The Place of Arts Medicine in Diagnosis and Healing, Journal of Humanities Therapy

The Place of Arts Medicine in
Diagnosis and Healing
Diane Leslie Kaufman1
Abstract: The Place of Arts Medicine in Diagnosis and Healing is
a multi-faceted personal and professional journey from the mythic
origins of arts and healing to contemporary applications of arts in
healthcare. As threads woven into a tapestry, Dr. Kaufman, a child
psychiatrist, poet, and an expressive arts educational facilitator,
traces family of origin influences that helped foster her interest in
arts and medicine, speaks of the essential need for “connectivity”
to facilitate “humanism in medicine” experiences, describes the
collaboration that led to the development of Creative Arts
Healthcare at University Hospital, and provides clinical examples
of story, myth and poetry as healing elixirs for children and
caregivers in psychiatric treatment. From a poetry contest for
healthcare students to a poem performance by high school students
in response to a violent killing, arts medicine has a vital role to play
in how we empathically connect with ourselves, our patients, and
our world.
Key words: arts in healthcare, humanism in medicine, poetry
therapy
1. How to Begin
Repeated but always new, and for over twenty-eight years, if you
were listening at my doorway, you could hear me say to a child or
1 New Jersey Medical School, USA.
E-mail: artsmedicine@hotmail.com

130 Diane Leslie Kaufman _ The Place of Arts Medicine in Diagnosis
and Healing
teen and their parenting adult, “Hello! How are you? I am glad to
see you. My name is Dr. Kaufman.”
I will look at them both, and turning my full attention to the child
will say, “I am a child psychiatrist. Do you know what that is?”
The child or teenager if engaged, and not already resistant to
being there, could reply, “They help people with their problems.”
Or they might shake their head with a “no” and explain that they
never heard that word before. Or perhaps they don’t answer at all.
With a young child I might add, “the word ‘psychiatrist’ is a
tricky word, as it sounds like it starts with …” and then I pause and
wait for the child’s response. In this interchange I hope to inspire
curious interest. That things are not always what they seem to be.
The child says, “with an s or with a c” and I agree that it does sound
like that. I go on to explain that, “It actually starts with a ‘psy.’ It’s
from another language, a Greek word.” Sometimes I may add that
the “psych” of psychiatry comes from “psyche,” the soul. “How
interesting!” I say to myself in an inner dialogue. A child
psychiatrist offers medical treatment to the soul (Wikipedia, n.d.).
I explain that a psychiatrist is a medical doctor. So you go to
grade school, high school, college and medical school, and then get
more training after that. And if they did all that (and who knows,
maybe one day they will) they could be a doctor, too. But I am not
a doctor who gives shots. The child who thought that might happen
shifts in posture and becomes more relaxed. I am a doctor who
helps with thinking, feeling, behaving, and sometimes sitting still
and paying attention.
I go on and explain that, “Everyone has some problems. I have
my own problems. And sometimes problems just happen to us and
it is not our fault. We don’t deserve it. But we still have to do
something about these difficulties. So there is nothing really to be
ashamed about.” I go further and add, “And sometimes people feel
bad about asking for help. But I feel if we really can love ourselves,
and know that someone can help, then we can feel proud about
getting the help that we truly deserve to get.”
And after this beginning, I ask, “So how can I be of help? Do you
think you are having some difficulty with your thinking, feeling,
behavior, or sitting still and paying attention? I want to hear what

Journal of Humanities Therapy Vol. 5(2014) 131
you think not what other people are saying. We all have a right to
our own opinion.” Sometimes the child will quickly reply that she
or he is having problems with behavior, attitude, anger,
moodiness, feeling sad, that they can’t sit still, or they have cut
themselves. Other times, especially a young child, might say, “I
don’t know why” and then I will respond, “Do you want to ask
your mommy or should I?”
All along I am trying to relate, foster engagement and show
concern. I explain that, “We are here to have a conversation
together. After all, you are the expert on you!” Communication and
collaboration will be our keys to success. There is an “art” to
relating to a patient.
2. Caring for Patients
In lecturing Harvard Medical School students in 1927, Dr.
Frances Peabody most famously said, “One of the essential
qualities of the clinician is interest in humanity, for the secret of the
care of the patient is in caring for the patient.” Caring can be
emotional, spiritual, physical, technical, all of these, and some of
these. When we truly care, we want to know “what’s wrong?” and
“how can I help or bring help to you?” We want to know the
presenting problems from the patient’s point of view. We do not
jump to conclusions. We ask questions and listen for answers. Our
empathy is paired with the demonstration of caring (Weiner &
Auster, 2007). We might recognize that someone needs help, but
realize also that they don’t want help, can’t accept our help, or may
not even know they need help. There are oftentimes real obstacles
blocking the way that must be better understood and overcome, in
order for help to be received. These barriers also apply to individual
healthcare providers, interactions with other healthcare providers
and to the systems within which we work. What are the barriers
that we face? And what do we do about it?
Caught within this tangled web as well, I recently poured out my
thoughts and feelings in a spontaneous essay. I wrote in big letters
at the top of the page, “Medicine IS Humanism” and proceeded to
write non-stop (Kaufman, 2014). It was not written for the purpose

