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Narrative and Healing

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Poetry and Healing
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Ted Kooser was Poet Laureate of the United States from 2004 to 2006, and was awarded the 2005 Pulitzer Prize in poetry for his collection entitled Delights and Shadows.  He presented this speech at the  American College of Physicians-Alaska Chapter meeting (http://www.acponline.org/meetings/chapter/ak-2008.pdf) on June 26, 2008.

Ted Kooser
Ted Kooser:  I grew up in central Iowa, in Ames, and was one of those kids who really didn't fit in too well.  You know, I was really an outsider.  I had no athletic ability, I couldn't play a musical instrument, I was scared to death of being in theatrical productions and one thing and another, and somehow or other, like a lot of adolescent boys, I wanted to be different and mysterious, and somehow or other I settled on being in the arts as accomplishing that.  It was mostly about girls.

So I began writing poems when I was quite young.  By the time I got to be in high school, I was writing a lot of poetry.  My high school sweetheart, with whom I was involved until we were freshmen in college from the time we were sophomores in high school, supposedly when we broke up took all the poems that I had written for her out into a ditch by the side of the road and burned them.  That's what I've been told.  Then this year we had my 50th high school reunion, and I wasn't able to go, I had another engagement, but somebody just before that called me up and they said, "You know, we've been talking to Nancy, and she says she still has some of those poems," and I thought, "Oh God."  Imagine how those would look today, to my literary critics, and there are many of them.

So I wanted to be a writer.  I graduated from Iowa State in a program where I could teach high school English.  I taught one year of high school English and didn't like that, and decided that I would go to graduate school and perhaps could figure out a way of teaching college English and so on.  I was admitted to the University of Nebraska, and my first wife and I moved out there.  She got a job in a public school teaching in a little nearby town, quite close to where we live today, as a matter of fact.

I was a terrible student.  I don't know that I am innately stupid, but I just could not do the academic work that they wanted of me.  All I cared about was poetry, and this was an academic English program.  Karl Shapiro, who had won the Pulitzer Prize and had been the editor of Poetry magazine, a very important American poet, was teaching at Nebraska at that time.  I fastened myself to Karl Shapiro the minute I got there, and we spent a whole year basically together, talking about poetry and writing and so on.  At the end of the year, my adviser called me in the office, and pressing the tips of his fingers together, said, "Mr. Kooser, you haven't really done anything that you were supposed to do this year, so we're taking away your assistantship."  So I was being booted out of the graduate school for bad behavior.  You know, at that time there weren't creative writing departments.  This was in '63 and '64.  The way we have them today, every college today has a creative writing department, but Nebraska didn't have one.  It was a standard academic program.

I had seen this coming, of course.  There was one class I didn't show up for, ever.  So they booted me out, and I had to find something to do.  My wife had some income from this high school teaching job she had, but I needed something, so I sat around for several months reading the want ads, and one day there was a management trainee position at a life insurance company in Lincoln, Bankers Life Nebraska, and it was an entry-level job.  I thought, "Well, I could apply for something like that and do that for two or three months and save up enough tuition that I could work on my M.A. several hours at night over the course of several years and finish my M.A."

I went to work for this life insurance company, did a year of letter-writing to policy holders about their beneficiaries and so on, and then I moved into the medical underwriting part of it, and I wound up staying on in the insurance business for 35 years.  I never liked it particularly, though if I had told my father and anyone in his generation that I was looking for fulfilling work, they would have looked at me like I was from Mars.  There was no concept of fulfilling work in that generation.

So I had accepted that I was going to have to work at something, and the job was pretty good.  I made pretty good money.  Somehow or other, and this is the way it works in large corporations, somehow or other without ever having had a business course, no training whatsoever, never particularly being passionate about the work at all, over the 35 years I was elevated to a vice presidency.  It all has to do with attrition.  Everyone else falls away and you sort of float to the top.

So I was vice president of public relations for a substantial life insurance company, Lincoln Benefit Life.  We had, at the time I retired, about 900 employees, and it was a big company.  It was a pretty high-stress job.  Once I became an officer, it was pretty stressful.  In the fall of 1997, my mother, who lived in Cedar Rapids, Iowa, about 300 miles away, became increasingly ill.  She had COPD and was suffering more and more, and needed to go into an assisted living situation, so my sister and I were arguing about all that, which was more stress.  We got her into the assisted living, and she lived three months into the new year, 1998, and died in March.  But during that time, I had been driving back and forth to Cedar Rapids and letting things go.

I had always been subject to canker sores from stress.  When things were going bad, one would pop out, and I would just wait it out.  I had developed a sore spot on the back of my tongue, and I thought, you know, this is another canker sore and I'm going to have a dental appointment coming up, I'll have him look at it, and so on -- but what happened was because of Mother's death and one thing and another, I put these appointments off.  Finally on the first of June, which is 10 years ago this first of June, I went to the dentist and he cleaned my teeth and looked me over and said, "Everything looks fine in there, Ted."  I said, "Well, take a look at the back side of my tongue there, on the left side.  Something is bothering me back there."

