“The doctor who only knows medicine doesn’t even know medicine.” This motto is engraved in the main atrium of the old building of the Abel Salazar Institute of Biomedical Sciences at the University of Porto, Portugal. Salazar, the center’s patron physician, was a renowned painter who resisted the dictatorial regime that governed the country in the mid-20th century. During his six years of study, the plastic surgeon and poet João Luís Barreto Guimarães passed this phrase daily before entering class, fully embracing its meaning. Today, he uses this saying as his guiding principle to teach how to interpret poetry at the same faculty where he graduated and where his father served as a professor.
At 57, Guimarães teaches the first poetry class for medical students in Europe. In a single semester, over 100 poems are analyzed in a class of around 30 students. In September, he will commence the fourth consecutive year of the course. All the texts have been carefully selected during his 40 years of writing. Some poems have even been translated by him. “What unites all the poems is empathy,” he remarks just moments before meeting some of his readers at a reading club in the Pequeños Seres bookstore in El Rastro, in central Madrid.
Before becoming a specialist in breast cancer, the winner of the 2022 Fernando Pessoa Poetry Prize was already an accomplished writer. “I started writing at 16, and soon my works appeared in literary magazines and in the Diario de Noticias de Lisboa. I published my first book at 20,” he shares without false modesty. Since then, he has published 15 works in Portuguese, and in March he arrived in Madrid to celebrate the Spanish translation of his book Mediterráneo (Vaso Roto). “My two professions stem from the same hands. In writing, I don’t seek precision, for it is a very static concept, whereas on the operating table and on paper, I pursue symmetry.”
Empathy through Poetry
Guimarães’s poetry reflects everyday life: having a coffee, enjoying the January sun, or observing the ebb and flow of strangers. “I rarely write about medicine,” he explains. However, all the texts analyzed in the course touch on recurring themes in a doctor’s life: birth, the practice of medicine, diagnosis, healing, and the fatigue that follows a long day. According to Guimarães, death is the most challenging topic for students, who are typically between 19 and 21 years old. “Most have never directly faced loss, and considering it on an abstract level helps prepare them for a profession that often involves delivering bad news,” he notes.
The educational value of the subject lies in broadening technically trained minds to embrace subjectivity. “It can be so satisfying to make a brilliant diagnosis and apply a treatment that one can easily lose sight of the fact that there is a person suffering from an illness,” Guimarães explains. This insight comes from personal experience: “Once my father received a complex diagnosis for a pathology that is difficult to detect, and I could see in the doctor’s eyes and mannerisms that he was more excited about the complexity of his work than compassionate about the seriousness of my father’s condition,” he explains, arms crossed and gaze fixed on his wife and oncologist, Teresa Barreto Guimarães.
The oncologist has attended her husband’s course three times. Classes take place on Fridays, and Guimarães encourages her to stay afterward so they can go for a walk and return home together. She expresses her enjoyment of witnessing the reactions and amazement of her future colleagues. The surgeon provocatively asks her if she has ever recalled a poem while treating terminal cancer patients. She reflects: “Of course, the poem ‘Biopsy’ by Helen Farish comes to mind. I often think about what might have been prevented had the diagnosis been made sooner,” she emphasizes while naturally reciting the first lines from memory.
I’m going to run away with my breasts
to Barcelona, to the Canary Islands.
Do you fancy a bit of life by the sea?
fishermen, local wine.
I’m not leaving another piece in the hospital.
Now I understand the tumor,
the way the cells clump together
in a crescent equal to a young moon,
a boat in calm waters, a net.
All those symbols of longing:
having paid attention
would not have materialized.
The oncologist acknowledges the necessity of this training within specialties like hers. “I have patients who require more than the 30 minutes allotted in my schedule. Some news takes time to convey, and the way we deliver it can alter the course of a disease,” she reflects. However, the discipline extends beyond merely reaching the patient; it also concerns how a future doctor aspires to be, fundamentally, a human being. “There is a poem that suggests the first thing a doctor should do when they arrive home is to change the light bulb. I explain that it is essential to recognize that the light in their home symbolizes their family, friends, and hobbies.” The professor emphasizes that the success of the course is also linked to fulfilling the personal aspirations of young people. “Once a student admitted they attended classes simply because they wanted to become a more cultured person,” he recalls with a laugh.
