Rose Flint
Poet for Health

Poet, artist, writer and broadcaster Rose Flint teaches Creative Writing throughout England and Wales. She is currently based in Bath where she has completed training as an Art Therapist. Her first full collection of poetry is Blue Horse of Morning (Seren Books).

Interim Report

First day sitting in on the surgery; I wondered, if by lunchtime I'd be convinced that that all the symptoms I'd heard about would add up to my own hypochondria. Would I be convinced that I too suffered from Housemaid's Knee? On reflection - not that one, its too unlikely. But Pinched Nerves, well, that's possible.. .a lot of us have Pinched Nerves.

Working as the 'Poet for Health' at Dean Lane Family Practice in Bristol, I'm learning a lot about illness and well-being, and about the body and its extraordinary, wonderful complexity in both sickness and in health. I am also learning something about the interconnected path of Body, Mind and Spirit through any illness, whichever area of the Self it manifests in.

There is a very holistic feel to this Doctor's Surgery. Dean Lane is a small crowded urban street in a bustling, shopping/residential area near the centre of Bristol. The Family Practice is housed in a pretty Victorian villa surrounded by trees and flowers. The waiting room opens into a walled garden, where old apple trees give up their fruit to a host of bees and birds sing out warnings as a lazy cat stretches out in the sun. Like any other surgery it's busy all day, with at least three receptionists coping with calls and appointments and several doctors on call.

The waiting room now has poems and information on the Residency displayed all round the walls and I have a Diary on the Reception desk; slowly people are coming to see me for individual appointments. Dr Gillian Rice, (who instigated the Poetry Place) and her colleagues are referring some patients, others are expressing interest after reading about me. I am also working in one of the local hostels for mental health service users. Other groups are planned for later in the residency.

The practice population of 9000 flows through the surgery in a huge tide, and I sometimes feel like a grain of sand in comparison. I won't be able to work with a great many people, a handful only - and already there are those I've met whose stories stay with me, make me wonder how they'll go on: the happily unexpectedly pregnant woman who miscarried, for instance. Miscarriage is so common in the first three months that patients are gently told to 'wait and see'. What happens then to the first flush of joy - or fear? This particular instance perhaps really illustrates the brief to 'explore the language barriers' between health professionals and patients. Sense and pragmatism are necessary, but maybe alongside the advice, a sheaf of poems relevant to this very particular time might help the patient to feel less isolated.

And Doctors only have five minutes a symptom. And the symptom first brought by the patient may not be the real symptom, the one they want help for. A patient may come in with a bad knee but it may be isolation or anxiety or grief that requires mending.

But those poems in the waiting room - and we are expanding to handouts too - make better reading than the May 1997 Cosmopolitan, or Golfing Weekly. At the moment there's Sophie Hannah for instance, with Symptoms which begins: 'Although you have given me a stomach upset,/ weak knees, a lurching heart, a fuzzy brain,/ a high-pitched laugh, a monumental phone bill,/ a feeling of unworthiness, sharp pain -'

She is of course, talking about love, and I've seen this poem raise a smile of recognition in both patients and professionals.

- Rose Flint

Final Report

This is an excerpt from a larger document by Rose Flint about her experiences and impressions of the Poet for Health Residency.

I still find it difficult to name my role. What both Dr Rice and I agreed on was the brief: 'using poetry as a way of helping people to engage with their emotions.' thus placing the emphasis very squarely on the process of the writing, not the product.

Before I started work I designed a poster which went up in the surgery, proclaiming in very big letters that a 'Poet for Health' was coming and would give individual sessions. A leaflet gave more information. All the doctors had been asked to refer patients to me but patients could also self-refer by just asking the reception staff to book an appointment in my diary which was held at the desk.

Dr Rice and I also selected a dozen poems which were laminated and put on display in both waiting rooms. In amongst the magazines I placed a pile of photo-copies of another twenty or so poems with an invitation to -'please take a poem'. This part of the project was on on-going throughout the six months and I think was very successful. All the photocopies disappeared eventually and were regularly replaced. I never actually saw anyone reading but from time to time little snippets of feedback returned to me: that so and so had liked a poem / that so and so was a poet and would bring some of his own in / was there a spare copy of.../ did I know a poem about.../ Although very time-consuming for me, selecting poems to share with lots of other people is always a great pleasure; here, I tried to find ones that held the idea of hope and change, including Native American healing songs. The poems themselves, their presence and mass felt like an ally for me. As if they brought the outside power of the cat under the sunlit apple tree into these rooms made grey with winter illness, with depression and stress. Having the poems there changed things.