He and his assistant were there, and he examined my tongue, and the room filled with silence.  I thought, "Uh-oh, here we go."  He said, "Well, I think we'd better have that biopsied."  So they sent me over to the dental college, and the oral surgeon at the dental college did a biopsy and called me in a week and said, "It's squamous cell carcinoma of the tongue," and they were referring me to the University Med Center in Omaha.  The dental college, of course, is connected with that college.

So, terrified, my wife and I went to the Med Center, and we met with a young head and neck cancer guy, William Lydiatt.  He is in practice in Omaha with his older brother, Dan, who's also a head and neck specialist.  At the first interview, Bill looked me over and said, "Well, Ted, how much public speaking do you have to do?"  And I said, "None that I couldn't give up to get well."  My wife interrupted and said, "You know, he is a poet, he does do poetry readings."  He said, "Well, I'm going to have to take out a substantial part of his tongue, and I just wanted to know, in case there's some speech impairment, what that will be like," and again, I reiterated that I didn't care, I wanted to get well.

But what was interesting, we said we would take a week to think about treatment options and one thing or another like that, whether or not we were going to do surgery or just complete radiation and so on, so we went away and came back in a week, and it turned out that this young doctor had gone to the Omaha Public Library, checked out all my books, and read them.  And I thought, "Now here's a doctor for me."  And it has turned into a wonderful relationship.  I've done some teaching with him and so on.

He operated on me on the 17th of June 10 years ago.  The tumor was about the size of a dime, clear margins all around, but he had been trained at Sloan-Kettering to do neck dissections too, and they did a neck dissection on this side, and three upper nodes out of the ones that they took were malignant.  So I was sitting in the hospital room, all bandaged up from this, and Bill came in to tell me about the radiation, that it would be necessary for me to go ahead with that.  He said something I would guess that many doctors have said to patients.  He said of the radiation, "You know, it's going to be tough," but he said, "You are about to enter one of life's great life-affirming experiences," and I thought that was just marvelous, because that really is what it turned out to be.  We've heard other people talk about how disease like this can enhance your love of life, and way of looking at life.

So I went ahead with the radiation.  We began about a month after the surgery, and I finished up at the end of August.  It was indeed very rough.  There were many mornings when I woke up that I wished that I had not.  I often would even pray in the evening that I'd be taken in the night because I didn't think I could stand any more of this.  The protocol that they had me on was the typical 30 radiations spread over six weeks, but they were going to give me three chemo treatments across this thing with Cisplatin, one at the beginning, one in the middle, and one at the end.  But by the time we got to the middle one, my mouth and tongue were so badly ulcerated that the protocol was abandoned, so I only had the one shot of Cisplatin, but maybe it did help to some degree.  Even if it was $1,000.

I came through the radiation.  I had the radiation done in Lincoln.  I had gone to Omaha to the Med Center, Lincoln's about 50 miles, I had the radiation in Lincoln from a radiation oncologist there named Dr. Howell-Burke, and then I started to come out of it.

Now I had not written a word.  I'm a compulsive writer.  All those years at the insurance company I got up every morning at 4:30 and wrote till 7:00, got my necktie on, went to work, was publishing poems in literary magazines and books and so on all that time.  But once this happened to me, I was morbidly depressed.  I was terribly anxious and so on.  And as I began to come out of this experience with this radiation to heal up from it in September and October and so on, I began taking walks in the morning.  We live way out in the country and there's a gravel road that runs by our place, and it's a mile down to the next corner and back.  So I would get up and make this walk.  My radiation oncologist said, "I don't want you out in the sunlight, so you're going to have to do this before the sun comes up."  So every morning I was out there walking two miles down and back.

One morning I came back and I wrote a little poem.  It was the first thing that I had written, and I was ecstatic.  I don't know that it was a particularly good poem, but all of a sudden I was going to live again.  This is the thing that I had been doing all my life, and I was going to redeem it and take it over again.  And I have a very good friend, Jim Harrison, he's a novelist.  Some of you may know some of his work.  He's the guy who wrote Legends of the Fall and so on, and Jim winters in Arizona.  So I took this little poem I wrote and I pasted it on a U.S. postcard and stuck it in the mail to him, just to sort of make a statement, that here I am again, and I'm going to be able to do this.  Then every morning I began doing that.  So over the course of that winter, as I recovered, I wrote around 130 of these short little poems based on these morning walks I was taking, and sent them all to Jim.  Then later I was to do this book, Winter Morning Walks: 100 Postcards to Jim Harrison.