Two Ways of Experiencing Time
For Guimarães the poet, time is an almost infinite resource; for the doctor, it represents the distinction between having more or fewer hours in life. This delineates the primary difference between his two routines. “I know my patients; I don’t know my readers.” This reading club is one of the scarce opportunities he has to interact with his international readers. A neuroscientist from Madrid, who is part of the group, raises her hand to ask him a question:
― How do you integrate science into your writing?
She speaks before 13 other colleagues gathered in a warm, dimly lit setting. The poet looks at her and replies candidly: “You will seldom find anything in my work concerning my profession, and vice versa. The first genuine convergence of the two occurs in the classes I teach.”
Guimarães encapsulates his two vocations with a scalpel and a pen. “In the operating room, when I discover a tumor, there’s no space for creativity,” he states. Saving lives demands precision, and within a hospital, he does not contemplate poetry—it is time to deliver accurate outcomes. Nonetheless, many aspects of the poetic experience manifest when talking about the human body: the Achilles heel, Cupid’s bow, Adam’s apple. And the subtlety of euphemisms to discuss passing rather than death. “The poetic experience is omnipresent and can also be discovered in the multidisciplinary teaching of empathy.”
The Portuguese poet Fernando Pessoa, after whom the most prestigious literary prize won by the surgeon is named, lived his life through various heteronyms—different personas or characters attributed to an author. The ability to avoid living a double life is what João Guimarães considers the most rewarding aspect of this experience: “Being a doctor who teaches poetry allows me to exist wholly in my duality.” This wholeness enables João and his students to fulfill Abel Salazar’s challenge: learning to heal with medicine, while also not forgetting to tend to the soul.
The Doctor Who Only Knows Medicine Doesn’t Even Know Medicine
“The doctor who only knows medicine, doesn’t even know medicine.” This thought-provoking motto is engraved in the main atrium of the old building of the Abel Salazar Institute of Biomedical Sciences at the University of Porto, Portugal. It pays homage to Abel Salazar, a distinguished physician and artist who was known for his resistance against the dictatorial regime that plagued Portugal in the mid-20th century. This poignant saying has inspired many, including plastic surgeon and poet João Luís Barreto Guimarães, who recalls how it influenced his medical and literary journey during his years of study.
João Luís Barreto Guimarães: A Unique Intersection of Medicine and Poetry
At 57, Guimarães is pioneering a first-of-its-kind poetry class for doctors in Europe at the same faculty where he graduated and where his father taught. In just one semester, he guides about 30 students through an exploration of more than 100 carefully selected poems. The course is now starting its fourth consecutive year, emphasizing the intersection of empathy and emotional intelligence within the medical profession.
“What unites all the poems is empathy,” Guimarães states confidently just before engaging with readers at a local reading club. This statement encapsulates the essence of his teaching philosophy, steering future medical professionals toward a deeper understanding of not only their patients’ ailments but also their emotional experiences.
A Journey from Literature to Medicine
Before establishing himself as a breast cancer specialist, Guimarães was a writer. His literary career commenced at age 16, leading to publications in various literary magazines and his first book at the age of 20. Currently, he has published over 15 works in Portuguese and is celebrating the recent Spanish translation of his book Mediterráneo in Madrid. He expresses, “My two jobs come from the same hands. In writing, I don’t seek accuracy, but rather symmetry.”
