To Die To Sleep No More

This is a poem written as a challenge to write a poem based on one of several “thesis sentences” provided during the Yale Writers Workshop. I chose the sentence, “Nightmares aren’t as bad as insomnia.”



A tropical depression moves in

and falls upon the shore.

No eye can stand still or evade

the demons and succubi that haunt

my nights. A tsunami of blood,

zombies chase me after dark,

Naked I arrive to the Calculus exam,

every time, I have forgotten to study.

Again I fail, my sleep is uneasy;

My car won’t start, I get lost walking home.

The alley is empty and long and ominous,

they follow me again, this time dragons and bears.

Tonight my eyes burn after lights are turned off,

heartbeats thrum in my throat. The moon glares

into my window, the neighbor’s dog is barking again.

I cannot escape the exhaustion of unrequited slumber,

The creeping regret of loss and boredom.

I would dream of nightmares, if only I could sleep.


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During Stephanie Hart’s Poetry Workshop at Yale on Friday, we wrote “circle poems” (that’s what she said.) I wrote the first two lines of this poem, then it was passed around the room for each person to add another line. After it was edited by the class, I took it and made some final edits in an attempt to  breath some life into this Frankenstein creature. I cannot take credit for the beast-with-two-backs reference, nor the phrase “sweet taut rump.” Those were the creation of a couple of attractive blonde women in class, one of whom went to Cambridge and the other Oxford.  It’s always heartening when intellectuals peruse the gutter.


Fifty Shades of White

The bright light white of the next day’s sun,

glimmering pebbles along the river run.

Her skin trembles, our kneecaps bump;

My hand flows down her sweet taut rump.

She glances towards the meandering stream,

Her toe dips in, I begin to dream:

Our bodies are one, or so it seems —

A two-backed beast in four-legged jeans.

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Back in the 1980’s, my medical school  adopted  a Pass-Fail system of grading. The administration boasted of how they had reduced the pressure and competition of medical training by eliminating grades. But they added an additional grade of Honors for the top 10% of each course, thus negating the original intent. For many students, the presence of the rare and lofty “Honors” actually heightened the intensity and ruthlessness of competition to which doctors in training are prone.


MD or not MD, that is the quandary.
Whether ’tis easier on the butt to suffer
The hours and minutes of outrageous lecture.
Or to take a stand against a sea of schedules
And by leaving end them: to sit, to study
No more; and by no study, to say we end
The head-ache, and the thousand unnatural exams
This flesh is heir to – ’tis a vacation
Much to be admired. To sit, to study,
To study, perchance to learn; Aye there’s the rub.
For in this study of life, what learning may come,
When we have bubbled in this meager sheet,
Must give us Pass. There’s the respect
That makes Doctors out of B.A.’s,  B.S.’s.

For who would bear the classes of so long a time
The lecturer’s wrong, the proud Profs disdain,
The pangs of borrowed money, the sleep’s delay,
The insolence of course directors, and the stench
Of formaldehyde and rotten flesh,

While he himself his dissection make
On a bare cadaver? Who would gladly bear

To bleed and sweat under a weary light,
But for the hope of something here after;
The Doctorate of Medicine, with whose bestowal
All good things come. Piques the will,
And makes us rather bear those ills we have
Than to cast off eighteen years of education.

But compulsion makes cowards of a few,
And thus the nature of these students
Is sicklied o’er with the pale cast of concern,
And enterprises of little consequence,
With this regard, their meanings twist awry,
And lose all moderation.
I want you now, the fair Honors!
Nymph, in thy transcriptions
Be all my virtues remembered.

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The opening sentence of this poem is a direct quote from an anatomy lecture during first year medical school. The entire class of 160 was hunched over their papers scribbling maniacally the entire lecture.  As usual,  I wasn’t taking notes but was instead  listening intently when I  was struck by the beauty of this description of a rib. I looked around the room to see if anyone else had noticed the that high art had entered into an anatomy lecture. As I scanned the room, he lecturer locked eyes with me. He shrugged his shoulders as we stared at each other. He then slowly bent his knees until he  disappeared behind the lectern. No one else in the room noticed.