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of being published. The driving force was to be understood. I
shared what I had written with friends. Much to my surprise and
delight, one asked if she could publish it on Health Cetera, the blog
of the Center for Health Media and Policy at Hunter College.
Medicine Is Humanism
The practice of medicine revolves around people. The
person in need is at the center of the health-caring circle, and
all around are other people who are trying to be of help. Blood
tests,respiratory devices, infusions, MRIs,and other forms of
advanced technology at their very best diagnose and treat and
that is so very important and essential, but they alone cannot
care. They are not alive, and they know nothing about love,
joy, kindness, sorrow, loss, dying, death, and the cry of a new
born child. Only human beings can care – that is, if they
choose to do so. If they are encouraged to do so. If they have
experienced other human beings caring for them and about
them.
And it all starts with each of us. Do we have the courage to
express the humanity of our own beating and sometimes
breaking heart? Do we have the passion and determination to
change a culture of business as usual? To acknowledge that
the “hidden curriculum,” can become more powerful than all
the humane lessons we are taught in lecture halls? That
“hidden curriculum” the one not spoken of aloud, but acted
upon is rather the anti-practice of medicine, the health un-
caring institution.
The cure, I believe, is not “humanism in medicine.”
Because to me, the phrasing and timing are all wrong. Let us
pause,take a deep breath,rememberdeeply, and bring to mind
what we seem to have forgotten. Medicine IS humanism. As
Hippocrates said, “Wherever the art of medicine in loved,
there is also a love of humanity.” And from that foundation,
life affirming questions can be asked:
Who are these unique people who have come to me for help?
What is their story?
How can I respond to their needs?
What kind of doctor am?
What are the qualities of my medical practicing?

What does my health care institution reveal about how it
cares for human beings who are sick?
How does this institution care for those who are trying to be
of help?
And what intentional actions can I bring to my encounters
with these center-of-the circle people that show I care and
because I care,I am an even more competent, effective, and
professional physician?
This is not a quiz, but is a test of how I will respond each and
every day to the call of being a physician. One day we will all be
at the center of that circle. When “connectivity units” are equal to
“productivity units,” or better yet when it is comprehended that
there is no lasting productivity without caring and connection, the
art of medicine will be practiced.
3. Growing Up with Poetry
As a young child, asked to explain in a grade school
composition, what I wanted to be when I grew up, I wrote in
innocent big lettered penmanship, “a medical doctor or a medical
drawer.” How could I have known then that this is exactly what I
would become so many years later? My personal life and
professional work has been an inspired journey guiding me to that
place. Being here with you today is part of that journey. Poet John
Keats in 1817 wrote of the importance of “negative capability” as
it allows us to inhabit possibilities. Psychiatrist Carl Gustav Jung
spoke of the transformative power of carrying the “tension of the
opposites” (Art Quotes, n.d.). For me, the seeming polarity of “a
medical doctor or a medical drawer” has evolved to become who I
am: an arts medicine practitioner.
If you were to look up the phrase, “arts medicine,” you would
find that it refers to providing medical care to the special needs of
musicians and other artists (Dictionary.com, 2014) but that is not
how I choose to use these words. And I find I am in good company

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in defining things for myself, as Lewis Carroll (1871) so aptly
expressed in Through a Looking Glass:
“When I use a word,” Humpty Dumpty said, in a rather a
scornful tone, “it means just what I choose it to mean – neither
more nor less.”
“The question is,’ said Alice, ‘whether you can make words
mean so many different things.”
“The question is,” said Humpty Dumpty, “which is to be master
– that’s all.”
But I am not, like Humpty Dumpty, trying to be scornful. I hope,
rather, to be uplifting. After all, Humpty Dumpty fell down, and no
one was able to put him together again. To the contrary, my aim is
to bring wholeness to us all. In fact, the root origin for our words
“health” and “healing” is to “make whole” (Dictionary.com 2014).
As a child I liked to write poetry. My mother was constantly
writing poems that she called verses. When she died I inherited her
love of poetry, literally and figuratively. She wrote thirty plus
volumes of poetry, 100 typed poems per volume, the diary of her
life in all its ups and downs and sideways dimensions. And my
favorite Aunt, who so loved me, wrote poems dedicated to me, and
gave them to me as I was growing up, so that I could live my life
better from what she had learned through living hers. She even
wrote a play about my family when she took a college English
course, in which she described a secret pain that she somehow
understood I had been living with since being a young girl. I only
discovered this years after she had died, when I was reading her
writings that had been given to me. I felt as if she had reached out
from the grave to comfort me. And so it is with art, for art expresses
what it means, how it feels, to be human.
4. What’s in a Name
My birth name is Diane. I was named after my mother’s one doll.
Because I was the youngest, the baby of my family, the endearment
for my name became, Dianee. As an adult woman and medical
doctor, I called myself Dr. Kaufman. But as I began to understand
more about art and medicine, I boldly asked to be known as Diana.

