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Sunday, January 21, 2018
HomePolicyAffordable Care ActWe Can’t Sleepwalk Through This One, Darlings

We Can’t Sleepwalk Through This One, Darlings

Yesterday, our president-elect met with a noted vaccine skeptic. Trump and his team have been mulling the privatization of the Veterans Health Administration. Republican congress members are eagerly anticipating their repeal of the Affordable Care Act, even though most Americans say they don’t support a repeal without a replacement.


“We can’t sleepwalk through this one, Darlings.”


That’s Joanna Macy, longtime peace and environmental activist, scholar of Buddhism and systems theory, and translator of the poet Rilke whose work, since November 9, has been my light and my salvation. Macy made that remark in an inspiring 20-minute talk she gave at the Bioneers conference in 2014. She shows in this speech how Rilke’s words are inextricable from her philosophy:

I am so grateful to be alive now. For life to continue, that means . . . we have to make a giant step in our consciousness. We have to make real what we dream and know and intuit. That we are one-planet people and we can only be one-planet people if we honor all our differences. . . . Rilke said:

Quiet friend who has come so far,
feel how your breathing makes more space around you.
Let this darkness be a bell tower
and you the bell. As you ring,

what batters you becomes your strength.

I’ve written at this blog, over the past several years, on the power of poetry to inform health care practice and policy. But we are entering a new political era, one that may force a further dissolving of many rigid old divisions—the arts from science, environmental activism from health care advocacy, research from clinical practice.


For this, we need poetry. Why? Because we have to make a giant step in our consciousness. Because we have to make real what we dream. Because we can’t sleepwalk through this one, Darlings.


Last November MacArthur fellow Claudia Rankine published a poem she had written a year before the passage of the ACA, called The Health of Us. The poem creates community from its first word, “We.” Rankine’s incantatory rhythm reminds us of the hope inspired by the mere thought of health care for all:

                                                         we understood
the impossibility of real equality but this single shift
toward a national community we thought
despite being founded on genocide and sustained by slavery
in God’s country we thought we were ready
to see sanity inside the humanity

Of the many challenges ahead, perhaps our greatest will be preserving that sight. How will we maintain our ability to see, and help one another to see, what Rankine so brilliantly calls “sanity inside the humanity”?


I wrote in 2015 that what poetry has to offer health care and health policy is its “reporting on the human beings at the heart of a vast and sometimes spiritless industry.”


But Rilke says it better. His sonnet, which Macy quotes from in her speech, continues:

Move back and forth into the change.
What is it like, such intensity of pain?
If the drink is bitter, turn yourself to wine.

Written by

Joy Jacobson, MFA, is the poet-in-residence at the GW Nursing Center for Health Policy and Media Engagement. Her poems have appeared in Smartish Pace, Beloit Poetry Journal, The Examined Life and other journals. She was a winner of Health Affairs 2015 Narrative Matters Poetry Contest, and her journalism has been recognized by the Association of Health Care Journalists, the Association for Women in Communications and the American Society for Healthcare Publication Editors. In 2016, her essay on using poetry in nursing education appeared in the anthology Keeping Reflection Fresh: A Practical Guide for Clinical Educators. At Hunter College, where she co-founded a program in writing for health care professionals, she co-created an academic writing curriculum for undergraduate and graduate nursing students. She has led workshops in poetry and narrative writing for interprofessional clinicians, clinical and humanities faculty, nurse managers, and cancer survivors and their siblings. She has previously had residencies at Vermont Studio Center, the MacDowell Colony and Helene Wurlitzer Foundation. Ms. Jacobson was the managing editor of the American Journal of Nursing for 10 years.

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  • What a great piece, Joy. Thanks for reminding us of the poetry even when the reality of our present circumstances seem so dysfunctional, even absurd. Sleepwalking is not an option. I believe the moment is coming when critical mass will be achieved, when the lies will be exposed, and all Americans will demand change. Thank you for allowing us to see the connection between poetry and health as well as the connection between poetry and action.

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