In the 250 years since its founding as the first medical school in America, the Perelman School of Medicine has produced many alumni and trainees who have gone on to gain the high­est honors in a variety of medical fields. So far, however, there has been only one to achieve eminence in the field of litera­ture. A seemingly tireless writer who produced many volumes of poetry, prose, drama, and autobiography, William Carlos Williams, M.D. 1906, was posthumously awarded the Pulitzer Prize for Poetry in 1963 for Pictures from Brueghel and Other Poems. Along the way, he also received the Gold Medal for Poetry from the National Institute of Arts and Letters and the National Book Award for Poetry. And all the while, Williams maintained a long practice in pediatrics and general medicine and was for many years chief of pediatrics as what was then known as Passaic General Hospital in New Jersey. 

In many ways, Williams, born in Rutherford, N.J., remained a Jersey boy. He entered Penn’s medical school in 1902, after a special examination, when he was only 18. After earning his M.D. degree, he did internships at hospitals in New York City and traveled to the University of Leipzig for advanced study of pediatrics. But New Jersey drew him back and was his base for the rest of his life. For nearly 40 years, he served as chief of pediatrics at what was then Passaic General Hospital.

Although Williams had written some poems before enter­ing medical school, it was at Penn that he met one of the peo­ple who had the most influence on his writing. Ezra Pound, whose brilliant career as a poet was eventually overwhelmed by his fascist sympathies, was then an undergraduate. But the young Pound’s outspoken ambition and ideas on poetry and literature proved attractive to the young medical student. Wil­liams began to look beyond traditional verse of rhyme and meter and to try different forms. Despite Pound’s champion­ing of things European, Williams sought to develop a more “American” style, full of concrete images and details, sometimes using a more common American speech. He acknowledged the significance of a modernist poem such as T. S. Eliot’s 

The Waste Land, but Williams was determined to write po­ems that did not require, for example, knowledge of mythol­ogy. As he later phrased it: “No ideas but in things.”

What Is the Writer’s Business?

It’s likely that Williams’s career as a physician had some­thing to do with his artistic credo. An article on him in The New York Herald Tribune (January 18, 1932) began this way: “Medicine and literature make the best possible combination in a man’s life, according to Dr. William Carlos Williams.” Later in the piece, Williams is quoted: “It seems to me that writing complements the doctor’s life so well. When you are tormented by people’s illnesses, it is a relief to be able to write your emotions down. Even surgery has its poetic side.” The Herald Tribune also noted that he would sometimes jot down his poetic ideas on prescription pads between calls. Later, Williams said that he wanted to write about the people who were close to him, not in the abstract. “That is the poet’s busi­ness. Not to talk in vague categories but to write particularly, as a physician works, upon a patient, upon the things before him, in the particular to discover the universal.”

This does not mean that all of Williams’s work is crystal clear. Even Pound, in fact, criticized one of his books as “inco­herent.” Williams would also mix genres, which could throw some readers off. One of his more daunting works may be Pa­terson, eventually consisting of five volumes, all about the people, geography, and history of the New Jersey city. It even includes letters from another New Jersey poet who attained fame, Allen Ginsberg.

One of Williams’s poems that is often anthologized demon­strates his urge to avoid the grandiose and obscure, to speak more directly but artistically. “This Is Just to Say” could very well have been dashed off on a pad (not necessarily one for prescriptions) and stuck on a refrigerator:

I have eaten
the plums
that were in
the icebox
and which
you were probably
for breakfast 

Forgive me
they were delicious
so sweet
and so cold

A poem that seems to allude to his other profession appears in an early collection called Spring and All (1923). It begins “By the road to the contagious hospital.” Williams then evokes a rather bleak landscape, with cold winds, dried weeds, trees “with dead, brown leaves under them.” Then in the short poem comes the turn: “Lifeless in appearance, sluggish / dazed spring approaches –” Spring is not yet an obvious powerful force, but there is a growing sense that things are starting to change. The last lines:

One by one objects are defined --
It quickens: clarity, outline of leaf
But now the stark dignity of
entrance -- Still, the profound change
has come upon them: rooted they
grip down and begin to awaken

Here the lack of a period at the end of the poem seems quite functional!


For a look at the most recent issue of Stylus, go to: http://www.themedicalstylus.com.

A Legacy Lives On

The University of Pennsylvania did not overlook Williams’s achievements in his chosen fields. In 1952, he received an honorary degree. More recently, the poetry prize for the best original poems by a Penn graduate student (in any school) was named the William Carlos Williams Prize, presented jointly with the Academy of American Poets.

The spirit of Williams lives on at Penn Medicine in a differ­ent way as well. A fourth volume of Stylus, which describes it­self as “a medical humanities literary and art journal,” has re­cently been posted. Most of the contributors in the new issue are medical students and Ph.D. candidates here. The editors have connections with the University and with medicine. The founding editor, Yun Rose Li, is a fifth-year M.D.-Ph.D. candi­date at the Perelman School. She is finishing her clinical train­ing after having completed her doctoral dissertation in ge­nomics and computational biology. There are also pieces by an assistant professor of clinical neurology at HUP and a staff chaplain at HUP. The faculty advisors are Horace DeLisser, M.D. ’85, associate professor of Medicine and head of Penn Med’s Spirituality, Religion, and Medicine program, and Zach­ary Meisel, M.D., M.P.H., assistant professor of Emergency Medicine and a frequent columnist for Slate and for Time.com.

