Literature, Arts, and Medicine Database

Zimmer, Paul
The Tenth Circle

Zimmer's poem begins with policy guidelines for landlords whose elderly tenants may be calling the switchboard more than three times per month for health emergencies. According to the guidelines, such patterns suggest that the resident, no longer capable of independent living, can be moved to a health care center.

In response to the policy passage, an advisory poem is constructed by the narrator for his own father who, we can assume, values his independence. In essence the son advises silence about medical events such as a fall: "tell no one." If an ambulance should arrive, don't get in.

The strong warnings reflect contemporary health care systems in which the prevailing practices correspond to Dante's Inferno, particularly the tenth circle. At that level, everyone faces one direction and people are "piled like cordwood inside the cranium of Satan." Cries for help are unheard and unanswered.

Illness has always suggested nightmarish qualities, but health care systems have been regarded, with some notable exceptions, as sanctuaries of care. With recent demographic shifts and a burgeoning elder cohort, care provisions have not kept pace with need. Tremendous concern exists for aging citizens, family members, and care providers about the "management" of care in the decades ahead. Unfortunately, institutional care realities are frequently so discomforting that the impression created in the poem is familiar.

It is useful to include excerpts from Dante's Inferno in discussions. How does the policy statement differ in style and content from that of the poem?