Little did they know and rarely did they ask, the reason for my
request. Diana is the Roman equivalent of the Greek Goddess
Artemis, who is the twin sister to Apollo. Artemis, and how
interesting that her name begins with “art,” is the “Hellenic goddess
of the hunt, wild animals, wilderness, childbirth, virginity, and
protector of young girls, relieving disease in women; she often was
depicted as a huntress carrying a bow and arrow” (Wikipedia,
2014). She was worshipped throughout Greece with the most
famous temple being at Delos where she was said to have been
born. Her temple in Iona, Turkey was one of the Seven Wonders of
the World (Wikipedia, 2014). Far from it was a wish to be
worshipped. Not that at all. Rather, I wanted to invoke the presence
of Artemis and Diana into my life.
Artemis’ twin brother is Apollo. Their parents are Zeus and Leto.
One rendering of the myth is that Artemis upon being born, then
helped her own mother to birth her twin by serving as midwife.
Apollo was “variously recognized as the god of light and the sun,
truth and prophecy, healing, plague, music, poetry and more.”
Apollo was the “oracular God – the prophetic deity of the Delphic
Oracle.” He was the God of Medicine. Apollo’s son, born from a
union with the mortal woman, Coronis, was Asclepius, God of
Healing (Wikipedia, 2014).
5. The Hippocratic Oath
The original Hippocratic Oath, recited and pledged upon
becoming a physician harkens back to these mythic origins:
I swearbyApollo, the healer,Asclepius, Hygieia and Panacea,
and I take to witness to all the gods, all the goddesses, to keep
according to my ability and my judgment, the following oath
and agreement…” It ends with the words, “If I keep this oath
faithfully, may I enjoy my life and practice my art, respected
by all humanity and in all times; but if I swerve from it or
violate it, may be the reverse be my life (Wikipedia, 2014).

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In swearing their allegiance to the God Apollo and what he
represents, physicians are actually pledging themselves to the
practice of art and medicine, whether they have that conscious
awareness or not. In other words, we healthcare providers can trace
our origins to the mythic realm of art and medicine.
6. Arts in Healthcare
The 2009 State of the Field Report from the Society for the Arts
in Healthcare defines arts in healthcare as “a diverse multi-
disciplinary field dedicated to transforming the healthcare
experience by connecting people with the power of the arts at key
moments in their lives. This rapidly growing field integrates the
arts including literary, performing and visual arts and design, into
a wide variety of healthcare and community settings for
therapeutic, educational and expressive purposes.” It further
explains that arts in healthcare can be applied to “patient care,
healthcare environments, caring for caregivers and community
well-being. “The special understandings of art therapy, music
therapy, drama therapy, dance/movement therapy,
poetry/bibliotherapy, and multi-modal expressive arts therapies are
all examples of arts in medicine practice. With specialized bodies
of knowledge, training programs and certification credentialing has
been established for these therapies.
Creative Arts in Healthcare emerged in the summer of 2009 from
a coming together of health care providers from across the
statewide campuses of the University of Medicine of Dentistry of
New Jersey (UMDNJ) who responded to an email which asked,
“Are you interested in art and healing?” At that pivotal meeting,
were nurses who were drawn to attend the meeting as they had a
space for neurologically challenged adults, the PALM Room
(planned activity and less medication), at The University Hospital
where art and music was being used to enhance patient recovery
and healing. Shortly thereafter, Judy Colorado, RN, Executive
Director for Patient Care Services, introduced me to Theresa
Rejrat, RN, the Hospital’s Vice President of Patient Care Services

and Chief Nursing Officer. Like a chemical reaction that only
occurs if the right elements are present at the right time and place,
that can work off of each other and with each other, the three of us,
each bringing our unique abilities and shared passions, vowed to
bring the power of the arts into the University and hospital setting.
I named our initiative Creative Arts in Healthcare. A
presentation was made to the Hospital’s Board of Directors and
eventually to UMDNJ’s Board of Trustees. A powerful excerpt
from the PBS Documentary, “Healing Words: Poetry in Medicine”
was shown on the arts in medicine program at Shands Hospital in
Florida in which a young woman suffering from sickle cell disease
experiences relief of her physical and emotional pain through dance
and poetry. The UMDNJ healthcare community was reminded that
as the whole person is impacted by medical illness, whole person
treatment is holistic, and focuses on healing as well as cure. The
1982 seminal article by Eric J. Cassel, MD, “The Nature of
Suffering and the Goals of Medicine” was quoted: “The relief of
suffering and cure of the disease must be seen as twin obligations
of a medical profession that is truly dedicated to the care of the
sick.” A list of research topics as referenced by the Society for Arts
in Healthcare in collaboration with the University of Florida’s
Center for the Arts in Medicine, on topics such as anxiety,
agitation, stress, post-traumatic stress disorder, sedation, asthma,
cancer, fibromyalgia, heart disease, Parkinson’s Disease, pain
(perception and medication), relaxation and sleep, blood pressure,
dementia, depression, hope and spirituality, nurse and physician
empathy and communication, and quality of life were described. It
was noted that arts in medicine programs such as Creative Arts in
Healthcare support and promote patient satisfaction, family
satisfaction, staff recruitment and retention, compassion
fatigue/burn out prevention, enhance community relations, multi-
cultural awareness and sensitivity, medical care, treatment and
emotional healing, and humanism in medical practice (Society for
Arts in Healthcare, n.d.)
A year later, Creative Arts in Healthcare became Creative Arts
Healthcare. It was real unto itself, had its own identity and did not
need to part of something else in order to be valued for what it was

