Listen to Journal of Clinical Oncology's Art of Oncology poem, "Transcription: Phone Call, 2018" by Elane Kim, a student at Harvard College. The poem is followed by an interview with Kim and host Dr. Mikkael Sekeres. Kim shares her poem that lingers in the spaces between words; a mother and daughter navigating illness and memory.

TRANSCRIPT

Narrator: Transcription: Phone Call, 2018, by Elane Kim

Spiculated mass, irregular contours.

Can you come to translate these words?

Something in the lung. Yes, I am eating well.

Birds, green ones, are nesting outside

the window. Singing as if they aren't young

but dying. Lately, I have been singing.

Since we last spoke, the snow has melted into pearls.

Rare and pale, glittering like it's the last time

you'll ever see it. Will you come see it?

In Korea, we say magpies bring good luck.

I dreamt of one the last night I slept well.

Though you are my daughter, I feel like

a child. In our language, the word for cancer

comes from the character for mouth.

The fruit you bought is too tough to swallow.

The cough is worse in the mornings

and after rain. When you were younger,

you loved the rain. If I could do anything,

I would like to see the snow.

To see it for the first time again,

the cold a shivering afterthought.

Time passes in pieces:

one appointment, then the next.

Monday, can you ask the doctor

about the prescription?

Will it be stronger?

Every new day is an empty one.

No appetite. No warmth.

I hope I did not give you a rotten body,

my body. Will I be stronger? I feel

a shattering inside. Hello?

You are breaking up.

Remember to eat well, daughter.

Remember to call home.

Dr. Mikkael Sekeres: 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 oncology field. I'm your host, Mikkael Sekeres. I'm Professor of Medicine and Chief of the Division of Hematology at the Sylvester Comprehensive Cancer Center, University of Miami.

Today we are joined by Elane Kim, a student at Harvard College. In this episode, we will be discussing her Art of Oncology poem, "Transcription: Phone Call 2018."

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

Elane, what a joy to have you on our podcast. Welcome and thank you for joining us.

Elane Kim: Thank you so much for having me - very excited.

Dr. Mikkael Sekeres: So am I actually. Elane, I was wondering, I think you may be one of the youngest authors we've accepted a piece from. You had an absolutely gorgeous poem that you submitted to us and we were so thrilled that you chose us for your submission and ultimately that we were able to publish it.

Elane Kim: Oh, that's so exciting.

Dr. Mikkael Sekeres: So, can we start out with just kind of some general questions about you? Can you tell us about yourself? Where are you from? And walk us through how you reached this point in your career.

Elane Kim: I'm originally from California, but I moved to the East Coast for college and I'm also a writer. I love to write fiction and poetry. When I first started writing, I wrote for fun for a really long time, but I started to kind of take it seriously in middle school because I went to this one slam poetry event and I remember I went home and I told my mom, "I am going to be a poet." And so ever since then, I've been writing poetry and it's been really awesome for me because it's my way of expressing myself and translating my world into words and having a space where I'm able to experiment fearlessly. So I love to write and it's been a journey for me because I started publishing little poems here and there. And now my debut full length is coming out early next year with a small and lovely press. So I'm very excited and also honored to be on this podcast with you.

Dr. Mikkael Sekeres: Elane, I can tell you as a parent of a daughter who's a rising senior in college, it's every parent's dream when your child comes home and says, "I want to be a poet."

So the question I wanted to ask is, are you a writer who dipped her toe into medicine or are you an aspiring doctor who dipped her toe into writing?

Elane Kim: Oh my gosh, it's hard to say. I really love science, but I also really love writing. So I think maybe it comes from a place of wanting to do both because I also think that, I don't know, I really, really admire doctors for everything they do because from everything I've seen, I feel like medicine is a place where I think you need to have very deep empathy in order to proceed. So I also think writing is a place where you need empathy and so I think maybe a little bit of both. It's sort of hard for me to see which angle.

Dr. Mikkael Sekeres: That's okay. You still have a couple years in college and, of course, the rest of your life to figure that out. But I think you're right. We obviously meet a lot of doctors who are writers. That's probably the main phenotype of the sort of person who submits something to the Art of Oncology at JCO. But I've always felt there's a lot of overlap between the two because inherently medicine is about storytelling. A patient comes to us with a story of illness. We tell that story to ourselves, to our colleagues when we're getting consults, and eventually we're trying to find the denouement of that story, where we have an answer for the story of illness. So I think it's great that you're still open to both aspects of this, writing and medicine, and I completely agree with you. I do think there's a lot of overlap between the two.

Elane Kim: I think that's really beautiful.

Dr. Mikkael Sekeres: Tell us about your journey as a writer then. So you talked about going to a poetry slam, but of course, you had to have gone there with a piece of poetry to participate. So when did you start writing poetry?