Empathy Through Poetry: The Course Structure
The structure of Guimarães’ course is predominantly focused on everyday life themes—portraying ordinary moments such as having coffee or observing the January sun—rather than the intricacies of medicine itself. He emphasizes that although he seldom writes about medicine, the themes discussed in class frequently revolve around significant aspects of a doctor’s life: birth, diagnosis, treatment, and the emotional toll of a lengthy day. Notably, Guimarães highlights the theme of death as the most challenging topic for his students, many of whom are navigating loss for the first time. He believes that engaging with these concepts profoundly equips them for their future roles as healthcare providers.
Benefits of Exploring Poetry in Medicine
- Fostering Empathy: Literature allows medical professionals to connect with patients on a human level, enhancing their ability to provide compassionate care.
- Improving Communication Skills: Analyzing poetry encourages clarity and effectiveness in conveying difficult diagnoses.
- Encouraging Reflective Practice: Engaging with poetry promotes self-awareness and reflection, critical for personal and professional growth.
- Enhancing Emotional Intelligence: Understanding the emotional landscape of poetry allows doctors to better manage their own emotions and team dynamics.
Real-Life Impact: A Case Study of Physician Empathy
Guimarães shared a personal experience that significantly shapes his perspective on patient care. When his father received a complex diagnosis, Guimarães noticed the physician’s enthusiasm for the medical challenge overshadowing the family’s need for compassion. This encounter motivated him to bridge the gap between clinical precision and empathetic patient care, a lesson reflected in his teachings. “Once my father received a complex diagnosis for a hard-to-detect pathology, I saw in the doctor’s eyes more eagerness for the complexity than compassion for my father’s condition,” he reveals.
The Role of Poetry in Oncology
Guimarães’ wife, Teresa Barreto Guimarães, an oncologist, has taken his poetry course three times. She acknowledges its relevance to her specialty, stating, “I have patients who need more than the 30 minutes in my schedule. Some news needs time to be told, and the manner of delivery can indeed affect a disease’s trajectory.” The integration of literature into her practice allows her to approach sensitive conversations with care and consideration, ensuring patients feel supported during theirs challenging moments.
Rediscovering Humanity in Medicine
For Guimarães, the dichotomy between being a poet and a surgeon is striking. While poetry embodies creativity and expression, the operating room is solely about precision and life-saving efficacy. He elaborates, “When I find a tumor, there is no room for creativity,” mirroring the seriousness required in surgical practices. Nevertheless, he believes elements of poetry naturally mingle into the medical vocabulary, evident in terms like “Achilles heel” and “Cupid’s bow,” which highlight the human experience underlying clinical language.
Creating a Culture of Care
Guimarães emphasizes that the essence of his class extends beyond medicine to nurturing a holistic approach to healthcare. “A poem suggests that a doctor should first change the light bulb upon returning home, signifying the importance of family and personal well-being,” he elucidates. This holistic view fosters resilience in young doctors, ensuring they remain whole even while facing the emotional demands of their profession.
Uniting Science and Literature
A poignant moment arises during a reading club event when a neuroscientist asks Guimarães how he incorporates science into his writing. He candidly responds, “You will hardly find anything about my craft in my work and vice versa. The fusion of both aspects occurs mainly in my teaching.” This integration enables future physicians to draw from both disciplines, enriching their medical approach with the nuances of literary expression.
Time: The Eternal Divide
Guimarães perceives time uniquely in his dual roles; for a surgeon, it can mean the difference between life and death, while a poet views it as a boundless resource. He aptly concludes, “I know my patients; I don’t know my readers,” emphasizing the often transient relationship between doctor and patient versus poet and audience. His poetry serves not just as an expression but as a bridge to understanding the underlying emotions faced by individuals navigating health and wellness.
The Poetic Journey: A Full Circle
Fernando Pessoa, the patron of the literary award Guimarães received, lived with many heteronyms—varied personas contributing to his diverse works. Guimarães feels fortunate to fuse his dual identities harmoniously. He summarizes his experiences simply: “Being a doctor who teaches poetry allows me to live out my totality.” In doing so, Guimarães and his students embody Abel Salazar’s vision—learning to heal not only from a clinical standpoint but also nurturing the soul through literature and human connection.
