People often use the word “sympathy” when perhaps “empathy” would be more accurate. To sympathize is to share, to actually enter into the feelings of someone else; to empathize is to be sensitive to, to understand the feelings of someone else without actually experiencing the feelings of the other person.

What I admire about Sophie Cabot Black’s “Biopsy” is her honest distinction between the two feelings in the first half of the poem; what I question is her blurring of the two in the second half of the poem.

In the first half of the poem, the narrator sensitively empathizes with the other person’s fear of lying down on a hospital bed. The line breaks in the first four lines are particularly strong as they suggest that the man equates lying down with possible death – “There is no getting back up,” “you put the body down.”

To allay the man’s (or boy’s) fears, the narrator lies down on the hospital bed first. What follows is my favorite part of the poem – “which is to say nothing / Except I am not him.” I appreciate the humility of this. She knows she is not being heroic since he is the one who will have to undergo the biopsy and suffer the most direct consequences if the biopsy brings bad news. She empathizes with his fear while acknowledging she can never truly sympathize.

Her action, however, does allow her to become as emotionally close to him as possible. She remains in his bed as the procedure begins, assuming – correctly or not – that both of them are doing the same thing – looking at the ceiling, imagining it is the sky, searching “for any possible constellation, something / Familiar to name.” First of all, what a powerful line break after “something” – they are searching for something….

But these last lines trouble me because Black has slipped from empathy to the sympathy. As I noted in the preceding paragraph, she assumes that both of them are doing and thinking the same thing. Wishful, sentimental, or bravado thinking? An example of true love allowing for perfect understanding of another person?

Under different circumstances, I might not notice her switch. But since she did, in fact, note that “I am not him,” I find the ending a bit out of synch with what went before.

Here is an earlier poem by Black. I must admit that, despite its imagination, I was offended by Black’s attempt to imagine what it must have been like inside one of the planes heading toward NY’s Twin Towers, to sympathize rather than empathize with a mother and her child –

THE LAST MINUTE by Sophie Cabot Black

As you hold the child tight, huddled
She asks for one more wish. Someone pushes

You to the back yelling you will soon
Be home. Is this moving away or toward;

Even air cannot find where to go,
While you make a way through one last story,

A fumble of buttons, her eyes held to yours
With everything she knows, her voice in

Your voice to drown out the engine
Burning as it was never meant to,

Such acceleration and so much light,
For many are the angels

On their knees, hoping to be first
As the City rises up to greet you

With some on their way to work, some stepping out
To take in the perfect day.

Hi, MA, You honed in on a division in the poem and in the narrator's feelings, a sympathy/empathy division. Somehow I never noticed that, probably because the poem goes through several natural shifts or segues that may have somehow camouflaged (for me) this one shift you talk about it. But I felt the changes reflect how an ordinary mind might work in the face of a hospital room and an impending procedure. In some ways, the narrator is all over the place -- thinking about the patient, where the ceiling tiles came from, how hospital sounds can mimic outdoor sounds, the way the techs and nurses are all dressed the same. You know, that's what it's like for me if I'm with someone in the hospital -- total sensory overload. I actually think that looking for constellations in ceiling tiles (or counting floor tiles or drips into an IV tube) is a mechanism the brain uses to calm or distract itself.

And I'm glad you posted "The Last Minute." I always find it helpful to have another poem by the same poet for comparison. I didn't feel offended as you did. I find it a very powerful and poignant poem, but will admit I may be overlooking something you see and I did not (see preceding paragraph). You know my favorite line in the second poem? "For many are the angels on their knees ..."

I think she might have two meanings here...not just the fear of death...but the wish to deny.

Patients, clients and friends...scores of them have told me they'd rather not know that they're dying/afflicted of/with cancer, HIV...or any other such terminal disease - that they'd rather go on, till they don't.

My favorite part:

...and a noise
Turning into trees whispering overhead.

Again, I see two references: the hum of machines in the room; and the patient joining everything else in the universe.

I guess I could say the same of the exact clothing....the scrubs could also be the black suits and dresses mourners will be wearing at the funeral.

I think that if the narrator is the parent or spouse of the patient...empathy would naturally turn to sympathy. When my husband or my children were in pain, I was also.

It's one of the reasons family members should not seek professional help from their own (be it a lawyer, nurse, or doctor)...It's just too damned hard to keep that distance when it's a loved one. (And yet...it's appalling the number of techs and professionals who will try to avoid any kind of humanizing contact with their patients.

I like the whole poem. I like the last lines as much as I do the first. Procedure rooms are by design...sterile (as is humanly possible). There isn't much that is recognizable, natural...let alone name-able, to the regular Joe.

I guess I could say the same of the exact clothing....the scrubs could also be the black suits and dresses mourners will be wearing at the funeral.

Hi cat,

Or maybe the narrator saw only MDs, interns, and RNs, i.e. those who dress in white, and she didn't distinguish between different outfits, just saw a blur of white in her distress.

MA

Hi MA,

While we I read much of the poem similarly (esp. your 5th ¶, "Her action...") - similar to what I said to BF in his (?) thread about his "meaningless" comment, there are some key differences in our readings as well..

Mainly, you and I seem to have markedly different definitions or connotations for the word "sympathy." For me, 'sympathy' has come to have (despite original definition) an element of something akin to condescension or pity or other kind of emotional 'distance' in it. It doesn't mean conscious or intentional pity or condescension but an element of detachment - perhaps from being too much the word used in Hallmark cards of condolence, the kind of word 'officially' given to sorrow for another's loss - that it seems to me to have taken on an element of formality and thus detachment.

