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Physician-Poets Use ‘The Write Stuff’ to Nurture Adult Cancer Patients

Stony Brook Program Opens GATE for an Improved Experience During Illness

Throughout history there have been physicians who have made names for themselves penning poetry and prose. Anton Chekhov, Sir Arthur Conan Doyle and William Carlos Williams are just a few for whom writing was a highly personal and cathartic experience. Today’s doctor-writers are increasingly focusing on the patient and wellness, and at Stony Brook they are taking healing to new heights through a new, collaborative art therapy intervention program called Guest Artists to Empower (GATE).

Poet DoctorsOne of the three components of GATE is The Write Stuff, a six-week mini-program through which physicians bring short stories, poems or essays to Stony Brook University Hospital and read aloud to patients, gently encouraging them to take time for self-expression, either through dialogue or by writing. (The other two GATE components are We’ve Got Mail, which introduces patients to visual art and collage, and It’s Your Move, which explores music and movement.)

In The Write Stuff, which concluded in May, the doctors met with the inpatients in a conference room on the oncology floor and created a warm, serene and inclusive atmosphere that reduced the fear that often accompanies the terrifying diagnosis of cancer.

Mixing medicine and the arts isn’t a new concept, as many major cancer institutes have programs for both adult and pediatric patient populations, but Stony Brook did not have a program that focused exclusively on the adult oncology inpatient. That all changed when Linda Bily, patient advocacy and community outreach coordinator for the Stony Brook Cancer Center, saw a video as part of her “Literature, Compassion and Medical Care” class.

Bily was so mesmerized by the video of doctors reading short stories, writing poetry and performing movement with critically ill patients that she asked Lauren Kaushansky, a lecturer in the Professional Education Program in the Department of History, to help her to implement a similar program at Stony Brook.

“Linda and I share an enthusiasm for nontraditional ideas, which is all about acknowledging and validating the patient and the patient’s experience,” said Kaushansky, who volunteered for The Write Stuff. “Several decades ago I was in the hospital for about a week and I was bored out of my mind. So since that time, I’ve been interested in enriching the patient’s experience. It is important to address both the patient’s mental state as well as their physical state.”

For Bily, improving the patient experience is paramount. In 1998 she was diagnosed with breast cancer and underwent three surgeries and six months of chemotherapy. “When I was in the hospital having my surgeries I remembered thinking, ‘Here I am, I’m isolated, I don’t get to hang out with any of the other patients.’ ”

CalloutAt Kaushansky’s urging, Bily asked Drs. Maria Basile, John Coulehan and Richard Bronson — her instructors in the “Literature, Compassion and Medical Care” class — if they would help her launch a program at Stony Brook similar to the one in the video. The physicians are published poets and the founders of the poetry community Astonished Harvest, which is under the auspices of the Center for Medical Humanities, Compassionate Care and Bioethics. Astonished Harvest provides a forum for participants to explore the experience of illness and healing and discuss bioethics issues through the medium of poetry.

The answer was a resounding “yes” from all three doctors, and The Write Stuff was born.

“When Linda Bily invited Astonished Harvest to play a role in her new program, I felt intuitively it might provide something of value to the right person,” said Dr. Bronson, a professor of obstetrics/gynecology and pathology and director of the Division of Reproductive Endocrinology at Stony Brook University Hospital.

Soon after the program made its debut last April, Kaushansky said she witnessed firsthand the transformative effect of poetry. One day Dr. Basile, a colorectal surgeon in private practice in Port Jefferson, New York, was scheduled to lead The Write Stuff. She was running late, so Bily asked Kaushansky if she would fill in.

Kaushansky sat down with one of the patients — who appeared anxious — and noticed that she had brought her own journal. She said she tried to relax the patient with small talk about spring and the blooms outside.

“That conversation led to the fact that she is an avid gardener, so we talked about the symbolism of a garden,” Kaushansky said. “But after a while I said, ‘That sounds great. Let’s write!’ ”

But the patient was not ready to write and withdrew, Kaushansky said. So the two resumed small talk until Dr. Basile arrived a few minutes later.

“Then Maria read this incredible poem. It was a very simple, very accessible piece with a repeating refrain,” Kaushansky said. “That’s when I said, ‘Oh, that’s beautiful, do you think we can write now?’ So the three of us sat together and wrote our own pieces. And despite the patient’s initial reluctance, she ended up writing a beautiful poem that reflected on her garden.”

Not all the patients who participated in the program wrote — some chose to read poems the doctors provided, while others just listened. “But it was apparent that the patients who spent time with us benefited from the experience,” said Dr. Bronson.

He recalled one session in which a man was wheeled into the conference room, eyes closed. But as time went on the patient sat up and leaned in, listening to the conversation. He eventually read a poem.

“In the discussion that took place over the course of an hour and in reading several poems, there was a major change in this person’s demeanor,” said Bronson. “It was not so much his reading of a poem — which was wonderfully done because he had a beautiful reading voice — but rather the time we shared together around the concept of reading poetry.”

Bily agreed. “Part of the healing nature of this program is just conversation,” she said.

Although it is hard to quantify the restorative effect of GATE at this time — Bily said the team is working with a biostatistician to analyze the data as the program continues — all 18 patients who participated in the pilot program and took an informal survey said they welcomed the activities, with 80 percent stating they would participate again and 60 percent reporting they experienced a lessening of pain.

Those results were deemed positive enough for the program to continue, Bily said.

“All three doctors said they didn’t think they would be impacted by this as much as they were,” said Bily. “They just thought they were coming to do a nice thing for the patients.”

Dr. Coulehan, emeritus professor of medicine and preventive medicine and former director of the Center for Medical Humanities, said that when he was asked to participate in the program, he was initially concerned that hectic schedules would hinder staff support and patient participation. But his involvement in The Write Stuff reaffirms why he became a poet.

“I started writing seriously in my mid-40s at a time when I was searching for better ways of understanding my experience as a person and physician,” he said, adding that he plans to participate in the program again.

“I would consider doing additional sessions in the Cancer Center to make it available to outpatients on chemotherapy, and also would like to see sessions held on units in addition to oncology,” he added.

—By Susan Tito; photos by John Griffin




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