ABSTRACT
This chapter, through a poetic imagination, draws out the beauty, elegance, and quality of medical diagnostics. Thus, we partly fulfil our promise to explore an overlap between poetry and medicine that transcends habitual instrumental and therapeutic uses for poetry in medicine, or of poets writing opaquely about medical issues. Further, we reconsider what is meant by “clinical reasoning” by moving away from traditional models drawn from cognitive psychology that place reasoning in the head, to consider reasoning as a worldly activity – both contextual and drawing on the life of objects or artefacts. Close observation (ekphrasis) and description are key shared qualities between the fields of poetry and medicine, and these are informed by similar tacit psychological structures: biomedical knowledge and a range of heuristics shaping clinical judgements, and poetic diction (forms such as rhythm and metaphor) shaping poetry. We draw on the poet Geoffrey Hill’s Mercian Hymns and its flawed figure of King Offa to illustrate how clinical reasoning is situated in the material of the world and depends on revealing qualities that matter (such as the symptomising body) through exquisite noticing of qualities of matter (the “stoniness of the stone”). We use Offa again to enact what poetry might do for medicine by demonstrating a way to think about the world that depends on poetry in order to understand it. Our argument is not only about poetry: it contains poetry and it proceeds in ways that poetry does. We consider in particular the work of the bio-philosopher Jakob von Uexküll, showing how place-based (poetics), rather than time based (narrative) understandings can inform medical thinking. After a critique of narrative medicine’s ineffectuality in comprehending nonlinear, achronological art, we return to Offa to illustrate James J. Gibson’s concept of “affordance” – where liquid or moving context teaches us how to respond to it, a vital notion in medical differential diagnostics where the patient is the key environmental affordance.