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and could bring to healthcare education and practice. Years have
passed since then, with Creative Arts Healthcare providing Grand
Rounds on music, poetry, dance/movement, photography and
drama for the purpose of enhancing the range of medical
interventions and a deepening of our understanding of those
amongst us who are ill and suffering. There were special
performances by an opera singer, a harpist from Israel playing in
the emergency room, and a special lecture by Annie Freud, an
esteemed poet who is also the great granddaughter of Sigmund
Freud. The Society for Arts in Healthcare provided us with an arts
in health expert, Judy Rollins, RN to help us develop mission and
vision statements. We partnered with the non-profit Creative
Heartwork, Inc. to bring arts at the bedside for inpatient children
and adults at University Hospital. We were even provided space at
the hospital for their offices. We received funding from the Institute
for Poetic Medicine for “Life Lines,” which was an expressive arts
poetry group for medical students. “Simply Being Human,
Expressive Arts for Healthcare Students and Providers” was a
research project funded by the Arnold P. Gold Foundation. The
project’s experiences evolved into a book chapter for the 2014 text,
“Creative Arts in Humane Medicine.” Poetry in Medicine Day,
which began even before there was a Creative Arts in Healthcare,
became integrated within it, and expanded further with the debut of
the Cry of the Heart Poetry Contest for healthcare students across
all UMDNJ campuses. These are but some of the many arts in
healing activities that came to life. As the poet Maya
Angelou said, “You can’t use up creativity. The more you use, the
more you have” (Art Quotes, n.d.).
As of July 2013, University Hospital became a separate entity,
and all of UMDNJ merged into Rutgers, the statewide University.
So as not to lose all that had been gained, the Arts in Medical
Humanities Initiative (AIM-HI) was established within the
Department of Psychiatry - Rutgers New Jersey Medical School,
Rutgers Biomedical and Health Sciences. I work within Rutgers
University Behavioral Health Care, where in my daily practice, I
meet inner city African American and Hispanic children and adults,
who can face challenges such as poverty, incarcerated and/or drug

addicted parents, community violence, lack of educational support
to meet their special needs, and histories of abuse. Their resilience
is awe inspiring and their tragedies are heart breaking. By
courageously holding two opposing forces together, a re-creation
and new growth can occur.
7. Poetry and Story and the Child Psychiatrist
Here are examples of how arts medicine in the form of poetry
can be a healing remedy for children and families as well as for
healthcare students and providers.
7.1 A Child Witnesses a Violent Killing
A young child who has already experienced traumatic loss in his
life looks out the window and sees his beloved pet cat attacked and
killed by pit bulls. He wants to rescue his pet but is held back by
his grandmother. He and a sibling are in treatment for Attention
Deficit Hyperactivity Disorder. As soon as they enter my office, I
can sense that something is very wrong. With many tears the family
tells me of the brutal attack. I put down my prescription pad and
decide another kind of writing is needed. I act as their scribe. I
affirm that what happened was horrifying and that their cat did not
deserve to die and to die so brutally, nor did they deserve to have
such a loss. I also suggest that their last memories of their cat does
not have to end with images of violence, but that they can recall the
love of their cat and their cat’s love for them. Out of this
interchange came their poem:
Patches We Love You
Patches we love you
Wearing your black tuxedo jacket With
a white shirt beneath it
Inside your ears it was pink and red

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PLAYFUL
Patches was playful
He was fun
ACTION
Patches was so active
He liked to run around the house
And play with me
TENDER
Patches was caring
He rested his head on me
He liked to fall asleep on me
CLIMBING
Patches loved to climb
On cabinets, trees,tables and people
He liked to climb on chairs, too
HEART
Patches had a lot of heart
He loved to rub A on her leg and
Then go to the door and pull it open with his paw
That’s where the cat food was and
Everyday at three o’clock he would climb On
the windowsill and wait for B
Patches would meow so loud when he saw him
ENERGY
Patches had a lot of energy
He loved to scratch the chairs and B- He
loved to run from room to room With
his tail standing straight up
Jumping from the floor to the tv to B’s
wardrobe and top bunkbed
He would climb on A‘s bed and Jump
off and land on the floor
He would sit there and jump onto
A‘s bike and then the windowsill
And then he’s jump off

SWEET
Patches was a sweet cat
He liked to cuddle with us
He liked when B gave him a bath
He liked when A poured out his cat food
Patches never tried to hurt anyone
Patches was always just playing
Patches favorite was B
That’s because they both like to run and jump
Patches we love you
We will never forget you
They signed the poem “Love” and then wrote all their names and
asked for me to sign my name as well. They drew a picture of
Patches with RIP, Rest in Peace, and added pictures of themselves.
I made copies of the picture for them and put their picture up on
my office wall. The girl sang a song about Patches. I gave them
copies of their poem.
In 2010, The Star-Ledger was writing an article about Poetry in
Medicine Day at the University and how poetry can help us to heal.
The article ended with these words:
Dorothy Thomas, 67, of Newark,was exposed to the poetic
technique last year, when she brought her two grandchildren
to be treated for attention deficit hyperactivity disorder.
Together, the foursome wrote a poem about Patches,a
family cat who was killed.
“I thought it was a good idea, because they could speak
about how they felt about Patches,” Thomas said. “I framed it
and put it in my house. Every now and then, we pick it up and
read it. It helps to remember him” (Mascarenhas,2010,p. 24).
Poetry much more than prescribed capsules for ADHD is what
helped these children and this family on that day and continued to
help them in the days into year that followed. Their poem will offer
healing all of their lives (Kaufman, Chalmers, and Rosenberg,
2014).

