Mandatum: Accompanying a Patient Until the Very End

Listen to ASCO’s Journal of Clinical Oncology poem, "Mandatum” by Dr. David Harris, who is an Associate Staff in the Department of Palliative and Supportive Care and Program Director for the Hospice and Palliative Medicine Fellowship at Cleveland Clinic. The poem is followed by an interview with Harris and host Dr. Lidia Schapira. Dr Harris share how his team honors a patient's spirit

TRANSCRIPT

Narrator: Mandatum, by David Harris, MD  

Where does the soul reside

in the darkness of the body?

Does it flicker along the highways of nerves

up the spine

up the neck

to the globe of the skull

or does it pulse, a lightening bug

in the vast caverns of our bellies?

The foot was his answer

his left, to be precise.

The cancer mushrooming from his heel

a small price

for a soul.

We told him

he had a choice:

We would take the foot

or this sarcoma would take

all of him.

But when he chose,

we did not understand.

We told him

a hundred times

in a hundred ways.

We told him

he did not understand

could not understand

so could not choose.

He told us

he once walked

all night through the cold to reach us.

“When I die I want to be

whole.”

The foot

where our flesh greets the earth’s

flesh. Where our weight

collects

builds

presses down.

Where else would a soul

want to be

when we slip

bare feet into sand

letting the cool stream

run over?

We washed and wrapped

the foot in white, clean cloth

then unwrapped it, to wash again.

Washing as the cancer grew.

Washing as the soul flickered.

Each day washing. Choosing

what we could not understand.

Dr. Lidia Schapira: Hello and welcome to JCO's Cancer Stories: The Art of Oncology, which features essays and personal reflections from authors exploring their experience in the field of oncology. I am your host, Dr. Lidia Schapira, Professor of Medicine at Stanford University. Today we're joined by Dr. David Harris, Associate Staff in the Department of Palliative and Supportive Care and Program Director for the Hospice and Palliative Medicine Fellowship at Cleveland Clinic. In this episode, we will be discussing his Art of Oncology poem, “Mandatum.”

At the time of this recording, our guest has no disclosures. 

David, welcome to our podcast and thank you for joining us. 

Dr. David Harris Thank you, Lidia. It's wonderful to be here. 

Dr. Lidia Schapira: Let's start by talking a little bit about your process for writing. You're a published author. We've published one of your beautiful poems in the past. This is, I believe, the second time. So tell us a little bit about when you write, why you write, and when you decide to share your writing with others through publications.

Dr. David Harris: I think my writing starts when I have an experience that feels profound and sticks with me, and there's a certain way that feels in my body. I'll leave a room and I'll say, something happened in there. It didn't just happen to the patient, but something happened to me. It'll be one of those moments, and I think we all have these that we keep coming back to, a patient that we keep coming back to, sometimes even a single sentence that somebody said that we keep coming back to. And over time, I've realized that when I have that feeling, there's some poetry there, if I can sit with it. And I spend a lot of time just sitting and thinking about the story and trying to find what pieces of it are meaningful to me, what images are meaningful. And from there, after a long time just sitting and experiencing and listening to myself, then I