Dannie AbseBMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6769 (Published 02 December 2014) Cite this as: BMJ 2014;349:g6769
- Sandy Goldbeck-Wood, Bodø, Norway
It’s as though Dannie Abse—physician, poet, Jew, Christian, atheist—was never quite a true believer in medicine. Grief wracked by the loss of his wife, Joan, in 2004, he documented depressive symptoms with a medic’s self objectification, but declined his physician’s actual advice—“to come if your symptoms persist.” He retorted, with just a hint of a grandiose flourish, “I’m not inclined to sit and disgorge egrimony facing the psychiatrist’s chair.”1 One might arguably read Abse’s whole life’s work as a kind of faithful disobedience to medicine.2
Abse followed his older brother, Wilfred—doctor, supporter, bequeather of textbooks inscribed with the flyleaf exhortation nil desperandum—into medicine, where he enjoyed a successful 30 year career as a chest physician. But there was always a whiff of subversion. He smoked. Intoxicated by the polyphony of words, he fraternised with other medical mavericks, warming to gerontologist and poet Alex Comfort’s doctrine of disobedience.3
Abse’s first collection of poems, After Every Green Thing, was published in 1948 while he was a medical student at Westminster Hospital, and he went on to write more than 30 books. He wrote memoir, fiction, plays, and criticism—but especially poetry.
His poetry addressed everything from painting, music, and the fortunes of Cardiff City Football Club to embodiment’s really big challenges—love, sex, death, ageing, the eroticism of everyday experience (hitting a six at cricket), and the olfactory physicality of memory (a fragrant climber planted by his dead wife “. . . so alluring, so delinquent, it could have made Adam fall on Eve, with delight”). His poetry won him prizes, including the Wilfred Owen award, and a CBE for his services to literature. He was elected an honorary fellow of the Fellowship of Postgraduate Medicine, and judged the inaugural Hippocrates Prize for Poetry and Medicine in 2010.
A later Hippocrates prize judge, former Welsh poet laureate Gwyneth Lewis, said of his work: “He wrote not out of the romantic neurosis of the poet, but from the position of being healthy and well adjusted. The poetry of health is much more powerful than that of illness” (personal communication, 2014).
As readers we can’t know what effect poetry had on Abse’s medical practice, although we can guess at the effects of attentive listening on empathy and reflection—effects well explored within the medical humanities literature.4 5 The effect of medicine, or rather of the sheer uncontainable corporeality of experience, on Abse’s poetry is stretching the seams of language everywhere. Unlike Keats or Carlos Williams—who largely kept medicine out of their poetry—Abse argued that poetry should not be “an escape from reality but rather an immersion into reality.”
For him this was a physical reality replete with “joyous ejaculations of the storms, copulating cats,” a man smelling his own hand unobserved. Taking his medical experience on equal terms with all other experience, he sings the exuberant colours of disease: the rose of a tumour, the green of festering limb, the plum skin face of a suicide. He describes with tenderness a dying man’s mouth sucking the flesh off a peach stone.6
Where Abse gives medicine centre stage, it is often to critique. His poem The Stethoscope appears to invite awe at the hieratic instrument transmitting privileged sounds “over young women’s tense abdomens . . . of creation and, in a dead man’s chest, the silence before creation began.” In the end, however, its iconic status is refused, the author venerating instead “my own ears . . . the night cries of injured creatures . . . lovers with doves in their throats,” in other words, the deeper magic of common human sensibility.7In the Theatre8 is a kind of poetic operation note based on a real life procedure observed by his brother Wilfred. Celebrity neurosurgeon Lambert Rogers’s fingers search for the locus of a patient’s pathology—“rash as a blind man’s, inside his soft brain”—when suddenly the patient cries: “You sod, leave my soul alone, leave my soul alone.” Rearing up in protest against well intentioned violation, this “arctic voice” challenges and chastens the clever, the famous, the diligent, and the blindly well intentioned.
If medicine was for Abse a career, it was poetry he called “a vocation, even a destiny.”9 Honouring medicine as craft, he refused to see it as a creed with privileged rights to control the narratives of health and illness. In his personal hierarchy of salutogenesis10—Antonovsky’s term for that which brings or restores health—medicine is subordinate to the reflexive, healing act of writing. Abse called it “an antidote to my widower’s depression.”11
While his brother was a psychoanalyst, Abse was arguably a poetic psychoanalyst of medical culture, inviting it on to the couch to examine its grandiosities and defences, truths and lies, and acts of physical and epistemological benificence and violence.12
White Coat, Purple Coat, the title of Abse’s expanded collection published in 1989, refers to the cultural cross dressing that defined his work—white being the clinical colour, while purple refers to the mysterious or magical, the wizard’s garment. It was a challenging tension to hold, and one for which we owe him gratitude: “in the white a man will freeze/and in the purple burn.”13 In his final, most poised book, Speak Old Parrot,13 Abse takes leave from this dual allegiance, personified in a piece of self ironic theatre, almost camp, as the ventriloquist bird with white and purple feathers.
" When I fed you with my two lives you took
your fill of both and soliloquised.
Now I'm tired and you nest elsewhere"
-he sighs, histrionic as a Shakespearean fool. But not least among the farewells is an old man's last homage - fond but by no means foolish - to the untheatrical art of medicine:
Lover of music more than his textbooks’
arrythmic prose and dated, almost dangerous
his Conybeare and his Boyd’s Pathology.
(Notes in the margin by the student he was)
What was it all about? Blunderbuss drugs
prescribed to ease the patient. And moonbeams.
A composer—a Beethoven, a Smetana—it seemed, could be deaf,
but not a doctor.
He had been a confidence man for the patient.
That’s how it was in the Theatre of Disease
and, at the final act, he had lifted
his stethoscope to listen
as if to Mozart.
Then, silently, relatives and friends filed out.
No applause. None for Hippocrates’ art.Portrait of an Old Doctor. From Speak Old Parrot by Dannie Abse. Published by Hutchinson. Reproduced by permission of the Random House Group.Photo credit: Amit Lennon
Cite this as: BMJ 2014;349:g6769
Dannie Abse (b 1923; q King’s College, London/Westminster Hospital 1950), d 28 September 2014.
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