Hole in the Heart, Hole in the Essay

The results for the second clinical study concerning PFO (patent foreman ovulae) closure are in. If you’ve been following my blog, you’ll recall that the doctors think I have a PFO, a hole between the atria of my heart that was supposed to close at birth but didn’t. The first clinical study that weighed the difference in effectiveness between closing the hole and managing it with anticoagulants showed no negligible difference. This second study, RESPECT, studied the effectiveness of a different closure device. The study shows that this device, the Amplatzer PFO Occluder, reduces stroke risk by 46.6 to 72/7 % over medical management alone.

These results may mean that I’ll be facing a PFO closure procedure sometime in the future, but for now I’m content to use what I’ve learned to help me think about an interesting question that came up in my MFA creative nonfiction workshop last week. We were talking about a segmented lyric essay, and I posed the question, “Considering the subject matter and the author’s treatment of it, is it fair to ask why the form is the only possible way for the writer to express what he’s come to say?”

It’s the old question of form fitting content. Take my heart for example. It’s meant to pump blood through my body. That blood isn’t supposed to shunt from my right atrium to the left through a PFO. That hole represents a defect in the form of the heart, and, therefore, the blood isn’t “expressed” the way it’s meant to be. If a clot moves from right to left, it can then travel up an artery to my brain, which is what the doctors think happened to cause my stroke.

Form and content. If the form is off in some way, the content isn’t properly expressed. Correct the content (close my PFO) and everything goes along all hunky-dory.

But, a student in my workshop said, why do we always hold lyric essays to that form and content standard. “We don’t ask that question of narrative essays,” my student said.

Point well taken. It seems to me that when the form calls attention to itself in some way by varying from the traditional, we immediately start to think about how the form is working in concert with the content. We’re less likely to ponder the same when reading a narrative essay because the form doesn’t call attention to itself. As lyric essays become more widely practiced and read, it may be that we’ll be less likely to consider that form and content question, but really it’s a good question, even for a narrative essay.

Thinking about all this after last week’s workshop, I came to the conclusion that the happy union between form and content in a narrative essay is announced through the narrative itself. The real-life story being told is one of such power, because of the tensions inherent in its storyline and because its telling takes us more deeply into the human heart, that it can only be expressed by being dramatized. I’m thinking of an essay like Barry Lopez’s “Murder,” in which a strange woman asks our author to murder her husband. Dramatic stuff, indeed. Lopez expresses the drama through a narrative that allows us to participate in the complicated and tense negotiations.

All of this is to say that the question of form fitting content is a fair question for both lyric and narrative essays. I find it important to always consider the best container to hold one’s subject matter and to fashion that container without holes so it can best perform its function, which is to communicate to the reader what can only be expressed in that form.


  1. Richard Gilbert on October 29, 2012 at 4:42 pm

    Thanks, Lee. This discussion is a good way to make conscious what often is intuitive on the writer’s part.

  2. Lee Martin on October 29, 2012 at 7:13 pm

    Richard, I agree that the choice is often intuitive. I offered this up as a way of thinking about how lyric forms often announce their reason for being somewhere in the text whereas narrative forms don’t come out and say, “I have to be a story because the story I am is 0ne you have to vicariously experience in order to fully appreciate the drama and the consequences.”This isn’t to say that a narrative essay has to be about explosive subject matter. It’s very possible that the events will be very small, but they will add up to something of great consequence for the writer. That something of great consequence will only be fully expressed through the accretion of narrative events. When story is the thing, then perhaps narrative best contains it, and it’s true that we don’t usually ask the question of why this form for this content, possibly because the content makes that so very clear to us on a level that doesn’t require articulation. But then again, perhaps the same could be said of the lyric forms, whose rationale the reader evokes herself from the silences created because the content is contained in this particular shape. Jeez, I’m talking myself into corners and out of them again!

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