he title of Rafael Campo’s mid-career book Comfort Measures Only: New and Selected Poems 1994-2016 seems to be a play on words. As a practicing physician at Boston’s Beth Israel Hospital who has worked for many years with AIDS patients and low-income patients with other poor prognoses, he is all too familiar with “comfort measures”—palliative treatment for patients who decide against interventional therapies that are likely futile and probably painful or limiting. These patients are the main focus of this collection.

The term “measures” is also a musty term for poetry, particularly the formal poetry Campo often writes. When modified by the word “comfort,” the phrase aptly characterizes Campo’s efforts to console readers confronting their own mortality or the mortality of loved ones. I think of “comfort” in this sense as almost synonymous with “consolation,” in the sense that Boethius used the term in The Consolation of Philosophy.

Campo begins in a way I would have recommended against, but he pulls it off. His introductory essay, “Illness as Muse,” makes it clear that he finds himself “drawn to write about illness.” Although he candidly identifies the risks of such writing, those risks do not alter his ambitions:

Illness is, after all, one of the few truly universal human experiences; to write in response to it necessarily demands active participation, not the kind of objective, soulless distancing so many doctors practice, and teach their trainees to practice.

By the end of the essay one understands that this poet-physician believes his profession and art are closely related vocations.

Campo’s poems from his first two books, 1994’s The Other Man Was Me and 1997’s What The Body Told, establish a firm foundation for his later work. Both books focus on his efforts to understand patients in ways that organized medicine discourages, and also address his efforts to grasp his own sexuality. These two books demand comparisons to the later work of Thom Gunn, the extraordinary formal poet who squandered most of his talents until, as a gay man living in San Francisco in the 1980’s, he experienced unexpected and continuing devastation all around him. That experience transformed Gunn and led him to write the incandescent poems of his 1992 book, The Man With The Night Sweats. 

In his early poems about his patients and his personal life Campo creates a tone reminiscent of Gunn’s. His language is accessible, sometimes even flat in the style of Robert Frost’s narrative poems, while still having nuance and depth, as in these lines (echoing Frost):

Two lovers met. It wasn’t lovers’ lane,
But a lesser traveled road. No others came.
                                                 (“Finally”)

Campo’s preference for formal narrative poems over the generic lyric free verse of our era suggests influences not just from Frost, but also from largely forgotten poets before modernism, particularly E.A. Robinson.

Campo’s use of rhyme and meter in his first two books is more accomplished than typical for emerging poets, although his use of off-rhyme occasionally relies too heavily on assonance and lacks musicality. These books also show a sense of humility too often absent in the poems of his contemporaries. Few poets today write about themselves with this kind of honesty and dry humor:

As a boy,
He knew that there would be awful things, the men
In hot showers suspecting it was true,
His brothers never loving him again,
A balding man, alone, having Campbell’s soup
For dinner.
                                               (“The Test”)

As one might expect, many of these early poems brilliantly capture the language of the medical world. In “Ten Patients, and Another” the reader cannot help but feel how the passive voice in medical reports walls off physicians from inclinations toward empathy.

Campo’s third and fourth books, Diva (2000) and Landscape with Human Figure (2002) reflect considerable continuity in vision, but also contain some significant changes. Advances in AIDS therapies had made treatment of patients less grim, but more complicated, as Campo elegantly describes in “Elegy for the AIDS Virus.” The poet’s more personal poems progress as well, moving from sexual discovery to contented domesticity.  

These were the books in which Campo went from apprentice to master. He ended his practice of capitalizing the beginning of lines, which allows him to open up for more sinuous syntax and nuanced thought.  His use of form and rhyme, which I suspect resulted from study of the prosody of James Merrill, is more skilled and confident. For instance, in “A Death Perplexing” he confidently alternates rime riche with more conventional rhymes.

Campo’s most recent two books, The Enemy (2007) and Alternative Medicine (2013), demonstrate a higher level of ambition and tolerance for risk. For example, The Enemy includes a sonnet sequence, “Eighteen Days in France,” that takes him from the familiar hospital environment into a different culture. Although Campo’s meditations often wander back to medicine, his creativity thrives outside of his comfort zone.