I want to talk a little bit about what I think was happening, in the event that it might be helpful to you at some point.  My experience of cancer was that I was dealing with something huge, ominous, and chaotic -- that there was no structure to it, no order.  I remember how I seized one day on something Bill Lydiatt said to me.  He said, "The progress of this tumor has a kind of order to it, that if it spreads it'll go down your neck into your thorax and so on" -- that there was a path that it might follow.  I mean, this is certainly not good news, but to me, the fact that a cancer could have any kind of order to it at all was sort of -- I could get hold of that.  It meant something.  Well, all this poetry writing was also trying to establish order.  If I could come home from a walk in the middle of this feeling lousy and make a little square of words with every one in its perfect place, then I had seized a little bit of order.  I began doing that, and immediately, day after day, I began feeling better.  Part of it was natural healing, of course, but I think a good part of it was the assurance that I was getting that there was order in the world.

Of course order and the arts are all interwoven.  I remember one time P.D. James, the great detective novelist, saying that the reason we read standard detective novels, and at the end when everything is solved and everything is tied up together, is that when we get to the end of the novel, we are assured that there is an order to everything.  This novel, in a microcosm, convinces us that there is order to everything.  This order was extremely important to me.

I thought I'd read some of these poems to you.  This is really what I'm best at, not so much at talking.  The first poem in the book was written later.  I wrote it as a preface.  This road I call the quarry road, because there was a gravel quarry at the end of it, and the idea that I could walk down this road and back and pick up something, a stone from the road, or see a bird, or something or other like that, and come home and write about it, had a kind of specialness to it for me.  This is the poem that opens the book.

The quarry road tumbles toward me
out of the early morning darkness,
lustrous with frost, an unrolled bolt
of softly glowing fabric, interwoven
with tiny glass beads on silver thread,
the cloth spilled out and then lovingly
smoothed by my father's hand
as he stands behind his wooden counter
(dark as these fields) at Tilden's Store
so many years ago.  "Here," he says smiling,
"you can make something special with this."

My dad was in the retail business all his life, and I loved the way his hands would work with bolts of fabric and so on.  And the road actually looked like that, it looked like silver beads in the morning with frost on it, this long bolt of cloth.  And here's the poem that I started with, that started that whole enterprise that morning when I came home.  Each of the poems has the date and then a little line that describes the weather on that date, as if it were a journal entry, and then the poem follows.  You can hear and feel the ominous overtones of the fear that I was bringing into these poems as well.

November 9

Rainy and cold.

The sky hangs thin and wet on its clothesline.

A deer of gray vapor steps through the foreground,
under the dripping lichen-rusted trees.

Halfway across the next field,
the distance (or can that be the future?)
is sealed up in tin like an old barn.

November 10

High winds all night.

Most of the snow passed north of us,
but this morning we're given the fancy white lace
at this edge of that blanket,
every weed on the roadside coated with ice.

Behind the counter at the post office,
somebody's small carton stamped with block letters:
ANGEL MOMENTS WITH SNAIL.

I drive very slowly all the way home.

November 12

4:30 a.m.

On mornings like this, as hours before dawn
I walk the dark hall of the road
with the life creaking under my feet, I sometimes
take hold of the cold porcelain knob
of the moon, and turn it, and step into a room
warm and yellow, and take my seat
at a small wooden table with a border of painted pansies,
and wait for my mother to bring me my bowl.

November 13

Sunny and cold.

Horsetail cirrus miles above,
stretched all the way from Yankton to Wichita.
I stoop on the road, small man in coat and cap,
tying his shoe.

A curled brown leaf lies on its back
lifting its undistinguished edges
into the glory of frost.

I might say that these poems are not spontaneous outbursts, in that I would rush home and write them down and they would be that way forever.  I am a tireless reviser, and I would come home from this walk -- you know, it might be five in the morning or five-thirty, and then I would actually work on the poem for several hours, and some of these little poems went through 30 and 40 versions before I got them exactly the way I wanted, but I was trying to be true to the experience as well.

Here's one that's typical of this sort of angst that I had over me.

November 14

In the low forties and clear.

My wife and I walk the cold road
in silence, asking for thirty more years.

There's a pink and blue sunrise
with an accent of red:
a hunter's cap burns like a coal
in the yellow-gray eye of the woods.

November 15

Cold and clear.

An anthem of geese on the wing,
and over the next field
a thin flag of starlings bellows and snaps.

At dawn, a sudden fire on a hilltop
four miles east --
Joe Skala's Airstream trailer
reflecting the sun.

November 17

Clouds to the west, clear in the east.

Older this morning, the moon
hid most of her face
behind a round gray mirror.

In a half-hour's walk I saw
six shooting stars.  Celestial notes,
I thought, struck from the high end
of the keyboard.

This is one of my favorites in the book.

November 18

Cloudy, dark and windy.

Walking by flashlight
at six in the morning,
my circle of light on the gravel
swinging side to side,
coyote, raccoon, field mouse, sparrow,
each watching from darkness
this man with the moon on a leash.

November 20

Clear and still, a heavy frost.

