by Paul Keenan, Lecturer in Intellectual Disability Nursing


(This article stems from a lecture I give on the MA in Interprofessional Health Care Education module: ‘Reflectivity on Professional Practice’ at Suffolk College, Ipswich.)

‘Poetry’s only obligation is to the truth. Whether this truth is widely popular or not is irrelevant. It should be the best truth possible…’ (George Szirtes, quoted in The poets speak, The Guardian Review, 09 April 2005, p.25.).

In preparing this article I became aware that there is little evidence on the subject within health and social care literature.There is some literature on poetry as therapy (e.g. Nairn, 1998), and the uses of creative writing genres in the context of professional reflection (e.g. Winter et al. 1999), as well as a handful of book reviews.

With limited material on the subject, I have explored a range of literature on the poetry of disability in terms of its significance and usefulness in the context of practice. What follows are some of those findings and my thoughts on them.

The aim of this article is to articulate ideas, words and imagery –thought seeds—so that we may give some consideration to investigating poetry’s possibilities for enriching our professional understanding. I hope the article will be useful to all health and social care professionals and that the selected representations it contains will be of assistance to novices and experts alike who are open to new ideas for facilitating and strengthening the interrelated professional triad of knowledge, practice and values.

Can poetry and other aesthetic mediums have an effective part to play in learning? This article argues that it has. As a poet and health professional, I can anatomise and describe the people whose care we facilitate. I can offer rigorous advice and examples, give voice to their perspectives, all of which are the outcome of an interrelated triad: the interaction between a critical, reflective and creative discourse.

Poems can provide important insights into human nature. They can make us laugh or bring us to tears, reveal important insights which are hidden, complex, may be shaming or may enrich us with pride.

According to Smyth (1996), understanding the patient or carer’s perspective is central to responding to their needs. We can partly achieve this goal through the use of good peer reviewed textbooks and good teachers who encourage us to think in different ways about particular human emotions or situations. However, literature, according to Calman (1997), can provide greater insight ‘to particular individuals or events in a way that adds colour, depth, and feeling’.

To illustrate this I want to explore a number of intimate, profound and conversational pieces by the master Australian poet Les Murray. The poems are from his Subhuman Redneck Poems (Murray 1996) and the title poem from Bog fox field (Murray 1991). Together they illustrate Murray’s ‘generous and expansive sensibilities’ (Forbes 1992) and his multifaceted talents.

In the title poem of the book by the same name, Bog fox field (Murray 1991 p. 50), the author explores the first Nazi Holocaust, focusing on ‘feeblemindedness’ (intellectual disabilities). As Murray highlights in the epigraph people were asked by their doctor to construct a sentence from the works ‘dog’, ‘fox’ and ‘field’ (for example, The dog chased the fox across the field). If the person was unable to answer correctly they were deemed to be ‘feebleminded’ and ‘for having gazed, and shuffled and failed’ were carted off in furniture vans to be gassed by exhaust fumes fed into the back of the sealed van (‘they then had to thump and cry in the vans / that ran while stopped in Dog Fox Field’).

With its historical theme, the sonnet has contemporary resonance. It echoes elements of the ‘bio-medical’, the ‘charity/tragedy’ and the ‘social disability’ models of disability (Gates 2002). It raises important ethical and moral issues regarding societies’ care of vulnerable client groups (‘These were no leaders, but they were first / into the dark…’). The poem encourages one to reflect on standard setting in professional care, service development and one’s own clinical practice. See, for example, McIntosh’s exploration of power in contemporary client examination (McIntosh 2003). The last two profound lines of the poem encourage one to explore themes of prejudice and whether elements of this are still sedimented within current care structures and procedures:

Our sentries, whose holocaust does not end,
They show us when we cross into Dog Fox Field.

(Murray 1991. p. 50)

The second poem I wish to explore is Murray’s ‘It allows a portrait in line scan at fifteen’ (Murray 1996, pp. 42-43). He focuses on his son at the age of fifteen, in relation to his autism, and displays great fatherly love and humour, as well as some bitterness, as he paints a richly detailed and holistic portrait of his son in all his wonderful and beautiful complexities.

