May 12, 2022
In the Book Notes series, authors create and discuss a music playlist that relates in some way to their recently published book.
Laura Kolbe's brilliant debut poetry collection Little Pharma is filled with poems that question perception and metaphysically examine the world we live in.
Literary Hub wrote of the book:
"This first book of poems by writer, doctor, and medical ethicist Laura Kolbe is vital and urgent, tempered by wit and layered language."
I wrote my debut poetry collection Little Pharma during medical school, residency, and my first job as a fully independent doctor. The character “Little Pharma” serves as a sort of alter ego throughout the book, poking around in the haunted spaces of the hospital and clinic, asking inconvenient questions, wandering adrift and amiss, muddling along, occasionally awash in joy, noticing.
I love and hate the term “doctor-writer” – on the one hand, it’s quite convenient and full of relentlessly interesting company (Anton Chekhov, William Carlos Williams, Mikhail Bulgakov, Louis-Ferdinand Céline, Carlo Levi, Walker Percy, Rivka Galchen, among many others). On the other, the label often comes with the expectation that what I write will be salutary, therapeutic, well-behaved, professional. I don’t think those are desirable qualities in a poem.
And while much of this collection is drawn from close observation of the body and its tissues, pathologies, clinics, and hospitals, there is much else, too. It seems to me that music lyrics are often more comfortable with the leaps in time and setting, the non sequiturs and rapid swerves of attention, that well-behaved poetry shuns, but which are the only way I know how to write about the fracture narratives encountered in clinical practice, and the revolving door to the big wide world outside of it.
My Body’s Made of Crushed Little Stars – Mitski
Many of the poems in Little Pharma are preoccupied with confusions in scale, which can happen when the eyes have spent too much time peering into a microscope or a cadaver or the feet have paced ten thousand steps around the same small ward. Is my body made of cells or stars? Is this a liver I see before me? Or a mountain slick with rain? I love Mitski’s batshit, leave-it-all-on-the-field version of this (also, her Byrne-ian shriek, “I work better under a deadline! I work better under a deadline!” – far more representative of my own inner monologue than I generally care to admit).
Get Me Away from Here, I’m Dying – Belle and Sebastian
Fantastic Voyage – David Bowie
I think it’s ok to admit that the reason most writers first take up their work is to make the incalculably, infallibly appealing thing that would metaphorically slay everyone we most admired and literally slay everyone else. Stuart Murdoch knows the (fairly guessable) contents of my teenage heart. “I could kill you, sure, but I could only make you cry with these words.”
Later we find other reasons to write, probably. One is all the rapid vanishing happening around us – deaths, extinctions, even just the ordinary evanescence of things not meant to last very long (thunderstorms, dance parties, stone fruits). Like most people who especially liked being in school (I realize we are a small and dull demographic), my first impulse is to make sure I’ve done all my homework before I speak. But my second, better impulse is to leap into words. Because possibly there’s too little time left to be too studied in one’s attitudes. “I'm still getting educated but I've got to write it down / And it won't be forgotten / Cause I'll never say anything nice again, how can I?”
Secondary Modern – Elvis Costello and the Attractions
I dearly love the first nine years of Elvis Costello’s catalogue, which has the feel of a meganovel about our narrator’s decade-long quest to uninstall the two-ton chip on his shoulder. (I feel you, Elvis.) A few of the poems in Little Pharma take, like this little whisper inside Get Happy!!, schooldays for their subject (“Self Portrait as a Young Republic,” “Fatti Maschii Parole Femine,” “Howard’s End”), but mainly I chose this song for the slinky way that it’s all preface. “There won’t be a problem ‘til the girls go home,” he keeps telling us, from “down in the basement.” WHAT HAPPENS DOWN THERE ONCE THE GIRLS LEAVE? It’s such a fun trick when artists can pull this off – I think of stories like Bolaño’s “Last Evenings on Earth,” with its ending, “And then the fight begins.” I tried to get close to this feeling in poems like “Little Pharma Encounters the Spine,” the “Imagining Marriage” poems, or “The Apparatus” – that the poem is the tiny verso painting on the back of the frame, and you’d have to flip it around to see the main picture.
