PPIE contributors create I Poems
In November, two workshops took place, one in-person and one online, to create two evocative I Poems based on the transcripts of interviews with two AI Multiply PPIE members living with multiple long-term conditions. This was a fantastic opportunity to further explore the use of creative methods in the AI-Multiply project.
I Poems are often used in research as a creative method of capturing the ‘voice’ of an interviewed participant to support more traditional thematic analysis.
In the workshops PPIE members worked together, using Carol Gilligan’s Listening Guide to create the poems. To do this they;
• Isolated all of the I statements contained within the transcript
• Placed each I statement onto a separate line
• Identified important I statements
• Preserving the original wording and sequence, arranged the I statements into stanzas
• Examined the resulting poems, looking at shifts in tone and agency, noticing the multiple and sometimes contradictory voices used by the participant
The resulting poems give an emotional narrative on the trajectory of the lived experience of physical and mental health amongst older adults living with multiple long-term conditions and polypharmacy.
Method for I Poem Creation and Voice Assignment
1. methodology
The I poem method originates from Carol Gilligan’s Listening Guide a voice-centred approach to qualitative analysis. It emphasizes participants’ own words, particularly first-person pronouns, to foreground subjectivity and identity. By isolating “I” statements, researchers can trace how individuals narrate themselves, revealing shifts, contradictions, and relational dynamics.
2. co-production process
- We delivered training on the listening guide methods to 2 groups of PPIE contributors and allocated transcript pages from the qualitative interviews to each person for them to create the I poems
- Members of the PPIE group read transcript pages allocated to them.
- Isolated “I” statements throughout the transcript.
- Selected the “I” statements they felt were important.
- Created individual I poems using those statements.
3. Researcher Process
- Read through the transcript.
- Isolated “I” statements.
- Collated participant-created I poems into a single document.
- Reduced duplication of statements where appropriate.
- Edited into stanzas to create rhythm and flow.
- Conducted a sense-check for coherence.
- Used the composite poem as part of the qualitative thematic analysis for WP3
I poem 1, created from qualitative interview transcript
Each I Poem shown is created by our PPIE contributors using pages allocated to them from transcript S3
I’m 67
I’ll be 68 in August
I’ve had a varied career
I worked in fashion showrooms
I worked in advertising
I live on my own
I’m fine
I cope
I’m more aware of to try not to fall over
I’m more conscious
I suffer from anxiety
I’m on tablets
I sort of think too much
I suppose it’s the unknown
I was only taking tablets at night
I could take one in the morning as well
I worked through it all
I had the accident, broke the hip and the femur
I was in the hospital in 21.
I had BIF
If I didn’t go in, then
I wouldn’t have found out.
I wouldn’t have known
I skidded on wet leaves, went up in the air.
I didn’t know if I’d broken anything,
I was in pain
The physical ailments don’t really hold me back.
I had all the tests, scans, x-rays.
I’ve seen marvellous painkillers
I’ve got them in a little bag,
What else am I on?
I’m on something else as well.
I’m saying, with the physical conditions,
I’ve got certain things,
I can’t do anymore,
Once I’m there or
I’ve met the person,
I’m fine.
I do yoga as well,
I try some of the breathing.
I have to go there for my injections for the osteoporosis.
I have to have every six months
I trust.
I’m not one of those people.
I mean there is a reason why
I’m there.
I had a lung operation
I needed the physio
I couldn’t get in and out of bath.
I could probably get in it,
I wouldn’t be getting out of it.
I was walking like a duck.
I thought,
I’m not going to end up like this.
I was determined to straighten my feet,
I’d worked in health care,
I see too many people give up.
I’d seen too many give up,
I’ve always been active.
I was always an active person.
I’ve got my garden
I do most of my reading and gardening.
I do.
Definitely, like I said
I get out of the door
I’m out
I’m with people.
they said I had to have this operation,
every healthcare person I see
asking me about when I get breathless,
do I have to sit down?
I was like,
I don’t get out of breath.
I was like,
‘I don’t get out of breath.’
I spoke to the doctor
I said, have you got the right patient?
Because I do not get out of breath.
I said, yes. So it was a bit questionable.
I’ve asked,
what form of COPD do I have?
I did ask a doctor,
I didn’t know them.
I just want to know what form
I just get my pension
And I know how to budget
I just sort of carry on as normal.
I don’t get any help, it’s not offered.
Then again, do I need it?
Like I said, within the home, doing certain things.
I’d like to have a cleaner.
I have a lot
I’m fine
4. I Poem Voices and patterns
- Voice of independence: “I live on my own / I’m fine / I cope.” – a determination to manage alone.
