I have now been running the emr.poetry account for a little over three years. Two hundred and ninety posts later, the account has over 80,000 followers from around the globe. There is an almost unmanageable number of submissions every day. If left idle for a few weeks, the submissions pile into the hundreds that I sort through when I have the time and motivation. Most submissions are good, a lot are funny, and a few have me in hysterics. There are the countless spelling errors in unfortunate places (‘Ward, mobilise, die’). There are the rich and colourful descriptions of psychiatric patients’ delusions, which, while an interesting insight, are automatically disqualified due to their extremely identifiable nature. If I had a dollar for every time someone sent in the words ‘pussy discharge’ in reference to someone’s attempt to record ‘purulence’ (yes, that is the word you’re looking for) I’d finally be able to quit my day job in which I write ‘purulent discharge’ about thirty times a minute.
But how does a submission make it on to the page? First, it has to make me laugh. Second, it should contain some innate x-factor that makes the string of text more than just an unfortunate sequence of words. Sure, some make it on to the page that are simply just a silly misspelling that lends itself to derision. But the truly great submissions are those that contain a certain poetic irony, or a deeper insight into the headspace of the author. That make the reader question: ‘why did they write it like that?’.
There are several devices the emr poet uses to enrich their verse including the addition of totally unnecessary detail – for example, verbatim accounts of patient’s abusive language: ‘patient told us to fuck off and called the consultant a “poofta bastard’.” Or the catty use of neutral third person voice to express frustration: ‘Extensive discussion with parents regarding grommets. This letter does not do justice to the extent of the discussion that took place’. The emr poem should not be disparaging of the patient, and the reader should not be led to mock them, but instead their mind should be turned to the internal life of the poet. How the unfolding scenario with which the poet is faced has been sensorially processed, internalised, and then recorded for all eternity. An insight into how they perceive the patient (true or otherwise) and in some cases how they perceive the world to be.
The most popular poem to date (included below) has over 11,000 ‘likes’ and continues to be a rich source of pleasure for followers.
(Jan 6, 2022, 11,215 likes)
So what makes it so good? Occasionally, I will modify the text structure of submission so that there are natural, lyrical breaks and create the shape of a stanza in the style of Rupi Kaur, or that 11.08am guy. This one was already beautifully presented. The structure of the stanza itself is remarkably elegant: its three lines set up with almost haiku-like symmetry giving a roughly equal number of syllables in lines one and three. ‘Patient teary + distressed / complaining of pain’ – a fairly quotidian start for an otherwise bland encounter, then boom: ‘Requesting a chardonnay’. What the fuck? Plot-twist aside, the author could have simply written ‘wine’ or ‘beverage’ but there has been a deliberate, and might I say, poetic choice to colour in that particular blank. ‘Chardonnay’: this single word is profound in that it instantly connotes a whole host of assumptions: that the patient is probably female; that they are in middle age; possibly with an inverted bob haircut with swept fringe; that they are a bit of a diva; that they are indeed Jennifer Coolidge from White Lotus. Remember, as a reader it is impossible to know if any of these things are true, but it is a telling glimpse through the eyes of an unreliable narrator. Poetry is fundamentally about producing vivid images with the merest of words.
(April 27, 2021, 1,488 likes)
Containing possibly my favourite line of all time, this is a criminally under-appreciated poem from the early days. It remains a hot contender when it comes to thinking about merchandise for the page, though I think having ‘NURSES NOT CUNTS’ on a t-shirt, as amusing as it would be, takes super-niche humour to a new level. Again, the fingerprints of artistic intent are fully on show here. There is first the decision to use the word ‘yanked’. This could have been made blander by the use of ‘pulled’ or ‘replaced’, but ‘yanked’ really gives the action a sense of assertiveness, bridled with emotion which comes blaring out in the next line “fuck off cunts”. The poem already functions in painting a picture, no doubt, familiar to the reader – an everyday encounter with an agitated or delirious patient going off their chops. But this poem wouldn’t work without the final couplet: ‘Patient told to mind his language, we are / Nurses not cunts’ - as if to suggest that if he had told them to “fuck off, nurses” that would somehow be more acceptable. The very idea of indignantly reminding someone that you are ‘not a cunt’ is obviously ludicrous. But in some ways it is also immediately endearing and you feel a closeness with the writer, who feels a need to have their defence of self-worth recorded in the patient’s chart for all eternity. And good on them.
(Jan 5, 2023, 6,518 likes)
Imagine receiving this as the overnight ward intern or resident. Your mind would probably be far from the poetic considerations at the time, but you can’t deny the text’s innate beauty. Here, it is not simply enough to say that the ‘patient swallowed [the] cannula’. To do so would be to say the ‘cat sat on the mat’ and the author knows this. There is an immediate visceral reaction of disgust in the reader, yes, but no wonder, no curiosity, no joie de vivre. The description is instead elevated by the following two lines, the use of the idiom ‘down the hatch’ like downing a shot of tequila at a hen’s party contrasting the very nature of what’s consumed. The cat no longer just sits on the mat – it leaps over the table, knocks over a vase, leaves a small shit in your morning coffee while looking you dead in the eye, to perch itself proud and indifferent on the mat.
In 1917, French artist Marcel Duchamp first exhibited a commonplace urinal on a plinth to a gallery of shocked critics and fellow artists, called ‘Fountain’. A replica of it now sits in the Tate Modern, London. It was a foundational piece in a movement called Dadaism, spearheaded by Duchamp, that sought to redefine what art could be. ‘Readymade’ pieces like these were objects without any particular significance in everyday life, but when placed in a gallery context, suddenly had special meaning attached to them.
What happens when everyday medical documentation is regurgitated in a serif font on white background and placed on a Rupi Kaur parody page? Well it’s certainly not earning me millions. But I do hope it makes readers do a double take, and when looking at the urinal in front of them (so to speak), think instead: ‘fountain’.
Okay I’ve always been obsessed with emr poetry, but ready your artistic process surrounding it has now made me love it that much more. It’s too easy to post all the absurd things we see in emr, but to actually consider it in a poetic context truly brings joy. Thank you for your contributions to current medical culture 🙏🏼
I love reading the posts in your account 😂