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7.2 A Boy is Depressed and Paralyzed
A teenager was hit by a car and paralyzed when he was a very
young boy. He is quadriplegic and has a tracheotomy. He is
depressed and has a history of psychosis. His name is Cody and he
was my patient. “Strangers come together for an artist in need” was
the title of The Star-Ledger article (2010) written about him:
Speaking isn’t easy for Cody Smith. His words surf the
labored waves of his breathing, audible when he exhales,
receding to near silence when he breathes in. That’s why the
young man, a quadriplegic since he was struck by a car fifteen
years ago, has turned to art to find expression.
“I write a journal,” he says. “Sometimes I write poems.
Sometimes, I paint.”
Cody’s computer had crashed and he was no longer able to write
in his journal. His depression was worsening despite medication. I
believed that his passionate need for artistic expression was vital
for his recovery. Through an amazing series of synchronicities, I
was able to have Cody apply for funding from the Paul Jackson
Fund (in honor and memory of a man who had become paralyzed
himself) for a new computer and to participate at the Wellness Arts
Enrichment Center, an arts program serving those with disabilities.
As Cody shared in the Star-Ledger article, “I’m happy when I can
paint and write.”
7.3 Grieving Mother and Child
A young girl accompanied by her mother is scheduled for a
psychiatric intake appointment. When asked what had happened
that led to their coming to the clinic for help, they both immediately
relive and tell the terrifying death by fire of the child’s grandmother
and step-father, as if it were happening that very moment. Now was
not the time for a standard intake evaluation. Now was the time to
connect with this traumatized mother and child; to validate their

feelings, acknowledge the terror of their experiences and to open a
place within them for healing. I turned to arts medicine for help,
specifically to mythology and the search for meaning. I shared with
them the myth of the phoenix, the beautiful bird who lives from
five hundred to a thousand years, from whose ashes arises the birth
of the new phoenix. Some have said that the story represents Jesus
Christ and the resurrection. The story teller Hans Christian
Anderson (1850) thought the phoenix represented the creativity
and rebirth that comes from poetry. I asked the girl if she would
like to write a poem. She replied that she would like to do that. Her
mother joined in the poem-making as I wrote their words on the
computer. Here is their poem:
The Phoenix
There is a phoenix in me
I will rise
Whenever I know
When the time is right
The sky will be bright
That way I will know
Everything will be alright
Because that's God in my sight
And He is letting you know
That with His Light
The time is right
Look at the light
Coming through the window
That way you will know
He is there for sure
Real events in the space of the office (now become a sacred place
for art, myth and poetry) entered into the poem when rays of
sunlight streamed into the room lighting upon their faces. I
suggested their exclaimed words “Look at the light coming through

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the window!” be added to their poem. I gave them copies of their
poem which they wanted to share with their family. We scheduled
another appointment for the following week and I continued with
the traditional psychiatric “intake” procedure. But on that day when
I first met them, we all agreed that something extraordinary was
“taken in” and “given out.” Time passed and recently I met them
again, following the girl’s many months of treatment in a higher
level of care program. She was doing very well. We shared our
memories on the first time we had met. She was moved to
spontaneously recite by heart, the Phoenix poem that she had
written. I opened the Integrating Expressive Arts and Play Therapy
with Children and Adolescents 2014 text to the chapter on “Poetry
Therapy.” There was their story and poem, as they had given their
consent for others to know what had happened on that day. I
promised that the next time we would meet, I would give to them a
copy of the book to keep and cherish.
7.4 Responding to a Woman’s Pain
The adoptive mother of two children with Attention Deficit
Hyperactivity Disorder comes alone to a session as her children are
participating in school testing. When I ask about the health of the
adoptive mother’s own mother, as I know she has been ill, the
adoptive mother expresses great sorrow and pain. It was as if the
mask that covers all our faces had been ripped off and the pulsing
ache of our hearts was revealed. Her words were so poignant,
rhythmic and important, that I wrote them down as I also deeply
listened to her. She knew that I was a poet. I asked her permission
to write a poem or a song from what she had shared and she said
“yes.” I asked if I could share her story and she said “yes, if it can
be of help to someone else.” The poem that ended up written,
inspired by her telling of her experience, was so beautiful that I had
it done in calligraphy and artwork. I gave her a copy of the poem.
She and her family later came to the annual Art Exhibit at Rutgers
New Jersey Medical School to see the poem which was on display.
The poem speaks from the heart to all hearts:

All There Is
Sometimes I don't know what to do
When mother says to me Bring
me flowers now
Not on the other day
I want to smell them now
When we were coming up
Mother would always say to me Bring
me flowers now
Don't wait for when I'm dying
To throw them on my casket
Back home from the hospital
Told nothing more can be done
My breath stops
Mother implores
I do not want to live this way
I do not know how to answer her
When she begs me for release
Living in denial of what is to be
With Grace and tears bittersweet
I just hold her hand and pray
Make time to smell the flowers
Before all time passes away
As a child I never understood
What mother was telling me
But now I do
The heart's bouquet is all there is
That and the smelling of flowers

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7.5 Mourning the Death of an Infant
A teenager in treatment for depression becomes pregnant. The
birth of the baby is a rebirth for the entire family. The baby dies a
few months later. I had received a telephone message that
something had happened. I knew it had to be terrible from the
sound of the voice. But I had no idea how terrible it would be and
how many would be mourning for all that had been lost. To help
with my own healing, I wrote a poem but never shared it with the
family as that would have been inappropriate. I shared it with my
treatment team at the clinic. We cried. At the funeral a poem was
read aloud by the grandmother. The poem was written by the
mother of that little baby. Here is the poem I wrote:
To You
Where did your soul go Oh
little baby boy
Back to the heaven’s
Night stars that always glow?
And when you left this earth Did
you know?
Or was it just a sweet dream Into
forever long ago?
And when your mother held you And
screamed in agony
Did her pain reach inside you
Or did God’s angels spirit you away?
Alone I hear these echoes
Bleed words upon this page
I say what will be spoken
All hearts break for you
How great the cost of love
Where did your soul go?

