The Idea of Medicine as Poetry: Alan Bleakley’s “Keats’ Lexicon”

The Bio-Illogical (Liverpool: The Artel Press, 2023. ISBN 978-1739900335).
Book Review by Dr. Shane Neilson

Alan Bleakley knows a thing or two about Keats. As an emeritus professor of medical education and medical humanities at Plymouth University Peninsula Medical School, one of his areas of scholarly interest has been increasing medical learners and practitioners’ tolerance of ambiguity. He aims to dismantle biomedical imperatives around certainty by engaging with Keatsian negative capability.1 Since he has written so extensively on Keats and encouraged the use of the poetic imagination in medicine, it is a treat to witness Bleakley use that same poetic imagination in a poem of his own, “Keats’ Lexicon.” The poem also serves as a good introduction to Bleakley’s recent poetry collection, The Bio-Illogical. “Keats’ Lexicon” imagines Keats, at the end of his life, pondering the intersection of medical philosophy and poetry. My close reading of “Keats’ Lexicon” uncovers the legacy linking two kindred spirits: Keats, the most significant physician-poet in Western history, and Bleakley, one of the most eminent health humanities theorists the field has known.


Keats’ Lexicon

Keats (alone and fevered)
his muscles growing hot
his gums bleeding

realises that poetry and medicine
share the same grain

with no wound to debride
Keats is soured in the broth of his own lungs

a once-springy moss spotted scarlet
each spot an exclamation

the terrain of pearled tissue
now a miracle farm of miniscule blood-oranges


Bleakley’s first line fittingly invokes “fever.” As Bleakley knows, Keats contributed much to the hoard of medical metaphors concerning fever. The word appears twenty-one times in Keats’s body of work and metaphorizes such qualities as love, passion, and poetic creativity itself.2 Here, Bleakley applies the state to Keats in what might be thought of as a morbid poetic justice, depicting Keats at the end of his young life, dying of tuberculosis in Rome. Yet rather than follow Keats’s tendency to metaphorize bodily fever as a tenor that describes an emotional state, Bleakley prefers to keep the fever more deeply embodied, describing its accompanying symptoms (“muscles growing hot” and “gums bleeding”). I see Bleakley’s Keats representing the body, even the palliative one near death, as a positive zone displaying life, reversing the medical tendency to consider the dying body as a negative state. Keats himself shared this tendency; metaphors of health outnumber metaphors of disease in his work.3

In the second stanza, Bleakley imagines Keats in a kind of fever dream, coming to understand that poetry and medicine, though not equivalent, share much in common. The realization comes in extremis, when Keats feels his bodily existence acutely and is not dwelling purely in the realm of poeticizing, a mode Keats rarely adopted (even the cerebral “Ode on a Grecian Urn” metaphorizes passion in terms of fever: “a burning forehead, and a parching tongue.”) One might argue that, near death, beauty and truth matter, but so do the fact of the body and the pressing necessity of relief. As Housser has written in a study of The Eve of St. Agnes, Keats uses “deeply embodied language to capture and describe all the human senses, and through this language he defines his dominant ethos: beauty is truth, beauty is life, beauty is all.”4

This depiction is in keeping with modes of embodiment found in disability poetics. Katerina Tsiokou explains that disability poetics abandons the Cartesian separation between body and mind and rejects the “structured, unified entity” in favour of one “that accounts for the various parameters of the primacy of the body in the realm of consciousness.”5 Indeed, the poem manifests Keats’s felt experience of fever in various bodily locations, each contributing to Bleakley’s realization concerning the consubstantiality of medicine and poetry.  

But what does Bleakley really mean when he writes that “poetry and medicine/shar[e] the same grain”? Reviewing Bleakley’s seminal text on medical metaphor, Thinking with Metaphors in Medicine, Anita Wohlmann observes that for him, “poetry and medicine both deal with the extraordinary, as well as with the confluence of multiple and sometimes contradictory meanings.”6 Like a doctor, “the poet is a diagnostician who treats culture’s symptoms.”7 Yet Keats’s diagnosis is certain. Bleakley does not need a medical version of negative capability (for the instrumental purpose of diagnosis). Instead, “Keats’ Lexicon” shows that the relation between poetry and medicine exists in a space of craft where ambiguity finds its boundary in a practiced intelligibility. In poetry, Viktor Shklovsky famously called this space “defamilarization,” and Bleakley’s version of the concept deems it a “strangeness,” one that healthcare workers “never knew they needed, for their own selves.”8 Such strangeness deforms language in order to call more attention to it; the denser the deformations, the closer the language approaches poetry. At the end of his life, Bleakley’s imagined Keats does not determine a diagnosis, but renders his subjectivity through bodily metaphor, for there is no “wound to debride,” no biomedical intervention or action, but rather an engagement with the poetic imagination to reconsider and reconvene the self.

