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Poetry and Medicine |

The Exterior Palace

Jack Coulehan, MD1
[+] Author Affiliations
1Center for Medical Humanities, Compassionate Care, and Bioethics, State University of New York, Stonybrook
JAMA. 2016;315(5):519. doi:10.1001/jama.2015.9789.
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Dressed for cocktails at noon, Mrs Melville
greets me by putting her whiskey down
while raising herself with her quad cane.
My entrance—her nurse’s cue to complain
about her patient’s tantrums and rejections.
I lean on a lovely couch in the sunroom,
listening to the nurse’s soprano line—
still drinking despite my strict instructions,
sneaking smokes, massive noncompliance.
Below it, a contralto line—I insist
you get rid of this witch and her agency.
Tools of the trade in my bag, but nothing
to set the ecology right. The nurse,
I suppose, is driven by trust in the power
of words to enlighten and enlightenment
to sweep the deck. My patient likes to flirt
and kibitz, she believes that I’ll wink
at her badness. She thinks I’m unable
to divulge the secret she and I share—
her internal palace, beyond its moat
and portcullis, beyond the magnificent
central court, is a dank, unheated place.
Neither of us goes there. I’m enjoying
a delicate pattern of sunlight
across the rug and six framed photos
of different sizes that show her smiling.


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