On the technical side, these fifth and sixth books display a poet who has labored carefully and successfully on his craft.  There are more flashes of dry wit—a quick jab at T.S. Eliot in “Heart Grow Fonder,” and these lines in the style of Billy Collins with a dash of Alanis Morissette:

I read in the newspaper once
about some poor sheep named Dolly
who was made to give birth to her own clone.
They looked alike. I thought it was ironic,
because who can tell the difference
between most sheep anyway?
                            (“For All the Freaks of the World”)

Campo also appreciates that the concision necessary for wit can make a somber point more compelling. “In Ghazal: By the Sea” all he writes about the appropriation of his father’s land was “My father’s house, in Guantánamo, stolen.” He includes no long narrative, no claim for victimhood—just six chilling words. Similarly, the unembroidered opening line of “The Performance,” which starts offhandedly with “Wish Bone the cancer clown,” is a model of powerful poetic constraint.

In these recent books Campo draws more heavily on repetition’s incantatory power. Sometimes, as in “Morbidity and Mortality Rounds,” he uses extensive anaphora; in this poem the phrase “Forgive me” creates a prayer-like effect. Much more than in the past, he relies upon repetitive received forms, such as villanelles, ghazals, and pantoums, sometimes using innovative techniques to extend his villanelles beyond the standard length. He also creates his own repeating formal structure in “Complaint,” a poem in which the rhyming couplets begin with a standard iambic pentameter line followed by an iambic monometer line.

Campo’s move toward more incantatory verse appears to reflect some dissatisfaction with, and perhaps defensiveness about, the simpler narrative style of his own earlier verse. In his newest poems he even makes the common misstep of writing several poems about writing poetry, such as “Hospital Writing Workshop,” in which he seems to lose confidence in his usual clear-eyed descriptions and does too much editorializing:

Arriving late, my clinic having run
past six again, I realize I don’t
have cancer, don’t have HIV, like them,
those students who are patients, who I lead
in writing exercises, reading poems.
For them, this isn’t academic, it’s
reality.

In short, though at the peak of his technical abilities as a poet, Campo appears to be increasingly uneasy about the subjects he has written about so well for so long. Perhaps the best evidence of this is a poem where the title speaks for itself: “Your Poems Are Never Joyful.”

In his most recent work Campo experiments with subjects and techniques, and is at his best telling the backstories of patients when their stories are the least predictable. One gem is “Eden,” a blank verse poem that begins with the storyteller’s simple “One day”:

One day, the boy who lived next door began
to eat the flowers in his mother’s garden.
He started with herbs she grew along
the borders: pungent sage and fragrant thyme,
Medicinal oregano. Before
too long, sensing he was onto something,
he turned to tasting roses, irises,
and then, as if he doubted he would find
true love,  the petals of the daisies, one
by one.

Since this is a Rafael Campo—not a Mary Oliver—poem, the reader should know that this idyllic scene cannot last, and it does not:

               By August it got dangerous:
he ate a foxglove plant, which made his heart
skip beats.

The poem ends with the subject of the poem heading to a hospital where the poet is not on duty:

                      They rushed him to the hospital
while we prayed hungrily for God’s forgiveness,
not recognizing what he really craved
was to be mortal, yet not be cast out
of our delicious earthly paradise.

This ending perhaps flags a way out for some of Campo’s frustrations—while the poem relies on his medical expertise, the patient’s experience in the hospital is only implied. What makes the poem memorable is his lovely echoing of the Bible, his unexpected bonding with his neighbors, and the strand of hope entangled with his fears.

At the mid-career mark Rafael Campo has already created a significant legacy by writing with empathy, humility, and attention to craft. As a formal poet he is among the best today, and no physician-poet has ever captured the tragedies, nuances, and intensity of work in a hospital as well as he has. The best news is that, as good as his poems have been, we can anticipate even greater comforts because his work is still improving and his vision still widening.