Elane Kim: I always wrote poetry for fun. I loved making cards and stuff for my parents and my family for every little event. So I was my own like Hallmark factory. So I used to write really silly things and so whenever like people wanted cards or anything, I always had a poem ready. But then I started taking it seriously after this slam poetry event. I feel like slam poetry is very rooted in emotion and performance. And so all the poets there are so awesome and they really like are able to get into character and share their story in a very like raw way, which I thought was so, so awesome.

And it was sort of the first time I had seen poetry as less of a vehicle for like a Valentine's Day joke or something and more of an actual story with like a punchline with a lot of character and individuality. And so that was sort of a space where I saw all these poets who were so excited about what they were doing and able to tell a story about something bigger than themselves. And so I think that was kind of a turning point and little middle school me, I was like, "This is totally what I want to do and totally something I want to pursue." And although I no longer am like strictly in the spoken word space, I still think every single poem should be read aloud and should be shared with people in a space where everyone's listening and everyone's able to gain something new from it.

Dr. Mikkael Sekeres: It's beautifully stated. And you know, that notion of reading words aloud is so important and that's advice that I give to some of my mentees even in scientific writing. As they're moving along, I'll actually say to them, "Okay, now read that paragraph or those sentences out loud and tell me if they make sense." And as they're reading them, they'll often realize, "Wait a second, it's constructed the wrong way. And I'm burying the lead or the grammar doesn't quite work out." And they rewrite it. So I love the fact that you talk about writing as something that should be read out loud. I think that's true whether you're writing creatively with poems or narrative pieces or even in scientific writing.

Can you tell us what prompted you to write "Transcription: Phone Call 2018?"

Elane Kim: Kind of like the title suggests, I wrote this poem after I had a phone call with a loved one that really stayed with me because I think there were a lot of, I guess, distances that were traversed through that phone call and it was a little bit more about what was left unsaid as opposed to what was said. So the poem is- it kind of addresses this, but there are language barriers, generational gaps, and also like the weight of illness that's bearing on this conversation that sort of bleeds into everyday life. And so I was thinking a little bit about how people can often carry conversations across physical distance and also emotional distance, especially in immigrant families, for example, where a lot of the times communication is something more emotional or cultural rather than something that's, you know, said through sentences. And so I think that the poem is both like a literal transcription of a phone call that's like spliced up, but also maybe like an emotional transcription where we're trying to preserve this moment of love and tenderness between a mother and a daughter.

Dr. Mikkael Sekeres: It's really a terrific piece. I keep saying this over and over again. You captured so much in so few words, which of course, is the goal of poetry. One of the things that I loved about your poem is how you captured the fractured nature of phone calls, particularly if you're hearing bits and pieces on either side of the phone call.

You start the poem focusing on otherness. I mean, right out of the gates, on being an outsider. Your first line is "Spiculated mass, irregular contours," which is some of our medical speak. And then the next line immediately says, "Can you translate these words?" You're already saying the person, the character who's speaking that line doesn't get it, right? It doesn't make sense to them. They need help in figuring it out. Can you talk about this from the perspective of coming from another country or culture and as a neophyte to medical terminology?

Elane Kim: Definitely. It's so awesome that you're able to notice all these small details and everything. That's so awesome.

Dr. Mikkael Sekeres: It's a testimony to your writing. You're a great writer.

Elane Kim: That's so kind of you, but I'm very excited to get to talk about all this. Yeah, like you said, there's like an insider/outsider dynamic. I guess as somebody who might be new to this country, there's also somebody who's new to medicine and how there can be a lot of barriers there where if you don't have somebody who's acting as somebody who can be in both worlds at once and translate these things, then you're sort of left in the dark. And I think the role of translator is very important here because you're not totally in one world or the other. You're kind of this floating being who is in charge of traversing both worlds and bringing, in this case, the mother from one to the next. But because of this, I think that sort of suggests that the person who is receiving the phone call is not totally comfortable in one world or the other world. They're sort of playing this mediator role. And I think that also maybe speaks to belonging in this poem as well.

Dr. Mikkael Sekeres: Yeah. It really emphasizes how critical it is, particularly with serious diagnoses in medicine like cancer, that people bring with them another set of ears, or sometimes we'll joke and we'll say they bring an ectopic brain with them, someone else who can listen because it's not only the medical terminology that people trip over, but like you say, it's the emotions of the diagnosis and how receptive people are to the information. So they need somebody else there as another source of truth and another advocate to ask the right questions and also make sure that what the patient is hearing is what's being said and vice versa.

So, are there poets who've been particular influences on you and if I could ask, who and how?