I Washed My Hands in Muddy Water – Stonewall Jackson
This great little number was written by Cowboy Joe Babcock and covered by everybody, maybe best by the unfortunately-named Stonewall. It’s on the one hand an “Amelia Bedelia”-type episode about literal-mindedness (“You said to wash my hands, Dad!”) and on the other hand a much more serious resignation to one’s own irredeemability. The backing vocals really get impish starting in the second verse, and it’s a lot of fun, even though you realize this is going nowhere good. “What need we fear who knows it, when none can call our power to account?” says Lady Macbeth on the subject of hand-washing. Pairs well with the (significantly less fun) poems that grapple with the complicity of the speaker, or of clinicians more generally, in continuing to motor along in a sometimes broken and cruel system of healthcare – “Little Pharma as Lady Macbeth” most specifically, but also “The Tower,” “Buried Abecedary for Intensive Care,” “Puck in Oncology,” and several others.
Where Are You Tonight – Bob Dylan
I tried hard not to use any albums featured in my partner Andrew Martin’s Book Notes on this site for his novel Early Work. Fortunately for us and unfortunately for you, dear listener, we share the same record collection. My second favorite moment on Street-Legal (after the Cassandra-at-the-Wedding-esque middle finger in the penultimate verse of "Changing of the Guards") is the outburst at the end of this song: “I can’t believe it! I can’t believe I’m alive!” The joy and shame in that yelp – it washes over me when I leave the hospital sometimes. Why am I the healthy one and not the one in the bed? Why do I get to hand over my pager and walk outside when this is all over, and slip my sneakers on, and pick up a few things for dinner? But also, thank goodness I’m not being asked to trade places. A happy, rotten relief.
Old Fashioned Shotgun Wedding – Tucker Zimmerman
While living in Charlottesville for medical school, I wrote a suite of poems, each called “Imagining Marriage,” several of which wound up in the back half of Little Pharma. The original project was to figure out how I felt about the institution Marianne Moore calls a “crystal-fine experiment, / this amalgamation which can never be more / than an interesting possibility….” The poems made a nice little sheaf and I’d still gotten no closer in my investigation, though eventually I married anyway. “Do you say I do? / Well, I suppose.”
Tucker Zimmerman reassures me that formalism is the last refuge of the pedant, anyway – as he says of a long premarital cohabitation: “That’s 10 years of sharing the same bathroom / And if that ain’t being married I don’t know.”
Tonight Will Be Fine – Leonard Cohen
On night shifts in the hospital, there are tiny “call rooms” you can retreat to when the work slows down deep in the night – a bunk bed, a phone, not much else. You might get a new “admission” (a patient in the emergency department needing to be interviewed, examined, treated) or be called to a clinical emergency on the wards in 30 more seconds, 30 more minutes, or not at all for the rest of the shift – no way of knowing what the phone or a knock on the door will bring next. Often around the 3 a.m. mark this tune would enter my head, verse two describing my situation exactly. “The windows are small and the walls almost bare / There’s only one bed and there’s only one prayer / I listen at night for your step on the stair.”
I think, too, of other great representations of waiting around in a too-small, ridiculous bed for the next Big Thing. Jean-Louis Trintignant under that silly fur blanket in My Night at Maud’s. The wonderful moment in Nabokov’s early story “Spring in Fialta” when the narrator is waiting to see whether his on-again, off-again lover will cross the hall in the château where they’re both staying: “how I waited, how certain I was that without my having to tell her she would steal to my room, how she did not come, and the din thousands of crickets made in the delirious depth of the rocky garden dripping with moonlight, the mad bubbling brooks, and my struggle between blissful southern fatigue after a long day of hunting on the screes and the wild thirst for her stealthy coming, … but the night raved on, and she did not come….”
