​Author's Note: When asked to describe the occasion of this poem, I recalled that I was seeing my primary care physician at the same time I was reading Céline’s Death on the Installment Plan. A bad combination.  In my physician’s office, I observed the same pathetic patients in Céline’s novel, fearful and frail and trying to repair bodies that would be beyond repair soon enough.  While I was dwelling on this, it occurred to me that I was simply observing the course of nature.  Most of what I was watching was due to excesses of the life condition, what can only be called excesses from Imagination, from that overstimulated Heart behind the heart. ​
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​Gifts


Nature overcompensates:
Additional vertebrae, 
Surplus molars, extra digits,
One more finger or toe
Just for good measure, and here,
Here is another five-chambered heart.

As if there is never enough,    
Like the patients of good will
Who cannot bring enough red wine,
Garlic necklaces, daily calendars 
With inspirational quotations
Given from gratitude,
Or admiration, or from the one
Last and only hope
They bring other things,
They bring themselves.

It is the excess of the well intentioned,
The camping outfitter who overfits,
The granger who overfeeds
For a winter that will never come.
The effusions of a heart pumping wildly
Behind the heart, with more imagination
Than any body can bear.


This poem originally appeared in The Journal of The American Medical Association, (JAMA.)
 
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