Some poets use elaborate imagery and metaphor to represent difficult emotions. Others write with a desperate, Ancient Mariner-like compulsion to rid themselves of their demons, penning work that bypasses form and aims straight for the jugular. The author of The Underwater Hospital falls firmly into the latter category. Whether describing lonely times at medical school or an incident of over-enthusiastic fisting, she is unashamedly candid and brutally honest. Leaving no room for weak sentimentality or over-wrought poetics, Jan Steckel takes no prisoners.

The themes and ideas in this collection are drawn largely from Steckel's former career as a pediatrician, and prove pretty harrowing reading. Issues of gross social injustice and misogyny prevail and are established in the first poem, 'Dios le Bendiga', in which a Spanish women begs to be cured of the syphilis she has contracted from her husband and passed on to her baby. Later, 'Three Little Sisters' laments the injustice of an American medical system which denies treatment to the sister born on the wrong side of the border.

The remaining poems draw on Steckel's often-difficult personal experiences as a bisexual woman. In 'Harder' we meet the woman who 'was trying to talk to a man in me/a rapist who wasn't there'; while in 'Daddy's Little Girl' it is the sexually cold girlfriend with rigid knees who poses the challenge. 'Hard as Nails' draws the two worlds together and discusses the gender inequalities inherent in a profession which has 'trained (students) to act like men'.

With perhaps one exception (Fourteen Crossings) the pieces are characterized by extreme tension between the personal, the professional and the political. Thematic conflict is represented through a melding of personal and medical language, creating an alienating, shock-effect that ensures against reader apathy.

Steckel produces some really striking, magical work. I particularly liked, 'Other, older students danced under/pre-AIDS disco balls, joyful before the fall', and the perfectly paced 'three little Salazar sisters from Salinas/come crestfallen in to my bedroom...' In 'The Maiden Aunts', a tribute to the poet's Jewish heritage, she rediscovers the beauty of language with some achingly wonderful, melancholic lines - 'She dreamed of the last Rabbi of Riga/turning from the door of the gas chamber'.

This is a very honest collection of work. Her fearlessness, resilience, determination and courage are refreshing. As a result, her work has a very human quality and packs the kind of raw emotion that suggests great potential, and a lot more to come.

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