Hektoen International

A Journal of Medical Humanities

Dylan Thomas’s terminal illness

JMS Pearce
Hull, England

Time held me green and dying
Though I sang in my chains like the sea.

– Dylan Thomas, “Fern Hill”, 1937

Dylan Thomas. From Poetry Foundation.org,
 © Hulton-Deutsch Collection/CORBIS/Corbis via Getty Images.

The poet Dylan Marlais Thomas (1914–1953) was born in Cwmdonkin Drive in Swansea on 27 October 1914. He was much in awe of, but devoted to his father, an English teacher at Swansea Grammar School. Florence Hannah (née Williams) was his loving, protective mother.

The shy child grew into a stormy, rebellious adolescent who sought attention with drunkenness and dilapidated clothes to shock his elders. The adult Dylan retained the guise of the hurt child who never grew up. He was gentle and kind but at times as rowdy as his hero, Christopher Marlowe. Though usually short of money, he was renowned for his wildly erratic lifestyle. He often drank to excess and was an incurable Lothario, but had a loving if tempestuous marriage with the often unfaithful, alcoholic Caitlin who at times tolerated his lapses. How could such a wildly disordered lifestyle produce such literary creativity? Perhaps because in his obsessive need to write perfect poetry, he was remarkably sharply-focused, strictly self-disciplined, and industrious.

Well versed in Shakespeare, Marlowe, Milton, and Hardy, he used many literary devices: vivid imagery, alliteration, dense word use, and internal rhyme. He revealed: “I like redeeming the contraries with secretive images; I like contradicting my images, saying two things at once in one word, four in two words and one in six.” Combining the elements of Romanticism and Surrealism, his common themes were of lost innocence, nostalgia for childhood, death and dying.

In 1934 he left Wales for London, won the Poets’ Corner Prize, and published his first book, 18 Poems. In subsequent years, he published eight poetry collections including more than ninety poems.1

His most celebrated were:

“And Death Shall Have No Dominion” (1933)
“Light Breaks Where No Sun Shines” (1937)
“Fern Hill” (1945)
“A Refusal to Mourn the Death, by Fire, of a Child in London” (1945)
“Do Not Go Gentle Into That Good Night” (1951)

He was much admired by and inspired The Beatles and Bob Dylan. His lyrical, often elegiacal verses laced with rich arresting metaphors were widely but not universally praised.1 With insight he remarked his writing contained “overweighted imagery that leads often to incoherence.” A powerful choice of words, rhythm, and musicality punctuate his lines. His poetry related to the working people, their lives, loves, and idiosyncrasies portrayed graphically and sympathetically. It was often laden with passionate, private feelings of life mixed with his morbid apprehension of death that he called “the poetry of womb and tomb.” He also wrote short stories, plays, and memoirs: one of his most admired is A Child’s Christmas in Wales. The BBC provided him with work writing scripts, frequent verse readings, and discussions.

With little trace of his Welsh origins, he acquired a distinctive, almost aristocratic speaking voice, which he employed with passion at his theatrical readings, which drew large audiences.2 Nobody with a love of verse could be unmoved by his compatriot Richard Burton’s 1954 reading of Under Milk Wood, perhaps his most famous play. Typical of Thomas’s humor, this was centered in the fictional village of Llareggub (sic, best read in reverse).

Final illness

Dylan Thomas had suffered from asthmatic bronchitis intermittently since childhood, and he was a habitual smoker. He died aged thirty-nine in 1953. John Malcolm Brinnin, a poet and his agent, in 1950 arranged a tour comprising talks, readings, and lectures in the US. Their acclaimed success led to three further American tours. The fourth and last began in New York on 20 October 1953. He was ill from the outset, and the prevailing industrial smog pollution brought on a severe attack, initially of bronchitis.

David Thomas uncovered much of the fictitious tales of his death.3 At the Poetry Center in New York on 23 October 1953, he was sick, shivering, burning with fever, and collapsed on stage at a rehearsal. But Brinnin had abandoned his care and supervision to Liz Reitell, his assistant who had earlier been Dylan’s lover.

At 2 am on Wednesday, 4 November 1953, Thomas left his hotel to drink in the White Horse Bar. He returned boasting he had drunk eighteen double whiskies, which the barman later stated was plainly untrue. Dylan usually drank half pints of bitter and also used to exaggerate the amount he drank to impress others.

