23 The Art of Healing by W.H. Auden

In this eulogy to his personal physician, who was “what all doctors should be, but few are,” English poet W. H. Auden considers the failings to which most doctors are subject and qualities that make a few great.

The poem begins with what “most” patients believe: that their doctors are immune to death as well as to the vulnerabilities and needs conveyed by our nakedness and served by marriage. The poet, however, we quickly learn, has been saved from this common error by being the son of a doctor, and of one, moreover, who understood both the true nature and the pitfalls of his profession.

Prepared by this early teaching, Auden early recognized the man in the doctor he now eulogizes. Far from the seeming immortal preferred by most patients, this doctor was himself ailing, not only from a natural illness but also from an “arrogant” therapy that overreached and made his condition worse. Understanding, then, both sickness and the need for circumspection in treating it, this doctor, though “difficult,” could be trusted.

The poet’s father cautioned him that healing was not a “science” but “the intuitive art | of of wooing Nature.” What does this mean? Is it true? If so, what does this suggest about the teachability of medicine?

The poet’s physician-father further observed that patients have unforeseeable “prejudices” that prevent them from reacting as beasts and plants do “according to the common | whim of their species.” Are human prejudices and nature really the opposing forces the poet here suggests? If so, how can a doctor accommodate both? Should he try?

The poet praises his physician for knowing, as Novalis did, that “every sickness | is a musical problem” and “every cure | a musical solution.” Is this an apt metaphor? What does it mean?

Auden also praises his doctor for treating his own small “ailments” well, and leaving his “major vices” alone. Is the capacity to do this necessarily praiseworthy in a doctor? Should not the physician care for “the whole person,” his vices as well as his ailments? How might the Hippocratic physician respond to this question? – Leon Kass

The Art of Healing (In Memoriam David Protetch, M. D.)

Most patients believe

dying is something they do,

not their physician,

that white-coated sage,

never to be imagined

naked or married.

 

Begotten by one,

I should know better.

‘Healing,’

Papa would tell me,

‘is not a science,

but the intuitive art

of wooing Nature.

Plants, beasts, may react

according to the common

whim of their species,

but all humans have

prejudices of their own

which can’t be foreseen.

To some, ill-health is

a way to be important,

others are stoics,

a few fanatics,

who won’t feel happy until

they are cut open.’

Warned by him to shun

the sadist, the nod-crafty,

and the fee-conscious,

I knew when we met,

I had found a consultant

who thought as he did,

yourself a victim

of medical engineers

and their arrogance,

when they atom-bombed

your sick pituitary

and over-killed it.

 

‘Every sickness

is a musical problem,’

so said Novalis,

‘and every cure

a musical solution’:

You knew that also.

Not that in my case

you heard any shattering

discords to resolve:

to date my organs

still seem pretty sure of their

self-identity.

For my small ailments

you, who were mortally sick,

prescribed with success:

my major vices,

my mad addictions, you left

to my own conscience.

Was it your very

predicament that made me

sure I could trust you,

if I were dying,

to say so, not insult me

with soothing fictions?

 

Must diabetics

all contend with a nisus

to self-destruction?

One day you told me:

‘It is only bad temper

that keeps me going.’

 

But neither anger

nor lust are omnipotent,

nor should we even

want our friends to be

superhuman. Dear David,

dead one, rest in peace,

having been what all

doctors should be, but few

are,

and, even when most

difficult, condign

of our biased affection

and objective praise.

Consider this:

1) What traits are “what all doctors should be, but few are”?
2) The patient poses the question “Was it your very predicament that made me sure I could trust you?” As health care providers, how can we respond to death and illness without insulting the patient with “soothing fictions”?