Poetics on human form, frailty
Review by Frances Chamberlain

I think we all, male and female alike, have wondered how medical professionals view us as patients. Do they see a patient fully clothed and out of the examining room and go, "Ugh, nice-looking face. But all those warts I just saw!" Do they recall the physical blemishes when they look at us and talk to us, and do those blemishes tarnish their view of us as people?

Do medical professionals really care about us as patients? Do they ever think about us after a visit and wonder how we're taking the good news, or the bad news?

I believe we get part of the answer in Cortney Davis's new book I Knew a Woman: The Experience of the Female Body, published by Random House © 2001.

Here is a nurse practitioner and poet—she has published two poetry collections, The Body Flute and Details of Flesh—. She can view the human body as something poetic and beautiful, and then detach enough to look at a specimen clinically, to ask the right questions to lead to a diagnosis, and to treat a problem with an appropriate amount of emotional separation.

In one chapter she describes how it feels to sit in the pathology conference room; the table surrounded by attending physicians and two chief gynecologists. Along the perimeter of the room are the nurse practitioners, residents and students.

"As we concentrate on the pull-down screen at the far end of the room," Davis writes, "shelves crowded with leather-bound books stand guard behind us. These volumes hold the pathology reports of all the cells and all the organs harvested from patients during various tests and operations since the hospital opened. What's missing from these reports are the patients themselves: what they look like, what made them laugh, who desired them. Somewhere on these shelves is the account of Eleanor's Pap tests and biopsies, illustrated by all the colorful slides the pathologist made. But nowhere does it say "Kind teacher" or "Woman whose hands fly up like chickadees."

Because I'm not a medical professional—because I never dreamed that I could be in an operating room without throwing up or fainting—I find myself duly impressed by someone who can transition from a deeply caring but professional nurse practitioner to a friend. Ms. Davis works as a nurse practitioner in an inner-city clinic for women. Her clients range from people with abuse issues, drug addiction and emotional problems, to those who are regular folks with inadequate health insurance. As she follows the lives of four very different women in this book, she gives us an intimate look into their lives, their problems, their weaknesses and sometimes their inspirational courage. She manages to do so, expressing her annoyance with uncooperative patients and hinting at her respect for others who handle illness with great wisdom and patience.

I had thought it unlikely that anyone in medicine, especially in a clinic setting where you might see someone once and then never again, could let themselves really care about their patients. I have renewed faith in the practice of medicine. Not expecting that everything has a cure or every physician can find the right diagnosis, but believing that there are those who bond with a patient and then, as a scientist, pursue the complex puzzle of the human body with undeterred passion.

Through the course of Ms. Davis's narrative, readers are treated to a rare inside view of what her thoughts are: about patients and their own strengths and resilience, about medicine, and about her own insecurities concerning her health, her view as the patient.

As Ms. Davis herself waits to go into the OR for a breast biopsy, she recalls: "A nurse came up to the other side of my stretcher. She didn't introduce herself but said, 'I spoke to your doctor. He wants you to have an IV anyway, just in case we need to give you something.'

"My heart started to pound, poom, poom, poom, poom. All of a sudden I was losing my grip on the sense of wellness I'd been clutching all along. If I could just manage to hold on to it, if any patient could, then we'd be the equals of the health care team, not their victims or passive recipients."

And there was Ms. Davis's persistence, or dogged determination you might say, in getting to the bottom of everything. Do you expect a pregnant teenager with an abusive boyfriend to tell you everything? Do you expect her to even understand what is happening to herself? And women who had suffered in other ways, but had learned to keep quiet about it? We know they're not going to spill their guts until they've finally, after a long, long time, established a relationship and built trust with their nurse or doctor.

"There is something about two women face-to-face in a small room that allows confession, or perhaps there is something in the nature of sorrow that longs to be shared. When a woman speaks, I catch hold of her words as if they were silken threads. Slowly I gather them in, braiding the strands and hoping to create something tangible just by listening."

I realized, as I read this, how much of a therapist a nurse or doctor has to be, encouraging trust, coaxing people to tell things they never wanted anyone to know, things that might be embarrassing or hurtful. As a nurse practitioner, Ms. Davis weaves back and forth between the clinical investigator, searching for the answers, and the patient listener.

You can't read "I Knew a Woman" without being impressed by the poetic beauty she finds in the human form, without knowing that this woman is a poet as much as she is a nurse practitioner. But you also remain constantly aware of the work involved in medicine, the constant search for small clues, the right diagnosis and treatment, and the indispensable value of communication between patient and health care providers.

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Editor's Note: Website for the book's author: www.cortneydavis.com.

Frances Chamberlain is a freelance journalist from Connecticut