 A few hours later, symptoms worsened. Reitell was alarmed. Brinnin ignored reports of his illness from Ms. Reitell and did not see him again until he was lying in a coma in the hospital.3 She summoned Dr. Milton Feltenstein, her family physician. He visited Thomas three times in his hotel room, and each time he injected corticotrophin and morphine. The next day, 5 November, after a dose of no less than 30 mg of morphine, he became comatose and was admitted to St. Vincent’s Hospital. Feltenstein belatedly secured the services of a neuroradiologist, Dr. Carlos de Gutiérrez-Mahoney, who took charge; the junior doctors were Drs. McVeigh and Gilbertson. A tracheostomy was performed and he was placed in an oxygen tent.4 He never recovered consciousness and died on Monday, 9 November 1953.

It has been reported that Dr. Feltenstein never examined Thomas’s chest nor took notice of his cough and breathlessness5 He dismissed his symptoms as delirium tremens caused by alcohol withdrawal, though x-rays showed pneumonia. Drs. McVeigh and Gilbertson later were said to have been “stunned by Feltenstein’s intransigence in the face of what to them was clear evidence that he was wrong. Feltenstein also forbade any other doctors to become involved in the case.”6

 Milton Helpern, an eminent forensic pathologist, carried out the autopsy and concluded that Dylan’s death was due to edema of the brain, but the primary cause was not alcoholic cirrhosis but hypostatic bronchopneumonia:

The pathologist found no evidence that Dylan’s brain had been poisoned, damaged or changed in any way by alcohol. He issued a Notice of Death in which he said he was unable to confirm any diagnosis of alcoholic brain damage. Nor did he find any signs of alcoholic hepatitis or cirrhosis in the liver. The immediate cause of death was swelling of the brain, caused by the pneumonia reducing the supply of oxygen.3

The eminent forensic pathologist Bernard Knight examined the autopsy report and concluded that “the severity of the chest infection, with greyish consolidated areas of well-established pneumonia, suggests that it had started before admission to hospital.” The notes about Thomas’s admission are summarized in a memorandum written by Dr. William Murphy, a Maryland physician who importantly examined the poet’s hospital papers in 1964 on behalf of his widow Caitlin. Murphy noted in a memorandum to David Thomas:

It is quite apparent that it [morphine injections] could do no good …The rationale of this form of medication continues to escape me.3

 Even after Dylan’s admission to hospital, Feltenstein insisted that his diagnosis was correct, although chest x-rays and the autopsy showed pneumonia. The reports of Feltenstein’s attentions are conflicting7; he visited him frequently but plainly misdiagnosed his illness. His prescription of large doses of morphine in someone with pneumonia appears indefensible.3 Reitell would later describe him as “a wild doctor who believed injections could cure anything.”8 Caitlin flew to New York but she became psychotic, was put in a strait jacket, and confined to psychiatric care. Years later she lived in Italy, had other lovers, and died in Catania, Sicily in July 1994.

Brinnin and Feltenstein escaped legal action for alleged failure in their duty of care. Brinnin created a cover-up by publishing Dylan Thomas in America (1955) in which he propagated the myth that Dylan had died from alcoholic brain damage.

He was buried in Laugharne, and almost thirty years later a plaque was unveiled in the Poets’ Corner of Westminster Abbey. The Dylan Thomas Centre has a permanent exhibition on Dylan and his life. The year 2014 marked the celebrations of the Dylan Thomas 100 Festival.


  1. The Collected Poems of Dylan Thomas: The New Centenary Edition. Ed. with Introduction by John Goodby. London: Weidenfeld & Nicolson, 2014.
  2. Paul Ferris. Dylan Thomas: The Biography. 1977; Ferris, P. (2017, September 01). Thomas, Dylan Marlais (1914–1953), poet. Oxford Dictionary of National Biography. Retrieved 30 Nov 2023.
  3. Thomas DN. Fatal Neglect: Who Killed Dylan Thomas? Poetry Wales Press, 2008.
  4. Ruthven Todd’s Account Events Leading up to Dylan’s Death. An original letter sent to the poet and broadcaster Louis MacNeice. 23rd November 1953. http://www.dylanthomas.com/dylan-thomas-centre/exhibition-items/ruthven-todd/.
  5. Dalrymple T. The death of Dylan Thomas: a conspiracy theory. British Medical Journal 2010;341:c4595.
  6. Nashold J, Tremlett G. The Death of Dylan Thomas. Edinburgh: Mainstream, 1997.
  7. Aeronwy Thomas. My Father’s Places. Little, Brown Book Group Ltd, 2009.
  8. PoemHunter.com: Poems – Poets – Poetry Dylan Thomas

JMS PEARCE, MD, FRCP, is emeritus consultant neurologist in the Department of Neurology at the Hull Royal Infirmary, England.

Fall 2023



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