells you their darkest secrets and greatest shames that are tied to their disorder. Mental illness colors an individual’s entire life. Again, numbers don’t come close to encapsulating an individual’s life, but stories can and do.

As a provider, seeing patient after patient with concerns can drain one’s empathy, energy, and ability to think clearly. I find creative outlets like poetry to be vital to the process of charging that battery. It is a way of taking those pent-up emotions and shared experiences and reprocessing them in a way that makes sense of them. So much of what we treat seems senseless and random; creativity gives us a vessel through which we can channel those emotions and experiences and come to some kind of conclusion, whether or not it is definitive. To be succinct, it helps me sleep at night. It keeps nightmares at the door. And it helps me to help my patients.

These poems were written during my medical training. Writing was crucial for me as I was going through medical school and residency. It has always been my greatest tool for processing difficult thoughts and emotions, and that habit served me well in my training.

I wrote “Physical Exam” early on in medical school. We were practicing techniques on volunteers (called standardized patients) and something about the whole process felt clinical, cold, and almost demeaning. I felt like I was asking too much when I asked them to change into a gown; it was a process that felt like I was stripping away part of who they were. The invasive nature of the entire process was something no one really talked about, so I tried to capture that in the poem.

“Boy on Beach” was inspired by a photo of a child named Alan Kurdi. He was a Syrian refugee who drowned in the Mediterranean Sea; his body washed onto shore. In the photo, you cannot see his face, just his lifeless body and the clothes he was wearing. I found the photo disturbing, and I had trouble processing it. The line “my conscience will not let me be content,” and the repeated line with conscience changed into conscious was an attempt to describe my inability to stop thinking about it—the image and the injustice of it all. I felt completely powerless, and writing helped a bit.

“Patient F” was inspired by a patient in a child unit where I trained. She was a little girl who had such spark but also a dark and biting wit. The room lit up when she was in it, and it felt like the only person who could not see that was her. There are things we cannot say to our patients, especially inpatients and children, as I am a firm believer in setting boundaries and not letting countertransference interfere with appropriate care and treatment. As with the other pieces, the poem helped me process what I felt.

Boy on Beach

My conscience will not let me be content.

Limp, he washed up on the sand.

Red shirt, size XS.

Blue shorts, size XXS.

Muddy shoes, children’s size six.

My conscience will not let me be content.

A mother that has been.

A mother that may be, only

the restless ventricles of my heart and the

restless ventricles of my brain will allow

one or none,

orphaned or aborted but—

My conscience will not let me be content.

I skim the water with my toe

pregnant oceans,

giving new life, a womb

taking it back, a tomb.

My conscious will not let me be content.

Physical Exam

Hi, I’m the doctor.

Take off your shirt, please.

Your pants, too.

Take off your shoes, your socks

Your boxers and bra.

Take off your makeup, then

Take off your hair.

Take off your eyes, your

Nose, your fingers and toes.

Take off your face and your skin.

Take off your muscles and tendons and nerves

Take off your vessels, your

Ribs, your bones.

Take off your intestines and your lungs.

Take off your heart.

Take off your brain.

Take off your self.

Name, please?

Patient F

You are so bright, star child.

The scars on your wrists have

healed so well because you are

so young.

You have everything ahead,

you have the Milky Way in your grasp.

Tie it to your heart and tell the world:

I am infinite, I am the only one.

Protect your heart with hydrogen ions and

atom bombs.

You are seen, and you make the world rethink

what a child can be:

infectious brightness cutting through infectious hate.

Do you know how to keep the darkness away?

You think you must embrace it, and with a

heart so bright, maybe you should, but

never let it sink your soul.

Never let the dark matter tear your gravity asunder.

You must be patient, star child.

These years are fleeting but formative,

brief beginnings but they etch

scars in your heart like

chemtrails in the sky.

You must be resilient, star child.

There is only one way to cross an asteroid field.

You must travel like the light you are.

You must move with fleetness of foot and

fearlessness of failing.

You must take your ship and

sail it as far as it may go.

Ground control to the skies, and

we all must watch you fly.

Fly so far that this hospital room becomes

a speck of dust in an

infinite universe.

Dr Maier is a psychiatrist with Network 180 in Grand Rapids, Michigan. She strives to integrate the humanities into psychiatric training and practice.