The first few days of the Residency were spent mostly sitting in on Dr Rice's surgery, and generally getting to know the place and its people. I slowly met the doctors and found that they were all very supportive as were all the other clinical and clerical staff. I quickly realised that the internal life of a busy surgery is lived at running speed. The Appointment Book is the beating heart, the clock that everyone chimes with, the ruling metronome of the day. And most days, everyone seems to be scrabbling to catch up with its demands: they are running late, behind time, as if in a race.

In the first few months only a few patients responded to the idea of working with a poet, then gradually more came, until I was seeing people for individual sessions approximately once a fortnight. All of these were women, ranging in age from late teens to late sixties. If there was one unifying theme it was depression. In very varied ways, all of the ten I worked closely with were depressed but some were involved with their doctor because of physical problems, including arthritis, weight problems or long term illness. Although the doctors told me a little about their patients who came to see me, I did not utilize their medical notes and only in one instance referred to them. This meant that I 'met' the patient on non-medical grounds and worked with what they chose to bring to me, without preconceptions of my own around their needs.

All the clients expressed the need to 'talk' as a priority. All of them held high opinions of their doctors and one of the most frequently made statements was: 'I didn't want to bother him/her.' Deeply sensitive at this point in their lives, these women were acutely aware of themselves as bringing 'burdens' to lay on an already overstretched and overloaded doctors. They would say: 'I didn't want to depress her with all my worries' or 'there wasn't time to really explain'. Their own self esteem was very low and they often found it difficult to ask for what they needed, which in many cases was 'talk' and the reassurance, the witnessing and reappraisal of their inner world which could result from it. Often they admitted that physical concerns seemed to be the only appropriate thing to take to the doctor, even when they knew that what they wanted was to howl and cry or be angry, or to argue out a problem. Most of these women were on antidepressants but were not classed as having 'acute depression'. Some were very regular visitors to the surgery, others much less so.

I worked differently with each individual, trying to find a way that best served their own needs. Some were more practised at writing than others, some had once enjoyed poetry, others had neither written nor read any. In a typical Art Therapy session, the materials would be there for the clients to use, in silence if they wished. Working with words I found that the 'material' would be in effect the words spoken between us, everything that the client brought to the session, and my response.

Some clients had a willingness to work 'in the moment' utilizing the time to begin poems, as they arose out of our dialogue. Sometimes I would ask them to pause and start to discover more about the situation/feeling which they were describing; directively using writing exercise models to open the way into the material. For other clients, writing in front of me was too inhibiting. Initially, I scribed for them, making notes of their words and then setting them down together. But I found this method of working disturbed me. Whilst I wrote nothing that I not been given by the client, my own selection and patterning of material tended to gloss-out the natural voice of the patient. The sophistication of these poems seemed to reflect a desire for 'product' - was I more concerned with 'getting' a poem, than helping the client to go through the process of making one? I dropped this way of working, and dropped too my expectation of necessarily getting any poetry at all, from anybody.

As I became more used to working with individuals and poetry I began to trust to the poetry happening elsewhere. I had spoken to everybody about writers' notebooks and as time went on all the clients acquired their own notebooks and began to use them, bringing in both bits and pieces or whole poems which we then worked on together in the session- either editorially or therapeutically. Some clients wrote very little, one never brought me her written work but did show some drawings; others wrote a very great deal and I encouraged them to use computers and to build up folders of printed work.

In the last few weeks of the residency I asked some of the people I had been working with if they would like to form a writing group for the last few weeks. This proved successful and had an afterlife when the residency finished.

I had had to lose the idea that there would be a huge production of poetry from everyone or even that there would be any poetry at all. This in itself raised many questions for me, about what poetry actually is. Sylvia Plath once said that poetry was her 'deepest health', Yeats called poetry 'the voice of the soul'. I don t think poetry is only an arrangement of words on paper, nor is it simply the process of making the product but it might be. It has within it a desire for life, a desire to take a route which leads both into the deepest self where soul resides and out again, as the written words, or the experience, engage with the exterior world. There is an essential paradox here - to go within is to be more in the world.

I have been asked if the residency was a success. 'Success' is a difficult word to evaluate. Some of the long term patients are still seeing their doctor just as frequently, yet they seem 'different' in their mood, perhaps a little happier. Others are no longer on medication. Certainly the patient's evaluation sheets and letters reflected enthusiasm.

It would seem to me that these sessions could benefit so many people. To write your feelings down on paper and then read it later can give you so much information about yourself.... If these sessions could run in Doctor's surgeries and hospitals they could be an extension of treatment.

- Rose Flint