Professor Femi Oyebode and the Poetry of Disquiet

This is a guest post by Femi Oyebode, Professor of Psychiatry at the University of Birmingham and a recent speaker at Mind Reading 2017: Mental Health and the Written Word, a one-day programme of talks and workshops seeking to explore productive interactions between literature and mental health both historically and in the present day, organised collaboratively by Diseases of Modern Life and UCD Child and Adolescent Psychiatry.

The title of this blog might as well have been ‘Mining Medicine from Literature’, borrowing from Professor Fergus Shanahan’s excellent talk at the recent Mind Reading 2017- Mental Health & the Written Word conference held in Dublin in March since that is the subtext this blog.  My contribution was a workshop on the poetry of disquiet. (A podcast of this and other talks is available here). In preparing for my session, I went back to Bashō (1644-1694), a master of classical Haiku. His life was marred by a number of tragedies and hence he understood the spirit of disquiet. His father died when he was 12 years old and his patron also died suddenly when Bashō was 22 years old. At the age of 39 years his home burnt down and soon after his mother passed away. In 1693, a year before his death, his nephew, Toin, for whom he was responsible, died suddenly from tuberculosis and, the following year Toin’s wife, Jutei, also died whilst looking after Bashō’s house.  Towards the end of his life, his poetry centred on sabi, described as a sense of loneliness or aloneness in poetry that conveyed a tragic sensibility. So, you can see why Bashō was my guide and model.

Haiku with its disciplined and highly concentrated form gives an idea of why poetry is such an effective mode for communicating emotional disquiet, for expressing despair and for anchoring a mind that’s in turmoil, grounding it in the firmly shared perspective of human frailty as well as strength. It is comforting to know that others have responded to loss with frailty but have nonetheless triumphed over dark feelings. I did not say much about Haiku at the workshop save to allude to its simplicity, its power and its use of time, place and imagery to capture stillness in a fluid world. Perhaps also like all poetry the pacing and pulse of the words act to comfort too.

Elizabeth Jennings (1926-2001) understood mental anguish. In poems such as “Sequence in Hospital”, “A New Pain”,  &  “Night Garden of the Asylum” she exposed to the reader’s scrutiny the tedium of hospital life, the sharp and distinct pain caused by the visiting lover’s departure, and the isolating influence of disease as it marks out the distressed soul as Other. These poems speak directly to make memorable but also, and perhaps more importantly, to draw attention to aspects of illness, asylum, and suffering that can go unrecognized by clinicians if not by family. When Jennings wrote

“Observe the hours which seem to stand

Between these beds and pause until

A shriek breaks through the time to show

That humankind is suffering still […]”

She ensured that the reader was involved in the situation, that they became an observer of the ward experience, that the veil covering the manner of existing in a hospital ward was pulled back so that nurses and doctors who may have become inured to the fact of what it means to live on a ward have their compassion and awareness rekindled.

In my view this is the proper role of the humanities in medicine- the capacity to make fresh for the clinician, a situation that is so commonplace, so ordinary that it loses its uniqueness. For the patient these situations are anything but ordinary.

I did not refer to Ivor Gurney (1890-1937) at the workshop. He lived the last 15 years of his life at the City of London Mental Hospital where he continued to compose music and write. Gurney’s gift was to be able to communicate the intensity of his feelings of despair and his powerlessness in the face of extreme anguish.  He wrote in “To God”

“Why have you made life so intolerable

And set me between four walls, where I am able

Not to escape meals without prayer, for that is possible

Only by annoying an attendant. And tonight a sensual

Hell has been put on me, so that all has deserted me

And I am merely crying and trembling in heart

For Death, and cannot get it. And gone out is part

Of sanity. And there is dreadful hell within me.

And nothing helps […]

This is a poem of what it is like in extremis. It makes it impossible for anyone to come to think of depression, or better still melancholia, as anything other than serious and unimaginably painful. The descriptions in textbooks and the attempts to standardize the features of severe mood disturbance fail to communicate the gravity and enormity of the human condition that clinical labels denote. Gurney’s writing, his desire to escape the pain of depression is most patently expressed in “An Appeal for Death”. He wrote

“There is one who all day wishes to die,

And appeals for it – without a reason why –

Since Death is easy if men are merciful.