The poem provides authentic descriptions of the manifestation of autism in his son,+ from a father’s perspective. With ‘autism’ being such a broad, almost catch-all term, the descriptions seem far more useful for professionals providing person-centred care than the traditional assessment tool entries, such as stock phrases and ticks in boxes. It would be interesting to compare and contrast the detail of the father’s descriptive poem with that of the professional’s assessment notes.

For example:

He no longer hugs to disarm. It is gradually
allowing him affection.
It does not allow proportion. Distress is absolute,
shrieking, and runs him at frantic speed
through crashing doors. (Lines 2-3).

He can only lie in a panicked shout
sorrysorryididn’tidoit! Warding off conflict
with others and himself- (Line 10).

He has forgotten nothing, and remembers the
precise quality of / experience (Line 23).

He is anger’s mirror, and magnifies any near him, raging it down (Line 30).
He lives in objectivity (Line 35).
Eye contact, Mum! Means he truly wants
attention. It dislikes I-contact. (Line 39).

He is equitable and kind, and only ever a little
jealous. It was a relief when that little arrived. (Line 40).

The long, sweeping and fast moving rhythmic lines contain images full of movement and feeling. It is clear he sees his son first, his son with autism, rather than an ‘autistic’ son. This is evident by the oscillation between ‘he’ and ‘it’, ‘it’ of course being ‘autism’. Fatherly love and critical, reflective thought is evident throughout the poem. All these images are in stark contrast to the Freudian psychiatrist who says in blunt and insensitive terms that their son’s autism was caused by ‘refrigerator’ parents, and we sense Murray’s bitterness in telling this.

The Last Hellos (Murray 1996. p. 63), an elegy for his father Cecil, recounts the poet’s grief during his father’s last ‘two to six months’ and the three months that followed his death. In section one, of the four-section poem, Murray begins with a plea and a statement of acceptance after hearing the shocking news:

Don’t die, Dad –
But they die. (Lines 1-2)

The signs and symptoms of the father’s terminal illness are described in striking detail:

This last year he was wandery:
took off a new chainsaw blade
and cobbled a spare from bits (Lines 3-5)


His left shoulder kept rising
higher in his cardigan (Lines 8-9)


…he now missed
food on his knife’s side. (Lines 31-32)

There is a great warmth and tenderness of tone evident throughout the poem as he comes to terms with his father who is ‘busy dyin’. Although he begins section four with the line: ‘Grief ended when he died’ (Line 55), it is evident from the last stanza that he still experiences his loss:

Snods mind us off religion
Nowadays, if they can.
Fuck them. I wish you God.
(Murray 1996. Lines 74-76).

Finally in The Cotton Flannelette (Murray 1996. p.72), Murray recounts the story of a relative who at the tender age of six was severely burnt when her nightdress caught fire after brushing past the hearth. Ignoring the medical wisdom of the local doctor who had ‘spared her the treatment of the day’ and advised the mother to let her die, the family are united in loving care and devotion, as each take their turn round the cloak to rock the bed when she ‘whimpers…/ O shake the bed! Through beak lips that never / Will come unwry.’ And, ‘wring pale blue soap-water over nude bladders and blood-webbed chars.’ Until the doctor gives in and’…wraps you / in dressings that will be the fire again, / ripping anguish off agony’. The poem ends with the tender lines:

For the sixty more years your family weaves you
On devotion’s loom, rick-racking the bed
As you yourself, six years old, instruct them.
(Murray 1996, Lines 33-40)

The poem clearly shows that professionals don’t always know what is best. Secondly, according to Alexander (2000), because the family listened to their loved one’s needs she was able to live a fairly good life, to the age of sixty-six by all accounts.

A more detailed account of these poems may be found in Peter Alexander’s (2000) highly readable biography of Murray. For a more critical study providing detailed readings of many of Murray’s poems, as well as the literary and cultural contexts surrounding the work, see Steven Matthews scholarly work Les Murray (Matthews 2001).


The uses of poetry in professional learning are various. It can provide additional:

  • sources of knowledge.
  • starting points / triggers for reflective though and critical analysis.
  • Exemplars for developing more accurate, precise, truthful and authentic expressions.
  • Exemplars of reflection.


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