Postgraduate Education Corner: MEDICAL WRITING TIPS |

On Writing Poetry FREE TO VIEW

Michael Zack, MD, FCCP
Author and Funding Information

Correspondence to: Michael Zack, MD, 101 Main St, Suite 110, Medford, MA 02155; e-mail: mbzack@aol.com

Chest. 2008;133(1):294-295. doi:10.1378/chest.07-1365
Text Size: A A A
Published online

What is “best” or “good” in poetry? Although one could present a primer on rhyme, simile, meter, and other didactic attributes of contemporary poetry, such is not the purpose of this new section of CHEST “Pectoriloquy”. In writing good poetry there are many degrees of freedom with respect to these tools of poetic writing. As in the visual arts, theatrical arts, and musical arts, there are numerous ways to achieving “good,” all allowable and all equally respectable.

What really matters in poetry (as is also true in medical interventions) is outcome. To continue the metaphor, specific materials and methods matter only as means to the end. Does the experience of reading the poem make a difference, reward the time spent, and create impact? If so, it is good poetry notwithstanding its form, rhythm, lyrical quality, and complexity.

I once wrote a semiparody of poetry contests. It speaks to the issue of discovering what distinguishes good from contrived.

Medical School

In med school first you listen,

then you imagine,

reducing yourself to scale.

Next you take a stab

at what’s wrong,

articulating a diagnosis.

And finally you treat.

After trying this on people

a few decades,

(successfully I might add),

I realized that in listening,

imagining, reducing scale,

diagnosing, treating,

I had been taught,

and had been practicing,

not just medicine,

but also poetry.

So I entered this contest

for the greatest poem.

My friend said be clever,

to win you must do a few things.

Never write about love,

at least don’t mention it as such,

change its identity to August corn

or herons in flight.

Use the words “shards” and “bone,”

avoid rhymes, use meter,

dialogue in taxi talk

and California speak.

I employed complex gerundives,

ornate adjectives, intricate adverbs.

My metaphors were gorgeous, poignant;

my conclusions profound.

But alas I lost.

Go back, he said,

you must try again.

Initial your first two names,

remove most vowels

from your last name,

tell them you’re from Paraguay.

Change the line endings and

tab the line starts to marginless

asymmetric anarchies.

Yet I lost again.

Perturbed, angry, rebuked,

I dashed off a note

to the committee

voicing my total frustration.

“What did they want?”

I implored. “Are there ever

successful poems?

How could one win?

It’s like trying to find a desert,”

I finished,

“by imagining an ocean and then taking away the water.”

“Ah,” their responding letter replied,

That’s interesting.”

The writer had been trying too hard to conform to external rules, and failed. Once he freely expressed his internal voice however, he succeeded.

These “tips” have no intention or even capability of teaching how to write poetry. That is also extraneous to the mission of Pectoriloquy. Good poetry is not programmable in a formulaic, codified way; it just is.

Yet, there are some tips to writing good poetry that have proven worthwhile. Most important is to read and read and read poetry. The more poetry is read, the better the writing will become. The more food one samples, the better skills one will have as a cook.

It is perhaps easiest to describe good poetry by characterizing some important attributes. When a word or metaphor or image hits home, vibrates and resonates, lingers, and startles (all effects poets strive for), one should pause and reflect on how the poet achieved that outcome. What were the devices he used? Put your finger on them and then emulate that process with your own words. Be aware as well when you read something than seems vacuous, boring, unenlightening, trite, or clichéd. Those negative experiences are diagnostic of not-good poetry.

Strive for clarity without being literal and obvious, succinctness without being empty. Short is preferred over epic. Create an experience recognizable in the reader. Write as if someone is listening, with whom you want to be conversational. Make that dialogue likeable, not arrogantly pedantic or presumptuous, not gratuitously difficult.

By way of example consider the following poem:

So much depends


a red wheel


glazed with rain


beside the white


This poem, written by William Carlos Williams, a New Jersey pediatrician, forever changed American poetry. The key to this poem is the phrase: “so much depends”: perhaps his peacefulness, his focus, his sense of order, of universe, whatever … you may in fact choose whatever noun resonates most with your own persona.

Here’s another tip: S.O.A.P., you know like in our progress notes. Many great poems have the Subjective (“so much depends”) and Objective data, (“wheel barrow”, “rain water”, “white chickens”). In poetry, the Assessment is a personal choice, what to extract from the poem, what it means to you, and what is the recognizable moment. And alas, there is no Plan. That is where poetry stops short of medicine … it’s only about the assessment, reverberating in our memories. The reader can plan accordingly and idiosyncratically, or not.

Some More Tips

  • Avoid the obvious, the sentimental, the melodramatic. This can be very difficult when writing about medical themes that may be inherently melodramatic. The secret is not to overstate what is intrinsically overly powerful by itself. Red need not be necessarily chosen for a dramatic sports car’s color.

  • Revise, revise, revise. Each revision should get a little bit closer to the perfect expression of what you are trying to communicate.

  • Oscar Wilde once wrote “all bad poetry springs from genuine feeling.” He meant that one must go beyond, way beyond, simply genuine feeling to write well. The art of writing is to aesthetically and tastefully convey that genuine feeling and have it resonate to another.

  • A good poem should have surprise, a newness of expression, a revisitation of the poet’s experience as one you yourself have had, a discovery.

  • Poems should have an edge, an attitude.

  • They should be concise … every word mattering, as a member of a team working toward a goal. Nothing should be extraneous, unnecessary, redundant. In good writing, an adjective isn’t chosen to prop up a weak (poorly chosen) noun, or an adverb to resuscitate an ineffective verb.

  • The poem should be unique.

  • It should inspire trust in the reader to give over one’s intellect and emotion to the writer.

  • Poetry should avoid preachiness and never give instructions to readers on conclusions.

Good poetry is like a good movie, a good dinner, a good TV show, a good medical journal editorial … it lingers, the time investment pays off. Even if seemingly not interested, one can pick it up and get into it, which characterizes a good magazine, such as The New Yorker for example.

Pectoriloquy is the distinct articulation of the sounds of a patient’s voice, an increase in vocal resonance, heard on applying the ear to the chest in auscultation. Thereby, whispering becomes audible. This makes the choice of “Pectoriloquy” to title this section particularly apt. Because, in summary, the goal of good poetry is really to do exactly that: augment what is there, make it heard, make it coherent, take near silence and give it a voice, honest and true, transmitting it to our senses and thence to our understanding, our pleasure, our growth.

The author has no conflict of interest to disclose.




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543