The pale gray road lit only by stars.
A rabbit runs ahead, then stops
at the edge of the sound of my footsteps,
then runs ahead and stops again,
trembling in darkness
on the cold outer rim of the present.

I was on the cold outer rim of the present just about every day throughout that.

November 22

Sunny and cool.  Thin clouds.

In his drab gray overcoat,
unbuttoned and flying out behind,
a stocky, bullet-headed owl
with dirty claws and thick wrists
slowly flaps home
from working the night shift.
He is so tired he has forgotten
his lunchbox, his pay stub.
He will not be able to sleep
in his empty apartment
what with the neighboring blackbirds
flying into his face,
but will stay awake all morning,
round-shouldered and glassy-eyed,
composing a poem about
paradise, perfectly woven
of mouse bones and moist pieces of fur.

You get an idea of what those are like.  I don't want to bore you to tears with all of these.  But this is another one I'm very fond of.  I'm devoted to my dogs.  I have two right now.  One's about 10 years old, Alice, she's a border collie mix, and I have a yellow Lab who was a stray, whose name is Howard.  Whenever I'm away like this, traveling, I call home in the evening to say hello to my wife, and I'm always hoping that she'll tell me how the dogs are, that I don't have to ask, because I get in trouble if I say right away, "How are Alice and Howard?"  That's advice for all of you.  You don't want to go for the pets before the wife, or the spouse.

But at the time I was sick, I had a very old sort of Dalmatian cross named Hattie, and this is a little poem about Hattie and I walking on one of those mornings.

January 19

Still thawing, breezy.

Arthritic and weak, my old dog Hattie
stumbles behind me over the snow.
When I stop, she stops, tipped to one side
like a folding table with one of the legs
not snapped in place. Head bowed, one ear
turned down to the earth as if she
could hear it turning, she is losing the trail
at the end of her fourteenth year.
Now she must follow. Once she could catch
a season running and shake it by the neck
till the leaves fell off, but now they get away,
flashing their tails as they bound off
over the hill. Maybe she doesn't see them
out of those clouded wet brown eyes,
maybe she no longer cares. I thought
for awhile last summer that I might die
before my dogs, but it seems I was wrong.
She wobbles a little way ahead of me now,
barking her sharp small bark,
then stops and trembles, excited, on point,
at the spot that leads out of the world.

And I would weave members of family into this too.  I may be peculiar this way, and maybe because I'm a sort of sentimental sort, but I had a lovely family when I was a little boy.  I had great-aunts and great-uncles who had come from the 19th century and still spoke German and went to German services at the German Lutheran church, and were really from a different time.  And I was fascinated by these people.  I loved to go to my granddad's filling station in Guttenberg, Iowa, and sit under the awning with the old men and listen to them tell stories.  Probably my biggest literary influence ever was sitting with a can of sody-pop under that awning of that old gas station listening to these old guys come down and talk about how things had been when they were young, and so on.

So here's an example of just a touch of weaving one of my lost ancestors into a poem.  I find that every day, if I watch myself and monitor this, every day at some moment, I pull all these people up from memory and look at them for a minute and then let them subside away.  I've done this for years and years.  It's not by intention, it's just something about me that does that.  I review all these people.  It's a marvelous thing, really.  And when I talk to people about writing about family, everybody says, "Well, I'm afraid what I write is not going to be any good."  The point is that if you write it down and stick it in a folder in the kitchen drawer or something or other, someone will come along someday long after you're gone and find that little description of Aunt Harriet and read it, and all of a sudden Aunt Harriet comes back up into her life for a little while again.  It's a little touch of immortality that we can give these people.  So here's my grandfather's brother, Lou Mosier.

A rag rug of a landscape this morning
remnants of dirty snow,
torn strips of muddy stubble field.
Behind the yellow windowshade of dawn,
in an enormous sunny room,
my grandfather's older brother, Lou,
wearing a woman's apron, blue and white,
bends stiffly away from the loom
upon which he's weaving the day
and rummages through his bag of scraps.
He needs one with a spot of green
to show me down here on the gravel road
stepping along in my winter coat.

And there are these little moments that are kind of epiphanies that I would experience, you know, and out there all by myself, it was very still usually on those mornings, with snow on the ground.

January 27

Thirty-four degrees and clear.

Fifty or sixty small gray birds with crests
in a bare hackberry tree this morning early,
not one of them making a sound
or even the neat black silhouette of a sound
against the rising sun.  They let me
walk up close, then one by one
they leapt from their perches and dropped
and caught the air and swung away
into the north, becoming a ribbon first,
and then, in the distance, confetti
as they sprinkled their breathtaking silence
into another bare tree.

In most of my poetry that I've written over the years, I don't like to be front and center in the poems.  I like to be describing things that are happening, and the poems that I'll read tonight will be much different than these, they're poems in which I see something happen, watch somebody at a garage sale, that sort of thing.  These poems I wrote for this purpose are much more personal than anything I've ever done in my life.  It's really kind of a unique book for me, and I don't know that I'll ever go back to trying something like this again.  But here I'm closing the book.

