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About a hundred billion tweets ago, in the middle of June, the writer Sherman Alexie sent out this tweet: “What is most

Poster for 100 Thousand Poets for Change

lacking from American poetry: humor and rage.” I’ve thought of this brief literary criticism off and on ever since. I’ve seen plenty of humor in contemporary poems—even the Poetry Foundation now bestows a prestigious poetry prizefor humorous poems—but what about rage? I’ve not heard of any awards given for rageful poetry.
But that doesn’t mean there aren’t poets putting their rage to use. Just last week, on September 29, poetry readings and other events were sponsored worldwide by a grassroots group, 100 Thousand Poets for Change. According to their Web site, these events seek to address societal ills like “wars, ecocide, the lack of affordable medical care, racism” through a community focus on the arts and “peace and sustainability.” In its inaugural year, 2011, there were 650 events in 550 cities.

A similar movement in the United States, Split This Rock, seeks to “celebrate the poetry of witness and provocation” and urge poets to assume “a greater role in public life.” The organizers took the name from a poem by Langston Hughes,” Big Buddy”:

Don’t you hear this hammer ring?
I’m gonna split this rock
And split it wide!
When I split this rock,
Stand by my side.

Poet and novelist Alice Walker, in an interview published earlier this year, in conjunction with the Split This Rock festival where she presented her work, said that the best poetry “cuts through to the heart of what’s of value in life. To really be true to your own spirit. To be awake and develop patience so that you truly understand what it is you’re trying to do, desire, and who in fact you really are. … It’s a wonderful gift to the planet.”

I shouldn’t take a tweet too seriously, but Alexi hit on something I don’t often articulate. I’ve had some of my poems published, and even won a prize or two. I have an MFA in poetry. I’ve given readings. But what value does poetry really have in our society? His comment on rage got me thinking about how vital poetry is and has been in many cultures worldwide. Neruda, of course, was revered as a poet and statesman in Chile before the coup in the early ‘70s, illustrating Shelley’s famous quip that “Poets are the unacknowledged legislators of the world.” And poetry is a life-and-death endeavor for some: just yesterday a Tibetan poet self-immolated in protest against China’s policies in his homeland.

But in the United States? Quick: can you name a living American poet? Okay, can you recite a favorite poems by one of your contemporaries? Or (**gasp**) can you imagine Kay Ryan moderating a presidential debate?

As we head into high debate season in this last month of the presidential campaigns, we all might do well to take a look at this sampler of political poems at the Poetry Foundation. Here’s one stanza, by poet Fred Merchant:

I think that if my tongue alone could talk
it would swear
in any court that poetry
tastes like the iodine in blood,
or the copper in spit, and makes a salt stronger than tears.

Next week I’ll post on poetry, empathy, and health care reform.

About a hundred billion tweets ago, in

Ann Campbell, RN-BC, MPH is a hospice nurse at an inpatient palliative and hospice care program in New York, and is currently an NP student at Hunter Bellevue School of Nursing. She is a research associate for the CHMP.

You’re going to die.

 It’s the statement none of us want to hear, but at some point will all face, even if it’s directed to a loved one: “we’re going to lose him” or “he’s gone.”

As a hospice nurse and nurse practitioner student I see that all too often, this discussion occurs when death is imminent, even though the writing has been on the wall for some time. Naturally, patients and families hold out for a cure as the odds of survival fall precipitously. Every failed intervention may bring new side effects, suffering, and a stronger medicine. As alternatives dissipate, the hope for a miracle cure grows. Finally, after numerous hospitalizations, difficult interventions, and toxic drug regimens, if patients are lucky a physician will prepare them and their families for a death that may come in days, possibly hours. The loved one continues to receive medications for symptom mitigation in the days that follow. Families and patients alike are distraught, confused, and frustrated. There is not enough time to adjust to this new reality.  Although patients are often comfortable at the end thanks to the hospice nurses and medications, could we have done better?

Palliative and hospice care is often left for the very end of life. However, a new study of Nurse Practitioners integrating palliative care into a primary care model confirms the benefits of early integration. This is shown to reduce emergency department visits and improve symptoms, which increases time at home and quality of life.

Our health care system faces the challenge of allocating limited resources to an aging population. The focus is on solutions that improve patient quality of life while minimizing unnecessary expenses.  One proven way to achieve these dual goals is for Nurse Practitioners to actively integrate palliative care into the health care system at an earlier time.

I’ll never forget one patient I cared for. When diagnosed with a terminal form of cancer he went on vacation. He and his wife circumscribed the earth because they knew their time was limited, and they wanted to make it count. In the clinical realm, the same type of patient is often treated despite inevitable failure, and harsh side effects from medications. Perhaps earlier discussions about death will help more people maximize the time they have with their loved ones, and decrease unnecessary waste in a system with finite resources.

Ann Campbell, RN-BC, MPH is a hospice

The New England Journal of Medicine is among the most widely read health professional publications in the U.S.

President Obama and Republican Presidential candidate Mitt Romney know how important the support of this core constituency is to their respective campaigns. NEJM invited the candidates to appeal directly to readers through personal essays, which appear in the September 26 online edition. You can read the President’s complete essay here, and Governor Romney’s here.

The New England Journal of Medicine is among the most widely read health professional publications in the U.S.

President Obama and Republican Presidential candidate Mitt Romney know how important the support of this core constituency is to their respective campaigns. NEJM invited the candidates to appeal directly to readers through personal essays, which appear in the September 26 online edition. You can read the President’s complete essay here, and Governor Romney’s here.