The tone and style of any written work varies with the purpose of the writer, and her intended audience.   The purpose of a news article, for example, is to deliver facts without bias to a general audience.  A poem, however, appeals to the reader’s emotions:  it attempts to establish an intimate relationship with the reader so the reader can “walk in the shoes” of the poem’s persona.   In this exercise, I ask students to take an objective description of a disease and then imagine this disease from the point of view of someone close to the patient, or of the patient himself.

Here is an excerpt from a news article, “Genetic key to rare disease found”, that was published in the Honolulu Advertiser on April 24, 2006.
“Researchers have discovered the gene that causes one of the rarest congenital disorders, a disease called FOP that turns muscle into bone, forming a second skeleton that eventually renders the patient immobile like a statue.”

The article goes on to describe the symptoms of FOP in clinical terms:  immobility, difficulty breathing, swellings on the arm, neck or shoulders, accompanied by severe pain.  It is evident at birth and is indicated by unusually short toes that point outward, but frequently is misdiagnosed and inappropriately treated.

Fascinating stuff.   Here is my thought process as I mull over this disease:

1.    What stories have I heard that remind me of this disease?  Medusa from Greek myths and the basilisk from European legends (and from Harry Potter) turn their victims into stone with a single glance.  When Lot’s wife disobeys God and looks back, she turns into a pillar of salt, and King Midas accidentally turns his daughter into gold.  These stories may be alluded to in your poem.
2.    Imagine this disease as a human enemy, or imagine the cells of your body as your infantry.  What is happening in this battlefield?  You might want to personify the disease, or describe it as a metaphor.
3.    What was the patient like before this illness?  Juxtaposing scenes of the patient now with scenes from when he was healthy heightens the poignancy of the illness.
4.    Imagine this disease with all of your senses.  Describe not only what you see, but what you might hear, smell, feel, or even taste.
5.    Most importantly, how would I feel if I were a live witness to this disease?  As a mother myself, it would be easy to imagine the pain of a mother watching her child suffer—particularly if the parent felt in some way responsible for the disease.  Since this disease is inherited genetically, the mother is—in a twisted way (and poetry is all about twisted ways)—guilty.  Here we can make a connection to King Midas and the agony he felt when he realized his greed, his human failings, took the life of his daughter.
I want to point out that even though you are moving the point of view     from an objective observer to someone involved in the drama of the illness,     the poem does not have to be in first person.   Students often find that first person is the easiest and most natural voice to write in, but a poem can be in second or third person and still be rich in pathos.  I choose to write in second person and address the child as the “you” in the poem.

Here is my poem about FOP, from the mother’s point of view:

Medusa’s Child

It began innocently enough
a small swelling bruise, an ache
childhood scrapes and growing pains–
we didn’t think your limbs, limber
as strands of honey, would crystallize,
cloud and darken and age,
but even as you lay
curled in my lap, your tender
baby fingers probing my mouth,
your soft cells mutinied, one by one,
sold themselves into bondage,
mustered into a monolithic mass of bone.
You had a dowager’s hump at age 5.
Still, my young ancient,
your silver laughter bubbled over
your wizened lips,
the high chime of your voice
scattered into the reaches of our home.

Now silence weighs on us
it sits and smothers
even the labored wheeze
of your faint breath.
Your tongue lays listless
dull like the wooden clapper
of a cast iron bell.
My sweetheart,
you were frozen into a pillar of salt,
when I, startled by your cry,
looked back and watched
the lights drain from your face
your thin arms raise and stiffen just
as you were about to
catch me in a tight embrace.

As a side note, allusions in a creative work do not have to be absolutely historically accurate for the reader to make the connection.  For example, Lot’s wife turned into a pillar of salt when she herself looked back, but in my poem the child freezes when the mother looks back.   In both instances, the woman is punished for “looking backwards”—perhaps for sentimentalizing past memories.