In the tradition of biomedical quantification, I will carefully itemize Bleakley’s series of metaphors in “Keats’ Lexicon.” Densely deployed, the metaphors appear one per line: “soured in the broth of his own lungs”; “a once-springy moss”; “each spot an exclamation”; “terrain of pearled tissue”; “miracle farm of miniscule blood-oranges.” In each one, the body is tethered to a novel tenor: “lungs” as a “springy moss” reflect an ecological metaphor; lung tissue, or the multiple spots that are not deemed diseased but instead become exclamations, ask for interpretation, not only as a bodily act but as a demand for care; “terrain” and “pearled,” the former continuing the germinative, ecological meta-metaphor and the latter an actual pathological description of the border of gross anatomical specimens, both refer to the body once more (“tissue”); finally, the efflorescence of the body itself, its constitutive fruit, the “blood oranges”—in another metaphorical flourish—exist in the lungs’ larger “farm.”

Bleakley’s metaphors bring together poetry and biomedical discourse under the banner of close scrutiny: the body is seen according to the medical gaze described so well by Foucault, while also vivified with novel metaphors, so as to add—as Keats himself did—to the metaphor horde.9 That the poem concludes not with a metaphor promising eternal life but rather with an insistence on mortality (the oranges are blood oranges, not fruit from the proverbial tree of life) is entirely in keeping with Keats’s own vision, for Keats did not subscribe to Christianity and maintained a “deep and abiding skepticism about the possibility of knowing with certainty any kind of transcendent or higher reality.”10 The poem ends not with transcendence but with the body. “Keats’ Lexicon” makes a corporeal poetry, and thereby enacts the idea of medicine as poetry, demonstrating the shared semiotics of both practices.


Shane Neilson is a poet, physician, and critic who lives in New Brunswick. He recently published the poetic nonfiction memoir Saving (Great Plains Publications, 2023).



[1] Alan Bleakley and John Bligh, “Students Learning from Patients: Let’s Get Real in Medical Education,” Advances in Health Sciences Education 13, no. 1 (January 18, 2008): 103; Alan Bleakley, John Bligh, and Julie Browne, Medical Education for the Future: Identity, Power and Location (Dordrecht: Springer Netherlands, 2011), 115.

[2] Yasir A. Al-Jumaili, “Metaphors of Fever in the Poetry of John Keats: A Cognitive Approach,” Cogent Arts & Humanities 7, no. 1 (2020): 5.

[3] Hermione de Almeida, Romantic Medicine and John Keats (Oxford: Oxford University Press, 1991)

[4] Kathie Housser, “Sensuous Embodiment in The Eve of St. Agnes,” at the EDGE 1 (2010) 115.

[5] Tsiokou, Katerina, “Body Politics and Disability: Negotiating Subjectivity and Embodiment in Disability Poetry,” Journal of Literary & Cultural Disability Studies 11, no. 2 (2017): 209–10.

[6] Anita Wohlmann, review of Thinking with Metaphors in Medicine: The State of the Art, by Alan Bleakley, Literature and Medicine 39, no. 1 (2021): 167.

[7] Wohlmann, review of Thinking with Metaphors in Medicine, 167.

[8] Peter Steiner, Russian Formalism: A Metapoetics (Ithaca, NY: Cornell University Press, 1984); Bleakley, Bligh, and Browne, Medical Education for the Future, 169).

[9] Michel Foucault, The Birth of the Clinic: An Archaeology of Medical Perception (London: Routledge, 1976), 166.

[10] Ronald Sharp, “‘A Recourse Somewhat Human’: Keats’s Religion of Beauty,” The Kenyon Review 1, no. 3 (1979): 5.

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