5 Jan, 09 | by BMJ Group
Reflecting on the challenge by Alex Jadad and Laura O’Grady to define health, I begin to conclude that it can’t be captured in a few words. Disease is a simple concept compared with health, and diseases can be defined — but with all the paraphernalia of pathophysiology, epidemiology, symptomatology, and the like. Defining health will be more complex and more unfamiliar.
Reading Harold Bloom’s essay “The art of reading poetry,” I began to think that poetry might manage what prose cannot. “Poetry at its greatest,” he writes, “has one broad and essential difficulty: it is the true mode for expanding our consciousness.” We perhaps need our consciousness expanded to define health. Poetry expands consciousness, says Bloom, through what he has learned to call “strangeness.” He then quotes Owen Barfield, who writes that “strangeness arouses wonder when we do not understand; aesthetic imagination when we do.” We might know health when we see it defined in great poetry.
But great poetry — perhaps like a definition of health — requires enormous intellectual agility on the part of the reader. The pursuit of health cannot surely be passive. “The art of reading poetry,” concludes Bloom, “is an authentic training in the augmentation of consciousness, perhaps the most authentic of healthy modes.”
I was fascinated that he used the word healthy in this final clause in his essay, although I’m note sure I understand him. Presumbly he means that other ways of expanding consciousness—through drugs, for example—are less healthy.
Having had this (perhaps silly) idea that health will need to be defined in poetry, not prose, I searched for a poem. What I found first was some definitions of poetry at the start of Neil Astley’s “Staying alive,” one of Britain’s most popular anthologies of poetry ever. Its title implies health as does its sequel “Being alive.”
Astley describes the poems as “life affirming,” and John Berger says the poems will leave people “feeling less alone and more alive.”
“Poetry,” writes Christopher Logue, “cannot be defined, only experienced.” Is it the same for health?” A poem should not mean, but be,” writes Archibald MacLeish, but Yeats is more helpful: “Poetry is truth seen with passion.” If poetry could help us see the truth of health with poetry we’d be getting close. Then I remember one of my favourite quotes—from John Kennedy: “When power leads man toward arrogance, poetry reminds him of his limitations. When power narrows the area of man’s concern, poetry reminds him of the richness and diversity of existence. When power corrupts, poetry cleanses.”
Health surely has to do with acknowledging limitations, remembering the richness and diversity of life, and cleansing. But could the definition of health be captured in one poem? I doubt it, but I decide to start with two of my favourite poems: Louis McNeice’s “Snow” and C P Cavafy’s “Ithaka.”
“Snow” tells us that “World is suddener than we fancy it. World is crazier and more of it than we think/ Incorrigibly plural…feel/ The drunkenness of things being various.” These seem to me to tell us something about health—that it can surprise and isn’t all about eating apples, moving your bowels regularly, and exercising. By definition I can’t explain what the poem says, but I feel health is there.
Similarly “Ithaka” for me provides insights on health — call it expanded consciousness — not available in prose. “As you set out for Ithaka [death perhaps even probably]/ hope your road is a long one,/ Full of adventure, full of discovery. You’ll not be afraid of monsters “as long as you keep your thoughts raised high,/ as long as a rare excitement/ stirs your spirit and your body.” Later, “Ithaka gave you the marvellous journey,/ Without her you wouldn’t have set out.” The whole poem gives me thoughts on health beyond what WHO can offer.
Neither poem on its own defines health, but perhaps a poetic genius could define health in one poem. Maybe that poem is written and I don’t know it. Or maybe the definition needs an anthology, and Astley’s two volumes are an excellent start. Maybe when somebody says “Tell me, what is health?” I could hand him or her these two books and say “That is as close as we can get.” I suspect the world wants something more operational.
So, the search continues, but poetry, I feel, will be part of the answer — if there is an answer.
“We were all brought up to want things and maybe the world isn’t big enough for all that wanting.”
John Updike, Rabbit Redux
To treat the poem as a site at which a predetermined set of useful things may be found is to fail to treat it as a poem.
Journal of Medical Ethics 26:31-36 (2000)
The use of poetry in health care ethics education