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As compelling as it may be to survey historical examples of the marriage between poetry and healing, still there is little scientific data to support its validity. The situation is similar to that surrounding the placebo effect: If we can't understand how it works, then it must not be real. And in the case of St. John's wort or echinacea: If the medical or pharmaceutical industry can't profit from it, then it must be quackery -- never mind new discoveries of chemicals in herbal remedies that may be the basis for their claimed benefits. While it would certainly be wrong to say that poetry can cure cancer or AIDS or depression, it is fair to consider how reading and writing poetry could help those who are "intoxicated" by illness, to borrow from the title of literary critic Anatole Broyard's indelible memoir of his battle with prostate cancer.

Having been well trained by Harvard Medical School, I come prepared with a list of possible "mechanisms of action." It would be difficult to prove any of these, but some are accepted in psychiatric and behavioral medicine circles.

First, there is the therapeutic effect of assigning a name to a patient's symptoms; imagine amplifying that effect by allowing the patient to discover and to name the affliction. Creating metaphors in poetry is similar to the healing process in that it involves an imaginative translocation from one state to another. The poem, in its rhythms and rhymes, metaphorically restores the sufferer's control over deranged bodily functions.

At the same time, poetry places the patient in direct communication with others who have suffered with a disease, across centuries and cultures. Writing poetry dramatically establishes the patient's authority, which so often is taken by the medical establishment. Poetry also empowers by allowing the patient to identify with the illness. Perhaps most important, the poem provides a non-judgmental way to explore and accept death as one possible ending to the patient's life story, an outcome doctors are notoriously inept at helping patients to understand.

Poetry teaches not only about the illness itself but about the human experience of it. When I talk to Elizabeth, who is actively engaged in the process of re-imagining her own illness through creative self-expression, I wonder whether some of these principles might resonate with her. I wonder how she felt when she finally did read "Cancer Winter," an unforgettable sequence of sonnets in Hacker's collection. A sonnet is a love poem in which the speaker immortalizes the beloved against the ravages of time. I wonder whether it is possible to love one's disease, what it would feel like to forgive the terminal diagnosis the way Hacker does when, at the end of one sonnet, she declares:

The setting sun looks terribly like blood.
The hovering swarm has nothing to forgive.
Your voice petitions the indifferent night:
"I don't know how to die yet. Let me live."

I have always drawn a sharp breath of recognition at this confrontation with one's own mortality, and the power of the human spirit to overcome. I don't know whether this is the definition, really, of love -- but whatever it means, I feel certain that Elizabeth, her blue eyes stubbornly ablaze with life, has understood it.
salon.com | Dec. 8, 1999

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