Complete Physical by Shane Neilson
Complete Physical will appeal to physicians and patients alike, which includes most of the multitude. Doctors can read the book and sympathize with its complaints; patients can read it and know the mind of their doctor better.
Shane Neilson’s accustomed fascination with the two great subjects, love and death, has taken a purely professional interest: he has written a poetry that has fused his typical poetic concerns with that of his profession as a physician. The poems are primarily lyrics, but there is the occasional villanelle and sestina amidst a squalid sea of punchy narrative; all of the poems ponder what it means to be ill, and some of them celebrate what it means to get better. Some poems even consider the tragic point when illness becomes identity. In every poem his ‘patients’ come alive, but the main character is that of the observant doctor, chiding, cheerleading, sometimes just doing his duty.
2011—ForeWord Magazine Book of the Year,
Table of contents
Part One: White Coat
The Doctor Readies The Breathing Tube
The Death of Leo Emberson, November 2006
The Death of Josie
Letter to Leo
Ten thoughts before the stroke
Before (Doctor Monologue)
After (Patient Monologue)
Penny has Parkinson’s
Old Anatomy Textbooks
On Conducting Complete Physicals
Testing 1, 2, 3
Inside the Examining Room
Love Squawks Through Technology
Christ Child in the Incubator
The Missed Appointment
On-Call Song: To My Wife
Love Poem For the Doctor’s Wife
Love Poem For The Doctor’s Wife Revisited
The heart is statutory
Ode to Stealth
Part Two: Black Bag
Song of the Most Responsible Physician
Irony is the Wrong Diagnosis
The Doctor Will See You Now
Secrets my Stethoscope Told Me
The dugouts of misery
No ill effects
Why we suffer: a conversation
My Illness, revisited
Taking charts home after work
The law of gravity
Reading H. L. Mencken
How Doctors Think
Canadian physician and writer Shane Neilson immerses readers in the human struggles and surprising joys of being what some term ‘a healer’ in his latest poetry collection, Complete Physical. Neilson, however, does not believe in such a glorified title for the work he does. In ‘Song of the Most Responsible Physician,’ he lays out his job for all to see: ‘Actually, I’m an actuary, / an on-call oddsmaker, / the farmer who closes the barn door / after the horse thief makes a home visit.’ He may see his place in his patients’ lives as common or mechanical, but nearly all of the poems in this collection look at the workings of the heart. They take readers into the torturous moment of delivering bad news; they find celebration too late in the life of a deceased patient; they worry at not having done enough; and they realize that love in all its forms -- lost, found, hoped for, and shunned -- is often the source of our ills.
Underneath all of the pain that Neilson sees and describes so originally, there is a quiet joy for simply being alive. In the poem ‘On Conducting Complete Physicals,’ from which the title of the collection is taken, he says that love seems ‘a more pertinent question / than the latest burp or cough.’ But, he implies, intrinsic in such a diagnosis is a treatment ... and do we really want treatment for love, or for life itself?
Throughout Complete Physical, Neilson takes readers through a gamut of physician-related emotions and situations, from helplessness in trying to master the language of grief in ‘Campanology’ when ‘all that comes out / is a sound like a tolling bell’ to the whimsical nature of doodling on his prescriptions in the poem ‘Prescription Pad.’ In addition to the sheer variety of subject matter in his poems, Neilson has a gift for working with forms that accentuate the range of emotion; straightforward narratives have their place alongside lyrics, sonnets, villanelles, and sestinas. Furthermore, Neilson has a masterful ear and uses sound in ways that draws readers into that very important part of the physician’s job: listening. A dicey trip down the throat is described as ‘jingly jangly’ and a ‘gurgling drama.’ The sound of grief, ‘one long lowing moan,’ drags readers down with it.
As is typical with The Porcupine Quill’s books, Complete Physical is strikingly designed with line drawings from nineteenth-century anatomy texts on its cover and throughout the book. The arresting language, sound, and subject matter of Neilson’s poems, coupled with the design, make this book a difficult one to put down.
—Jennifer Fandel, ForeWord Reviews
‘The book shines a light on the amazing resilience of humans, on unrealistic expectations placed on doctors, on the emotional trauma of treating untreatable pain, on regrets for past errors, on impersonal technology, and on pessimism in the professions.... It is heavy stuff, but achieves much more than therapy for the writer. In its fearless contemplation of pain and death, Complete Physical celebrates the pervasive beauty and power of love.’
—Phil Gravelle, Erin Advocate
‘In New Brunswick-born Shane Neilson’s latest poems, the doctor continues to find inspiration in medicine. His verse is clinical and carefully executed, like surgery. It’s a pulse beating in step with the cold, old anatomy diagrams dissecting the body. But what Neilson cuts into here isn’t diagramed flesh and bone, but his own heart yearning for love in a life surrounded by death and sickness.... His only prescription? Love.’
