There are many studies on writing, palliative care, and healing. In his article “Poetry and Healing at the End of Life,” Dr. Patrick Clary discusses the role of writing based on the five tasks of relationship completion by providing examples from patients and personal experiences with his father (798). These five tasks promote smooth communication and closing at terminal scenarios, and they consist of “I love you, I forgive you, please forgive me, thank you, and goodbye” (Clary 798).  Since reflective writing and reading can encourage emotional healing even years after a loss, Clary recommends learning poems by heart and utilizing resources like the app iPoem to have these writings available at any moment (798-799). An important highlight of this study is that it emphasizes writing in reflection to personal relationships as an effective way to reach peace and healing during uncertain times. 

       Similarly, a common theme in the discussion of poetry in palliative care is negative capability. John Keats, a physician and poet, initially used this term to refer to the skill to face and adapt to uncertain and contrasting circumstances (Coulehan and Clary 384). Interestingly, Jack Coulehan and Patrick Clary argue that the difficulty of understanding a poem can improve this ability, adding that reading the poem out loud is especially helpful (385). It is also important to note that poetry can help patients provide meaning to their circumstances and serve as a tool for self-discovery (Coulehan and Clary 386). This analysis contributes to the academic conversation by defending the importance of poetry in promoting empathy in medical workers, which will be demonstrated in my case study.

       Although reading poetry is helpful, writing about challenging experiences can have significant benefits for physical health. In the study “The Immunological Effects of Thought Suppression,” Petrie et al. reveal that emotional writing causes an increase in immune cells, more specifically T helper cells (1269). Contrastingly, avoiding thoughts about distressing experiences decreases the level of these cells (1269). This finding suggests that reflecting on past challenges and their meaning in our development can improve the immune defense of patients. On the other hand, a study by Helen Marlo and Mervyn Wagner does not support that writing about challenging experiences improves overall mental or physical health (212). However, they do indicate that writing about positive experiences cause better moods (212). This discovery is still significant because attitude is essential during end-of-life scenarios. Possessing a proactive attitude allows patients to appreciate those moments with their loved ones and enjoy what really matters at this life stage. 

 

Analysis

       Before analyzing Raymond Carver’s and Christian Wiman’s writings, it is crucial to study the background of the authors and how it impacted their poetry. Raymond Carver was born in Oregon in 1938, and he greatly influenced the American short story during the 1980s. He also wrote poetry extensively throughout his life, including seven poetry books (“Raymond”). Carver’s book All of Us: The Collected Poems is one of the primary sources in this research. He struggled with alcoholism throughout his life, being hospitalized many times. However, he overcame his dependency in 1977. Unfortunately, Carver was diagnosed with lung cancer some years later and died in 1988 (“Raymond”). On the other hand, Christian Wiman was born in 1966 in West Texas (“Christian”). He has written four poetry books, including Every Riven Thing, the other primary source in this study. Wiman was diagnosed with Waldenström’s macroglobulinemia, a form of blood cancer, in 2005 (“Christian”). As a result of their experiences battling terminal diseases, both Carver and Wiman have written plenty of poems reflecting on faith, uncertainty, and strength. While their styles might be different, they explore the themes of communication and religion with a direct and bold language.

       Communication between patient and physician is a principal element in Carver’s poems “Proposal” and “What the Doctor Said.” In both poems, the speaker receives alarming news about his health. However, the interactions between him and the medical worker are contrastingly different in the two poems. In “Proposal,” communication between physician and patient is not as successful due to the doctor’s way to deliver the news:

“But he loves his life,” I heard a voice say.

Hers. And the young doctor, hardly skipping a beat, “I know.

I guess you have to go through those seven stages. But you end 

up in acceptance.” (Carver, “Proposal” 20-23)

In response, Dr. Sandra Lee Kleppe from the English Department of the University of Tromsoe argues that the physician in this poem fails to empathize with the patient. She determines that the medical worker “clings stubbornly to his terministic screen, despite the distress of the patient and his companion” when he solely focuses on science rather than comfort (Kleppe 43). For Kleppe, the function of this interaction is to show an unsuccessful attempt at empathy from the medical worker. On the other hand, Gopinath Khutia offers a different argument. In his article, the author notes that the physician’s recommendation in “Proposal” introduces the theme of acceptance of disease in the poem. He does not interpret this interaction as ineffective, but as a “proposal to accept life and illness simultaneously” (Khutia 286). Khutia’s analysis of the poem could indicate that the physician practiced negative capability effectively because he was able to deal with the contrasting possibility of life and disease. Khutia considers Carver's poetry as a guide about dealing with the inevitable consequences of the fragility of the human body. 