“Ribs are long, and thin,

and curved, and slightly twisted.”

Attached at the spine and arching out

to each side, these bones reach

the mid-axillary line; then bending

inward to grasp the sternum, a cage is formed,

enclosing the thorax and holding within,

by a solid hug of ribs, the vital organs:

The Heart and Lungs,

The Phrenic, and the Vagus.

To Autopsy is to self inspect; to self reflect.

Dissected free from fascia, picked clean

from flesh, the rib mirrors the eye.

It has a simple beauty, an archaic truth,

revealed by the careful touch and the proper gaze

of Galen or Vesalius, who while holding this lone

bone torn from chest and bringing it to light

cries out, “Why this bone is long and thin

and curved, and somewhat twisted.”

A single rib, alone, separated

from the body, has a history; it connects

to other times, other spines;

evoking the carcass of each man

now dead and recalling the birth

of Eve. This is the bone into woman

transformed: long and thin,

and curved, and lithely twisted.

After midnight when I cannot sleep

and my thoughts dissolve and blur

along the uncertain edge

of my darkened room, I murmur

to myself, ribs are long, and

thin, and curved, and

sightly twisted.


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Back in 1975, before the days of mass hybridization, watermelons had seeds. When I worked for a summer at a grocery store in Estes Park Colorado, one of my many tasks involved cutting melons so that the seeds were not visible. Near the end of the summer while I was passing on my expertise at watermelon slicing to a new employee, the lost-looking 20 year old darted his hand under the melon just as I shoved the knife down. He went to the ER. I never saw him again. I wonder to this day why he did it.



There is an art

to watermelon slicing.

Reading the skin just right

and directing the slice between

the seeds, revealing

a cut surface of solid red meat.

Covered in Saran and placed on a bed

of ice, such a melon entices:

the illusion of a melon

without seeds, the hope

this may be the one seeds forgot.


The ripest melon is chosen,

I place it place it on the slab.

Guided by the line drawn

by my fingers, the knife hovers

over the landmarks, the ridges

of alternating stripes, green

by darker green. The knife lingers

as I wait for the sweet crunch

of split rind. Raising my shoulder

and leaning down, I hear the delicate

crack of flesh parting by my touch


I can see, this is another

perfect cut. The slice is deep,

to the quick. An artery

is now open, my blood

wells up and flows by this pulse.

Such bleeding, it seems,

should never stop.



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This is a series of vignettes drawn from a larger unfinished work entitled A Suicide. It is written in the first person.  You might think it is about me  — it’s not.  As a physician and psychiatrist, it is both a gift and a  burden that patient stories often become our stories.




It has something to do with edges, the corners

of my room, the way sun streaks through my shutters

and seeks out every angle, slicing deep

into shadows, marking the walls and exposing the floor.

These walls are not perfect, my ground, uneven,

the cracks and pits are caught by light

and magnified – grotesque, unfathomed flaws.

When I was young, I once saw a crack so long

it seemed bigger than any wall, stronger than any plaster.

Breaking loose and splitting wide, this fantastic chasm,

this monstrous mouth, would swallow whole my house.

Such cracks are always waiting, waiting to take me in.


Something is wrong in my room,

but it cannot be me, it is not

my head, my brain is perfect,

unflawed. I have vision, I reason

beyond all limits. The problem

isn’t there, it isn’t

my mind. It is

what I lack, I do

not have.

I cannot reach, my touch is loose.


This is the day

I have always waited for.

All my life has tilted

towards this point.

A hot day in the middle

of August, a perfect

reflection of every day

I have ever known.

This is to be

that delicious day

when all the thousand

wrongs of my life

will be set right.

Everything will be focussed

into a few final moments

and dispersed by one wave

of my hand, tossed out

into the sky, crimson dissolving

into blue, casting a purple

haze over the horizon.


