Friday, March 17, 2017

`But His Mind Was Not In It'

“When Keats was dresser almost every wound was or quickly became a foul-smelling, festering sore, the dressing of which had to be frequently changed, often more than once a day.”

A dresser was a surgeon’s assistant whose job it was to dress and bandage wounds. Long before Semmelweis, Pasteur and Lister – that is, from 1811 to 1815 -- John Keats apprenticed at Guy’s Hospital in London. Keats was fifteen when he went to work for the surgeon Thomas Hammond. Sir William Hale-White explains in Keats as Doctor and Patient (Oxford University Press, 1938):

“In those days a medical student was apprenticed for four or five years to a practicing doctor to whom a fee was paid. The apprentice was provided with board and lodging, he helped the doctor in his work, he picked up what knowledge he could, he compounded pills and other medicines, he drew teeth, he vaccinated and he bled patients.”

Hale-White (1857-1949) had an advantage denied most biographers and literary scholars.  He was a doctor, and was appointed assistant physician at Guy’s Hospital in 1886, promoted to physician in 1890 and consulting physician in 1917. Hale-White walked the same wards as Keats, a century later. In ninety-six pages he details Keats’ training as a physician, his abandonment of that calling to write poetry, his tuberculosis, failure of diagnosis and treatment, and death at age twenty-five. Hale-White’s prose, in its clarity, precision and absence of embellishment, gives evidence of his medical training on every page. Dismissing the notion that Keats was sickly from youth and showed signs of being the “consumptive type,” Hale-White writes:

“We may safely picture Keats as having had good health in boyhood and youth. He was very good looking, had beautiful eyes and hair, he walked well, fought well [he trained as a boxer], and could work hard. [Keats’ friend] Cowden Clarke says he was active, athletic, and enduringly strong . . . He was generous, loyal and affectionate, particularly fond of his sister and brothers, sometimes quick-tempered, and especially he became indignant at injustice.”

Hale-White’s medical diagnosis, substantiated by later scholarship, sweeps away two centuries of myth-making:

“He caught consumption almost certainly from [his brother] Tom, with whom he lived for months before it killed Tom in December 1818. From this date until February 1820 Keats occasionally complained of not feeling well—he did not bathe for this reason. Whether this was owing to tubercle bacilli in his lungs, or to some other cause, we do not know; the tubercular disease of his lungs first showed itself on the 3rd of February 1820 when, fourteen months after Tom’s death, he coughed up blood. The disease then progressed in Keats in the usual way until it killed him in February 1821.”

One admires a doctor or writer who acknowledges the limits of what he knows and sticks to demonstrable facts. Keats was never formally diagnosed with tuberculosis because, in a sense, it didn’t exist. The bacillus that causes the disease was not identified until 1882 by the German physician Robert Koch, and a fairly reliable immunization was not developed until 1906. The treatment was not widely accepted until after World War II.

Hale-White sounds angry when he describes the treatment the poet received – frequent bleeding, malnutrition, indoor confinement. Doctors went on treating him (and millions of others) when they had no idea what they were doing: “They had no thermometers with which to see if the patient was feverish, no microscopes with which to investigate the expectoration, and no X-rays with which to examine the chest visually. They were like extremely short-sighted people trying to grope about without glasses.”

Hale-White partially forgives the doctors of Keats’ day:

“They suffered from the additional disadvantage that their instruction had been the traditional teaching stretching back for centuries, hence they bled and starved their patients. This teaching was founded upon doctrines which had proceeded from the imagination, and as these were wrong, the treatment was wrong. It is the old, old story that mankind will not be content with saying we do not know. Rather than do this they imagine.”

Little has changed, of course. Among the things Hale-White admits he cannot understand are why Keats so readily gave up medicine and why medicine plays so small a role in his poetry. He cites lines 221-226 from “I stood tip-toe upon a little hill,” written shortly after Keats left Guy’s Hospital:

“The breezes were ethereal, and pure,   
And crept through half closed lattices to cure  
The languid sick; it cool’d their fever’d sleep,  
And soothed them into slumbers full and deep.          
Soon they awoke clear eyed: nor burnt with thirsting
Nor with hot fingers, nor with temples bursting.”

The passage “suggests he was describing what he must often have seen in fevered patients.” Perhaps, but other poets who never studied medicine could have drafted those lines. In his closing paragraph, Hale-White is more convincing:

“It is clear that his medical studies influenced his writing so little as to be negligible. This is remarkable, for, although he had for five years out of his short life studied medicine and had been in daily contact with possible medical subjects for writing, he did not use them. His native industry made him work hard at medicine but his mind was not in it.”

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