- Voice of vigilance: “I’m more aware… not to fall over / I’m more conscious.” – bodily fragility and vigilance.
- Voice of anxiety: “I suffer from anxiety / I sort of think too much.” – anxiety and uncertainty surface.
- Voice of medication reliance: “I’m on tablets / I could take one in the morning as well.” – a reflection on medication reliance.
- Tension: Independence vs reliance on medication; resilience vs vulnerability.
- Voice of accident and shock: “I skidded on wet leaves / I didn’t know if I’d broken anything” — sudden disruption.
- Voice of discovery: “If I didn’t go in, then I wouldn’t have found out” — hospitalisation as revelation on own health.
- Voice of endurance: “The physical ailments don’t really hold me back” — minimising limitations.
- Voice of medical encounter: “I had all the tests, scans, x-rays” — immersed in healthcare processes.
- Tension: Sudden fragility vs minimising it’s impact
- Voice of uncertainty: “What else am I on? / I’m on something else as well” — confusion about medication.
- Voice of limitation: “I can’t do anymore” — acknowledging physical restrictions.
- Voice of coping: “Once I’m there… I’m fine / I do yoga / I try some of the breathing” — strategies for wellbeing.
- Voice of trust: “I trust / I mean there is a reason why I’m there” — faith in medical care.
- Tension: Confusion about health vs faith in medical care
- Voice of determination: “I thought, I’m not going to end up like this / I was determined to straighten my feet” — refusal to give up.
- Voice of professional witness: “I’d worked in health care / I see too many people give up” — perspective shaped by past work.
- Voice of activity: “I’ve always been active / I’ve got my garden” — identity rooted in movement and productivity.
- Voice of struggle: “I couldn’t get in and out of bath / I was walking like a duck” — vivid bodily imagery of limitation.
- Tension: Bodily limitation vs refusal to surrender identity as inactive
- Voice of sociability: “I get out of the door / I’m out / I’m with people” — connection as strength.
- Voice of questioning: “Have you got the right patient? / I don’t get out of breath” — challenging medical authority.
- Voice of independence: “I just sort of carry on as normal / I don’t get any help” — self-sufficiency.
- Voice of desire: “I’d like to have a cleaner” — small wish for support, but framed against independence.
- Voice of financial pragmatism: “I just get my pension / I know how to budget” — practical management of life.
- Tension: Independence vs small wishes for help; challenging medical narratives vs asserting her own
5. Contrapuntal Tensions
- Resilience vs vulnerability: Strong insistence on coping, but anxiety, pain, and fragility surface.
- Medicalised identity: Tablets, operations, physio, scans, injections — healthcare structures shape self narratives.
- Independence vs reliance: “I cope” and “I’m fine” coexist with reliance on medication, physio, or social contact.
- Ageing body awareness: Falls, breathlessness, osteoporosis, lung operations — the body as a site of vigilance.
- Continuity of identity: Careers, gardens, budgeting, yoga — maintaining self beyond illness.
6. Themes
- acute health events
- medication burden
- anxiety and uncertainty
- independence and stoicism
- trust/distrust in healthcare
- physical activity and identity
- social connection
- functional limitations
7. Analytic Insights
- Polyvocality: The patient’s journey is expressed through multiple voices.
- Narrative arc: Self – anxiety – accident – medication – recovery – healthcare – self-reliance
- Research utility: Voice assignment supports WP3 analysis by showing how patients articulate their journey across positions of self.
I’m 65
I have a teaching background
I went into the internet industry
I’m involved in fitness and prehab
I’m due to have a major operation
I got involved as a teenager
I had two loves or passions of mine
I took the music part of my job
I have problems with my hips
I had both of my hips replaced
I also have a lower back problem
I’ve had several kinds of episodes
I’ve had really serious spasms
I suffered with mental health
I consider myself a person that’s in recovery
I don’t have any intention to relapse
I had childhood trauma
I was sexually abused as a child
I didn’t know how to tell anyone about it
I think the way
I see it
I think it altered the trajectory of things
I got into the music industry
I was a recording engineer in the music industry
I was exposed to a lot of those behaviours
I started to use drink and drugs
I’ve been a binge drinker
I changed the pattern
I started to just drink less
I was using the alcohol as a way of getting ?