March 18

Gusty and warm.

I saw the season's first bluebird
this morning, one month ahead
of its scheduled arrival. Lucky I am
to go off to my cancer appointment
having been given a bluebird, and,
this world.

And then here's the very last one.

March 20

The vernal equinox.

How important it must be
to someone
that I am alive, and walking,
and that I have written
This morning the sun stood
right at the end of the road
and waited for me.

But I wanted to share those poems with you because I think writing can be a wonderful thing for patients to be doing.  Even if it's just jotting down things that you get kind of obsessive about.  I keep a notebook by the bed because sometimes when I'm under stress I'll wake up, and I would guess some of you do this too, and I've got this tape loop running, and it says, "I shoulda done this.  I shoulda done this.  I shoulda done this.  I wish I had said that.  I wish I had said that."  Over and over again.  Well, I've discovered that if I make the effort to just simply write down something on that notepad about that, I can go back to sleep and get it out of my head, you know.  And I think that probably works in lots of other ways, that by writing our experience down, we get out of that muddle of all that language just sort of drifting around in there.  I think if patients write letters to other people -- real letters, not emails necessarily, but real letters to other people where you actually have to think about the words you write out with your hand -- I think that surely could be of help to people.  Again, it's all this business about clarity and order in a chaotic time, I think.

Any questions about that whole process? 

Question-and-Answer Session

Q:        I'm just curious, you're a writer, and in those walks that you had, did you think of that as a chore, coming back, or were you excited to come back and write about those things because it was an inspiration or a release for you?  I'm not a writer, so to me it would be almost -- I have this obligation or this chore that I'm going to do when I get back.

A:         I really never felt under pressure to write one of those, but I would delight in finding something on the road and picking it up, you know, a lump of quartz or something or other like that, and I have another poem, I don't have it along with me, in my book Delights and Shadows called "Surviving," that I wrote at about this time, and in it I notice a red ladybug on a white window sill.  The poem really focuses a tremendous amount of light and attention on this ladybug.  It's the sort of acute attention that comes out of all of a sudden being given the world back when you thought it had been taken away from you.  I would take this simple thing of a dried leaf, a stone -- during radiation, by the way, to find my way through the 30 steps, I would drive into Lincoln about 20 miles to get my treatment, and then when I came home I'd stop and get the mail up at our mailbox, and then I'd walk a few feet up and down the road and I'd find a stone on the road, and I took it down and put it on the window sill, so I could measure off all those days with those stones.  I've still got them.  I keep them in a jar on my desk as a sort of reminder.  But it was that pleasure in finding something, yeah.

Q:        You've done poetry most of your life, and being a poet, you are always observant, seeing things around you.  Having gone through your experience with cancer and come out the other side, have your perceptions changed at all?  A couple of other people have talked here about the vibrancy, and I can -- that even though it wasn't me, I was close enough to the event through the virtual experience, that things are much more vibrant to me now.  I don't know if that's been your experience because of the fact that you were observant before?

A:         Well, I trained myself to be observant a long time ago.  I think the big change is that I don't waste nearly as much time as I used to.  I spend a lot more time doing things like this and a lot less time watching "Law and Order" reruns on TV.  And that's part of it, I think.  I talk to any number of other people, though, who have had similar experiences, who have found all of a sudden life to be very vivid and bright.  You hate to fall upon cliches, but those people who say that cancer can be a gift I think are dead right -- that it really can focus you in ways that -- and another thing that it gave me was, I was never really a horse's ass, I mean, I've always been a fairly decent person.  But it delivered a dose of humility -- I mean, it really hit me hard.  I have a poem -- you'll forgive me if I read this again tonight to the whole audience.  If I can find it here.  This is a poem about the common experience that patients have.  I wrote this at the lead cancer center in Omaha in the waiting room one day when I was waiting to see Dr. Lydiatt.   After I got onto the six-month checkups later on, I went up to see him one day, and I had a new book out.  It's called Local Wonders: Seasons from the Bohemian Alps.  I took it up to give it to him and to get looked over.  We were sitting in this little examination room, just the two of us, and he said, "Ted, I want to tell you something.  Since I saw you last, I've been diagnosed with a thyroid cancer."  He said, "I was out with my family" -- he has three children and a wife -- "and we were driving out to my mother's in western Nebraska, and I got to coughing and I put my hand on my throat and felt it, just like that."  So his brother had actually done the surgery, his older brother, and it turned out he was fine, didn't have to have any radiation or anything.  So we were in this common thing in this room.  And I said, "Give me that book back, I want to read you something."  This is the very last passage in Local Wonders.  We sat there in this marvelous relationship of patient and doctor, both of us frightened and up against it.  He was of course handling it very well.  This is a prose passage.  It's the very last passage in this book.  This book is about living in rural America.

