Literature Annotations


Watts, H. David
Starting the I.V.


On-Line Text and Audio
Genre Poem
KeywordsAnesthesia, Doctor-Patient Relationship, Empathy, Physician Experience, Surgery
Summary

This poem explores the act of inserting an intravenous line (I.V.) into a patient just prior to induction of anesthesia or sedation. The physician-narrator is initially full of bravado, stating "I am good at this" and "I'm the best". The physicality of the act is detailed: the vein "lies stretched and succulent" and the needle "waits / like a mosquito attached / by its sucker." By the end of the second stanza, however, when the I.V. has been successfully inserted, the significance of this seemingly simple medical intervention is stated: "I am suddenly aware / I am connected to his brain."

It is this power, the fear of this power felt by both the doctor and the patient, and, by extension, the fear of anesthesia or sedation, that form the heart of the poem. The narrator states that he cannot let his own fears about anesthesia and "loss of control get in the way." Instead he accepts the power and control that the patient gives him and "bring[s] him down."

CommentaryIssues of trust, fear, empathy and connection--both physical and non-physical--are contained in this poem. The physician-narrator senses the patient's fear by noting his muscle tension; he slides his fingers over the patient's arm, feeling the vein. This skin-to-skin connection is then altered by the break in the skin; after the I.V. is inserted, the physician is connected to the patient's bloodstream and can easily affect the patient's body by the injection of a drug. By exploring multiple issues that arise from the routine act of starting an I.V., the author underscores how complex and multifaceted is the world of medical intervention.
SourceJ. Amer. Med. Assoc., 267(6): 866 (1992)
PublisherAmerican Medical Association
Place PublishedChicago
Alternate SourceTaking the History
Alternate PublisherNightshade
Alternate Edition1999
Place PublishedTroy, Maine
Annotated by Shafer, Audrey
Date of Entry 04/23/97
Last Revised 04/22/05