Water and land with chances are packed full.

Who all day wishes to die […]

Suicide is the unexpressed but obvious desire here. Suicide is a difficult subject. Clinicians are confronted with suicide in their daily work. It challenges the primacy in medicine of the drive for life and the systems in medicine that act to save, preserve, and prolong life. It is capable of infecting the natural optimism of youth, of the young clinician and of the established clinician too, with a slow canker that imperils and corrodes confidence and enthusiasm. And, instead of turning the clinician towards the patient it can turn them away because of the subtle yet virulent energy that the subject of suicide possesses, and that is seen as best avoided if at all possible. I suppose I am hinting at the cost to the clinician of dealing with these situations. What literature does is to allow for a discussion about the depth and extent of feelings involved in this trade between clinician and patient of gross and inexpressible despair and hope. Literature does not solve these dilemmas but can create a space where profitable discussion can take place.

At the end of the conference, the following day, on Sunday, Jan and I went for a walk along from Dun Laoghaire to Joyce’s Tower at Sandycove. It was a blustery morning walk with intermittent rain. On the first floor of the tower was the room that Joyce shared with his friends including St John Gogarty. It was easy to imagine that Joyce and his friends had just stepped out and could return any minute. The way in which the room seemed to be waiting for its previous occupants put me in mind of Fernando Pessoa’s house in Lisbon, at Rua Coelho da Rocha, Campo de Ourique. When I visited his first floor flat, it was just as if he had merely stepped out for a minute. There was his black jacket and waistcoat, a white shirt and black tie, his bed with its yellowish brown and white stripe cover and the black hat resting on it. There was his pair of black shoes and a bookcase with a few books. The title of my workshop was taken from a collection of Pessoa’s, Book of Disquiet.

Fernando Pessoa (1888-1935) was a Portuguese poet who wrote prodigiously in several heteronyms including Alberto Caeiro, Ricardo Reis, Alvaro de Campos, and Alexander Search. He also wrote under his own name. There is a distinction to be made in Pessoa’s work between what might ordinarily be termed pseudonyms and heteronyms. Pessoa wrote in heteronyms, meaning that there was a well-developed character, style and voice to each name that he assumed and wrote under.  It is when he wrote as himself that we come closest to his melancholia. In “Diary in the Shade” he wrote

“Do you still remember me?

You knew me a long time ago.

I was the sad child you didn’t care for

But gradually got to be interested in

(In his anguish, his sadness, and something else)

And ended up liking, almost without realizing it.

Remember? The sad Child who played on the beach

By himself, quietly, far away from the others,

And he sometimes looked over at them sadly but without regret…”

Pessoa continued

“I know you’re watching and don’t understand what sadness it is

That makes me look sad.

It isn’t regret or nostalgia, disappointment or resentment.

No..It’s the sadness

Of one who, in the great prenatal realm,

Must have received from God the Secret –

The secret of the world’s illusion,

Of the absolute emptiness of things –

The incurable sadness

Of one who realizes that everything’s pointless, worthless

That effort is an absurd waste,

And that life is a void {…]”

Pessoa’s response to this existential melancholy was writing. In other words, it was the business of creating and ‘embracing the unreal dimension’ of fiction that allowed him to transcend the ‘incurable sadness’ of living. Pessoa concluded

“My world of dreams fashioned in broad daylight…

Yes, that is what gives

My face an oldness even older than my childhood,

And my gaze an anxiety within my happiness”.

I think that with Pessoa we come full circle to the idea that writing itself, literature can be mined from medicine, from ailments and afflictions. It is not just medicine that is being mined from literature but that there is a mutuality of relationship between medicine and literature. The conference showed this interdependence between medicine and humanities to the participants’ advantage. It was absolutely clear that this interdependence was enriching.

--Femi Oyebode