I realize all the above examples are about erotic apprehension, whereas I’m talking about things like heart attacks and strokes, right? Yes, though I heartily second Woolf, in her essay “On Being Ill,” that the world of medicine – the “being ill” she writes of, but also the witness of illness, its investigation and treatment – has of late only brushed against its full linguistic potential, and so we are forced, for now, to borrow from other tropes while we invent the words we’ll need.
“Strange indeed,” she writes, “that illness has not taken its place with love, battle, and jealousy among the prime themes of literature. Novels, one would have thought, would have been devoted to influenza; epic poems to typhoid; odes to pneumonia, lyrics to toothache.” And likewise: the antsy giddiness, the impatience, the self-recrimination, the shyness, the flutter in the gut, the very occasional triumph, of the young-ish doctor – where are the ballads and the libraries I need to speak of this?
Reckoner - Radiohead
It’s the more keyed-up tracks on In Rainbows that actually help me get from point A to point B sometimes, but the long, melting outro of this song is the one that I think about as a writer: why should the end of a work have to obey the premises or the aesthetic of its beginning? The vocal and string line at the end strikes me as a deliberate echo of the Lutheran hymn that curls itself into the opening chorus of Bach’s St. Matthew’s Passion. “Die Kunst der Fuge” is also visited by the ghost of Bach, and is as preoccupied as Thom Yorke with where the water goes, and who decides.
Tell Me Something Good – Rufus & Chaka Khan
I had to include this for the messenger function of my day job. So much delivering of news! There are labs to report, and CT scans and TTEs to boil down to manageable chunks, and EKGs to translate into language, and best of all, sharing with strangers the delightful-to-them news that they might never need to see me again.
The tachypnea of the backing vocals in this song is incredible. Somebody get some bloodwork on that guy.
Sodade – Cesária Évora
I wrote much of this book while living in Boston, whose large Cape Verdean community even has a restaurant named after Cesária. Saudade/Sodade (Portuguese/Cape Verdean Creole) seems to be one of those untranslatable words that means something like infinite melancholy laced with the sweetness of recollection. I listened to this one a lot while driving along the Emerald Necklace getting to and from late shifts at night. Who showed you this long and distant path? she asks. To what can I attribute the course of events? To the unanswerable bewilderment of songs about the road (all of them: I/you just have the urge to move and I/you don’t know why) I can add a few poems for the glove compartment. “Shades Pulled Down,” “Little Pharma,” and “The Apparatus” are some starting points.
I Summon You – Spoon
A Shot In the Arm – Wilco
“The signal’s a cough.” “Maybe all I need is a shot in the arm.” Ugh, all my favorite Sad Dad Bands predicted the past two years of world history as well as my entire medical career and my debut book of poetry! Well played, sad dads.
If You Know You Know – Pusha T
Chewing Gun – Annie
Blood and Fire – Niney the Observer
The epistemology of reading poems and of writing them is such a funny business. In this collection I tried very hard to ride on instinct (“if you know you know”), knowing I could be dead wrong about which darlings to kill or resuscitate (“you think [that line’s] chocolate but [it’s] chewing gum” but hoping something will catch correctly (and hoping to have the good sense to let it burn).
Sister Ray – The Velvet Underground
Not necessarily a helpful song to loop in one’s head while trying to place a central line in the ICU as a sweaty trainee, or while trying to revise a poem, but we don’t choose our brains. Pace Lou Reed, disciplined technique can really aid the search for the main line (cf. “Little Pharma’s Course on Sonography”). Or at least so it seems in hindsight – I’m now in the same mess writing my second collection of poems.
Laura Kolbe is a doctor and medical ethicist at New York–Presbyterian/Weill Cornell Medical Center. She studied English and American literature at Harvard and the University of Cambridge. Her work has been anthologized in A World Out of Reach. She lives in Brooklyn with her partner Andrew and their dog Bonnie.