       Even though there are varied interpretations of the patient-physician relationship in Carver’s poems, these interactions still shape the speaker's and patient's response to their condition. For instance, after receiving the news in “Proposal,” the speaker and his loved one decide to get married (Caver, “Proposal” 38-43). When preparing for the wedding, the speaker explains:

 We were getting ready, as if we’d found an answer to

that question of what’s left

when there’s no more hope . . . (Carver, “Proposal” 50-52). 

In this poem, the speaker is showing an external response to his condition. Receiving his diagnosis prompted the speaker to act, influencing readers to do what they always have wanted to do. Additionally, the poem's discussion of a question and an answer could encourage patients to ask themselves this question and find their own answers. For patients reading the poem, romantic love might not be the answer to what they need during these moments, but they may find it is family, company, or a hobby. This poem could motivate readers to practice the five tasks of relationship completion that Dr. Clary mentioned in his article “Poetry and Healing at the End of Life” (798). Therefore, reading the poem is the triggering point for patients to live a fuller life. 

Conversely, Wiman’s poems usually show the internal response or contemplations of the speaker. In the section “2047 Grace Street” of the poem “One Time,” the speaker observes his loved one sleep and reflects on the connection between God and “standing where a world is ending/ for one man” (Wiman, “One Time” 34-35). This writing reveals boldness and bravery as Wiman approaches conversations that most people do not feel comfortable with. Consequently, author and editor William Giraldi visualizes this poem as Wiman coming closer to the notion of a silent and terrifying God (200). Wiman’s style does not indicate rejection; rather, he accepts this reality and challenges “our infantile human projections of the divine” (Giraldi 200, 201). People tend to associate faith only with happiness and order, but Wiman shows that a belief in a divine power does not preclude suffering. Wiman’s writing style also reveals boldness both in the poems’ titles and stanzas. For instance, critic Charles Parsons notes how Wiman’s poetry became shorter and more direct in later poems (46). This trait is not only evident in the titles, but the poems themselves consist of a language that “offer something of the stark, often defiant, lives of the characters within them” (Parsons 46). This characteristic of the speaker is especially evident when he directly addresses God:

Praise to the pain 

scalding us toward each other, the grief

beyond which, please God, she will live

and thrive. And praise to the light that is not

yet, the dawn in which one bird believes,

crying not as if there had been no night

but as if there were no night in which it had not been. (Wiman, “One Time” 38-44)

Wiman’s stance regarding faith is somewhat contradictory as he conveys a bold but praising attitude in this poem. This surprising tone results from the repetition of the word “praise.” Patients reading this piece of literature might wonder why he is holding such a unique praising attitude. Hence, this poem could encourage patients to reflect on the topic and re-evaluate how they perceive their circumstances. The speaker’s reflection on how pain brought him closer to his loved ones can help patients reading the poem to provide meaning to their own struggle. Ultimately, readers can mirror the speaker’s internal response and ability to deal with contrasting emotions in their lives.

       Similarly, the title of the section as the name of the street makes the poem more personal. The title prompts readers to imagine the street and the house where the couple is resting after such difficult news. The intimate sense of the poem is vital for patients reading the poem as they likely identify this private moment and feelings as an experience that they also went through. Also, the poem provides an insight into the patient experience, which can aid physicians in better understanding the perspective and needs of individuals dealing with terminal illnesses. Overall, the speakers in Carver’s “Proposal” and Wiman’s “One Time” bring attention to what matters during these difficult times: love. Both speakers turn to their loved ones for mutual comfort.

