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Examination

When a patient tells me she’s in pain, I try to whittle the wood of that word into a more precise shape: sharp, numb, radiating. I pay attention to the way she is sitting, if her blanched knuckles or quiet wincing elucidate more than she can put into words. I lie her down and palpate the four quadrants of her abdomen. To understand someone’s pain, it must be elicited, must be physically returned to. I apologize, then push down harder.

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When writing, I try to reinhabit. “If you mention a house in a poem,” a teacher once told me, “you need to know the name of the street and the type of flowers in the neighbor’s garden.” The peripheral details that don’t make it into the poem—soft footsteps in a museum, the shape of hermaphroditic snail love darts—must exist fully in my head. I spend a lot of time eliciting nostalgia. I spend a lot of time on Wikipedia.

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When my patient reflexively flexes her abdominal muscles against the pressure of my fingers, I note in the chart: patient exhibits guarding in the left lower quadrant. I try to distract her. I ask her about her job, her husband. When I move up to palpate her chest, I drape a white cloth over the parts of her body I am not examining.

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As much as I return to a place, a person, a feeling, I am more interested in how I guard myself from re-experience. When writing a poem, my computer screen is a circus: even now this Word document shares a stage with a half-watched episode of The Real Housewives, a thesaurus entry on “inhabit.” I may or may not be listening to Kanye West. I may or may not be composing an email to my mom entitled “hallelujah!” My process is just as much about being present as it is about protecting myself, protecting my reader.

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The work in the clinic is the same as the work on the page: I want to bring you someplace painful, and I want to lead you out.