Where did your life go?
Oh little baby boy
7.6 Wishing for Mommy
A grandmother brings a young girl to the crisis unit. The child’s
mother has been murdered. When I ask about her wishes she tells
me she would like to “fly on the back of a bird” to see her mother
again. I am so moved by what she said, that I write a story called
“Missing Mommy.” In the story her dream comes true. When she
awakens, still full of happiness and excitement, she turns to her
wise grandmother, to ask her if what happened had been real. I gave
the story to the grandmother saying, perhaps one day many years
from now, if she thought it might be healing, to share it with her
grandchild. That was decades ago. A few months ago I decided to
have the story illustrated and become a children’s book. Just
recently, I met a young girl who was sad because her mother had
abandoned her. I showed this child some illustrations from the story
book. I asked her which one was her favorite. It was the one where
the little girl was flying on the back of the bird to see her mother
again. She said that was what she wanted to do, too. I told her about
the grandmother in the story, and how they had hugged and cried
at the end, and how safe that little girl felt with the grandmother’s
arms around her. Even though the little girl missed her mommy,
she also had love in her life now. The young girl sitting in my office
told me she felt a little better and began to smile.
Missing Mommy
Once upon a time there was a little girl. Her name was
Layla. Layla’s mommy had died. Layla missed her mommy
so much. When people asked her, “Where is your mommy?”
Layla would answer,“My mommy is in heaven and heaven is
in the sky. How I wish I could fly to heaven. How I wish I
could grow wings just like a bird. How I wish I could fly on
the back of a bird to see my mommy again.”
Each night Grandma gave Layla a sweet bedtime kiss
goodnight. And on one special night, Layla had a magic

and Healing
dream. Layla had beautiful wings that shimmered and
sparkled in the light of the moon. And with these wings Layla
could fly! She flew all the way to the top of the sky, past the
moon, and beyond the stars, and into the brightest light she
had everseen.All atonce,Layla knewthat the bright light was
her mother’s love lighting up the way. Layla and her mother
hugged each other. Her mother’s wings covered them both.
Layla could feel the beat of her heart. She could feel the
warmth of her love. Layla felt so happy.
The next morning when Layla awoke, she remembered how
she had flown to heaven to see her mother.
“Grandma, grandma! Let me tell you my dream!” “Yes,
please tell me.” said Grandma.
Grandma was a good listener and she listened to every
word Layla said.
Layla asked her Grandma, “Is it true? Did I really see my
mommy? Did I really grow wings and fly just like a bird?”
Grandma was a wise old lady and this is what she said:
“The world is a mysterious place my sweet Layla
This I know to be true
Love is the light that shows the way
Love is the light that brings each new day
Love is the reason angels have wings
Love is the song every bird sings”
Grandma and Layla hugged each other. They began to cry.
There were tears of love and tears of sadness. Tears of grief
and tears of gladness. And in that moment, Layla felt safe and
she felt loved. Layla began to smile a beautiful smile, and her
tears glistened like jewels upon her face.
8. The Powerof the Healing Arts
How does writing and reading poems and stories help us to heal?
Returning to Greek mythology, we find that Pegasus, the flying
horse, is the symbol of poetry. Pegasus’ father is Poseidon, God of
the Sea. His mother is Medusa, who brought upon herself the wrath

of the Goddess Athena by declaring she was more beautiful than
the Goddess. Medusa’s hair became writhing snakes and all who
looked upon her turned to stone. Perseus decapitated Medusa with
the help of Athena by wisely looking into his shield to see her
hideous reflection. From Medusa’s blood arose a full grown
Pegasus and a twin, the warrior Chrysaor, wielding a sword. Not
only could Pegasus fly, but the strike of his hoof caused
underground well-springs to flow. So esteemed was Pegasus, that
it was Pegasus to whom Zeus entrusted to carry his fearsome
thunderbolts (Hamilton, 1969; Mason, 1999).
Peter Levine, PhD (1977) sees the inherent powers of Pegasus as
instrumental to healing from trauma: “the winged horse and the
golden sword are auspicious symbols for the resources traumatized
people discover in the process of vanquishing their own Medusas”
(p.66). John Fox, CPT, founder and director of the Institute for
Poetic Medicine and author, reminds us that there is a “healing poet
within” that can be accessed (personal communication November
21, 2012) and internationally acclaimed storyteller Laura Simms
explains that stories can spark our “interest in each other,” and
becomes a “listening event” when we are “engaged and present”
which taps us into our “inherent sources of healing and
transformation” (personal communication November 13, 2012).
Pulitzer Prize Winning Poet Tracy K. Smith states, “Writing
poetry gives children permission to name the world as they see it
without having to rename it for adults” (personal communication,
October 17, 2012). I would add that permission is granted for
adults, as well. Through poetry and story, we can explore, develop
and express with new found courage, our own true voice.
The poem safely contains the emotion, gives it shape, form,
rhythm, meaning, and multiple dimensions for understanding. It
does this through the senses, imagery, and word play. We can
reflect upon our thoughts, feelings and actions. We can travel
through time and rewrite the past, enrich the present, and imagine
a new future. We can takes on other voices besides our own.
Imagination is our magic carpet ride. Metaphor allows us to
experience, understand, and communicate in new ways. In making
the poem, the self is expanded and re-created. Through this poetic