Elane Kim: When I was first starting out, I really appreciated slam poets and I still do. I love slam poets. I remember I would go home and watch YouTube videos like over and over of these poets performing their work. For example, I really love Sarah Kay. I also really love Hieu Minh Nguyen. Both of them, oh my gosh, so, so awesome. And I think they bring a lot of, especially Sarah Kay, she brings a lot of whimsy into her work and also a lot of naturalistic references and also like scientific references that you wouldn't necessarily expect. Like, she has this one poem about these birds called starlings and when they fly together, they fly in the big shape of another starling, which is really fascinating, but also very poetic. I listened to that. I was like, "Wait, that is so awesome that nature knows to do that."

So things like that, I think I take a lot of inspiration from whenever there's something I learn about in, say, like my bio class. I'm like, "Write that down, write that down." Because I'm like, "Oh, that could be something I put in my next poem." But I also really love a lot of Asian and Asian American writers who have been big inspirations to me. I really love Jenny Xie. She has a collection called Eye Level, which blows me away every time I see a poem from it. I also love Chen Chen. He has this one poem, "When I Grow Up I Want to Be a List of Further Possibilities," and I love that poem. It was one of the first poems I really fell in love with.

Dr. Mikkael Sekeres: You've given me and our listeners a list of people to look up and to read. It's great.

I'm curious about your writing process. What triggers a poem and how do you face the dreaded blank page on your computer?

Elane Kim: So the way you avoid that is you never have it for too long. My method of writing, tried and true, is I have this one document where I collect everything and it's like my scraps and even the most random, like, 'this would never go in a poem' random like throwaway lines, I put them all in one ginormous document. I don't know what I'm going to do if I lose access to it, to be honest, because it's like many, many pages. Basically, I just collect everything there. Like I will be in class and I will hear someone say something that's like just in a conversation, but I'm like, "Wait, that's kind of poetic." And I write it down or like walking down the street and I'm looking at the water. I'm like, "Huh, that water looks a lot like this." And I write that down. And so I have this huge, huge running document that has all these random lines.

And so for me, I think writing is less about going into a document and like just type, type, type, type. It's more about for me like, how can I take these fragments and put them into a story? Like these random fragments. How can I tell a story out of these pieces that seem disparate initially? For me, I don't have a blank page for too long. My issue is like, how can I make this random mess of words into something that actually tells a story? But I think that's the most fun part of writing also is like putting together this puzzle.

Dr. Mikkael Sekeres: I have to say it's also the most fun part of medicine. We're handed chaos in oncology and we're asked to put it together into a story and hopefully a story with a happy ending. So that's great.

Elane Kim: I love that.

Dr. Mikkael Sekeres: So you're welcome to write that down in your scraps.

Elane Kim: Oh my gosh, it's going in there.

Dr. Mikkael Sekeres: So, I wanted to end by actually quoting the end of your poem, which was amazing. And the poem reads like this and one of the characters says, "I feel a shattering inside. Hello? You're breaking up. Remember to eat well, daughter. Remember to call home." And it's a marvelous, marvelously unsettling ending where both the phone call and the character are breaking up, while the character maintains her concern for her daughter. Do you think she's retaining some control of a cancer that obviously has gone beyond her control by expressing her maternal concerns about her daughter's welfare?

Elane Kim: Definitely. I think this poem is a lot about how the mother experiences this loss of control. I think there's a moment where the mother and daughter sort of switch roles during the process of her care. She talks about how she starts to feel like a child again or she starts to feel less like a mother and more like the daughter. But I think at the end of the day, the way she expresses her care for her daughter is the way that she always has through like these small gestures. No matter how sick she is, her first concern is always her daughter and whether, you know, she's getting her meals in and just hearing her voice over the phone is something that she looks forward to. And so I think being able to like put somebody else above yourself even when your body is at its most sick is something that, I don't know, I think I find it very sad, but also I think a lot of mothers would also relate to putting your child above other things in moments of illness. And so I think it's a very poignant moment, but also, yeah, one that kind of rings true.

Dr. Mikkael Sekeres: It's a poignant moment in an extremely poignant poem and beautifully written.

We've been talking to Elane Kim about her poem, "Transcription: Phone Call 2018." Elane, I want to thank you so much for joining us today. You are so incredibly accomplished and I can't wait to read all of your future pieces as well.

Elane Kim: Oh, thank you so much.

Narrator: Until next time, thank you for listening to JCO's Cancer Stories, The Art of Oncology. Don't forget to give us a rating or review or follow us and be sure to subscribe so you never miss an episode. You can find all of ASCO's shows at asco.org/podcasts. Until next time, thanks for joining us.

The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.

Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

Like, share and subscribe so you never miss an episode and leave a rating or review. Guest Bio: Elane Kim is a student at Harvard College.

Episode 8: Are Christian Men Weak? (with Ryan Miller)