Side Effects May Include
(The Chapbook 2015, $12)
By Leah Nielsen
If you Google the phrase “side effects may include,” the first three search results are 1) “EpiPen (epinephrine),” 2) “Ritalin,” and 3) “…trope as used in popular culture.’” However, if you add the name “Leah Nielsen” to the search, you will find something much more interesting, her poetry chapbook Side Effects May Include (SEMI).
Just 18 poems (chapbooks are by definition short) — the book explores the physical and emotional terrain of, well, side effects — the side effects that chronic pain has on a life, that illness has on the mind, that drugs have on a patient. It is the size of a magazine but sturdier, and printed in landscape format. The reason for this becomes clear when you open to the first poem, “Patient,” which has 26 very-long-lined couplets that span the entire length of the page. This opening poem also offers a perfect beginning to this book’s prime subject:
“Name and name of guardian or spouse, name of insurer,
name of insured, name of the name you once went by / names
of immediate family members living and dead, if dead name
what killed them, names of the diseases all of them had, // names
of the children you were supposed to have had had you been less academically inclined, less prone to pain . . .write it down…”
What follows, in addition to a handful of narrative poems, are poems in the form of charts, diagrams, questionnaires. This is not a book of poetry to be afraid of — it is a book of familiar “forms.”
“Pain Intensity Numerical Rating Scale,” for example, and yes that’s the title of a poem, is a vertical diagram from 0 to 10. Each pain intensity level has its own corresponding cause, including, “1: Ring tones — Für Elise, Baby’s Got Back. Also, unorganized closets,” “6: Shoeless airport security checks . . .” and “10: Worst Pain. Each storm along Carolina’s Outer Banks brings the vanishing of road segments. . .” Poems like this one help us place the narrator in the medical world, where she clearly spends a lot of her time, and her personal interior one where she struggles with her physical pain.
“Automatic Thoughts on Self-Hypnosis” is one of several “Automatic Thoughts” poems, which help clarify the book’s central question: Under the influence of chronic pain and its associated medications and their side effects (e.g., brain fog), how does one follow through with a complex thought? A narrative? A life?
Answer: You make charts. You rate your pain levels. You evaluate. You put it down in fragments. And you do it with equal parts hilarity and darkness.
One row of the chart indicates instructions for the narrator, “concentrate on relaxing every muscle in your body,” and this is some of what follows (where italics indicate the hypnosis instructions):
Automatic Thoughts: I would not, could not
Physical Response: you will experience increased awareness of internal functions
Emotional Response: also, you will feel like a boob
Cognitive Distortion: alternately, you will feel fat
In “Automatic Thoughts on Keeping a Pain Diary,” the narrator is to track her “pain level on the pain diary form three times a day at regular intervals.” Under “Automatic Thoughts” she writes “pain not level, not leaving, pain like lava, like an avalanche,” and in the same row under “Emotional Response,” she notes “severe depression, anxiety or despair.”
It is not always her own pain either that she must sort. In a prose poem, “Hurts a Whole Lot,” written in the second person, the narrator addresses a young friend who was pulled off a ledge by police and who she visits in a facility where “the TV is stuck on Fox News, this being Tuscaloosa [Alabama].” She brings him “No lighters. No shampoo. No sharp objects. . . a pen (allowed) and a yellow legal pad.” Providing an essential balance, this poem shows us a narrator who longs to care for, rather than be taken care of. Continuing to weigh what is allowed and not, Nielsen ends the poem in this sweet and regretful way: “[I am] allowed to play older sister, but not to take this punch for you.”
Nielsen is clearly at her funniest when she is making fun of the medical world’s approach to chronic pain (e.g., charts, emoticons, numbers), as well as its approach to dispensing information. The poem-brochure “A Patient’s Guide to Narcotics,” is a great example. If you wanted you could tear it out and fold it into an actual brochure, like one you’d find in any Western-medicine waiting room, a stock photo of happy people included.
In the brochure, Nielsen becomes our guide to prescription pain medication in a panel entitled “You May Need Narcotics if…” A few reasons that make the list are, “The mere idea of pain reminds you of late September tomato vines coiled about rusted cages,” “You teach,” “You have children or were unable to have children,” and “You understand the wood shed, door almost unhinged, battened down, twined up.”
You should also know that possible side effects of narcotics may include “the inability to tell your pain to f*** itself,” “the inability to hula-hoop or get drunk enough to hula-hoop at parties . . . ,” and “the desire to snap shut the glove compartment of your life.”
So much more could be said about this successful and ambitious book and the myriad of ways that Nielsen has found to channel and sort experiences and sensations, pain and joy (“The perennials, the pure poetry of their names — bleeding heart, coral bell, astilbe, and fox glove — the cedar mulch spread thick, the two of us covered in its mustiness,” from “No Hurt, Happy”).
SEMI is a beautiful, fun, moving book. Give the patient a questionnaire and she will fill it out. But give the patient who is also a poet a questionnaire and she will turn it into something else entirely.
You can purchase Side Effects May Include by Leah Nielsen from the Chapbook Journal’s website
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