When Empathy, and Healing, Are Elusive

As studies suggest empathy in medicine continues to decline, mirroring the trend seen in other societal realms, poetry remains an important medium for questioning why, and reclaiming it. In the poem “20 Marlboro Reds,” smoking, both a communal bonding ritual and noisome health risk, becomes a complex metaphor for our vexed attempts to connect with others. The desire to belong and the harmful effects of smoking are simultaneously evoked when the speaker first experiences nausea after trying cigars offered by a friend. Colloquial, almost irreverent language belies the speaker’s nagging aloneness: as the stanzas wryly move through his adolescence and young adulthood, two “black cigarillos” at parties (accompanied by “thick liquor,” another fraught social lubricant) seem a jaunty rallying cry for teenage rebelliousness; and later, smoking marijuana because “a girl wanted me to” and finding “nothing happened” suggests that genuine human connection remains elusive. The irony in the search for shared feeling deepens when eventually, we infer, the speaker becomes a physician and a patient with metastatic lung cancer is craving a cigarette, so the speaker offers to fetch some. With roles reversed and the speaker and would-be healer now supplying the cigarettes, long-sought empathy is never really kindled, as the request is forgotten and instead they watch a wholesome television show together. Any facile notion of empathy is critiqued, however, as in the final lines, the speaker ruefully smokes the cigarettes himself after the patient dies, ever alone in his frustrated quest, “while I contemplated what/was killing me.”