About fifteen years ago I created a distinct literary genre, which, to the best of my knowledge, remains mine alone. No imitators have leapt into print in flattery of my bold success. The genre is that of the rhyming clinical letter.

In the course of my work as a general practitioner it frequently falls to me to write letters of referral to colleagues. This task awakens the creative impulse. Imagine a patient named Giles. Imagine the poor man suffering from a painful swelling in or around the anus that extinguishes the quotidian joys of defaecation.

The referral letter ought to inform and entertain the recipient and embody the cardinal* virtue of empathy. It might read as follows:

Dear John**/Julia**,

imagine the grief of poor giles –

not for him the lavatory smiles,

nor for him excretory joy

as he strains

with pains,

poor afflicted boy

and what can ail this knight at arms

alone and palely toiletting?

the sedge is withered on the lake

and no birds sing

for giles is sore in his ring

perusal of his fundament reveals

a bunch of grapes.

imagine how the poor man squeals

like a bunch of barbary apes

sitting down to canapes

i know dear john/dear julia

surgeons care not for poetic wiles:

so i’ll be brief, i will not fool ya’

giles poor boy, suffers from piles

So far so brilliant. And so obscure: the creative writer can never publish the rhyming referral for fear of violating the confidentiality of the patient.

So it is that for fifteen years I have strained my muse in the service of the ill and the illiterate.

The birth and the flowering of a special genre, the eruption into the clinical arena of lofty thought and sublime expression. A covert cultural revolution.

Farewell, a long farewell, to all this greatness.

It so fell that one such referral that described the distressing cyst-making propensity of a patient in the following

terms:

Jules*** creates full many a cyst

Jules*** is thus much offpyst…

This elegant epistle found its way to the specialist’s office, where an officious secretary took it upon herself to read it. The lady bridled, telephoned the practice of the referring GP and registered her strong objection.

We poets might describe the secretary as much offpyst.

The GP was urged to resist the poetic urge and to desist.

And so he does.

High Art, Great Literature, the World of Letters are of course much the poorer. Sic transit gloria ****

* this virtue should ring a pell

**john and **julia are names created for my fictive purpose;

i declare that there is no resemblance between these imagined names and any real person or (in the case of any surgeon you might know) of any half-real person.

*** giles is not the true name of the lady in question

**** gloria is not the name of any real lady

Dedicated to edward john anstee, robin hood with a scalpel.