A Poetry Craft Essay by Eileen Toomey
It Started with a List: CRAFTING A HELIX POEM

It Started with a List: CRAFTING A HELIX POEM, a Poetry Craft Essay by Eileen ToomeyIn August 2020, early in the pandemic, I was lucky to attend a remote workshop with poet Lidia Yuknavitch who shared with us a narrative structure called the helix. A helix consists of two intertwining threads of text, like DNA strands, creating a striking contrast between different types of language or perspectives. The structure allows elements to exist side by side without directly intersecting, creating tension and interplay between the clinical and the personal. This juxtaposition can reveal unexpected connections and provide a fuller, more nuanced expression of complex experiences, such as navigating serious illness amid broader societal challenges.

In August 2021, a year after I took Lidia’s workshop, my husband Michael was diagnosed with Stage Four Melanoma in his lungs and adrenal gland. Immunotherapy wreaked havoc on him. Six months later, doctors found more cancer in his thyroid, resulting in its removal in January 2022.

“Can you print out that list of your medications for me?” I asked him two years later, in late January 2023:

Medications                                      Daily                         Purpose

Diltiazem                                        240 MG                      Blood pressure

Olmesartan                                     40 MG                        Blood pressure

Atorvastatin                                    20 MG                        Cholesterol

Albuterol Sulfate                           As Needed                 Breathing, wheezing

Duloxetine                                      60 MG                        Depression, fibromyalgia

Clonazepam                                   As Needed                 Anxiety

Gabapentin                                     100 MG                      Nerve Pain

Omeprazole                                    20 MG                        GERD

Levothyroxine Sodium                 150 MCG                   Thyroid hormone

The number of medications represented just how overwhelming Michael’s side effects and health issues were. “In sickness and health” was difficult, even after thirty-four years of marriage.

For most people, this list would come in handy when speaking to doctors, but as a writer, I thought I might be able to use it creatively. I taped the piece of paper to the wall in front of my desk.

The TV was always on. Michael enjoyed Morning Joe on MSNBC while we sat and drank our morning joe.

Trump, abortion, the border, Kevin McCarthy, insurrection, Biden…. The tyranny of the 24/7 news cycle.

We also saw numerous drug commercials, side effect warnings floating like steam rising from our coffee….

Nivolumab, sold under the brand name Opdivo, is a medication approved for the treatment of certain types of advanced cancer….

“That’s me!” Michael would say. …side effects may include inflammation of the lungs, liver, colon, hormone-producing glands, and other organs. Opdivo may cause your immune system to attack healthy organs and tissues in your body...

“That bitch!” I’d think, knowing full well that the immunotherapy had saved his life.

In June 2022, on a regimen of steroids, his face bloated as he, at times, filled with rage. We drove from New Jersey to Chicago. Trump flags and Don’t Tread On Me signs multiplied along the Pennsylvania Turnpike and through Ohio and Indiana. Upon return, I wrote a ghazal, “American Carnage” about driving with Michael on steroids while the House Committee Investigation findings played on the radio. In the ghazal, the same word or phrase is repeated twice in the first verse and then at the end of every other line thereafter.

6 sharp, stop for bagels, the highway calls.
Jersey to Chicago, the highway calls. 

Down 95 to the Penn Turnpike, Trump
signs past Philly exits, the highway calls.

The House Committee Investigation
on CNN radio, the highway calls.

Scrolling through NewPages, I found a poetry contest sponsored by Cleaver Magazine: Form and Form-Breaking. I thought of Lidia Yuknavitch’s narrative helix—take specialized language and “toggle” it with personal narrative—which made me think of the road trip, then the commercials, and finally, that list of medications.

In the poem, I stopped repeating the phrase “the highway calls” at the end of every other line to break the ghazal form and give space for more narrative road imagery. Since the medical language followed us like a shadow, I indicated this with a lighter font, envisioning the old-fashioned paper prescription label that still comes with a jar of pills so each line had to be the same length:

Click the image to read “Immunotherapy” in full resolution.

The helix structure proved to be a powerful tool. Form can be an integral part of a poem’s meaning. By alternating lines of clinical medical jargon with personal experiences, the space between these contrasting elements became a fertile ground for unexpected connections. “T cell assassins, radicalized” invites reflection on the nature of internal and external threats. This structure enabled me to express not just the facts of our journey, but the emotional texture of it.

As for me and Michael, we still had our laughs, and I always did lose the lighter. As I sit with this poem and remember that period in our lives, I’m comforted by the link between the challenges we face and the art we create. I don’t know why writing helps, but it does.


Eileen Toomey has been published in The RumpusCleaver Magazine, Oyster River Pages, and various literary magazines. Her poem “Immunotherapy” won second prize in Cleaver’s FORM & FORM-BREAKING Competition and was nominated for a Pushcart Prize in 2023. Her creative nonfiction piece “Canaryville Girls” won second prize in Cleaver’s DUALITY NON-FICTION Competition in 2024. Eileen is a book inc writer and an instructor at Project Write Now, a non-profit writing organization, located in Red Bank, NJ. She is currently working on a memoir about her childhood in the working-class neighborhood, Canaryville, on Chicago’s south side. You can find links to her publications and social media accounts at https://bookinc.org/member/etoomey.

Read Eileen’s award winning poem, “Immunotherapy.”
Read Eileen’s Writing Tip, “Deadheading.”
Read Eileen’s award-winning essay, “Canaryville Girls,” which won second prize in Cleaver’s DUALITY Creative Nonfiction Competition in 2024.

Read more Craft Essays on Cleaver.

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