Sarah Smith is a board-certified family physician, an author, and a mother of two.
Michelle Dyer’s poem simply named “Breast Lump” (Intima, Fall 2020) gives a personal account of a patient contemplating cancer as she undergoes a breast biopsy. In contrast to the modest title, throughout the poem Dyer uses evocative imagery and illustrative metaphors to describe “these cells of me that should have died but didn’t.”
The poem begins, “I didn’t know it’d / look like a lima bean.” This poignant first line compares the potential cancer to a vegetable, and the poem continues to liken the doctor to an inpatient chef. As the patient watches the procedure, she processes the possibility of a life-threatening diagnosis. Her thoughts are so distressing that she shifts to imagining “clouds, seeing knights on horses / and elephants with umbrellas.”
The poem then becomes sentimental, and the patient recalls an instance with a friend in her twenties. She remembers saying that if she were a vegetable, she would be a beet because “it tastes like earth, / and it trickles purple rivers down your chin, / and what is more childhood than tasting / dirt and purple.” The patient yearns for this simpler, happier time.
Reading this poem as a physician, I reflect on the patients I have had the pleasure to care for who have shared with me their unique descriptions of disease. I remember one woman who, when looking at her abnormal mammogram, told me the spiculated mass pictured on the film reminded her of constellations in the night sky. Another patient who had lung cancer would refer to it as “the alien in her chest.” Another woman I knew who had lived with metastatic cancer for fifteen years laughed as she told me that she was “like the roach who circles the drain but refuses to die.”
For many patients it seems that using metaphors and imagery helps with confronting their cancer. Thinking of the disease as an “alien foe” is more relatable than malignant cells, and a chef is more familiar than a physician who is operating on you while awake.
Dyer concludes the poem with the patient wondering “if the bat inside / my breast will emerge from its cave or if / I should give it a name.” This final line again demonstrates how if one chooses to describe disease with imagery, it can serve as a positive and creative way to manage the fear and anxiety of a daunting diagnosis.
Sarah Smith is a board-certified family physician, an author, and a mother of two. Her first book, The Doctor Will Be Late, was published earlier this year. She has also been published in Kevin MD, Brief Wilderness, and Sheila-Na-Gig online. She holds a Bachelor of Arts from the University of Notre Dame and a Doctor of Osteopathic Medicine from Ohio University. She lives in Tampa, Florida.