Walt Whitman: a difficult patient

Jack Coulehan
Stony Brook, NY  (Fall 2017)

On June 15, 1888, the following notice appeared in  the New York Times under the headline AGED POET SUFFERS RELAPSE:

“Prof. William Osler, of the University of Pennsylvania, was summoned by telegraph this afternoon to go to Walt Whitman’s bedside. The aged poet had a relapse, and it was feared that he was dying. When the doctor came away from the little frame house at 328 Mickle Street, Camden, at 8 o’clock tonight, he said the poet was resting easily and about holding his own.”

Walt Whitman in 1888

Osler first visited Whitman in 1884, shortly after moving to Philadelphia to take up his position as Professor of Medicine at the University of Pennsylvania. Dr. Maurice Bucke, a Canadian psychiatrist and mutual friend, had asked Osler to look in on Whitman, who was complaining of dizzy spells and fatigue. The professor obligingly  crossed the Delaware River to Camden and made a house call. The poet had no residual neurological deficits from his earlier stroke. Osler was unimpressed with Whitman’s current symptoms and later described him as “a fine figure of a man who had aged beautifully, or more properly speaking, majestically with a large frame and a well-shaped, well-poised head…“ 1, p. 21

Four years later, however, the situation was more serious. On June 14, 1888, Whitman developed slurred speech, prostration, and confusion “such as we know are not uncommon with sclerosis of the arteries of the brain.”1, p. 178  When Osler was called in, he recommended general supportive care and issued a cautiously optimistic prognosis (as the Times reported), but evidently did not present his patient with a specific diagnosis or discuss pathophysiology.  Whitman gradually recovered over the following weeks, but his health gradually deteriorated over the next several years until his death in 1892.

During those years Osler served as the poet’s primary care physician. Their relationship was respectful, but not ideal. Whitman frequently complained about the great clinician’s rosy bedside manner.  “Osler made light of my condition,” the poet wrote. “I don’t like his pooh-poohs. The professional air of the doctor grates on me.”1, p. 50 On another occasion he told his friend Horace Traubel, “I confess I do not wholly like or credit what he (Osler) says. I do not fancy the jaunty way in which he seems inclined to dismiss my troubles.” 2 Evidently, Osler continued to speak in generalities, rather than addressing specific concerns that Whitman raised as he became progressively more feeble.

This situation contrasts with some of the poet’s earlier medical experience.  For example, shortly after his stroke in 1873, Whitman consulted Dr. Mathew Grier who must have explained the cause of the problem.  Whitman later wrote to his friend Peter Doyle, “Did I tell you that Dr. Grier here says that my real disease is the brain not being properly furnished and nourished with blood…” The poet’s other physicians included Drs. Silas Weir Mitchell and his son John Kearsley Mitchell. The famous neurologist  and champion of neurasthenia made house calls on Whitman twice in 1878 when the poet reported symptoms of rheumatism and prostration, which he had self-diagnosed as a recurrence of his previous stroke. Mitchell assured him that the stroke, which had resulted from a ruptured blood vessel in the brain, was not responsible for the current symptoms. These, Mitchell claimed, were caused by chronic stress, perhaps exacerbated by anxiety over a public lecture the poet was just then preparing to give.3 In other words Mitchell considered the illness a manifestation of neurasthenia. He prescribed travel, mountain air, and vigorous outdoor activity, which was Mitchell’s generic regimen for neurasthenia in males, quite the opposite of his more famous regimen of complete bed rest for female neurasthenics. 3 The poet took Mitchell’s advice seriously and embarked on a trip to Colorado, after which he professed himself cured.

Dr. William Osler, Walt Whitman’s ‘jaunty’ physician

While Osler’s optimistic persona must have pleased many patients, it irritated  Whitman. He judged his doctor’s cheerfulness to be insincere, or at least questionable. The elderly poet was an eccentric who fiercely valued his independence. While at times he showed a sweet and gentle side, he could also be touchy, irascible, and assertive. As the poet grew more feeble  during 1888 and 1889, Traubel recorded a series of house calls during which Osler assured him that he would soon recover.  “Do not take a gloomy view of Whitman’s case,” Osler told Traubel, “he will come around.” 2

Whitman was a master of self-promotion. He appeared to encourage members of his inner circle who viewed him as a prophet as well as a poet. Dr. Maurice Bucke even wrote a book claiming that his friend was one of the few humans who had achieved “cosmic consciousness.”  The others were Jesus, Mohamed, and the Buddha. Did Osler fail to understand that his one- size- fits- all approach to physician-patient communication might not be appropriate for a patient with Whitman’s complex and eccentric personality?

Although dissatisfied with Osler’s bedside manner, the poet respected his doctor’s clinical abilities. Several months after the medical crisis in 1888, Whitman wrote, “As for Osler: he is a great man—one of the rare men. I should be much surprised if he didn’t soar way, way up—get very famous at his trade—someday. He has the air of something about him—of achievement.”2  Indeed, by that time Osler had already accepted the position of Professor of Medicine at the new Johns Hopkins medical school in Baltimore.

Osler was a sensitive, cultivated man, but also a rationalist who initially looked askance both at Whitman’s exuberant poetry and the cult that had grown up around its author.  Although he admired the man, he had no wish to become a disciple.  He loved poetry and enjoyed quoting passages from Shakespeare and the Romantic and Victorian poets.  Regarding his first impressions of Leaves of Grass, Osler later wrote, “Whether the meat was too strong, or whether it was the style of cooking—‘twas not for my pampered palate.” 1, p. 22 He found his new patient’s long, unruly poems and earthy subject matter self-indulgent and lacking in discipline. The boisterous persona reflected in Whitman’s poems jarred Osler’s methodical mind.

In his later years, Osler grew to respect his one-time patient’s poetry as well as his charismatic personality. In fact, at the time of his death from pneumonia in 1919, he was in the process of writing an appreciative reminiscence of his encounters with Whitman.

The uneasy but respectful relationship between these giants in their respective fields provides interesting material for reflection. If the poet was so dissatisfied with Osler, why did he not go back to Weir Mitchell or his son, who were more easy-going and communicative?  Mitchell’s reputation as a clinician easily equaled Osler’s, and he was a poet as well. Could it be that Whitman benefitted in some way from Osler’s staunch optimism, or had developed deep trust in Osler’s judgment despite the constant complaints he issued to Traubel and others?  Alternatively, why did Osler not modify his paternalistic approach, since it seemed clear that Whitman preferred to play a more active role in the relationship?  And those time consuming house calls that required taking a ferry across the river! Why not recommend a more pliable colleague?

References

  1. Philip Leon, Walt Whitman & Sir William Osler, ECW Press, Toronto, 1995.
  2. Horace Traubel, With Walt Whitman in Camden, vol. 2, at http://www.whitmanarchive.org/criticism/disciples/traubel/WWWiC/2(accessed May 25, 2017)
  3. Feinberg CE. Walt Whitman and his doctors. Arch Intern Med 1964; 114: 834-842.

Jack Coulehan, MD, MPH is an Emeritus Professor of Medicine and former director of the Center for Medical Humanities, Compassionate Care, and Bioethics at Stony Brook University. Jack’s essays, poems and stories appear frequently in medical journals and literary magazines, and his work is widely anthologized.