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‘Medicine’: A poem born of compassion, strength and triumph

Audrey Shafer discusses the intellectual and personal inspiration behind the poem "Medicine," featured in Stanford Medicine's year-end video.

What is medicine? The question might seem an obvious one. Medicine is a means to health. It's science that impacts people. But through a poem featured in Stanford Medicine's year-end video, "Medicine," Audrey Shafer, MD, explores the depths of this question, peeling back its many layers, coloring medicine as a purveyor of healing, wisdom, compassion, discovery and connection.

"I have a long, wonderful, multilayered history at Stanford Medicine," said Shafer. Once a Stanford School of Medicine medical student, then a fellow, Shafer later became an assistant professor of anesthesiology, preoperative and pain medicine in 1990 and professor in 2007. But last year, Shafer adapted to a new role -- this time as a Stanford Health Care patient.

"I had major abdominal surgery for advanced cancer at Stanford Hospital, and it gave me a really different view than I had before," Shafer said in a recent interview. "Everyone -- the transport people, the receptionists, my surgeon and his team, the surgical ward nurses, my anesthesiologist -- was fantastic. I felt very grateful."

Narration by Adjoa Boateng, MD. Photos by Jim Gensheimer.

Through her prose, Shafer, now emeritus professor, casts medicine as a culmination of the mundane and monumental. With the knowledge of a provider and the humility of a patient, she weaves together the scenes of everyday hospitals, navigation of obstacles, a never-ending quest for knowledge, and the underlying thrum of energy that fuels an entire community of caregivers, pioneers and teachers.

Shafer, who worked for most of her clinical career at the Palo Alto VA Medical Center, also thrives in a creative space and, as founder of the Medicine and the Muse program at the Stanford Center for Biomedical Ethics, her unique blend of experience in arts and sciences made her particularly well-suited to lend her poetic talents.

She said she's always believed that the arts and humanities are an important part of medicine.

"It's a strength to acknowledge how the humanities help us more deeply understand the human condition, and support critical thinking about medicine, illness and health care," said Shafer. "I'm grateful that, as part of my career and faculty development, I've been able to work with and learn from people who are interested in the combination of the sciences and arts, and that I've been able to invest some of my academic time in an area which enables me to think in ways resulting in this poem."

The ultimate teacher

Shafer drew on what she knows best to inspire "Medicine": Her own experiences at Stanford Medicine and her vulnerabilities as a patient.

In one verse, for instance, she speaks to the importance of diversity in a community and how it underpins the fabric of Stanford Medicine:

Medicine is this -- an ever education that teaches
love, that teaches justice, that teaches speak up, that teaches pride
that teaches the colors of the many threads which weave among u
s

"This is deeply important to me, and it's a core part of our work and who we are," she said.

Another part of the poem touches on comforting a health care worker who's had a difficult shift.

... we are medicine
from a grinning preschooler as her end-of-treatment bell rings
to a friendly check on a colleague after a heartbreak shift
we are medicine ...

"I feel that this is true; we look out for each other," said Shafer. "We're aware of when somebody has witnessed a particularly tough case. Part of caring for a patient can include sadness and, for me, this was important to explore -- recognizing that we need to care for the carer as well."

Sharing vulnerabilities

Partway through the poem, Shafer's poignancy turns patient-centric, as she draws on personal memories from her time as a patient. "I wrote a line about the body no longer being scripted," she said. "In other words, you can't predict what is going to happen to you, as someone who is mortal. The lack of a script can feel really frightening, but I felt it was important to include one's vulnerability as part of the patient experience."

Medicine is this: a gaze from a waiting room window
your body no longer scripted, your fingers tap quietly
you rise to the call of your name, to a receptionist's bright smile

Shafer recalled one moment that stood out: waiting in her surgical ward room. Typically identifying as the person doing the teaching -- it was with mixed emotions that she suddenly became the subject of medical student and intern education, she said.

"We say in medicine that the patient is the best teacher, and there I was -- my body personally teaching these students. It was bittersweet," she said.

Shafer says she feels grateful her surgery was a success and that she felt fully cared for, by her physicians, by the nurses and by the chaplain who wove an unflappable support system.

"I have felt that, in many ways, the medical humanities are like a grove of trees," she said. "On the outside, one sees an individual, gorgeous oak tree. But underneath those trees have roots, which talk with each other -- connections that are crucial but not always fully visible. That exists at Stanford Medicine. These connections provide the structure and support we all need."

Read the full poem below:

"Medicine"

By Audrey Shafer, MD

Medicine is this -- the sun dries your unfurling wings and you stand
commencing with new wisdom

Medicine is this -- we are alone, each in our own body
yet, like roots intertwining trees below the forest floor
we connect, each to each to each

Medicine is this -- an awareness of transience
eternity held in a single moment
the moment held with a steady gaze
researcher, teacher, patient, doctor
the connecting circles of those who care

Medicine is this: we are here
beside you, beholding you; we listen
we pave a path girded by scientific discovery
and remain here, with you, as you feel the gentle warmth of health

Medicine is this -- an ever education that teaches
love, that teaches justice, that teaches speak up, that teaches pride that
teaches the colors of the many threads which weave among us
that teaches the long arc of mending and care

Medicine is this -- a life you dream becomes the life you lead
you sit at the bench searching for an answer
the many nights, the puzzling paths ending at the secret garden's locked gate
and just then it comes, the very question you need to turn the key
you connect with those around you, and you smile
curious as morning light to see what the day will bring

Medicine is this -- masks and shields, gloves and glass
a door from today opens to tomorrow
an overture: a chance to breathe, to sigh, to smile

Medicine is this: a gaze from a waiting room window
your body no longer scripted, your fingers tap quietly
you rise to the call of your name, to a receptionist's bright smile
while above, the helicopter brings a new family to the wide arms of healing

Medicine is this: long nights, long hallways, infinite pages
hard choices, fatigue felt in bones, yet
clocks become calendars, neophytes become seasoned
and welcome, as they had been, all who come to learn
connections like bridges through generations
each knowing more, each contributing
as the community of medicine
nurtures insights to full flower, from the promise of green buds
to the sun-tipped splendor of blossoms open to the world

Medicine is just this: us
we are medicine
from a baby's first blinks in the light
to a patient's guided steps after surgery
we are medicine
from a grinning preschooler as her end-of-treatment bell rings
to a friendly check on a colleague after a heartbreak shift
we are medicine
from the first white coat to the cap and gown
we champion the head and heart of research
to understand, to pioneer, to transform science into hope
we are medicine
all of us shining points on a great linked sphere
together we learn
together we teach
together we discover
together we share
together we heal
together, we are medicine.

Photo by Jim Gensheimer

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