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Pectoriloquy, A Retrospective Analysis FREE TO VIEW

Michael B. Zack, MD, FCCP
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Dr. Zack is Section Editor for the “Pectoriloquy” section in CHEST.

Correspondence to: Michael B. Zack, MD; e-mail: MBZack@aol.com

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

Chest. 2009;135(1):8-9. doi:10.1378/chest.08-2261
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One year ago, CHEST launched the poetry section “Pectoriloquy,” becoming only the fourth international medical journal to publish poetry. Given the uncertainties of how poetry would be received by its readers, whether they or others would submit to CHEST, and what the quality of such submissions would be, it was indeed a courageous journalistic trial.

The outcomes of that trial are informative. During this past year, more than 1,000 poems were submitted and read, from which 22 were published. For any poetry journal, such numbers and selectivity are extraordinary in a first year. The quality of the submissions was outstanding, attracting writers nominated for Pulitzer and Pushcart Prizes, winners of the Yale Younger Poets Series, and academicians in numerous English and creative writing departments. No one was accepted because of those distinctions, however, and no one was rejected because of their absence. Poems were read in a “blinded” method, the Editor unaware of the writer's CV.

A significant number of submissions explored two topics: breast cancer and dementia in a family member. Although on occasion the quality of nonpulmonary themes merited acceptance, editorial preference was given to poems with pulmonary themes. Among the published poems' topics were lung cancer, polio, pulmonary fibrosis, asbestosis, asthma, and sleep apnea. The poets were overwhelmingly patients or their family members; much more rarely, physicians or nurses. That was a surprise to us; we envisioned that most of the submissions would be from medical professionals. Apparently, patients and their families saw in CHEST an opportunity to inform, be part of a forum, and share their medical experiences through poetry. In fact, dozens of times submitters would reply to our rejection notices by thanking us for providing this unique expressive medium for them, grateful that at least this medical journal and community was listening to their experiences.

We realized this project gave us the unique opportunity to set extremely high acceptance standards from the outset. The goal was, and remains, to make CHEST a publisher of world-class poetry, offering its readers excellence in medical poetry in addition to excellence in pulmonary science.

The editorial selection process involves several screens. Poems must conform to the format guidelines published in CHEST for authors. Themes must be of medical relevance, and ideally on pulmonary issues. Additionally, we want to publish the very best. Furthermore, we had stylistic ideals. A substantial number of poems were effusive in their depiction of pain, sorrow, fear … all the unspoken emotions backgrounding patient encounters. The sincerity and honesty of these were indeed moving. However, in medical poetry (which thematically is inherently so dramatic and narratively so powerful), subtlety, irony, or understatement usually transmit much greater impact than sentimentality, cliché, or overstatement. We sought writers who had stripped off pretense and contrivance, and burrowed down to the intimate stark reality of the emotion experienced and shared. Good poems, as is also true of patient dialogues, tell two stories: that which is written/said and that which is deduced. Experiences shared poetically are, on one level, memoir, profoundly autobiographical and real, which gives them their intense vitality. They surprise, come to an unexpected conclusion or a striking last line.

One final editorial filter seemed appropriate and mandatory for poetry published in a nonliterary journal: clarity, accessibility, and relevance. The editorial goal of “Pectoriloquy” is not to flash and bedazzle with gratuitous stylisms, covert symbolisms, or intricate metaphor. The goal rather is to connect as directly and powerfully the medical poem and the medical reader in an intellectual and emotional dyad that informs, enlightens, pleasures, and startles with recognition of a moment that has been ours. At the end of the read, the process will somehow have made a difference.

For example, there was a wonderful poem published in “Pectoriloquy” by a patient with sleep apnea.1 The world's experts on sleep apnea, most of whom read CHEST and know almost everything known about sleep apnea, having read that poem, will now know a little bit more about it than they knew before they read it.

We are delighted that pulmonary patients and their families have contributed their poetry so enthusiastically to CHEST. We hope this continues, invited and encouraged by our readership. Importantly, we hope that more medical professionals will advantage their unique access (which other writers never have) to create and submit poetry.

The poetry published is complementary to the science that surrounds its pages. Both are ways of exploring the complexity and experience of pulmonary disease. Neither is competitive with, nor antagonistic of, the other. If science is about what can be empirically observed, poetry is about what can be phenomenologically felt; it helps make conscious the unconscious. Poetry, like science, is a decoder of what otherwise appears as mystery, a seeker of truth, a way of understanding. It deals with and in abstractions, just as physicians do with concepts like dyspnea, fatigue, or malaise, for example. The coupling of these two domains extends even to structure: the rhythmicity so fundamental to poetry mirrors biological and physical life such as heart beats, breathing, tides, seasons, diurnality. And it extends also to language, for physicians, like poets, are interpreters of (patient) language, its nuance, and yes, its camouflage.

On a personal note, I am extraordinarily indebted to the Editor in Chief. He was graciously willing to listen to and explore what must have seemed like an outlandish proposal to publish poetry in CHEST. He was a strong advocate and remained diligent in shepherding this renegade idea through an equally open-minded and embracing board of Associate Editors. Additionally, he and they gave this pulmonologist/poet complete editorial freedom to grow and steer this section as its Editor. For all of these enabling kindnesses, I am most grateful to him and the Associate Editors.

Pectoriloquy, a year later, seems a wise fit in this journal. On many levels, some unexpected, it has truly demonstrated excellent outcomes in its year-long trial.


Morrison D. I couldn't sleep. Chest. 2008;133:1527. [CrossRef]




Morrison D. I couldn't sleep. Chest. 2008;133:1527. [CrossRef]
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Pectoriloquy and poetry. Chest 2008;133(1):10-1.
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