After we discuss this example, students pull cards with a disease written on it.  Alternately, if students are familiar with a particular disease and want to write about it, they can elect to do so.  Here is a short list of diseases and disorders from Roget’s Thesaurus:

cystic fibrosis
color blindness
bubonic plague
Lyme disease
cadmium poisoning
tetanus or lockjaw
Down’s syndrome
radiation sickness
sickle-cell anemia
muscular dystrophy

Once students have selected a disease, they look for a clinical description of it on the Internet.  This web article should include a description of the symptoms, the causes, who it affects—as much information that they can find about it that is written in an objective voice.  From here they go through the thought process as described above, and then they write their poem.
Here are two student samples.  Students were allowed to choose the form of their response to this assignment.  It could be a poem, a prose piece like a diary entry or a prose poem.  David’s piece is in prose, but makes use of poetic devices such as metaphor.

“Alzheimer’s” by David Rassmussen

The glass is half full, or is it half empty?  Those past events that are inscribed into one’s mind, what are they…memories, yes memories.  I can’t recall when it started anymore.  But the how.  I can still recall the how.

It started out like a scratch on the glass.  The scratch you see when you pull a glass from the dishwasher or when you clink two glasses together.  Either way, it started like a scratch on the surface.  Missed appointments, slip-ups on a person’s name, and only slight recollections of events that were clear to everyone else.  These were the first few scratches on my glass.

Over time they grew larger and larger.  The missed appointments became missed anniversaries, the names escaped my lips whenever someone came up to me, and the fuzzy events became so distant that I no longer have any memory of the ones I actually experienced or the ones I forgot.

On the day the glass cracked, I woke up in a strange room next to a strange woman.  I got into a car that I thought belonged to me and started it up.  Driving on my way to somewhere, my body seemed to forget how to drive and I ended up at a 7-11, more accurately in 7-11, through a set of glass doors, shelves and magazine stands.

And now I’m drifting from pure awareness to unknowing uncertainty.  Like a goldfish, I don’t remember any of my friends or even when I ate.  Sometimes my muscles themselves forget how to move.  Permanently stuck in this world of constant resets which at any moment I might reset to try to figure out…what was that word called again…memories yes that’s it memories.

“America’s Toll” by Colin Hirai

It all began in the doctor’s office.
Hiroshima, Japan.
Another day for the check up,
so many sick people around me,
coughing, breathing, sleeping,
all of them with problems but me—
the lucky one.
I prance into the doctor’s room and fly
onto the warm counter.
Look at me!  I’m healthy! I said.
The doctor’s smile radiated toward my eyes.
She is fine, good news has come,
although there appears to be a black dot,
no need to worry—it’s a present
a present of good fortune.

I awake next morning as the sun rises up,
the dot is still there smiling at me.
The dot makes me feel elegant like a swan in the lake,
dancing through the streets as the frogs watch with glee,
boys look at me at the beauty spot draws them near.
I am happy very very happy.

Weeks go by, the sun and moon dance their ballad,
mom sees my dot on my skin,
she drags me to the same black house again,
the same haven the doctor is working in,
his expression is bleak, sweat rolls down his face,
he calls my dot something I don’t know.
But I know.  It is the Trojan Horse,
the one that surprises with happiness
then strikes with sorrow,
taking away my bliss,
the same ominous cloud that sends everyone in Japan away
into that dark mist where I will never see again.
What is wrong mom?  What is wrong?
I am going to be just fine.  Don’t worry.

This lesson was part of a unit on tone and style in my writing class, but possibly a unit exploring disease and illness could be developed in collaboration with the biology teacher.  There certainly has been a long list of writers whose illness has colored their work:  Samuel Johnson, Albert Camus, Eugene O’Neill, D.H. Lawrence, and Edgar Allan Poe.  Injury and illness afflict many fictional characters and are central to their psychology.  Susan Sontag writes about being “exiled” from the country of wellness in her book, Illness as Metaphor.  Indeed, what is the line between “good health” and illness, and how does one live with the sickness we call “life”?

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Susan currently teaches English in the high school at Mid-Pacific Institute.  She received her M.F.A. in fiction and poetry writing from the University of Oregon, where she also received her B.A. in general science and English.  She has published stories and poems in Bamboo Ridge, Calyx, and the anthology Honolulu Stories, and has had short plays produced by Honolulu Theatre for Youth.