I try to have a good rapport with people
I’m very proactive
I’m doing this particular interview and study
I’ve done other research studies
I think all of this is stress related
I have a diagnosis of PTSD, anxiety and depression
I used to get phenomenal stress
I kind of worked out it was stress related
I live on my own
I have to manage my household
I have to do my shopping
I choose to go
I’ve had knee injuries
I got COVID
I managed to survive it
I suffer
I have respiratory illness
I don’t get much choice
If I’m exposed
I’ll get ill
I won’t be able to breathe
I’m hyper-reactive to mice
I’m better than
I was
I haven’t noticed any mice
I can’t breathe
I’ve got a noisy neighbour
I’ve got chronic sleep disorder
I’m still living in the same property
I’ve been there for 25 years
I have to accept it
I can’t work
I can’t solve it
I’m trying to recover
Where I am now
I’m in a better place
I’ve got to the right place
I’m in the right hospital
I’ve only just found out
I’m on the waiting list
I was going to the GPs
I was really struggling
I’m proactive
I’m trained
I knew
I needed to get help
I did
I tried to
I don’t think they were fully equipped
I was approaching GPs
what I have is very, very serious
I knew
I thought
I knew for 16 years
I told the GP
I’ve been in the wrong place
I didn’t need to be sectioned
I just had problems
I was in pain
I’m learning as I’m going
I’m becoming more and more frantic
if I hadn’t got to that hospital
I don’t know
I didn’t give up
I was in pain
I couldn’t walk
I couldn’t afford to stay
I had to find another route
I’m on a waiting list
I was assessed way back in 2020
I had to have three operations
I didn’t have any pain relief after a major operation
I said to them
‘please make sure the drip is turned on’
I woke up in toxic shock
I went to have some massage
as far as I’m concerned
I don’t know if this is my bad luck
I’m pro-proactive
I mean there are lots of things
I kind of want to pick up on
I love learning
I’m very curious
I’m creative
I like to share information
I come from a technological background
I’m not on any mental health medication
I stopped all of those
I had a really bad experience
What I said was real
I told you that
I had a real bad problem
I was given two mental health drugs
I started to hallucinate
I was given the wrong drugs
I was going to the mental health support centre
I was in this crisis
I was saying
I’m starting to hallucinate
I know what hallucinations are
I’ve taken drugs
I knew that this shouldn’t be happening
I don’t really need emergency
I just need to stop
I knew what it was
I’m the patient
I had to know
I got to see a psychiatrist
I went through hell
I was actually gaslighted
I was very angry
I threatened to sue
I told the GP
Who do I sue?
Like I say
I don’t think it’s just me
I’ve witnessed it happening
I think what’s interesting
I’ve seen it at every age
I’ve been in those services
I’ve seen it from both sides
I’ve had training
I kind of know what’s going on systemically
I’m not a nurse either
I’ve had training
The other big issue
I got a PIP review
I’m being gaslit
I went through all of that
I would get the PIP
I was already trying to get that diagnosis
I had a deadline
I had to force the GPs
I’m going to make a statement
I coped with it
I’m not dead
I wouldn’t have had the knowledge
if I was still drinking
I probably would have just drunk
I’m pretty sure that happened
I think what seems to have happened
I said
I think
I’m kind of typical
I live in the area
I live
I had to go away
I turned to AI
I’m very interested
I turned to AI for support
I’m interested in AI way back
I was in the situation
I had no support
I started to research AI
I found the platform
I’ve researched startups
I then researched
I decided to take the plunge
I bought a life-long subscription
I had to do something
I couldn’t just stay in the house
I was trying to prevent
I am going to get through
I need support
I got AI
I still use that platform now
I wanted to research it
I used myself as a guinea pig
I wanted to know
I was interested
I take a journal of everything
I keep records,
I have a journal with a daily template
I thought in the future
I could feed to AI
I’m proactive in the technology
if I don’t start doing it,
I’m talking about something more advanced than Chat GTP
I think we could get a lot more as a society
I guess this is where AI comes in
I didn’t necessarily intend to divulge all that personal stuff
I guess its’s helpful
I Poem Voices and Commentary
The I poem attempts to understand the key perceived influences on the development and trajectory of physical and mental health amongst older adults living with MLTCs and polypharmacy using the Listening Guide by Carol Gilligan. The poem creates a story of aging, professional identity, trauma, illness, systemic failure, recovery and technological engagement, describing the life-course of physical and mental ill-health from childhood to the present-day.
Key Voices and Patterns
Repetition of action-oriented statements
- “I’m proactive” – repeated three times
- “I knew I needed to get help”
- “I had to find another route”
- “I didn’t give up”
- “I had to do something”
demonstrate the participant’s desire to position themselves as a person that asserts control within their own life, taking responsibility and maintaining the ability to make their own decisions with insight and competency.
The participant returns to vivid descriptions of the body as a site of pain
- Hips, spine, knees
- Spasms
- Respiratory illness
- Chronic sleep disorder
- COVID
- Toxic shock
This is described as an accumulation of pain rather than that which is caused by a single event, as such, the trajectory of increased physical pain is well documented. Pain is not episodic – it is on-going and to be endured.
