Poetry and psychiatry: panning for joy in all the wrong places

Matthew Shipsey on his pursuit, as a child psychiatrist, of joy: ‘such a human madness’

For R & Q


"Days you are sick, we get dressed slow,
find our hats, and ride the train.
We pass a junkyard and the bay,
then a dark tunnel, then a dark tunnel.

You lose your hat. I find it. The train
sighs open at Burlingame,
past dark tons of scrap and water.
I carry you down the black steps."


I am not a father. I have no hats to find, no trains to ride, no steps to carry you down. You may someday exist, and there is nothing in this world that I hope for more.

But having spent a third of my career in children’s hospitals – having traced my hands along the dark tunnel’s wall, having spent the past three months working with a profoundly traumatised young child – that hope is buttressed by an anti-hope: may we never have to ride that train. May you never know the black steps.

Maria Hummel, whose poem is quoted above and continues below, cared for her sick child for years. In another poem she writes: “somewhere there is a tree / that grows its leaves on the inside. / Somewhere a forest that rustles and hushes / in no breeze.”

I’ve written previously how poetry has something particular and peculiar to offer medical practitioners. I think this connection draws from how medicine, too, inverts and invests new meaning into language. We run the list and round on patients. When we hand over, when we hand back, I like to imagine we do so with two hands. Growth, anywhere else, denotes forward, upward progress. Growth, for us, is a dark tunnel; a crab, tunnelling toward annihilation.

In the children’s hospital where I previously worked, the oncology ward is named St John’s. I’d be glad to never darken its door again, but I always wondered and never learned: which John was it? The voice crying out in the desert, the baptist? Or the beloved one, the disciple? In a sense, the children there – saints, all – embodied elements of both. I’ve never felt so singed by the radiance of another’s love then when bypassing a parent to take bloods from their sick child. And I’ve never felt so keenly my own mortal coil then when confronted by a family’s shuffle down St John’s long, dark corridor. A shuffle that still echoes within, like Rilke’s famous admonishment: “for here there is no place / that does not see you. You must change your life.”


"Burlingame is the size of joy:
a race past bakeries, gold rings
in open black cases. I don't care
who sees my crooked smile

or what erases it, past the bakery,
when you tire. We ride the blades again
beside the crooked bay. You smile.
I hold you like a hole holds light."


I am an uncle. On the blessed day my brother’s daughter was born, the child we had struggled to reach for three months entrusted me with her suicide note. I like to think I received it with two hands.

It reads: “I laugh and smile but behind that mask is me a broken down girl.”


Joy: an exalted emotion which defies easy description. Understated as an acorn, yet when seized by it we are filled with the light of being. (Kierkegaard: “Joy is the present tense, with the whole emphasis on the present.” ) Notice how much work it is doing in Hummel’s poem, how lightly it carries it: Joy stretches over the stanzas, defiant, as “train” turns to “blades,” and will become “knives”; as her child tires in a race past bakeries, as her child goes slow. Joy is not caring who sees your crooked smile. Joy, writes Zadie Smith in a brilliant and challenging essay, “is such a human madness”. Human madness of course is our number, as psychiatrists – so too, joy?

I, for one, have gravitated towards child psychiatry and children’s hospitals – despite dark tunnels, black stairs, unpunctuated suicide notes – precisely because of joy. In pursuit of joy, in fact. It seems to me that children live and breathe and move in a slightly altered atmosphere: in a child’s presence there is a charge, a sense of unpredictability, of being seen in a different way. There is a sense, too, that children are more naturally attuned to serve as joy’s medium. They are all present tense, eyes always open, ready to participate with whatever moves them. Every moment is triggered for transformation.

And what is our role in this, for children in hospitals or despair? If it is for a child to just be, as I think it is, then it is for us to behold, and to be beholden. Or, as Smith has it, to recognise and reflect joy in that “strange admixture of terror, pain, and delight” which comes from raising a child. As doctors our help may be but briefly required, but so long as children are “under our care” (a rare example where medical-speak reflects our truer, softer intent) we are of that proverbial village that raises them, and subject to strains of the same terror, pain and delight. Subject, in other words, to joy.


"We wear our hats and ride the knives.
They cannot fix you. They try and try.
Tunnel! Into the dark open we go.
Days you are sick, we get dressed slow."


On the blessed day my brother’s daughter was born, the child under my care reached out from under her mask to ask for help.

Behold: we lower lanterns into holes, like buckets into wells, we try and try, we pan for joy in all the wrong places.

Beholden: into the dark open we go.


“You were not here to teach us, but we did learn”: the final words in Patricia Lockwood’s novel, No One Is Talking About This, addressed to her sick niece.

Doctor, from the Latin “to teach, to show.”

Patient, from the Latin “to suffer, to bear.”

Doctor, to a broken down girl: you were not here to teach us, but we did learn.


What is it we learn, venturing into the dark open of hospital wards and outpatient clinics, day after day? Or: how do we learn?

Who speaks the word “Tunnel!”, the poem’s only spoken word?

The answer to both, I’m beginning to think, is love.

Forgive me three final quotes to bring this home:

i) Simone Weil: “Love is the soul’s looking.”

ii) Christian Wiman: “Joy, that something in the soul that makes one able to claim again the word soul.”

iii) Ross Gay: “What if we joined our sorrows? What if that is joy?”

Love, I’m beginning to think, is what opens us to finding joy in all the wrong places. If joy is that something in the soul that comes from joining our sorrows, then love is the look that joins the souls.

Jesus said seven things on the cross. The third (according to Wikipedia) enjoined his beloved John and his beloved mother, with a simple word: behold! Joy, in all the wrong places.

My beloved niece and my beloved patient will likely never meet. And yet they too, somehow, are enjoined. This mystery of a world. If we seek transformation, we have it with a simple word: behold!
Matthew Shipsey is a psychiatrist in training.

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