|Keywords||Anesthesia, Body Self-Image, Doctor-Patient Relationship, Ekphrasis, History of Medicine, Patient Experience, Power Relations, Sexuality, Surgery, Technology, Vision Disorder|
|Summary||"Propofol" is a 20 line poem of five quatrains each with an a-b-a-b rhyming scheme. Appearing in the June 30, 2008 New Yorker magazine, it is a description of the Classical allusions and hallucinatory experience surrounding the administration of the hypnosedative, propofol, to the speaker-patient for an undescribed medical procedure.|
It involves a whimsical conversation, of sorts, between the patient and the physician. After the patient references many of the Greek and Roman materials (moly, mandragora), art ("Euphronios' famous calyx-krater" [http://en.wikipedia.org/wiki/Euphronios_krater]) and deities (Somnus, Hypnos, Morpheus) involved with sleep and death ("Sleep and Death were brothers"), the physician is made to ask why the patient is there - one presumes, and only hopes, he in fact knows!
The poem ends with the onset of what is known as procedural sedation ("A traveller/approached the citadel even while I was speaking,/seven seconds from my brain; then it was snuff."). The final two lines describe the image - apparently now in the hallucinating patient's head - of Félicien Rops' 1879 painting "Pornokrates", in the Musée provincial Félicien Rops, Namur, France (http://www.museerops.be/tech/drawing/pornokrates.html), the genesis of which Rops described thus in a 1879 letter to Henri Liesse:
"I did this in four days in a room of blue satin, in an overheated apartment, full of different smells, where the opopanax and cyclamen gave me a slight fever conducive towards production or even towards reproduction."[quoted at the Musée provincial Félicien Rops site.]
|Commentary||Propofol, or 2,6-diisopropylphenol, is an intravenous agent used in the U.S. for anesthesia and procedural sedation both for humans and in veterinary practice. When used for procedural sedation, i.e., when the medical provider is about to perform a brief and unpleasant procedure that would be too uncomfortable for the patient to tolerate awake, even with less than sedating levels of pain and relaxation medicines, propofol is ideal. It has mild analgesic properties and can be safely combined with stronger pain medicines, has a rapid onset of action with a brief duration, and is amnestic, meaning the patient does not recall any of the events or pain of the procedure. (Since propofol is a milky white formulation, it has thus earned the nickname of "milk of amnesia.") Some of the common procedures for which we use it in medicine are colonoscopy in the out-patient venue, and joint manipulations, e.g., reducing dislocated shoulders, in the emergency department.|
Although I come to this poem, unlike most readers, uniquely qualified (I was a Greek and Latin major in college and remain active in the Classics; and, as a 64 year old emergency physician, I have given, and received, my share of propofol), the educated reader will understand most of the references without the need to consult texts (or the internet) of pharmacology, mythology or art. Some of them are intentionally arcane, like moly and mandragora, but are actually fun to research.
Mr. Kirchwey clearly likes to use medical subjects for his poems. (See "Barium" and "Sonogram" in this database) Employing one's own illness or procedures as the basis for literature is a hoary tradition, ranging from Ovid's Tristia to Virginia Woolf's On Being Ill (also in this database) to Paul Muldoon's poems in this database.
Although the poem succeeds in setting the proper mythological and ancient setting for the themes of sleep, death, hypnosis and the altered level of consciousness/hallucination surrounding such procedures, whether it be via propofol or other hypnosedatives, it suffers from the derogatory tone applied to the physician as buffoon/foil: when the physician smiles, it is with one that is "thin and slight"; when the witty poet refers to the Sleep and Death as brothers, Doctor Day can only reply, "I am a singleton" (a word that one can not help but feel was chosen purely for its rhyme, since it adds nothing else to the poem); lastly, the doctor looks "blank" in response to the allusions to doctor qua Somnus or Hypnos or Morpheus ("Classics not his thing, I guess.") These are unnecessary slights and again do not further the poem, or, for that matter, the poet.
It is interesting that the final lines of the poem refer to Pornokrates, a neologism of Rops. The word/name (derived from πορνη [prostitute] and κρατέω [hold sway,, rule]) does not appear anywhere in a generous assortment of classical art, literary and mythology texts I consulted. While I have never personally experienced such hallucinations with propofol, or heard of them from the many patients to whom I have administered it over the past 12 years, a search of PubMed does identify sexual hallucinations with such sedation, especially with propofol (e.g.,Therapie. 2008 Mar-Apr;63(2):141-4. Epub 2008 Jun 20. "Propofol-induced hallucinations and dreams").
|Source||New Yorker Magazine|
|Edition||June 30, 2008|
|Annotated by||Ratzan, Richard M.|
|Date of Entry||03/30/10|