literature and medicine

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.