Observing Keats

I’m still thinking about John Keats and medicine. I’ve recently written a couple of articles – one on Jane Austen’s ‘Sanditon’ and one on Keats’s ‘Ode to Psyche’ – which consider how professional medicine might have provided nineteenth-century writers with a model for effective literary practice (in the description of characters, for instance, or in the communication of humane knowledge). But I think (or I hope) that, in the case of Keats, there’s still more to say, specifically about how his time as a medical student and dresser in London in 1815-17 trained him in a diagnostic method, and in a particular approach to working with patients, that also informed his poetry.

British medicine in the early nineteenth century was engaged in an ambitious (if uneven) process of professionalisation, exemplified in the 1815 Apothecaries’ Act, which for the first time mandated a (roughly) standardised curriculum of instruction and examination for trainee apothecaries. Keats was one of the first students to enrol at Guy’s and St Thomas’s hospitals after the passing of the act, and, as John Barnard has shown, in 1815-16 he attended the eminent surgeon Astley Cooper’s lectures on anatomy and on surgery. Cooper was an important contributor to the professionalisation of medicine, and especially to the development of a scientific approach to diagnosis and surgical treatment, which rejected systematic theorising and relied instead on empirical data and on detailed anatomical knowledge.

Descriptions of this approach are everywhere in notes taken by students who attended Cooper’s lectures at the same time as Keats (notes that are now held in the archives of King’s College London and of the Royal College of Surgeons). One student, Joshua Waddington, recorded Cooper as saying that the ‘principles’ of surgery ‘are founded upon observation of diseased living, and the examination of diseased dead Animals, and on experiments made on the living’. Another, George Ray, noted down the same maxim: surgical principles ‘are derived from three sources. 1st from the observation of the symptoms of Disease during life. 2ndly from the examination of the appearance of the body after Death. 3rd by experiments on living animals.’ For Cooper, it seems, observation, examination, and experimentation formed a kind of scientific trivium that underpinned surgical practice, and that viewed the living and the dead as the data of medical science.


St Thomas’s hospital, where Keats attended Astley Cooper’s lectures.

How might this approach have informed Keats’s poetry? To give one example: in ‘The Fall of Hyperion: A Dream’ (1819), Keats uses the Greek myth of the war between the Titans and the Olympians as the narrative framework around which he constructs his definitions of poetry and of the poet. Moneta, the goddess of memory, gifts the poem’s speaker with ‘A power […] of enormous ken / To see as a God sees’ (1:303-4), which enables him to witness the sufferings of the defeated Titans Saturn and Thea:

                     A long awful time
I looked upon them: still they were the same;
The frozen God still bending to the earth,
And the sad Goddess weeping at his feet;
Moneta silent. Without stay or prop,
But my own weak mortality, I bore
The load of this eternal quietude,
The unchanging gloom, and the three fixèd shapes
Ponderous upon my senses a whole moon. (1:384-92)

The critical consensus about these lines (most recently set out by Brittany Pladek) is that they describe an instance of imaginative identification with suffering, of sympathy or (to use an anachronistic word, not coined until the early twentieth century) empathy. The most important words here, in this interpretation, are ‘I bore / the load’. But what load is the speaker bearing? I’m not convinced that he is sympathetically experiencing the Titans’ grief and humiliation. Instead, the feeling he describes appears to be a kind of boredom, or a detached (and therefore, perhaps, professional) indifference. The difficulty that faces him in these lines is not that of surviving the superhuman pain of the Titans, but that of maintaining his disciplined, monotonous observation throughout the ‘long awful time’ of their stillness (it’s a difficulty that’s articulated in the sound of Keats’s blank verse, and specifically in the acoustic repetition of ‘ponderous upon my senses’). In his efforts to understand the Titans, the speaker first and foremost looks at them rather than feeling for them, an approach that agrees with Astley Cooper’s insistence on the centrality of observation and examination to diagnosis.

This is not scientific objectivity, which Lorraine Daston and Peter Galison define as ‘knowledge that bears no trace of the knower’; the speaker’s observation of Saturn and Thea is filtered through his ‘own weak mortality’. But it is knowledge in which the subjectivity of the observer is distanced from those he observes: he characterises the Titans not as living and suffering persons but as visual ‘shapes’. Rather than describing a process of imaginative identification, these lines suggest that, in poetry as in scientific medicine, fellow feeling perhaps needs to be subordinated to observational accuracy. And, to put forward the kind of speculative hypothesis of which Cooper disapproved, I also think that the speaker’s observation of the Titans indicates that there is a place in poetry for ‘experiments made on the living’. ‘The Fall of Hyperion’ may be interpreted as an experiment that tests what happens when a poet tries to observe, diagnose, and describe suffering magnified to eternal, immortal proportions.

‘Condensed Sensibility’: Keats, Medicine, and Sympathy

I’ve just published an essay on John Keats in a special issue of the journal Romanticism. The essay builds on the work of several critics, particularly Nicholas Roe, James Allard, and R.S. White, in arguing that Keats’s poetry was informed by his time as a medical student and dresser at Guy’s Hospital (1815-17). It tries to bring something new to the study of the connections between Romantic poetry and medicine by focusing on the concept of sympathy. Throughout his writing, Keats champions sympathetic feeling for others as one of poetry’s central concerns, but he also imposes limits on the exercise of sympathy, seeking to preserve an objectifying distance between the poet and the emotions that his poetry examines. This model of restrained sympathy was influenced, I think, by Keats’s medical training, and particularly by The Hospital Pupil’s Guide, a volume first published in London in 1816 and ‘addressed to students of the medical profession’, and which Keats is likely to have read. Even if he didn’t, he would have been introduced to a similar understanding of sympathy through his attendance at the lectures of the renowned surgeon Astley cooper, whom White identifies as the lead author of the guide.

