The frayed dignity of the patient described in this poem, his intelligence matched by the inexplicable intransigence of his alcoholism, moved this VA psychiatrist to describe the clinical encounter, apropos for April, Alcohol Awareness Month.
A patient in the arms of alcohol.
I must go, he says, as he stands outside
The temple, a ruined temple, his bald pate topped
By a splattered port wine stain, a tattered skull cap,
Remnant of respect for an amnestic God.
He can discuss literature and politics,
In coherent discourse, but his upright posture
Obscures the prostrate soul: he has joined the derelict choir
Of despair. Respite, respite is all he can take,
Until the buzzing in his head becomes an importunate roar,
The sound whose only resolution is a drink.
Not given to weeping, his lower lids glisten,
And he’s overcome by sudden squalls of tears,
Moved by our embrace. His exile, though,
Is permanent. I must go, he cries, I must go.
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The imaginary title I have for my poetry is "All of Psychiatry in One Poem," and by that I mean that I try to explore the possibilities of expression, of feeling and thought, in my poems as I do with my patients.
The frayed dignity of the patient described in this poem, his intelligence matched by the inexplicable intransigence of his alcoholism, moved me to describe the clinical encounter.
Dr Kravitz is Staff Psychiatrist, VA Connecticut Healthcare Services, and Assistant Clinical Professor, Yale School of Medicine, Department of Psychiatry, New Haven, Connecticut.