As such, empathy strikes me as the word that is relevant throughout this poem. In the therapy world, "empathy" is the goal of putting oneself in another's "shoes" as much as is humanly possible, genuinely feeling or seeking to feel as closely as possible what it must be feeling like for the other person - and from a position that is more personal and connected (a spirit which from my pov the word 'sympathy' seems to have lost for the most part).

(Not sure I'm articulating my view of this distinction as adequately or on target as I would like.)

The line you identified as your favorite includes the words that actually perplexed me - "which is to say nothing" ... I found this an odd formulation - although, even in my initial reading, I gave it the benefit of the doubt as meaning what I hear you finding it to mean - it just seemed it could have been worded more transparently or something. I liked very much how you said what you got from the line ("She knows she is not being heroic since he is the one who will have to undergo the biopsy and suffer the most direct consequences if the biopsy brings bad news.") but i just didn't find those five words of it to be the best way of conveying that. (For me.)

And, now, as I find myself taking up the "sweeper" position in IT's wake repeatedly today, I will say I share her take on the other poem you posted here and didn't find it offensive either.

z

Hi cat,

I shared and appreciated your take on several aspects of the poem here - your point about 'exact clothing' extending from a place where it is now presumably "all white" to a place where it might be "all black" was an interesting notion I hadn't considered.

You raise a point that has a flip side too, however, and points to a probably ultimately no-one-answer dilemma, one which I have more experience hearing or knowing from the other side: Namely, patients who are NOT told the truth of their illness and, sometimes, doctors deem that loved ones should be told before the patient, in ways that deny the patient the right to self-knowledge and choice in who else should know and in what manner. There are tricky boundaries here. I've tended to be aware abuses (what I would call abuses) on the other side of the coin from the one you raise and sometimes patients being "the last to know" in cases where they should have been the first - in their own view and in mine.

Perhaps a distinction you would intend as well (??) would be that once a patient knows that cancer, say, is at issue, then s/he may well choose to not want to know the blow-by-blow particulars or the latest updatings. What troubles me is when a patient is not told - first and foremost - of a diagnosis that is, after all, their body and their fate.

again, appreciating your comments here,

z

the patient has a right to know it. and to know it before his/her family.

I was speaking of the diagnosing...of patients who refuse diagnostic procedures because they'd rather live without knowing...

Speaking of that...and this is just an aside: PSAs...prostate specific antigens...I don't know the protocol nowadays, but when this antigen was first discovered, any man, every man, over 50 was tested once a year, routinely.

Now. If the PSA is too high to be attributed to benign prostatic hypertrophy...or if the number is moderately high, and his rectal exam is off...even a bit...he'd be in for a biopsy...a painful procedure, btw. Now matter how unlikely the cancer was to kill him.

Most prostate cancers are slow-growing...imagine the man who's 70 or even 80 years old...diagnosed with a disease that will not kill him before he dies from old age or some other ailment.

Once diagnosed with prostate cancer, his family will pressure him to treat the cancer...and until later stages, the treatment is surgical. Prostatectomies can leave a man incontinent and/or impotent. Granted, the normal 80 year old is probably impotent most of the time, anyway....but he's usually still got control of his bladder.

Surgeries are always a risk...but when the patient is an old man...the risk jumps, leaps.

By 2000...there were docs NOT ordering routine PSAs for old men (unless specifically asked for by the patient)...better not to know. better not to treat if something turns up.

****

anyhow...

I'm not suggesting that patients shouldn't be told if they're sick or dying. I'm sorry if my first post gave that indication. I was talking of patients who choose not to know. Who choose not to be tested in the first place...no blood tests, no biopsies...Denial...head in the sand.

Granted. If someone would rather just let nature take its course...more power to them. But if they hope to live, the sooner they know if they're ill, the more options are available, and the more likely they will be able to survive.

was suggesting that she might also be referring to that uniform that mourners wear.

i have no real clue...like i wrote, i just felt that the author might mean it in "two" ways...

ah! you're right: I didn't realize you meant choosing not to even do the diagnosis ... And I share your point of view on that completely, as you stated it in your last two ¶s here ...

I would hope that new treatments will keep developing that offer alternate ways to rule out cancer short of biopsy. I know for example that ultrasound is now used as an interim stage for diagnosis after mammogram in a way that didn't used to be used and instead they went to straight to, as MA notes, painful fine needle biopsy, often only to wind up being a false alarm. The more false alarms people have, the more resistent they become also to even doing the diagnosis if it's so painful...

And, now that baby boomer males are reaching the age where prostate cancers manifest most often, it seems that it's practically an epidemic for men, and the determiners for when to biopsy and the options for treatment with more or less risk of side effects are expanding too - but hopefully will keep expanding more. Depending on the doctor, it seems that keeping updated among doctors is so varying that you still have doctors opting for biopsy unnecessarily alongside other doctors not doing so or even advocating doing so early enough. Alas, there's so much "timing is everything" as regards all cancers. I've lost people ranging in age from my 6-year-old godson to my 93-year-old mother to cancer, and seen a variety of reasons to anguish about the vagaries of medical wisdom as to when to do what diagnostic test and what to make of the findings.

z

Mainly, you and I seem to have markedly different definitions or connotations for the word "sympathy." For me, 'sympathy' has come to have (despite original definition) an element of something akin to condescension or pity or other kind of emotional 'distance' in it.

`When I use a word,' Humpty Dumpty said, in rather a scornful tone, `it means just what I choose it to mean -- neither more nor less.'

Z, you and HD can define "sympathy" however you like. But we mere mortals will have to stick to what the dictionary says.

: - )

MMMA
(mere mortal Mary Ann)

Biopsy's attention to the way in tight places the mind focuses on small things engages mine.

THE Jim Powell of San Francisco ?

d;-)