Neilson has a talent for powerful compression of language. By which I mean, his poetry can be dense and pack a wallop. When writing about poetry, I always feel I lack a proper vocabulary. I don’t know what to say about Shane’s stuff, except it’s uniquely his, and that’s the mark of a true craftsman.
—Michael Bryson, Underground Book Club
‘If Complete Physical comes across as a little uneven it is perhaps because it’s like a Doctor Who version of an old-fashioned black medical bag, bigger on the inside than on the outside, a catch all for whatever the doctor thinks might come in useful, holding everything from a thermometer to an MRI machine. A rummage through it is likely to turn up just the thing you need to help you think about the issue at hand. ‘‘I am priestly,’’ the doctor tells us, in ‘‘Curing Blindness,’’ ‘‘leveraging hope and faith and that grand panacea, love, against death. . . What I tell you is like connecting dots: there are points of light, and if you cannot see them, I will heal your blindness.’’ ’
—Sheila Smith, Tangerine Tree Review
When your calling is preserving life, you come with a few unique ways to analyze the matter. Complete Physical is a collection of poetry from Shane Neilson, reflecting on his profession as a physician and his entanglements with love and death. Complete Physical is an intriguing collection, and a recommended one.
—James Cox, Midwest Book Review
... addresses big questions about death and heartbreak from a medical perspective. Neilson navigates; not as all-knowing doctor, but as poet-priest-doctor feeling out the space between patients, their bodies, and their illnesses, all through the use of language.’
—Sarah-Grace Ross, A Writer Without Residence
I have a book of medical poems coming out with the Porcupine’s Quill in the Spring of 2010. As usual, I had trouble coming up with a title (this will be my fifth book, it doesn’t get any easier.) Titles always come late with me, as I find it difficult to sum up an entire collection in just a few words. For a year I debated White Coat, Black Bag: it had the right ring to it, the white coat suggesting all that is good in medicine, as if the coat were the white hat of a good guy, and the black bag suggesting black art. Indeed the book has two personalities: the first section will make my residency professors at Memorial University proud, for it is empathetic and supportive. The second section is more circumspect, wondering how it is that people contribute to their own illnesses, and is overtly frustrated. But the provisional title came to ground when my editor warned me of a CBC Radio program of a similar name, and for several months I suffered the anxiety of an author without a title. I debated the default position, naming the book after a favourite poem, but that seemed inadequate. Luckily, my publisher came up with a simple and elegant title: Complete Physical.
I think the new title does say it all: physicians must be thorough, their assessments ‘complete’. And every office visit provides an opportunity, in being complete, to seek the truth. My physicals are divided into halves: the first part gathers history, learning what transpired in the past year, how the new is new and the old is the same or changing. The second part leverages that information against the patient’s own body, seeking quickly for clues (the symptom of chest pain leading to the finding of a heart murmur) but also checking out the parts that the patient is not complaining of.
How do the poems do this? Well, there is the trick of the anecdote: certainly some patients have struck me more than others, and their predicaments worth a poem. Medicine is a means of knowing a person, and some of the poems try to take on the patient’s raiment. Yet they are written from my perspective, and so have a dual life. There are other poems that take on certain diseases, sly poems that try to terrify, although the image of the doctor tempers that terror. And other poems display my misgivings about medicine, about being privileged in the way that we are, to see so much suffering, nobly and ignobly borne. Nobly and ignobly witnessed!
My favourite poems are not ambiguous and interpretable in myriad ways; they are ambivalent, the equivalent of cherishing and despising a thing simultaneously. The most interesting part of a physical exam is a social history, the part where I learn how patients live their lives, and often discover information about how they will die them. The poems in the book freight complicity with beauty, they tend my flock not with judgement but with rueful wonder. During the ‘cpx’, as my day sheet nicely abbreviates, I am a seeker, trying to find out information. The poems are exercises in answering the most important question the cpx begs: how are we to live in this world? The poems make that question tangential, they throw in details to make the poem fastenable, real, but they are always answering in earnest.
Excerpt from an Interview with Shane Neilson by Sheila Graham-Smith at the Tangerine Tree Press and Review
Poets have their own individual obsessions, but I’d have to say that love and its corollory sex, and also death, are the big three for most of us. We’re always dying in thine eyes. There is an idea that poetry can and should be about anything, and I think that’s true, I’d hate to limit poetry, but I must confess that I get bored by poems about butterflies (though I’ve written my share) and I need the big subjects to validate the depth of what poetry aspires to achieve. But doctors ... in a sense, we deal in death. All illness are a prelude to it, are intimations of mortality, are threats to the mortal coil. It’d be an overstatement to say that all my patients are afraid of death when they come in with their undiagnosed symptoms, but looming over my title as physician is the power to deliver terrible, terrible news. I palliate several patients a year, and derive poems from that process.
