CMAJ • May 26, 2009; 180 (11). doi:10.1503/cmaj.081783.
© 2009 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Humanities

Poem

Reading electrocardiograms

Shane Neilson, MD

Family physician, Guelph, Ontario

Metaphors are easy. What it isn’t:
no fingertip sworls, so the police
aren’t interested;
no long lines or abrupt breaks
like palm-reading;
no fuzzy snowstorm screen like a
crystal ball;
no crazy QRS dowsing. No one
can even tell
that the heart is beating: the
lights may be on,
that’s all. You need a pulse for
that. You need more
than chicken scratch, and what
of the exploring heart,
the intrepid muscle with a
wandering baseline?
No habla anglais. Ne parle pas.

What it is: a detective story.
The private dicks are part of it.
There is a gravedigger
shovelling the Q wave’s six feet,
the long plot of a pause.
It is a history: grizzled, from a
Grizzly Adams.
But in the end it is an ocean, an
ocean of waveforms,
an ocean that stretches across
the basin of a life.
Each feeler P, P of
reconnaissance, P of preceding,
leads to the enormous yes of a
don’t-give-me-a complex,
then the billowing blanket of a
ST segment
sloping up or down depending
on bed angle.
Bedside, I peer at the tracing

and think lifestyle modification,
lifestyle modification, what
every heart needs
is the amplitude of truth. But I’m
not looking for truth.
I’m looking for closed-mouth
moments and the wave
of goodbye, goodbye, which the
police would be interested in,
there is an order to stay within
the city,
but it is unenforceable.





This Article
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