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Connelly, Julia E. MD

doi: 10.1097/ACM.0b013e3180674739
Medicine and the Arts

Dr. Connelly is codirector, Program of the Humanities in Medicine, and professor, Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, Virginia.

In “Wild Geese,” Oliver focuses on the human tendency to judge and compare experiences, a process that creates mental dichotomies such as good or bad, happy or sad, right or wrong. Literally these constructions define how we feel, what we think, and how we react as the events of our lives unfold during the course of the day. This distinctly human focus also invites the reader to share sorrow and grief, then with a single, yet repeated word, “meanwhile,” the poem unfolds into the larger reality of nature and the reader is called to join in and then transcend this constructed world by moving into a greater understanding beyond human perspective and concern.

“You do not have to be good” opens the poem and asks the reader to consider not only whom the speaker is referring to, but also to wonder about the whole situation. Is someone trying to be good, but failing? Is someone trying to live up to an ideal, but finding the journey of perfection a difficult and hopeless one? The reader might also choose to inquire about the voice of the speaker. Who is it that says, “You do not have to be good”? Perhaps the voice of wisdom directing us beyond human longing and suffering as if to say, Listen to me, I'm telling you a secret. This life is not about good or bad, happiness or sadness. There's another path, another perspective, another way. Oliver also points to the frequent feelings of guilt, shame, and inadequacy when we don't live up to our own standards as when we make mistakes or things go wrong for us in some way. The impact of judging others and ourselves based on the ego's vulnerability is to feel flattened, defended, afraid, and worried. In response, we often harden ourselves: we lose the connection with and experience of pain and sorrow in our lives as we distance ourselves from feeling such emotions. An important downside to this cascade of reactions is disconnection with the full range of our emotions, including love, joy, pleasure, curiosity, and so on. We seal off our hearts.

Perhaps the most powerful and frequently quoted lines of the poem prove simple guidance for this predicament: “You only have to let the soft animal of your body / love what it loves.” But this raises other questions for many readers. What do I love? What does my body love? Who is this soft animal? And again, the reader is invited to find love by reconnecting with sorrow, “Tell me about despair, yours, and I will tell you mine.” Such sharing, as we know in medicine, offers an opening to feeling many things, including love and kindness.

Oliver then expands the field by turning to the timelessness of nature, and finds the truth that we are a part of the whole. If we can accept ourselves as we are, we come to realize we reside “in the family of things,” listening and responding to possibilities as they are presented to us.

Medical education offers many opportunities to study the various aspects of this poem. Physician, Kate Scannell, and author of Death of the Good Doctor, was surprised while caring for AIDS patients to learn that being good did not mean doing everything technically possible for the patient. That being good as she understood, did not describe the doctors aim to be present, experience compassion, and attempt to understand the meaning of the situation to the patient. Measuring ourselves as physicians and our students as good only dooms us to the cycle of guilt and despair, to disconnect with ourselves and, ultimately, with our hearts. Perhaps medical education can find a new model by exploring poems such as this one.

In A Hidden Wholeness, Parker Palmer argues that self-care is never selfish. Yet, it is easy for physicians to get stuck in their guilt, inadequacy, and frustration due to desires for perfection while working within a culture that minimizes the importance of personal interaction and appreciation of feelings. Students often feel that they have lost some aspects of themselves such as joy, spontaneity, creativity, connection, and they can articulate these losses by the second semester of medical school, if not before. No doubt the loss of the connection with love occurs, especially as students begin to feel overwhelmed and fearful about the future, and as clinical events make premature demands on their psyches. As students begin to feel the need to distance themselves from the experience of painful events such as ill health, dying, and physical pain, they also shut out love and the opportunity to experience true compassion. Oliver urges this reconnection with pain, sorrow, grief, so that the love that heals can be expressed as an aspect of our wholeness. Health care providers need to experience love and kindness directly in order to care for themselves and their patients. Discovering one's place “in the family of things” is an essential journey for all physicians to take.

Julia E. Connelly, MD

© 2007 Association of American Medical Colleges