       Another crucial element in Carver’s and Wiman’s writings is that their poems allude to the audience by sharing similar experiences. For instance, in Carver’s poem “What the Doctor Said,” the speaker narrates the moment when he got his diagnosis. After giving the news, the physician suggests resorting to spirituality as medical treatments have not been enough: 

He said it doesn’t look good

he said it looks bad in fact real bad

he said I counted thirty-two of them on one lung before 

I quit counting them

I said I’m glad I wouldn’t want to know

about any more being there than that

he said are you a religious man do you kneel down

in forest groves and let yourself ask for help

when you come to a waterfall

mist blowing against your face and arms

do you stop and ask for understanding at those moments. (Carver, “What the Doctor” 1-11)

Critics examine the responses from the physician in the poem with different emphases. For instance, Dr. Sandra Lee Kleppe interprets this interaction as successful because the doctor stops focusing on possible treatments and “drops his scientific terministic screen” (42). According to Dr. Kleppe, the response from the physician indicates an understanding that the patient needs support (43). Therefore, Carver's purpose in this poem might be to illustrate what he considers adequate communication between patient and physician. 

       Contrastingly, some critics interpret the physician’s spiritual advice as having a different purpose. In his book Technique and Sensibility in the Fiction and Poetry of Raymond Carver, Arthur Bethea argues that the poem shares a rejective tone toward the physician’s religious suggestion (254). Interestingly, he notes the constant use of the numbers 32 and 33 in Carver’s poems (253-254). Bethea explains that because Christ was 33 years old when he sacrificed himself, the number 32 represents a world without salvation, suggesting an ironic or reluctant tone in the poem toward religion (253). Based on this premise, Bethea offers a perspective that contrasts starkly with Kleppe’s view on the poem “What the Doctor Said” as suggestive of faith. Since the doctor in the poem counts 32 spots in the speaker’s lungs, Bethea argues that the poem conveys “a nonteleological vision rejecting metaphysical transcendence” (254). The author also suggests that Carver’s lack of punctuation further emphasizes the rejection of a “teleological order” (Bethea 254). Later in the poem, the speaker’s thankfulness to the physician seems forced, which could support Bethea’s argument. The contrast between Bethea’s and Kleppe’s interpretation of Carver’s position on religion demonstrates that it is possible to interpret the poem “What the Doctor Said” as transmitting a bold, dismissive attitude toward the idea of religion or faith. 

       However, some of Carver’s poems convey an open attitude toward faith. For example, in “My Death,” the speaker remarks that he would like to die surrounded by his family, where he can “see them one last time/ and take that memory with me” (Carver, “My Death” 11-12). In response, Professor Arthur Bethea notes a slight suggestion of an afterlife as the speaker plans to take this memory somewhere else after his death (242-243). Bethea also identifies a proposition of next life in the poem “Movement,” where the speaker asks readers to imagine “[t]he sense of movement/ as you’re borne along to the next place” (Carver, “Movement” 16-17). When reading this piece of writing, Bethea interprets the “next place” as a new life after death and the mentioned movement as spiritual agitation (243). These varied interpretations indicate a contradictory position from Carver about the topic of faith and afterlife that represents the viewpoint of terminal patients. Not only this characteristic can aid medical professionals comprehend their patients, but patients might be able to better handle their own contrasting feelings and views after reading the perspective of the speaker and author. 

       Another key element in Carver’s “What the Doctor Said” is the familiar or even stereotypical language in the poem. The poem opens with sentences that physicians often use when diagnosing patients, such as “it doesn’t look good” (Carver, “What the Doctor” 1). The familiar language could make patients feel identified with the speaker as they likely heard similar statements from doctors. This connection between speaker and reader is essential because it can help patients feel understood and accompanied in their battle against illness. Consequently, this feeling of company can provide strength during these challenging moments. 

       Additionally, Carver utilizes symbolism to inform readers about patients’ needs. The waterfall in the poem could represent God, nature, and what we cannot control. A waterfall can be intimidating since it has water falling from a significant height, so it could represent entities that have power over us, such as medical workers. Therefore, the suggestion to ask for understanding in front of a waterfall can pose a surprising and vital message for medical workers. This idea can help physicians realize that patients need comprehension and comfort after receiving their diagnosis, not treatment options that might not work.

       Similarly, the lack of commas and periods in the poem conveys the shock of the speaker when receiving his diagnosis. During these moments, many people would feel like time is passing too quickly or too slowly. The absence of punctuation provides a sense of confusion or uncertainty to readers about the reading speed. This sensation could further help patients to connect with the speaker. Also, the repetition of the verb “said,” even found in the title, emphasizes the limitations of medical workers as there is nothing else the physician could do. 