Life is a long walk forward through the crowded cars of a passenger train, the bright world racing past beyond the windows, people on either side of the aisle, strangers whose stories we never learn, dear friends whose names we long remember, and passing acquaintances whose names and faces we take in like a breath and soon breathe away.

There is a windy, perilous passage between each car and the next, and we steady ourselves and push across the iron couplers clenched beneath our feet.  Because we're fearful and unsteady, crossing through wind and noise, we more keenly feel the train rock under our legs, feel the steel rails give just a little under the weight, as if the rails were tightly stretched wire and there were nothing but air beneath them.

So many cars, so many passages.  For you there may be the dangerous passage of puberty, the wind hot and wild in your hair, followed by marriage, during which for a while you walk lightly under and infinite blue sky, then the rushing warm air of the birth of your first child, and then, so soon it seems, a door slams shut behind you, and you find yourself out in the cold, where you learn that the first of your parents has died.

But the next car is warm and bright, and you take a deep breath and unbutton your coat and wipe your glasses.  People on either side, so generous with their friendship, turn up their faces to you, and you warm your hands and theirs.  Some of them stand and grip your shoulders in their strong fingers, and you gladly accept their embraces, though you may not know them well.  How young you feel in their arms.

And so it goes, car after car, passage to passage, as you make your way forward.  The road bed seems to grow more irregular under the wheels as you walk along -- poor workmanship you think -- and to steady yourself, you put your hands on people's shoulders.  So much of the world, colorful as flying leaves, clatters past beyond the windows while you try to be attentive to those you move among, maybe stopping to help someone up from their seat, maybe pausing to tell a stranger about something you saw in one of the cars through which you passed, was it just yesterday or the day before?  Could it have been a week ago, a month ago, perhaps a year?

The locomotive is up ahead somewhere and you hope to have a minute's talk with the engineer, just a minute to ask a few questions of him.  You're pretty sure he'll be wearing a striped cap and have his red bandanna around his neck, badges of his authority, and he'll have his elbow crooked on the sill of the open window.  How impassively he will be gazing at the passing world as if he's seen it all before.  He knows just where the tracks will take us, as they narrow and narrow and narrow ahead to the point where they seem to join.

But there are still so many cars ahead, the next and the next and the next, clatter to clatter to clatter, and we close the door against the wind and find a new year, a club car brightly lit, fresh flowers and vases on the tables, green meadows beyond the windows, and lots of people who, together -- stranger, acquaintance, and friend -- turn towards you and, smiling broadly, lift their glasses.

So I read that to Bill that day, and the two of us sat there and cried in that office.  He was much more under control than I was, but it was a marvelous moment.

Since then I've done a number of things at the Med Center with students with him.  There's a project some of you may have read about called Saving Faces.  There's a painter in Scotland by the name of Mark Gilbert, who began in connection with hospitals in London, doing oil portraits of people who'd had facial reconstructions.  And my doctor got onto this and invited Mark to come over, and Mark has been in residency now for a little over a year at the University of Nebraska Med Center, doing that kind of work in preparation for a show that's going to be in December in Omaha, but also working with medical students about observation skills.  Mark teaches these young students drawing skills, and it's a marvelous technique, because if you have to draw something, you really do have to look at it, and it's a way of training them to try to be more observant.

And then I go up and do writing skills for observation.  I usually do something kind of wacky.  This last time I did it, I took up a sackful of pineapples, and I divided the students all into groups, and I told them that they had to write descriptions of pineapples in such a way that someone who had never seen one would know what it was or would be able to envision it.  It's a very challenging exercise, I'll tell you.  There's a lot to a pineapple.  We've done some things like that, and had a pretty good time.

I'm going to close the reading part of this with this poem, which I wrote at the Cancer Center, that I started to read a minute ago, and I'm coming back to it here.  This says a lot to me, looking back at it, about how I was beginning to feel a part of the patient community, to be absorbed in it.  This business about humility -- it is such a democratizing experience to be in an oncology waiting room with the banker from the biggest bank in Omaha, and at the other end of the room, or maybe seated side by side to him, the woman who on her knees every night cleans the floor in the banker's office.  And we're all in this together.  So here's this poem, and then I'd be happy to take questions, and if we finish a little early, it'll be to the advantage of the next speaker.

At the Cancer Clinic

She is being helped toward the open door
that leads to the examining rooms
by two young women I take to be her sisters.
Each bends to the weight of an arm
and steps with the straight tough bearing
of courage. At what must seem to be
a great distance, a nurse holds the door,
smiling and calling encouragement.
How patient she is in the crisp white sails
of her clothes. The sick woman
peers from under her funny knit cap
to watch each foot swing scuffing forward
and take its turn under her weight.
There is no restlessness or impatience
or anger anywhere in sight. Grace
fills the clean mold of this moment
and all the shuffling magazines grow still.