and Healing
relationship, emotions can become experiences to embrace, feel,
know, take in, let go of, integrate, and ultimately to share with
ourselves and others in more life affirming ways. Through this
poetic journey in which we enter our own self and into the self of
others, we come to recognize that as human beings we are not alone
despite the separation of our physical bodies.
8.1 Massacre inNewtown, Connecticut
Art can respond to tragedy where the heart cries out and knows,
“there but for the grace of God go I.” Such was my experience of
the tragic events of December 14, 2012 when twenty children and
six adults were murdered at an elementary school. As I wrote in the
Poetic Medicine Journal that included the poem, “In Memory of
the Future” and a link to YouTube:
The Newtown killings were horrifying. Hour upon hour for
that entire weekend, the sounds, faces,words, and images of
that terror,that overwhelming grief, entered me.And I entered
it. I had to write a poem. No. I wasgalvanized to write a poem.
I could not be mute, turned into stone, in the face of this
Medusa. Like Pegasus born out of her blood, I had to awaken
and know I had wings. With poem in hand, I went to Newark
Arts High School. I felt so strongly that this inspired poem
contained an energy that could inspire others to express and
create. I want “In Memory of the Future” to travel the world
so that everyone who hears it will make the poem their own,
by choosing to end violence in whatever ways they can
(Kaufman, 2014).
The poem performance by the Newark Arts High School
students in music, dance, art and recitation, is powerful. Many of
these students have witnessed and/or experienced violence within
their own lives and communities. Their passionate voices are can
be heard far beyond the borders of Newark as they reach out to the
families of the victims, across the United States, and into the larger
world.

In Memory ofthe Future
We all participate in the pain of the world
Some make it
Some endure it
Some turn their eyes away
Some plead for the pain to stop
Some are witnesses
Some are perpetrator Some
are victims
Some are innocents Some
are hateful
Some carry anger Some
carry rage
Some carry tears.
And weep for us all
Some carry guns and pull the trigger
Some carry burdens so great Breaking
hearts and spirits Splitting us from
God and each other
20 elementary school children murdered 6
adults trying to protect them
Slaughtered on the altar of violence
They learned awful things in school that day
And we the living
Do we dare to look upon
Unfathomable Unimaginable
Terror and pain
In the face of a 20 year old
But as that was not nearly enough
26 more dread deeds had to follow
Then turned the gun upon himself Mourners
must mourn
Cry out their pain and seek solace
Wherever they may find it
That is their task
When all bodies have been buried Some
will think to feel to ask
What will the days after bring

and Healing
Will we honor or forget the dead Who
once laughed and played
And loved and lived like us Take
meaningful action
Or hopelessly bow our heads
We all participate in the pain in the world
Shattered hearts despair more bloodshed
9. PhysicianHeal Thyself
Healthcare students and providers need healing, too. Here is a
2014 prize winning poem by Paul Rocco Allegra, a first year
medical student at Rutgers Robert Wood Johnson Medical School,
who entered The Cry of the Heart Poetry Contest:
Maybe
Metal gurney against preserved flesh,
maybe this isn’t the first time we’ve
met.
Maybe we accidently locked eyes in a restaurant,
quickly looking to our plates in order to avoid
each other.
Or maybe I’ve walked by you
at a busy city intersection.
Two lives that came so close
but didn’t arrive until now.
Perhaps you’ve seen me speeding
down the parkway,
my yellow and red surfboards rattling amongst a nest
of fishing rods and an old white cooler in my silver
pickup.
While I headed south towards exit 98,
maybe you were heading north to tell
your family the bad news.

While I blasted the radio and rolled down the windows,
slamming my hand against the dashboard to the beat of
guitars, you drove in silence, rolling rosary beads
against your sweaty fingers.
While I thought of waves,
you thought of how to spend your final months, or
how you would break the news to your only son,
your caregiver.
Or maybe you were the woman in the tollbooth, the
person with whom I wanted to stop and talk, but
traffic laws necessitated our brief exchanges.
Maybe you didn’t know you were sick.
Maybe you did.
Maybe you were a nurse, or maybe even a doctor,
and you fell victim to the same illness you
treated. I may have been your apprentice, maybe
even your partner.
I scan your body,
shrouded beneath a green towel like a mummy
or someone hiding from monsters in the dark.
I lift the towel.
You are lying face down. I think that
you may be uncomfortable, I know I
would be.
Maybe you died from cancer.
Maybe, you were not as lucky as my mother.
Maybe you never achieved remission.
Maybe.
You may have been the woman sitting
underneath the rainbow umbrella, checking
badges for the Manasquan Borough so that I
wouldn’t use the beach without paying.

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Maybe we talked about how absurd it is
that one has to pay to enjoy a beach,
such a public place, and maybe you let
me sneak in.
But then again, probably not.
You may have given me a speeding ticket, or
I may have sat next to you on a bus.
Maybe it was a train…
Or maybe you lay next to me one summer day,
enjoying the vibrant sun against your warm
skin while I built castles and unknowingly
threw sand on you.
This is most likely our first encounter.
But when the time comes to flip you on your back,
I hesitate to look at your face,
because maybe, just maybe,
you’ve looked at mine.
10. The Place ofArts Medicine
“Studies show that incorporating the arts can save money,
improve the patient experience – and do a lot more” was the
headline of “Why We Need The Arts in Medicine” (2011) by Gary
Christenson, MD, Director of the Mental Health Clinic at the
University of Minnesota’s Boynton Health Service and then
President of the Society for the Arts in Healthcare. His closing
statement was, “Given the growing evidence of how the arts can
improve clinical skills, promote healing and prevent disease,
increase patient satisfaction, and help us find balance in our own
lives, physician should be advocates for the arts in general, and
more specifically, in medical education and practice.”
So where is the place for Arts Medicine in diagnosis and
healing? Let us imagine that the place is every place. That it
represents that inner healing fountain of well-being released by
Pegasus. It is Greek God Apollo’s union of medicine, poetry, and

