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What can we learn from a dying poet?
  1. John Birtwhistle
  1. Correspondence to John Birtwhistle, 19 Moor Oaks Road, Broomhill, Sheffield S10 1BX, UK; birtwhistle{at}

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Our publication of a new poem by Clive James may provoke many questions, among them what any poem is doing in a scientific journal. This journal has had a poetry page since its first volume in 2011, offering insights into the predicament of dying patients through literary as well as scientific writing. I am a literary academic not a doctor, but as an editor who has helped with the poetry page I have gained the following impression of its value and that of Clive James’ poem.

I learn from healthcare professionals that in the care for any patient it is important to understand not only what is going wrong and why, but also the depth and complexity of the patient's distress. Moreover, carers need to understand themselves and their colleagues and the stress that everyone around them is working under. If in the midst of all this they can show empathy, they may receive better information from the patient as to what is really wrong with them and what that person wishes to be done about it. Hence they may have a better technical understanding of their patients’ distress and can make better decisions on their behalf.

There are many thousands of poems about Death in the abstract. Philosophising about Death is a typical way of rendering it less real as an experience. But for this journal we look for quite specific kinds of poems. They have to speak about the actual situation of the dying person, their family, their friends or the doctors and other workers in the specialty of care for the dying. So we began with ‘Felix Randal,’ that profound poem by Gerard Manley Hopkins which has so much to say about any professional carer, in his case a priest.1 Other poems in the series describe or imagine the dying person's own predicament. Most valuable of all are those poems which are uttered by the dying themselves: for example, the Emperor Hadrian's address to his departing soul. At the moment, we are working with Japanese colleagues on new translations of poetry traditionally written by Zen monks on the verge of death.

In a radio interview in 2012, Clive James confirmed that he was suffering from B-cell chronic lymphocytic leukaemia, as well as emphysema and kidney failure.2 Since then, he has made several public statements about his terminal illnesses. He has also been publishing very thoughtful poems that face up to his condition.3 The generous way he has been talking about terminal illness is a service to public awareness. It is the same kind of benefit we have when well-known people speak out on taboo conditions such as depression, breast cancer or dementia. We wrote to James explaining the purposes of our journal and inviting him to consider submitting anything he thought might be suitable. He responded with this excellent poem.4

For our journal to publish a poem it needs to be of literary value, not just documentary. Science and poetry have their different methods and responsibilities, but they share this requirement. Just as a scientific article has to be precise and honest in its language, so every word in a poem has to answer to the closest possible attention.

So why is James’ poem so well written? Start with the title. The chilly bureaucratic phrase ‘change of domicile’5 detaches what is happening to him from any reassuring sense of home or country. He is treating fear of death in terms of a more graspable anxiety and remorse, such as we all know goes along with changing our legal status or moving house and downsizing our stuff. He knows that the word ‘change’ begs all the questions as to what kind of transition this might be. Rites of passage make sense when we are moving from one status to another, but as an atheist James cannot rely on this final change being a passage into anything whatsoever. His imagination of what it might be like is shadowy and disconsolate, rather like the classical Hades.

The opening five lines of James’ poem express his predicament as a rueful withdrawal from everything that his books and works of art have meant to him throughout his life. (The second stanza will be stimulated by the particular example of the ‘Chinese screen,’ which he appreciates as though for the first time.) A person's life, no matter how public and thronged with personalities it may have been, is revealed through such intimate acquisitions. The originality of James’ image of death as a ‘change of domicile’ refreshes the biblical and proverbial wisdom that we leave the world as naked as we came into it. Unlike the Pharaohs, we cannot take our goods with us.

Then something very interesting happens to the form of the poem. In the opening five lines, the loose possibility of half-rhyme has been emerging with ‘more’ and ‘here.’ But now the whole work is pulled together around the image of the sinister ‘new place’ he will soon have to occupy. James addresses that squarely, and as he does so he decides on an unobtrusive pattern of full rhymes for the rest of the poem. (Every end word from line six onward has at least one rhyme, and the two stanzas or sonnets are linked by the rhyme on ‘between.’) It is as though his will to confront the bleak opening realisation, about having to renounce his mental possessions, is represented by the poem itself as a will to muster its energies and shape itself up as a double sonnet. Shakespeare and Keats and other masters of sonnet form have strongly associated it with the theme of art as a futile but noble riposte to mortality. Even as James is about to disperse his library for ever, he is deliberately making a poem that will add to yet another book.

So the delicate crafting of the poem is not just some stylistic preference of his; it is close to the very meaning of the poem as it replies to his dying. And it is all done in ordinary language that does not show off as ‘poetic.’ Look at his phrase ‘The shelves come clean.’ That implies not only the literal clearing of his library shelves but also the sense of honesty, even of confession, that ‘coming clean’ declares in everyday language. ‘Truth clears away’ and finishes, even when it does not clean or absolve. James denies Christian ways of thinking about his life and death, but he seeks their equivalent in secular terms. As in other recent poems of his, the celebrated ‘reviewer’ judges his own conduct and implicitly seeks forgiveness from his readers and those he has loved. In its honesty and craft, his poetry restores an integrity which he admits has been—as with all of us—to some degree lacking in his life.

In such phrases, there is poetic compression of thought. For another example: he imagines his next premises will have ‘unforthcoming walls.’ If we think what we normally mean by ‘forthcoming,’ it is to be frank, personable, informative or to have something coming to us in the future. Writers are all too familiar with their next book being promised as ‘forthcoming.’ The word is fecund with what may be coming forth. To fasten the prefix –un in front of that word is to preserve all its yearnings while harshly negating them. Such constructions are typical of Shelley,6 a poet James studied; so a minor theme is that this touches on his relation to poetic tradition. Yet the reader is not aware of any strain in these effects. Such is James’ control of rhythm and tone that the writing seems fluent until his last sharp sentence, which fulfils the rhyme scheme but is rhythmically abrupt as though deliberately breaking off just when we feel he could have gone on.

The value of Clive James’ poem is that it makes an original attempt to envisage the ‘ever-during night’ of our oblivion. Imagining oblivion is of course a paradox, in that the poet has to find images for nothing. His next ‘domicile’ is as much about this perplexity as it is a picture of any possible home. By focusing on his books, James is saying goodbye to what is also part of his afterlife in the culture; his poem subtly affirms a literary life, even as that life is renounced. He is, as it were, retaliating against his condition by creating something that will outlast him. He has always been a skilled performer, and in this poem he is performing for us to the very last. When he is gone, we shall have his books for a while on our shelves.



  • Competing interests None. Clive James played no part in the commissioning, writing or approval of this article. A proof was shown to him as a matter of courtesy.

  • Provenance and peer review Commissioned; internally peer reviewed.

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