Chemo Refusal
Doctor’s gown off.
He looks again.
Goes tough, speaks plain:
“It’s back. Aggressive.
Don’t deny.
Without the chemo
you will die.”
The patient’s striking.
Coal-black hair.
A mouth on fire.
Some adults stare.
Married. Two kids
dressed with flair.
Teaches math.
Her children stare.
“When first discovered,
you declined.
I’m begging you
Do not go blind!”
She speaks, her voice
is soft, affirms—
her life. But only
on her terms.
“What are the odds
if I say yes?
They’re low. You know,
five years or less
of touch and breath,
of children growing,
the work I do,
that I adore.
I get the math.
My mind’s made up.
Thank you, doctor.
Say no more.”
One Plum
—a Petrarchan sonnet
You ask how much my patients mean to me?
She got under my skin—right from the start.
I watched her skin, her spine, her lungs and heart.
I followed her for decades, faithfully.
But then retirement came. With urgency.
I was about to set aside my art.
Life after death became my newest part.
No more long nights. No more emergency.
She came to see me one last time. She brought
A basket of fresh plums. This made me proud.
“I’m not allowed to take these, though.” With tears
She smiled and held them out. We both were caught.
I said: “I’ll take just one. That’s still allowed.”
I’ve kept that single plum through all these years.
Golan Shahar, Ph.D., is a professor of clinical-health psychology and public health at Ben-Gurion University of the Negev and an adjunct professor of psychiatry at Yale School of Medicine. His research examines stress, psychopathology, and mind–body processes. His creative writing, in both English and Hebrew, has appeared in On the Hill and Psychoanalytic Inquiry.
Thank you Golan, for these excellent poems. This is the first time I have ever read a set of poems (no less a sonnet) from a health professional about the relationship between himself and his patients. Your first poem hit home with me because my youngest daughter was diagnosed last year with acute myeloid leukemia at the age of 24; fortunately with chemo and a stem-cell transplant from my third daughter, she has survived and is today cancer-free. I would love to share with you a poem in blank verse about my daughter’s stem cell transplant which was published in February here at SCP :
https://www.classicalpoets.org/a-poem-on-her-daughters-stem-cell-transplant-by-theresa-werba/
And your plum poem is so poignant and understated, the Petrarchan form works exceedingly well here. Wonderful work!!! Thank you again!!!
Thanks, Theresa! I read your poem in blank verse and was awed. What a coincidence that we should meet through this topic, and what a relief to know that your daughter is well now.
Chemo refusal is a gnawing problem in oncology, and I was trying to give voice to this patient because, ultimately, this may be the only way to reach her, whatever the consequences.
Thank you also for your comments on the Petrarchan sonnet. Sonnets, in all their forms, strike me as particularly apt for medical poetry because their structure can hold both chaos and sudden turns of plot.
Thanks again for reading so thoughtfully and for sharing your own experience.
Golan, there is such a sincere depth of compassion and understanding woven into your poetry. Clearly, they come from a professional practice of one who has felt the heartbreak and indomitable spirit of others sharing in and caring for their broken dreams.
Thanks, Roy, for seeing this. I do write about my patients, but not only about them. The clinical-health psychology arena is a formidable avenue into the human situation. It is replete with the very same drama that I am trying to absorb and render in poetry.
Thank you for reading my work so thoughtfully.
Golan, These are gems, offering insight into the minds and souls of your patients and of you, yourself, as their care provider. I hope that you will continue to share your verse with us. This from a fellow poet who once looked like a plum but is now beginning to look more akin to a prune.
Thank you very much, James! I am truly grateful for your evaluation and comments. You know, the shift from a plum to a prune requires a considerable drought 🙂 I feel privileged to dwell in, and survive, such droughts (after all, I live in the desert…), and I am very grateful to SCP for providing a platform on which I can air these verses.
Thanks again for your generous words!
“My terms” made me stop. The power of the human spirit. Thank you for this education…
Thank you, Michael. I see it exactly the same way—as a testimony to the fierce power of the human spirit.
Many sad and bittersweet memories in medical practice. You captured it well, Golan.
Thank you very much, Gerald! I am at awe with respect to the lives of medical team members and am trying to give voice to their predicaments.
That’s a lovely sonnet, Golan, on the touching kind of give-and-take possible in medical practice. I’ve recently lost a best friend to cancer, having lived closer to her than her family could do during six months of treatment. The agonizing discomfort and uncertainties of treatment, and the distance usually maintained by doctors showed me why chemo refusal represents a good choice of “life on my own terms” to very many patients. On the other hand, another friend took chemo on his own terms by fasting before and after, which gave him a much more comfortable experience that may yet be life-saving. His own research and one helpful nurse made all the difference. Your own concern for mind-body processes and sensitive psychology to accompany therapy represent to me an important step in the many advances now taking place in standards of care.
Thank you so much, Margaret, for this thoughtful and moving response. I am very sorry for the loss of your friend. Your account captures precisely the complexity I was trying to approach: that illness and treatment are experienced not only by the body, but by a person struggling to preserve agency, dignity, and a sense of life on one’s own terms. This does not make the medical choices any less difficult; if anything, it makes genuine dialogue between patients and clinicians all the more important.
I was especially touched by your observation about mind-body processes and the psychological accompaniment of medical care. That intersection is very close to the heart of both my clinical work and my poetry. Thank you for reading the poems with such sensitivity and for sharing these experiences.
Thanks for these two well-crafted poems. The first has a terse, almost staccato structure that emphasises the grim choice that has to be made. The second is a nicely constructed sonnet.
Thanks, David! You got it right so very much. And the staccato structure also conveys the oncologist’s frustration in the face of the patient’s refusal. He comes to her with fury: “Shut the Fxxx up and let me cure you!” Which further solidifies the patient’s position. Writing this poem enabled me to see that more clearly.
One Plum is where I took a breath. 🙂
Mr. Shahar’s “Chemo Refusal” is surprisingly dramatic with so few words.