The Hospital Pupil’s Guide insistently presents medicine as an objective and scientific practice, a stance designed to reinforce the growing professionalisation and intellectual authority of medical work and medical practitioners in the early nineteenth century. But while the guide celebrates the ‘rational exercise of the mental faculties’, it also highlights the important but ambiguous role of sympathetic feeling in professional medicine. It advises its student readers that ‘in the practice of the Profession, benevolence of disposition’ is ‘imperiously demanded.’ This argument betrays a fear that, as medicine becomes professionalised, its practitioners may act as, or be viewed as, unfeeling specialists rather than gentlemanly benefactors.

However, the guide also warns that correct professional action depends on the capacity to mediate between sympathy and professional expertise: ‘genuine sensibility, while it enters into the sufferings of others, is yet a principled feeling, and its first emotion is to relieve that suffering. In his prosecution of the line of conduct dictated by his judgment, the surgeon is deaf to the pains of his patient’. The Hospital Pupil’s Guide characterises this as a ‘condensed sensibility’, and concludes that ‘a man who has not obtained this self-control, is unfit for the practice of his profession’.

How does this model of ‘condensed sensibility’ influence Keats’s thinking about poetry? There is evidence for its importance to him throughout his letters, even when he is arguing that poets have a particular capacity for unmediated and unrestrained sympathy. In November 1817 his claim that ‘if a Sparrow come before my Window I take part in its existince [sic] and pick about the Gravel’ is followed by his admission that ‘I sometimes feel not the influence of a Passion or Affection during a whole week—and so long this sometimes continues I begin to suspect myself and the genuiness [sic] of my feelings at other times—thinking them a few barren Tragedy-tears’. This insusceptibility, he claims, is not ‘heartlessness but abstraction’. Like the self-control advocated in his medical training, Keats’s abstraction distances him from other people, but it also enables him to develop self-knowledge through an objectifying examination of his feelings.

John Keats

John Keats, 1819

Throughout 1819, worried about his financial prospects, Keats frequently considered the possibility of resuming his medical career. Writing in a letter about the possibility of taking a position as a surgeon on a merchant ship, he applauds the clinical stance of such work, its emphasis on the impartial analysis of, rather than the sympathetic identification with, other people: ‘To be thrown among people who care not for you, with whom you have no sympathies forces the Mind upon its own resourses [sic], and leaves it free to make its speculations of the differences of human character and to class them with the calmness of a Botanist’. The removal of sympathy has two related effects: it turns the mind away from others and towards self-knowledge, and it enables the scientific observation and classification of other people’s personalities. Although Keats decided not to re-enlist in the medical profession, his poetry makes consistent use of these objectifying strategies of internalisation and systematic observation. It also asks how these strategies might work in co-operation with the exercise of the sympathetic imagination.

Keats’s ‘Ode to Psyche’, for example, reveals several similarities between the methods of medicine and poetry. If the ode as a form aims for synthesis, then this particular ode aspires to a synthesis between sympathy and self-possessed impartiality. Keats presents a number of different approaches to poetic creativity over the course of the poem, and the movement between them constitutes, among other things, an effort to withdraw from or delimit sympathy. First, there is the intimate apostrophe of the opening lines:

O Goddess! hear these tuneless numbers, wrung

By sweet enforcement and remembrance dear,

And pardon that thy secrets should be sung

Even into thine own soft-conched ear: (ll. 1-4)

This apostrophe implies communication and relationship, but it also distances the poet from other people by figuring the human soul as a generalised abstraction, which is personified in and addressed through the figure of Psyche: Keats’s deployment of apostrophe, like the model of medicine set out in his hospital training, simultaneously involves connection with others and detached observation.

There is a comparable ambiguity in the poet’s relation to Psyche in the ode’s final stanza:

Yes, I will be thy priest, and build a fane

In some untrodden region of my mind,

Where branched thoughts, new grown with pleasant pain,

Instead of pines shall murmur in the wind: (ll. 50-53)

In these lines Keats internalises his observations of Psyche, worshipping her within his subjectivity. This process encapsulates the ambivalence towards sympathy shared by Keats’s poetics and the medical profession. The affective ramifications of the poet’s thoughts, ‘new grown with pleasant pain’, might suggest that his worship is an expansive process of imaginative sympathy with the feelings of humanity, encapsulated in the figure of Psyche. As in medicine, however, this sympathy is simultaneously an objectification, a conversion of other people’s circumstances and sensations into a cognitive assessment of symptoms, and that objectification is realised through Keats’s internalisation of the Psyche myth in his mind. The ode stages a poetic method which is founded on strategies of internalisation, self-examination, and observation. As in nineteenth-century medicine, sympathy in this poem is informed by, and to some extent dependent on, a disciplined resistance to feeling.