song. It is Artemis midwifing us through to a new birth. It is the
respect we give to our patients and to ourselves. The true meaning
of “respect” – “to look back” as in “to see again” beyond the eyes
of our prejudice (Dictionary.com, 2014). It is recognizing and
welcoming the person within the patient, what it means to truly
have person-centered care. It is minding and mending the body,
mind, and spirit. And knowing that patients are much more than
sickness, and that health is much more than the absence of disease.
Arts Medicine is the architectural design of the hospital and
clinic, art in the hallways and rooms, the music or lack of music
that we hear, the way we resonate with our patients to hear and see
what might not be spoken aloud but what we sense is there. It is
how we reach out from ourselves to encounter another human
being not just because we are supposed to, or because it is our job,
but because we care and want to know that person for who they
are, and we will be responsive to what they need. Arts Medicine is
thinking to refer a patient to a music therapist, a dance/movement
therapist, an art therapist, a drama therapist and/or a poetry
therapist. It is asking patients and colleagues about their own
creative interests such as the role that drawing, reading, writing,
singing, listening to music, and dancing plays in their lives. It is
about humanizing our experiences with each other. It is in forming
community through art by writing a poem together, having a talent
show, and participating in a Literature and Medicine class. Arts
Medicine is reclaiming the creative expression that we pushed to
the side because we are always too busy, and we are still waiting
for the right time to start again: the flute or guitar we put down, the
song we stopped writing or singing, the paint brush that we haven’t
picked up, the fiction book we keep saying we will read but never
do, and the garden we never planted. All these “creativities” renew
us and help us stay whole, to keep in balance our right brain and
left brain, to bring all that we are into our life as human beings, and
into our professional roles as health caring providers.

and Healing
11. Change & Transformation
Many years ago, I read John Fox’s excellent book, Poetic
Medicine (1997). In it there is a writing exercise for making a
magic potion. At that time I was facilitating a Poetry and Medicine
elective at New Jersey Medical School and used this as a writing
prompt. Here is the poem I wrote on that long ago day:
Poetic Medicine
There is always a big black pot
Simmering
Bubbling
Boiling over with troubles
Scalded air rising hot
Burning eyes and skin A
big wooden
Hands spellbound
Can’t release the grip Stirring
wildly
Stirring non-stopping
And it’s always darkest night
The brew gets thicker and thicker
As more trouble keep piling in
You ask yourself, “Oh! When will it ever end?”
A whisper replies, “Pour out the pot and start all
over again!”
Years later in conversation with Simon Keller, a trained in Japan
ceramicist, who was providing an expressive arts workshop to our
medical students, I realized that the “pot” itself could be poured out
and reshaped and not just its contents. There was a “higher
knowing” already in the poem, as if the poem were preparing a
message for me to be absorbed once I was ready to receive it.
And this is the writing prompt I wrote later as companion to
“Poetic Medicine” for Cracking Up and Back Again:
Transformation Through Poetry (2007):

The pot which is our own vesselof being will surely break as
in breakdown or crackpot unless we do something about it and
ourselves. The poetry you are about to read is one person’s
perilous journey to become and be real. It is by surrendering
ourselves to the processof learning through life that life asour
teacher,reveals to us the essence of what it means to be alive.
When one person breaks silence, the truth in all of us gains
strength. There comesa time when the only answerthatmakes
sense is to “pour out the pot and start all over again.” When
we empty ourselves of our false nature, we are ready to be
filled by a powergreaterthan ourselves, which is Nature itself.
Are you ready to take your “poetic medicine?” How sick to
you have to make yourself in order to get well?
Perhaps we should also ask this question of today’s healthcare
providers and institutions. Is there no time for the human touch in
our faster and faster paced electronic world? Is there no time to
reflect, to listen to the patient’s story, to get to know them as a
person, and not just make them into a disease diagnosis? Are we
forced to judge ourselves and be judged by the institution solely
on our productivity numbers and not also our soulful healing
connections?
Each of us can make an important difference in helping to heal
our patients, ourselves, our families and community, and even the
healthcare settings in which we provide clinical expertise and care.
The word “place” (Dictionary.com, 2014) as a noun has twenty-
nine listings. And one of these is “place” in terms of indicating
“relative position in a scale or series.” Using this particular
definition, what is “The Place of Arts Medicine in Diagnosis and
Healing?” I would say a very important one, integral to how we
practice medicine, how we understand our patients and understand
ourselves, to how we are sensitive to the concerns of our patient
and the “what’s wrong” that might not be verbalized, and our being
open to the healing remedies that the arts can provide. Arts
Medicine calls forth our creative spirit that is within the body and
also beyond the body.
In the mythopoetic understanding and language of Lebanese
artist, poet and author, Khalil Gibran, “Would that I be a dry well,
and that people tossed stones into me, for that would be easier than

and Healing
to be a spring of flowing water that the thirsty pass by, and from
which they avoid drinking.” Yes, we should avail ourselves of this
healing elixir, this Arts Medicine, and drink from it freely so that
we may hasten our healing.
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Date of the first draft received July 18, 2014
Date of review completed July 28, 2014
Date of approval decided July 31, 2014

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