Putting palatable slant on whole truth

Some patients ask to be told the worst-case scenario, others initially retreat into a protective cocoon of denial

The 19th-century language in the poem featured below appears quaint to us now, as does the liberal use of capital letters, but a careful reading of this poem reveals a very interesting point of view which comes into focus in the last two lines.

Tell all the truth but tell it slant –

Tell all the truth but tell it slant –

Success in Circuit lies

Too bright for our infirm

Delight The Truth’s superb surprise

As Lightning to the Children eased

With Explanation kind

The Truth must dazzle gradually

Or every man be blind –

Emily Dickinson

Note the classic rhyming pattern at the end of every second line, but also the internal rhyming of “bright,” “Delight,” and “Lightning,” best appreciated when the poem is read aloud. Don’t be bothered by the use of “every man” to mean all humanity – that was a convention of the era in which US poet Emily Dickinson lived.

Throughout the history of thought and language, there runs a pervasive metaphor linking truth and light. Light is revealing, both of what we were seeking and also the streaks of dirt and imperfections which we would rather not be made aware of.

Dickinson does not use the word “light” in this poem, but many references to this metaphor run through it.

In some ways, this instructional poem reads like a little sermon or lecture, urging the reader to tell the whole truth but to do so kindly, from an angle (slant), and to dazzle gradually. Most, if not all, of our cultural traditions contain parables and allegories and fables – colourful stories containing a truth, but which tell that truth on the slant, making them more palatable and memorable.

Always tell the truth. That was a core principle in my upbringing. But when breaking bad news to a patient, for instance, how can we know how much of the truth to tell up front? Some patients ask to be told the worst-case scenario, others initially retreat into a protective cocoon of denial. That is where the principles and skills of a patient/ whānau-centred approach to consultations are so important – to be constantly open to and responsive to the words and unspoken cues from the patient.

The key message I take from this short poem is that it can take time for the iris of the soul’s eye to accommodate to the sudden glare of truth, and in medical practice it is helpful to be aware of this.

It is still however, the truth we are communicating “With Explanation kind”, not some falsity or obfuscation arising from a misguided desire to avoid causing any distress.

Greg Judkins is a writer and locum specialist GP from Auckland