I saw that kind of grace fill those rooms again and again with things like that.  It was just palpable, almost.  Anyway, that's my little reading.  Anybody else have any questions?

Q:        Carl Sandburg, the poet, described the word "happiness" once in a poem by the same name, and I thought he did a lot better job than Webster.  So my question to you is, what exactly is a poem?  What is a poem and what isn't a poem?

A:         Well, I would say that a poem is a kind of record of a discovery.  It is either a discovery in the world, like those poems on the road, or a discovery in memory, or a discovery even in the language, you know, a word that does something -- what you do is you try to make a record of that.  What differentiates a poem from prose, let's say, is that in a prose paragraph, you can change a word for its synonym without really affecting too greatly the way the reader is going to receive that message.  But in a poem -- you know, a short poem like this might have, conscious and unconscious, a thousand decisions that were made.  When a poem is finished, you should not be able to change a word for its synonym, to change a punctuation mark, a period for a semicolon, without slightly diminishing the effect.  Everything in the finished poem ought to be the perfect choice.  Now, the chances of achieving that are -- you know, it's difficult.  But that's really the standard I use.  Now that prose that I read about walking through the train is very poetic, very dense prose.  But it's more poetic than prose usually is, I think.  So there are variations all along a continuum there.  But I would hesitate to draw a broad line and say, "This is all this and this is all that."

Q:        Your career path is absolutely fascinating.  It has parallels to that of Albert Einstein.  People have realized Albert Einstein's greatest achievement, the theory of general relativity -- he developed the concept working in a patent office for two years, which was a very boring job with a reasonable living and a lot of free time to think, and his evenings were free and he had very little stress outside of work.  So my question for you is, getting called out of classic English academia may have been a serendipitous beneficial thing for your career.  Would you agree?

A:         Absolutely.  And the great irony of all this is that now I have three honorary doctorates.  So there are other ways of getting your doctorate.  But life is so infinitely random -- I have often thought that when I was in third grade in Ames, Iowa, walking two blocks to Beardshear School, if I had at one of those corners turned the other way and gone around the block the other way, my entire life might have shaken out differently.  At every moment there's a decision that's going to guide you around this way.  I also want to say something about luck.  I have been immensely lucky.  I'm lucky to be alive.  But my literary career -- there are lots of poets who are very good at it, and as good at it as I am, who have not had the luck that I have had.  Give you an example, just one of many, that Local Wonders book, that prose book about rural America -- when I wrote it, the University of Nebraska Press picked it up, and the then-director said, "Well, Ted, you're a pretty well-known writer here on the Great Plains, this book'll probably do pretty well here, but we don't have any great aspirations for it nationally at all."  This is long before I became poet laureate, three years before, so really I was kind of an unknown writer.  So every year, all the publishers in the country gather at some place.  This year they happened to be in New York for the New York Book Expo.  And what they do is, they take all the titles that they published for the year and they display them on tables.  And so in this huge room, the University of Nebraska Press, which is one of the bigger university presses in the country, had on the table the 180 titles or whatever it was that they had published in the year.  And a woman came walking along, paused at my book, opened it up to a passage about a cowboy shirt that my mother had made for me when I was 14 that I can still wear, and she was touched by this.  Turns out this woman's name is Jill Lamar, and she is the person who picks the books for the Barnes and Noble Discover Great New Writers.  I mean, there is no way that I could have choreographed.  You can't leave a book open there.  It wouldn't have worked.  That's one example.

Another one is that Copper Canyon, who publishes my poetry now, is a small press in Port Townsend, Washington.  There are nine people on the staff.  They don't have a lot of money.  They publish poetry exclusively, so there's not a lot of revenue.  Came time for all the books from 2004 to be submitted to the Pulitzer Prizes.  What you do is you have to send five or six copies of the book plus 50 bucks for every book that you submit to the Pulitzers.  Well, Copper Canyon -- 50 dollars is a lot of money to a little press like that.  At the very last moment, Joseph Bednarek, who's in the marketing department there, said, "Well, let's send this book of Kooser's in.  We'll put the 50 bucks behind it and everything."  And of course then it won the Pulitzer Prize.  But the idea that it might not have been submitted at all -- it was just lucky that at the last minute he thought, "Well, let's do it anyway."  But I have had lots and lots of lucky breaks like that.

Q:        I suspect that most people, when they are given the news that they have cancer, experience some kind of spiritual crisis.  They have to examine the meaning of life and their relationship with their faith in God.  Did it affect you that way, and could you share any of that with us?

