What Poetry Can Do: A Few Words on Mary Karr’s “The Patient”

A few years ago, I had the great privilege of studying under Mary Karr at Syracuse University.  Not only did she show me how to throw a moment into a pressure-cooker, how to strengthen my lines, how to look (in revision) for moments where I dodge and, instead, lean into what I was writing around, but she’s been an inspiration ever since I worked with her–in terms of both writing and managing somehow to keep that tangled ball of hissing snakes (otherwise known as Texas childhood) knotted and calm (or at least as calm as possible).

It’s difficult to pin down her personality’s whiplash bite better than she does in her writing: both poetry and memoir.  If you’re only familiar with The Liars’ ClubCherry, Lit, or the recently-released Art of Memoir, make sure you check out her books of poetry too:  Viper RumSinners Welcome, The Devil’s Tour, and Abacus.  Her writing jolts you into a new perspective, where her remarkable knack for detail lures and illuminates.  Today I’d like to write a little about one of my favorite Mary Karr poems, “The Patient,” which appears in Viper Rum.  An alternate version is available via The Poetry Foundation, but I’m just a bit more partial to this version.  I’ve included a recording (from a couple months ago) of me reading the poem:


by Mary Karr

At the end we prayed for death,
even phoned funeral homes
from his room for the best
cremation deal.  But back
when he was tall, he once put
my ailing cat to sleep,
or helped the vet and me
hold it flat to the table
while we felt all muscles
tighten for escape
then freeze that way.  Later
in my father’s truck,
I held the heavy shoebox on my lap.
He said, I ever git like that
you do the same.  I remember the slight
weight of my ten-year-old head
nodding without a pause.  We peeled
from the gravel lot onto the rain-
blurred road.  What did I know
of patience then? Or my dad
for that matter, shifting gears.
Each white second was knit
into a sheet that settled over his features
like a snowfield.  Forgive me,
Father, this terrible face.
I was the patient one.
I got what I wanted.

The poem opens with an assertion that presumes some underlying knowledge.  The opening line makes me question:  The end? The end of what? Who is we? But by the time the sentence unfolds across the next few lines, the situation becomes clearer.  By breaking the opening sentence the way she does, not only does Karr situate you in the weird atmosphere of an unnerving moment–calling funeral homes before a loved one has passed–, but she places heavier emphasis on the phrases “prayed for death,” “phoned funeral homes,” and “best / cremation deal.”  Not only do these phrases have a musical quality, but they support-beam the strangeness of the moment.

But just as soon as you think you’ve got your footing, Karr shifts time, place, and perspective, which is, part of what makes this poem genius.  The transitions in this poem happen so seamlessly, which highlights the central tension of the poem: “shifting gears” from life to death.  Look at the sentence that begins, “But back / when he was tall.”  The phrase itself seems accessible, pretty easy to parse, but the more I think about it, the more I realize it’s the sleight-of-hand moment.  The poem, which centers around the speaker’s father, the memory of putting a cat to sleep, and his final moments, literally forces you into the child’s perspective.  The speaker’s father wasn’t necessarily taller “back / when,” but rather the speaker was smaller since she was a child.  What seems like a slip, turns out to be the sharpest dodge of the poem because forces us into the child-perspective before leading us to the childhood memory.

Sure, there’s the obvious link of putting an animal down, but the way the images all suggest weight or heft, deepens the experience for the reader.  The poem forces us to feel the cat’s muscles in the moment of death, the “heavy shoebox on my lap,” and “the weight of my ten-year-old head / nodding without a pause.”  Because these images are so tactile, we slip not only into the child perspective, but also the adult consciousness with the rhetorical question that follows: “What did I know / of patience then?”  And because the memory’s embedded within an existing story about the hospital room where the speaker’s father’s dying, not only does it cause meaning to resonate, but it mirrors the way our speaker felt in those final moments with her father.  It gives us a glimpse of the experience.

Just as the speaker’s father “peeled / from the gravel lot onto the rain-/blurred road,” (isn’t “blurred” so good?!) the poem uses the reflective questioning to take us back to the present-action, where we hear our speaker cry out in direct address and ask for forgiveness.  And, just in case you forgot where the poem began, which can happen with stories inside of stories, the closing of the poem references the title, working to conflate the position of the speaker and her father.  But if you’re like me, the final line left me puzzled at first: what was it that you wanted? Another way to encourage the reader to the poem’s opening line, where we “prayed for death.”  The result creates a chilling effect, especially with the earlier calling out for forgiveness, not for praying for death, but for “this terrible face,” which probably isn’t bobbing up and down in agreement like her ten-year-old self.

And that’s the heartbeat of this poem, the tension between agreeing to her father’s wishes as a child, and the difficulty of accepting that upon the moment of death.  How life can get so twisted and frozen and awful at the end that you pray for it to stop.  Which she ultimately catches herself on, catches us on, and lightning-bolts us back to our shared but fucked-up reality.  Sure, she’s better than most at distilling a moment down to “each white second,” but through precise detail, the layering of story and memory, the heft and precision of the detail, this poem guts me.  Which is exactly what it’s supposed to do.

-Taylor Collier

2016-08-10 09.46.50

P.S. Now Go Out There (and Get Curious) recently dropped in bookstores around the country.  And you can follow Mary Karr on twitter: @marykarrlit


  1. She’s a master! S’why she’s my favorite poet.

    Thank you for sharing your insight into this incredible poem.

    • Taylor Collier

      August 20, 2016 at 10:06 am

      Agreed. Total master of voice, pacing, cinematic images, etc. I just love the way her sentences dart and jab and veer and upend themselves. Always eager to read her work. (P.S. I taught Liars’ Club last fall, and my students fell in love w/ it. So useful for teaching sharp writing on both micro and macro levels. The micro-level genius is where Mary’s poetic tact shines brightest.)

  2. Thanks for this. Nice explication of her poem. I studied with Mary at Syracuse many years ago. I love the no BS approach of her poetry. Nothing showy, nothing to prove–just communicating beautifully.

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