The form and topics of the new Stylus vary widely, and many catch your attention. One of the prose pieces that touches most directly on the practice of medicine is “Grey Zone of the White Coat,” by Avi Baehr, a medical student at the Perelman School who is completing a fellowship in health policy in Washington, D.C. Here she grapples with one of the inevitable responsibilities of the physician, being able to pick yourself up when a patient’s condition worsens and to prepare to face your next patient with full attention:

This was my first real taste of what it can mean to don the white coat and have the privilege of practicing medicine. It means seeing a horrible thing happen to a grandfather with a kind face. It means walking across the hall and plastering on a smile because I’ve committed not only to do-no-harm but to do good by that other patient, too. And he needs to have that re­assurance that my mind isn’t elsewhere. It means sitting down with a wife while her husband is in surgery and saying, “I’m so sorry this happened to you,” knowing she isn’t hearing a word that’s coming out of my mouth but hoping that she derives some small comfort from my stopping by in a crisp white coat with a stethoscope around my neck.

Dr. Williams would no doubt sympathize.

Putting her piece in context, Baehr says, “While I’ve seen a lot of really difficult things throughout my time in medical training, there have been a handful of experiences that have really stuck with me. I have found it incredibly cathartic to write about the experience. It’s something I do on the side in my free time, and mostly just for myself. However, I have sub­mitted these essays for publication a couple of times, when I think that the experience might resonate with others as well.”

Daniel Child is the author of “Blood,” which surprisingly combines some fairly precise medical terminology (isopropyl alcohol, the polypropylene parasite, clotting factor V) with al­lusions to medieval heresies (that fiend Cathar, auto-da-fé, inquisition). The youthful narrator expresses confidence that there is no trace in his blood of “the heretic / that infiltrated my family generations ago”; but then recalls that complacency “allowed the dissident’s influence to send my genetic prede­cessors to the hospital for their last time.” 

Child is now in the Ph.D. phase of his M.D.-Ph.D. training, with an interest in genetics and gene regulation. “Most of my writing efforts over the past year have been directed to a sci­entific end,” he says. “Fortunately, I enjoy the process just as much as I enjoy writing creatively.” He has read and enjoyed many of Williams’s poems and short stories. “His works have taught me a deeper understanding of empathy and compas­sion, the magic of genuine human relationships, and the sa­credness of the individual.” These themes, Child acknowl­edges, are not unique to medicine, “but they are attributes that seem to define the caring physician.” For himself, Child has found the creative process to be therapeutic: “Putting ex­periences and emotions onto paper enabled me to contend with challenges I didn’t realize I was facing.” 

How Did Williams Do It?

“Plastic Bags,” a poem by Ayoosh Pareek, makes use of a ubiquitous and perhaps overly familiar object of contempo­rary life: 

There is something fascinating about plastic bags,
Floating in the stratosphere, symbols of plastic love, discardable affection.

So begins the poem, which hints at dislocation, attempts to es­cape a reality, “drowning yourself,” “the inability to breathe.” One startling image that is both matter-of-fact and somewhat surreal: “Nothing resembles us more than a recently used ashtray.”

Pareek reports that “The Red Wheelbarrow,” one of William Carlos Williams’s most anthologized poems, was one of the first poems Pareek ever read. He enjoyed creative writing in high school and at Brown University, where he took a course taught by the poet laureate of Rhode Island. He also joined WORD!, a spoken word group at Brown, “because I thought I needed to explore other creative venues and expand my horizons.” Even in medical school, he has been typically writ­ing a poem every week. On the other hand, he’s not sure whether he will be able to continue writing while he pursues a career in orthopaedic surgery. “It’s hard for me to imagine how Williams did it,” Pareek notes, “especially being the pro­lific author that he was.”

But, like Williams, he hopes to be in it for the long haul.

Sara Rendell is a medical students as well as a Ph.D. candi­date  in cultural anthropology. For her, Williams has been “a huge inspiration,” and she marvels about his ability to write in the midst of a busy career. Rendell wrote her poem “Brush Strokes” while taking a break from studying histology slides as a first-year medical student. She was, she says, “both en­tranced by the complexity and beauty of what I was learning and overwhelmed by how quickly my tenuous grasp of any chunk of information could evaporate.” 

We do not memorize, we sweep details
-- dust trapped in cobwebs, nestled
between floor planks, abandoned
in the cabinet’s shadow. . . .

Perhaps even more frightening for the writer are these lines from later in the poem: “Words we once saw fade from the facts / we know . . .”

Rendell writes fragments every day. “When my schedule is lighter, I write 1-2 pages in my journal each night.” And she hopes to continue writing as she pursues a medical career: “I think I would dry up and disintegrate if I could not write.”  

Cover image: Brachial Graft, by Eo Trueblood, lead medical illustrator with Stream Studios at The Children’s Hospital of Philadelphia.

Excerpts by Williams from The Collected Poems of William Carlos Williams, Vol. 1, 1909-1939. Copyright New Directions Publishing Corp.

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