       A critical stylistic difference between Carver and Wiman is that Carver’s poems give more independence to readers on the reading rhythm, while Wiman’s poems are more metrical, intuitively guiding readers on how to read them. In contrast to Carver’s “What the Doctor Said,” Wiman varies punctuation in “Every Riven Thing '' to convey different messages in the starting line of each stanza: 

God goes belonging. To every riven thing he’s made

there is given one shade

shaped exactly to the thing itself:

under the tree a darker tree;

under the man the only man to see

 

God goes belonging to every riven thing. He’s made

the things that bring him near, 

made the mind that makes him go.

A part from what man knows, 

apart from what man knows,

God goes belonging to every riven thing he’s made. (Wiman, “Every” 11-21)

In the poem, Wiman focuses more on the relationship between the individual and God rather than on physician and patient interactions. In his review, critic Ryan Romine identifies his own youth struggles coming from an evangelical family while emphasizing how Wiman is reflecting his relationship with God. Romine notes that the poem shares “a frustrated anger at God that paradoxically comes from God; . . . like a tug of war between obedience and madness” (186). This tension is especially evident in the second stanza where Wiman writes, “God goes. Belonging, to every riven thing he’s made,/ means a storm of peace” (“Every” 6-7). Wiman’s faith and doubts in response to having blood cancer likely influence the contradictory tone in his poetry. Hence, this analysis highlights the duality of the relationship between God and person that creates the tension that readers perceive in Wiman's poems.

       On the other hand, American poet Adam Kirsch examines "Every Riven Thing" with a different focus. Kirsch interprets the connection between God and “riven things” as representative of the Christian faith (124). The author remarks that “Wiman writes with unremitting intensity about the quest for grace in a world full of pain and humiliation” (Kirsch 124). Hence, Kirsch highlights Wiman's attempt to sound compliant in the poem. However, the author perceives more tension in Wiman’s poem “Given a God More Playful,” where the speaker wants a God “less prone/ to unreachable peaks” (Wiman, “Given a God” 3-4; Kirsch 126-127). Both the setting and attitude of the poem suggest an accusing tone, to which Kirsch indicates that dealing with such a rare type of cancer presented to Wiman “the worst face of Nature, the face that speaks of pain and decay and death” (127). Consequently, Wiman explores the challenges that patients often face when having a terminal condition and faith. 

       In “Every Riven Thing,” Wiman alludes to readers by repeating the term “riven thing” and sharing feelings that patients likely experienced. Wiman likely uses the expression “riven thing” to represent all readers because everyone is broken or missing something. This technique helps readers, especially patients, to feel like the poem is directly talking to them. They can identify the tension and contradiction in Wiman’s reflections in his poetry, understanding that it is normal to face confusion and doubt. Likewise, when Wiman discusses what man knows, he might be referring to the uncertainty that patients feel. They are aware of the disease and possible treatments, but they are still missing the larger picture. They do not know what will happen and whether treatments will work. Therefore, Wiman notes how we belong in God and God belongs in us. Thus, we possess a part of the information that God knows, but God keeps some information from us that we still long to own. 

It is important to note that, although their poems can remind patients of past experiences, Carver’s and Wiman’s poems also reveal the strength of their characters. The illustration of resilience in the poems help patients realize their individual strengths. For instance, in Carver’s poem “Gravy,” the speaker narrates how he was able to stop his drinking addiction and how he was later diagnosed with a terminal disease:

No other word will do. For that’s what it was. Gravy. 

Gravy, these past ten years. 

Alive, sober, working, loving and

being loved by a good woman. Eleven years

ago he was told he had six months to live

at the rate he was going. And he was going

nowhere but down. So he changed his ways 

somehow. He quit drinking! And the rest?

After that it was all gravy, every minute 

of it, up to and including when he was told about, 

well, some things that were breaking down and

building up inside his head. “Don’t wipe for me,”

he said to his friends. “I’m a lucky man. 