Grasping for life, I feel

the touch of fingers tight

on this gun. These are

my fingers, this is my hand.

I reach deep

into my mouth, searching

for the softest spot, the surest

way through my neck.

Probing gently towards this delicate

sweetbread of my throat, it seems

this gun has always been here.

Curling my lips tight

on the barrel, I can taste

charcoal and steel. I shiver

to the touch of cold metal

held by my teeth. These are

my teeth, this is my kiss.

I sense the sharp snap

of the trigger, I smell

the smoke swelling

within the chamber.

But the hard crack

is beyond me: I leave that for others to hear.


In this final moment

as metal touch metal

and sulphur sparks saltpeter

into carbon dust, a chunk of lead

is set into motion. A thick sea of blood

and gristle flows within the wake of this bullet,

severing ganglia and splitting cord as the soft element

mushrooms into hard bone. There is a bloom of life

as brilliant and fantastic as the billowing smoke

and heated flame bursting from my pistol.


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The Chorda Tympani is a small branch of the facial nerve that passes through the middle ear. During first year medical school, my cadaver lab instructor offered a 6-pack of beer to any student who could locate this tiny nerve intact. I found it. He reneged.

I later wanted to somehow convey the experience of cadaver lab: dissecting a human body that has been drained of blood and soaked in formaldehyde and glutaraldehyde for six months until all the various tissues congeal into an indistinguishable greenish-grey conglomeration. Naturally, I turned to Lewis Carroll for inspiration.




‘Twere basilar, and the lithy nose

Did wod and wibble on the gabe;

All mimpy were the smegma toes

And the bonetome hacks outgrave.


“Beware the Chorda Tympani –

In jaws that bit, it jowls now dead!

Beware the fascial planes, and skin

With care this mummied head.”


He took his scalpy blade in hand,

By Grant his search was lead;

Then crouched he by the stainless tank

And thought a while instead.


And as in oafish stead he thought

The Chorda Tymp. with sheath of grey,

Came wiggling though the pulpy lot

And dangled where it lay!


One, two! One two! And round and round

His blunt-end probe went slurpy-slop!

He left it bare, and called for aide

To see what he did crop.


“And hast thou found the Chorda Tymp?

To me you this must show

That may be it! But do you know

From whence its fibers go?”


‘Twere basilar, and the lithy nose

Did wod and wibble on the gabe;

All mimpy were the smegma toes

And the bonetome hacks outgrave.



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what is a blog without poetry?


so much depends


a red wheel


glazed with rain


beside the white




 so important


a red radio


crusted with mud

and rust

nearby the pink




it really matters


a red nerf


soaked with toddler


is lost in the white




so pretty


a red


glistened with sweat

flung into

the white

cherry blossoms



your child support


on a red

bank check

scribbled in


inside a white




you need to wear Depends™


a Big Red sipped

in leisure

makes you


your white




so little depends


a red


swollen by vodka


with a white




who cares


a red

dodge ball

smelling of sweat

and saliva

hits you right

in the breadbasket



it never


the red


both silly

and somewhat clever

posted relentlessly

on WordPress



william carlos williams



by many

so obvious

his observations

so acclaimed

by white critics



Kurt Biehl

copyright 2011

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Post From Defunct Blog 5/7/2011

Last Tuesday, on NPR’s Talk of the Nation, Neal Conan guests were a couple of docs who wrote a book called “Shrink Rap.” They were talking about “what psychiatrists really do all day.” Neal requested to hear from psychiatrists to describe what they liked about their jobs. I sent the following email:

“As a psychiatrist with 20 years experience in multiple setting in three different states, what I love about my job is the opportunity to alleviate suffering and alienation at  human level. Many of the patients I have seen have had bad experiences with prior treatments. Even a 15 minute interaction has the potential for profound healing to take place . I need to know the medications, but more important is the ability to create a genuine and compassionate connection.”

Neal Conan read my email on the air. I chose not to call. I didn’t feel like rapping.

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