A:         Well, I've spent a lot of time in my whole adult life thinking about things like that.  I think that's part of what I do in poetry.  So I brood on those things a lot.  The presence of the disorder of cancer, the chaos of cancer, negated a lot of my sense that there had been a great unifying principle.  Coming out of that and since then, I have become more religious or more spiritual than I had been prior to that, I think.  I have always liked going to church, because it seems to me that it's a wonderful thing to be able to sit for an hour with a group of people who for at least one hour are doing no harm.  It's very comforting, in a way.  I have a feeling about the religions, that at the center of all of this, there is a common feeling among humans that there is some great mystery.  There is something that we are incapable of comprehending that is a powerful thing.  And I believe -- well, in metaphor, you have the real thing.  You have the glass of water, and then you have this imaginary thing to which you compare it.  This is called the tenor and this is called the vehicle.  Well, if the great unity or the great mystery is the tenor, then the vehicle are all the religions that surround it, so that all religions to me are metaphors for the same experience.  Each one -- and beautiful metaphors, all of them, the major religions are beautiful metaphorical expressions -- but at the center there is this thing.  That's my belief.  And I'm an Episcopalian.  I go through the Episcopal service every week, and people have said to me, "Well, how do you feel about communion, and all that, the blood and the body and all that stuff?"  And I say, "You know, it's metaphor.  This is what it is.  I'm participating in metaphor here.  And I'm happy to be."  I talked to a priest about this not too long ago, in Connecticut, an Anglican priest, about the fact that one of my friends had said that he couldn't go to communion, because he couldn't do that any more now that he'd grown up.  And the priest said, "He's taking it too literally," which I thought was really quite marvelous.  But I have a pretty rich spiritual life.  I like the scriptures.  I've been doing some psalm reading, and the psalmist -- it's so funny, the psalmist is such a pain in the ass.  I can't imagine what it would be like to be around the psalmist, who constantly is saying that he's being persecuted by his enemies and please help me out of this situation.  Come on.  But there's some beautiful language in it, of course.  What else?  That spirituality stuff probably killed everybody off.

Q:        You made a comment earlier that these were the most private poems that you had ever written.  As someone who likes to write but really is very very private -- I'm very private, I'm not sure that I want to share that with anybody.  How did that affect you in terms of your experience with cancer?  I know with my cancer, it made me even more private.  I felt so un-PC because I didn't want to share.

A:         Oh yeah.  Well, I grew up in a family where we never talked about feelings at all.  We were German-Americans, you know, very formal, and I occasionally would see my father give my mother a peck on the cheek, but there was nothing more demonstrative than that.  I remember very fondly being held by my father when I was a little boy, but in our adult lives, it was a handshake always, that sort of thing.  So we kept everything in like that.  And I could not have written those poems that are that intimate when I started to write.  But when this book came out, I had already been a writer for almost 40 years, so I felt much more confident that I could write something, that I was still in control of it, if that makes any sense.  Writing is about communication, though.  There are lots of people who say that they write only for themselves -- well, I don't know about that.  There's always the chance that someone's going to read it.

Q:        When you had the diagnosis of the squamous cell cancer of the tongue and you were going to be treated, did you feel like you wanted or got special care because of your profession and use of your voice and so on?

A:         I don't think so.  I really don't.

Q:        You just put yourself at the hands of the doctors and said, "Do whatever you think you should do"?

A:         Absolutely, yeah.

Q:        So you didn't go to the Internet?

A:         No.  Matter of fact, I didn't want a lot of information.  I'm tremendously suggestible.  All those years that I was a medical underwriter for the life insurance company, I had every imaginable disease.  Including breast cancer.  And so I didn't want to know a lot  about this.  I got my doctor's permission to let my wife talk to him about my condition, so she knew what the statistics were, and I did not.  I didn't want to know.  And it kind of went along those lines.  Now my wife is a breast cancer survivor of a couple of years, and she is the kind of person who devours information.  She knew everything about every modern drug, all the hormone factors and all those things.  I mean, within a week after her diagnosis, she had reams of paper that she had devoured.  She thrives on that.  But I'm not good about that kind of thing.

There have been several things that were said to me that I thought were very helpful throughout this process.  The first one was -- I can't remember who said this, whether it was my doctor or someone else, they said, "When you wake up in the morning, you look around and you say, 'Huh, doesn't look like I'm going to die today.  And the chances are really good that I'm not going to die tomorrow.  And unless things go catastrophic right away, I'm not going to be dead by the end of this month.  So what am I going to do?'"  And it was very helpful to me to look at it that way, that I had this whole day available, and I was fresh, and frankly I didn't feel too badly at all.  This was in the months fairly early on, when I didn't know whether there would be a recurrence or not, that sort of thing.  That was very helpful.

Another thing was that if you take a statistic like you've got a one in 20 chance of living five years -- Bill Lydiatt, my doctor, said, "Look at it this way, that out of 200,000 people, 10,000 of them are going to make it, and you can fit yourself into that 10,000, because that 10,000 includes a lot of people who have diabetes, who are smokers, who are drinkers, who have terrible conditions, and you can make yourself fit into 10,000 people, but you can't make yourself fit into that one out of 20."  I thought that was a very good thing.

I thank you very much for your attention.

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