Poetry Review – LITANY OF A CARDIOLOGIST: Carla Scarano considers a tightly-focussed debut collection by poet and heart specialist Denise Bundred
I know what a heart can do and how many ways it can fail [ “Cyanotic Child”]
Professional expertise and skilful poetic language coalesce in Denise Bundred’s debut collection. She worked as a paediatric cardiologist in Liverpool for twenty years, a job that not only enriched her experience of humankind but also triggered an insightful exploration of human frailties that start from the core of the body – that is, from the heart. This fundamental organ is described in different ways in the poems. It is ‘a remarkable machine/but it is just a pump’ whose ‘Defects can’t be cured/surgery can only compensate/for what isn’t there.’
The organ is minutely described in all its parts: the cavities and arteries and the alterations that cause faults and endanger children’s lives. It is the subject of most of the poems; the heart is a part of the body but, at the same time, it is observed in its uniqueness. It is subjected to modification but it is also implacable, if deficient. The poet describes in words what Leonardo da Vinci did in his anatomical drawings, as defined in the opening poem. This is the result of attentive observation and yet a ‘vision in every line’. Therefore, the heart is both the centre of our bodily functions, the pump that dictates our life and death, and the metaphorical core of our worries and passions. The language reflects this view, merging technical words related to heart surgery and heart failure with ordinary language, making clever use of alliterations that create unexpected poetic images. This technique also reveals a tension between the medical terminology and the ‘translation’ given to parents to communicate the origin of the dysfunctions to them. The technical words have an aura of mystery that is eventually unveiled, revealing a worrying reality. “Litany of a Cardiologist” is a good example. It integrates the captivating, mysterious sounds of medical language and the plain explanations provided for ordinary people:
Cyanotic, hypotensive, acyanotic blue, mottled, pink (as a baby) systole, diastole, asystole contract, relax, stop (as in heart) arrhythmia, bradycardia, tachycardia abnormal, slow, quick (as in beat) pansystolic, ejection, vibratory long, crescendo, musical (as in murmur) stenotic, incompetent, bicuspid narrowed, leaky, deformed (as in valve) hypertrophic, hypoplastic, dilated thickened, unformed, enlarged (as in ventricle) dyspnoeic, crepitation, syncope breathless, crackles, faint (as in failure) Congenital Cardiac Anomaly born with heart disease (as in child).
The prayer conveys a reality that deeply affects people’s lives, both the baby’s existence as well as the parents’. The words evoke mesmerising sounds, failures that can be fatal or may be cured if treated in time. There is always the implied risk of possible sudden collapses.
Diagnoses of failing hearts in babies and little children are hard to express. They might affect the lungs and the kidneys and consequently cause deterioration. Both as doctor and as poet, Bundred lives this experience intensely; she is aware that she needs to act coolly and quickly to save lives and, at the same time, she is emotionally involved:
I resolve inconsistencies into diagnosis, wipe the sweat from my hands, write my notes; make my decision. [“A Cardiologist Seeks Certainty”] Your first journey is alone, transported by paramedics, staff-nurse, doctor. Your parents follow in their car. … I angle light onto your leg, pierce baby skin, pass a tube up the femoral vein to your heart. [“Disordered Heart”] The scalpel traces a stroke down your chest. A string of rubies swells from the incision. No larger than a jeweller’s diamond wheel, a saw divides your sternal bone, twelve days old and follows the line already drawn. [“Open Heart”]
These lines reveal a deep involvement and profound compassion as well as professional self-control and a terrific balance of human qualities like serious commitment and humility. The poems are constructed skilfully; they describe the state of emergency and the heart surgery in a growing tension that involves readers emotionally and guides them in the complex actuality of the disease.
Parents are protagonists too, full of anxieties, as they are forced to hope and wait:
Sweat maps my back from neck to waist as I walk fluorescent four a.m. corridors to find your mum and dad. [“Disordered Heart”] The nurse ushers him past swing-doors where other children sleep and parents only wait. [“Anaesthetic”]
Most of the operations described in the poems are successful; lives are saved, though death lingers, giving the impression that we are between life and death in a balance that is always uncertain despite all the efforts, care and compassion of the doctors and nurses. The heart can fail in many ways, which surgeons might or might not be able to fix. Therefore, human frailties come to the foreground both physically and metaphorically. The collection ends with the poet’s retirement, a situation that cannot be avoided though she inevitably misses her work, the adrenalin, the responsibilities and the care she is committed to.
Language is paramount in this exploration; it shapes relationships and conveys the harsh reality of disease and suffering:
I weight words like morphine calculated to a tenth of a milligram or a diamond measured to quarter of a carat. I balance words like the pawnbroker, weighing bracelets, a broken necklace and a wedding ring. I feel the weight of words in the air of the room lighten or darken phrases to where they need to be. … My words probe like the fingertips which palpate your child’s chest, as he lies in the shade of the night-light on Trelawney Ward. … I have used these words before (will do so again) but each time I shape them differently. If you have no question left to ask, I have done all I could. Yet I bend under the weight of words when I say I’m sorry, there is no more we can do. [“Weighting Words”]
The surgeon chooses between life and death. They are difficult words to utter and they will leave traces of blood that will not save a life this time, like surgery can, but will create an emptiness that cannot be filled – the void of death.
This is a compelling collection that merges the professional experience of a cardiologist and the poetic vision of a thoughtful poet expressed in engaging language. The poet’s passion for her work reveals her commitment and care as well as a profound awareness of human vulnerability that calls for compassion and involvement.