I’ve had ten years longer than I or anyone

expected. Pure gravy. And don’t forget it.” (Carver, “Gravy” 1-15)

In the poem, the speaker holds a surprisingly grateful attitude towards his circumstances like the speaker in Wiman’s poem “One Time.” The repetition and emphasis of the word “gravy” throughout the poem and title reinforces the unusually grateful tone. Hence, this poem could also motivate patients to reconsider their perspectives and add meaning to their condition. The speaker is also portraying the poem subject as an agent when he exclaims, “He quit drinking!” (Carver, “Gravy” 8). Additionally, when the poem subject describes himself as a “lucky man,” he portrays his strength as just luck (Carver, “Gravy” 13). This technique results in the power of the individual to be more evident to readers, making patients remember when they have made similar excuses about their energy and perseverance. Therefore, Carver’s “Gravy” encourages patients to realize their own potential and ability to be agents of their life, like the speaker.

       In his poem “After the Diagnosis,” Wiman also refers to strength in association with luck. In the poem, the speaker explains how a tree close to his house survived harsh conditions, like thunder and wind. Interestingly, there is no mention of the speaker’s diagnosis as the title suggests, so the tree likely is a symbol that represents the speaker. The speaker reflects on how the tree was hit by lightning:

No telling how, 

with all the other trees around, 

it alone was struck. 

It must have been luck,

he thought for years, so close 

to the house it grew. (Wiman, “After” 4-9)

Since the tree represents the speaker, narrating the suddenness of the lightning hit to the tree conveys the speaker’s surprise when being diagnosed. In the poem, the reference to luck alongside strength serves a similar function as in Carver’s poem. The contrast between luck and strength in this poem likely makes it more evident for readers to realize the speaker’s agent power and their own. Even though the tree underwent harsh conditions like thunder, the narrator still describes the tree as “leaning, clenched, unyielding” (Wiman, “After” 32). Hence, the poem transmits a tone of perseverance and strength that can emotionally support readers. 

       Both Carver’s “Gravy” and Wiman’s “After the Diagnosis” utilize the third person point of view. This narration technique might result in two responses from readers. Firstly, it can make some readers feel identified and be proud of their strength. Other readers might feel like outside observers reading about a stranger. This last response can also be helpful for patients because they would be comparing themselves to the speaker, recognizing their past strength, and feeling encouraged to find it now. Carver’s and Wiman’s poems can connect with readers, creating a peer motivation phenomenon where speakers from the poems inspire patients.

       Writing poetry also provided support for Carver and Wiman when their health worsened. Indeed, the concept of permanence is constantly present in the writings of Carver and Wiman. In Carver’s poem “Your Dog Dies,” the speaker directly notes how the loss of his daughter’s dog prompted him to write a successful poem, but then, writing the first poem inspired him to write the second poem read by the audience (1-23). Literary critic J. P. Steed identifies this action by Carver as using poems as a transitional object (312). Although a dog’s death cannot compare to the death of a loved one, Steed argues that Carver is trying to “invest in an object (in this case a poem) a ‘magical significance’ as a means of dealing with loss” (314). Consequently, poetry possibly had a significant role in helping Carver to better cope with his health situation. 

       Furthermore, Bethea offers an additional perspective on Carver’s purpose in writing poems. He proposes as an example the poem “Work.” In the poem, Carver visualizes John Gardner going home on his motorcycle and thinking about work, described as “[t]he going/ to what lasts” (“Work” 14-15). Bethea interprets this extract as suggesting life after death through the writings left behind, emphasizing the theme of "permanence of art" (202). Hence, this analysis could indicate that the desire to express his concerns over his loss of health and to create something that would remain, even if he died, inspired Carver to write poetry. 

       Similarly, Wiman transformed his emotions and experiences into poems, likely looking for some permanence. In his interview with David Yezzi, Wiman reflected on how many writers, like Keats and Milton, inspired him to write something that would last (13). He further explained this process by admitting that early in his writing career, “there was a love of suffering simply for the intensity it offered, a malign energy that I was turning into art again and again” (qtd. in Yezzi 16). Here, the theme of converting loss into art is present as in Carver’s poetry. Interestingly, Wiman also confesses that writing something that will last is a lost cause, but he cannot help himself (Yezzi 15). This insight by Wiman suggests that poetry serves as an outlet for all his sensations and perspectives dealing with cancer.