There is the idea that poems are exercises in control. (I certainly believe it -- the wild poem is much more likely to be a failure.) That the poem is, as Yeats says, something ‘intended, complete.’ So the poet, when writing about personal calamity, imposes order on the disorder of illness. Poetry can validate the experience of illness without imposing the identity of illness. Patients mostly refuse to be thought of as diseased, as being of or consisting of their illnesses. I remember a paranoid schizophrenic candidly discussing that the diagnosis he had received was just a ‘label’ -- something to make sense of his life, but not to define it. A tool but not a deed. So the illness experience recognizes pain and suffering, but it doesn’t leak into selfhood. Many illnesses can be managed, but they can’t be controlled. Most people don’t choose to be sick. And choice is necessary for control. So the poem can only promise understanding, appreciation, and celebration, especially naming, but never control over a disease. Poems just aren’t that powerful... they are limited in that way.
—Tangerine Tree Review
Discussion question for Reading Group Guide
1. What are the different roles of doctors according to Neilson’s Complete Physical? Does the collection challenge or alter your understanding of a doctor’s primary role or project in a community?
2. Why is death such a prevalent topic for poetry? How does Complete Physical use the language of poetry to grapple with the topic? Consider ‘Campanology’ or ‘Prescription Pad’, as well as Shane Neilson’s interview with the Tangerine Tree Review here.
3. How does Complete Physical respond to the question of what it means to be ill?
4. Why does Neilson use different literary forms? Examine specific poems. Can or does language impose order on chaotic events like sickness or mortality? Is the attempt to find order through language a worthwhile project?
5. In ‘Curing Blindness’, the narrator writes of leveraging hope, faith and love against death. Is the opposition between hope, faith and love against death one that Neilson himself believes in? Are a doctor and his patients always working against death? Does Complete Physical present this battle in a hopeful or despairing light?
6. Consider the use and implications of the word ‘matter’ and the science of physics in Complete Physical.
7. Do you think that poets and doctors share a similar role in their community? Why or why not? Consider ‘On Diagnosing Alzheimer’s Dementia’.
8. Why did Neilson name the collection Complete Physical? Does the collection suggest that humans are completely physical?
9. How are illnesses defined or described in the collection? How does Neilson challenge or play with the concept of illness and cures? The last two lines of ‘Inside the Examining Room’ may offer a good starting point for this discussion.
9. What role does -- or should -- religion play in medical science? How does it figure in Complete Physical?
10. Love seems the most predominant theme in Complete Physical; Phil Gravelle of the Erin Advocate writes that ‘Complete Physical celebrates the pervasive beauty and power of love.’ Do you agree? Why is Neilson so preoccupied with love? How does love, an immaterial emotion, play such a powerful role in the workings of the body? (Or is love an immaterial emotion?)
Excerpt from book
On Conducting Complete Physicals
If love were a diagnosis,
I would chase it in a field of MRI machines
gone all blinky from delirium,
magnets gone randy.
If the insurance form said, Check all that apply:
Love, Lovesickness, Jealousy, Possessiveness,
all of it would be insurable in bouquets and chocolates.
If love were my diagnostic quarry
I’d hunt it like Cupid,
readying my quiver: Have you ever been in love?
With a Yes answer there would be a ritual cigar;
with No, a glass of bourbon.
It seems to me a more pertinent question
than the latest burp or cough.
But if there was a diagnosis,
and it was love,
would I order an unlovely blood test
to confirm, would I measure love’s telltale bump
with my hands, remarking on colour, border, size,
There would have to be a treatment for love.
What would it be?
‘Unlike most professions that find themselves expressed in poetry, doctors share one important thing with poets: an obsession with death. Shane Neilson has turned that obsession -- and the special deathwatching vantage of his medical trade -- into a collection of poems as beguiling and as brave as any I have recently read. In a clinical universe where suffering is distanced by language, Complete Physical becomes a kind of extraordinary talking cure. The human predicament has rarely found itself in such good hands.’
‘The carefully crafted poems of Complete Physical draw on Neilson’s experiences as a doctor to explore the limits of compassion. The poems express both the empathy of the doctor for the suffering of his patients and the steely-eyed detachment needed to survive in so much anguish and death. Neilson uses the discipline of rhythm and metaphor to speak directly to both the pain in illness and the joy of the life well lived in ways that recall the best of Alden Nowlan.’
‘In the great tradition of poetry by doctors, Complete Physical arrives not as a book of spare notes pinned to the refrigerator, but with all the gore, heroics, tender compassion, and sorrow of the dedicated physician washing his hands of the bloody day. Shane Neilson is a fine poet.’
Shane Neilson is a poet and physician who, in addition to several collections of poetry, has published in the genres of memoir, short fiction, biography and literary criticism. He is currently a fellow of the College of Family Physicians of Canada, a Vanier Scholar at McMaster University and editor for Victoria, B.C. publisher Frog Hollow Press. Though he lives in Oakville, Ontario, all of his work is rooted in rural New Brunswick.