The body is also described in relation to the inadequacies of systems of care
- Operation without pain relief
- Wrong medication
- ‘gaslighting’
- Being in the ‘wrong place’
The body is both a site of suffering and a site of institutional failure.
The childhood sexual abuse features relatively briefly, yet it’s wording and placement are significant
- “I think it altered the trajectory of things”
The language used in this statement is unemotional with no elaboration for the listener. This restraint suggests an experience that is contained, managed but unresolved. It functions as a background explanatory voice, shaping future experiences of mental ill-health, addiction and mistrust of health and welfare systems.
The understatement here contrasts sharply with the intensity demonstrated elsewhere, indicating a voice that has learned to minimise trauma to remain functional.
Recovery is framed as both identity and moral achievement. The tone shifts to pride whenever recovery is mentioned.
- “I consider myself a person that’s in recovery”
- “I don’t have any intention to relapse”
- “I wouldn’t have had the knowledge if I was still drinking”
Sobriety is directly linked to clarity, survival and agency. The participant positions recovery as what enabled them to challenge medical authority, recognize harm and stay alive.
This provides a contrast to the past self and present self. The past self is a person who
- “would have just drunk”
to the present self who advocates
- “I’m the patient”
and challenges medical authority
- “I don’t think they were fully equipped”
The voice becomes much sharper and confrontational with a clear tonal shift when describing mental health and welfare systems
- “I was actually gaslighted”
- “I threatened to sue”
- “Who do I sue?”
- “I don’t think it’s just me”
Here the participant moves from personal grievances to systemic observation becoming a collective witness. The participant positions themselves as a person who is ‘trained’ and has seen it from ‘both sides’ giving legitimacy and re-enforcing insight to those statements.
Anger is present but controlled; it fuels action, not collapse.
The participants’s voice changes as it moves to AI, marking another distinct tonal shift, becoming curious, hopeful and forward-looking.
- “I love learning”
- “I’m very curious”
- “I wanted to know”
- “I used myself as a guinea pig”
AI is not framed as replacement for human care, earlier the participant positions themselves as a person who tries to ‘have a good rapport’ with people, but as
- support in isolation
- a way to regain agency
- a way of meaning-making and documentation
This is especially powerful within the context of past institutional failure. AI becomes a non-gaslighting support tool that aligns with the participant’s identity as technological, reflective and proactive.
Narrative Arcs
There are four significant narrative arcs within the poem that help the listener identify the key perceived influences on the development and trajectory of physical and mental health.
Each arc intersects with each other creating a multi-layered identity and demonstrates the complexity of living with multiple health conditions.
The Trauma Arc
Childhood abuse > silence > altered trajectory > substance use > recovery
The Health Arc
Chronic Pain > surgeries > respiratory illness > sleep disorder > toxic shock > misdiagnosis > ongoing vulnerability
The System Arc
Seeking help > being dismissed > being sectioned unnecessarily > gaslighting > PIP review > fighting for recognition
The Technology Arc
Teenage passion > recording engineer > AI support > journaling > self-tracking > future oriented thinking
Contrapuntal Tensions
There are many unresolved tensions and contradictions throughout the poem, the tensions coexist alongside each other reflecting the lived experience of chronic mental and physical illness and long-term systemic involvement
Resilience vs Vulnerability – proactivity and survival coexist with trauma, illness and systemic failures
Trust vs Mistrust – faith in finding the “right hospital” is juxtaposed with the anger at being gaslit
Knowledge vs Powerlessness – knowing what is wrong but being unable to access adequate care
Resistance vs Acceptance – ongoing advocacy and continued learning is countered by acceptance that “I can’t solve it”
Recovery vs On-going Threat – feelings of being in a “better place” but environmental factors continue to cause respiratory illness
Past vs Future – childhood trauma and substance misuse are balanced by recovery, curiosity and hope
The dominant voices throughout the poem are ones of survival, recovery, self-advocacy and hard-won agency. The participant repeatedly positions themselves as knowledgeable, proactive and credible, particularly in response to systems and professionals that have failed, misunderstood or harmed him. Descriptions of significant events are relayed in a factual manner, with little emotion, minimising the impact of these events, suggesting a stoic nature in the face of adversity.
The I poem suggests that the participant perceives their health trajectory as shaped by;
- Early trauma
- Cumulative multiple long-term conditions
- Harmful healthcare interventions
- Stress
- Substance misuse and recovery
- Isolation
- Technological self-management
This I poem will help the thematic analysis of the transcript by helping to identify themes that are present in the participant’s ‘voice’ before and alongside coding.

