What makes the sestina such an entrancing poetic form is not just its 6-lined stanzas’ compulsively repeated endings, but also the variation of the repetitions’ order, which evokes the very human impulse to keep returning to the same task in an effort to get it right. Perhaps this aspirational perfection makes the form so applicable to clinical care, especially the work of medical trainees. The pressured “see one, do one, teach one” ethos of medical school is expressed in “So much depends,” the speaker’s jumbled patient care learning experiences reflected in the form itself. Fused stanzas suggest no time to pause; felt in the repetition of the poem’s emphatic title throughout is the concomitant burden of growing responsibilities (echoing its inspiration, physician-poet William Carlos Williams’ famous, deceptively simple poem “The Red Wheelbarrow,” in which the smallest details are potentially life-changing, just as in clinical care). The speaker wonders whether in medicine diligence suffices, ultimately realizing only after a patient is truly seen may the clinician feel some ease. The sestina’s other repeated words, “window,” “wait,” “medical,” “right,” “home,” each connote interrelated themes of transition and competence, constantly reconfiguring themselves as the speaker develops from timid observer and recorder of data into proficient clinician who integrates medical knowledge and humanism. The sestina’s summarizing 3-line envoi recapitulates the speaker’s (and all clinicians’) ever-unfinished learning journey: “…so much depends on if someone (a medical/Student) lays a hand just right.”
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