John Keats at Guy’s

On the 200th anniversary of the poet’s death in Rome, a guest post by London Historians member Suzie Grogan. 

It is a better and a wiser thing to be a starved apothecary than a starved poet; so back to the shop, Mr John, back to the ‘plaster, pills and ointment boxes &c. But for Heavens sake, Young Sangrado, be a little more sparing of extenuatives and soporifics in your practice than you have been in in your poetry.

When John Gibson Lockhart of Blackwood’s Edinburgh Review wrote this stinging review of John Keats’s Endymion in 1818, he could little have imagined the long-term impact it would have on Keats’s reputation. The poet himself was hurt, but not mortally so, as many of his friends and contemporaries would say after his death on 23 February 1821, from tuberculosis, at the age of just 25.

Lockhart was being smart, using a snippet of information about the education of this new, young poet to make what he clearly thought was a witty and pithy comment on poetry that Keats himself knew was far from perfect. Keats’s training as an apothecary-surgeon offered too tempting an opportunity for the reviewer to look clever at Keats’s expense, but for decades after his death, he was depicted as a frail youth, disillusioned by the attacks and driven to an early grave. 

Re-appraisals of his life and work, alongside his enduring popularity as one of England’s greatest poets, has ensured that Lockwood’s article is seen more for what it was to Keats – a spur to harder work and greater achievements. Far from Lockwood’s jibe that Keats was simply a pretty boy practising ‘poetry and pharmacy’, it is now known how important his medical training was to him and his development as a poet, and of his personal and poetical philosophy so eloquently expressed in his letters to friends and family. 

Studying Keats’s training, and the life of any medical student of the period, can only help to dispel the myth of a man fit only for the shop, dispensing powders, pills or some ineffectual ointment.

An apothecary in the early 19th Century. 

The challenges a young medical student faced are clear. It was not a job for the faint-hearted; neither was it lucrative, or necessarily successful.

John Keats was apprenticed to the family doctor, Thomas Hammond, in Edmonton, at that time a village in Middlesex some miles from the City of London. This was a private arrangement – as many similar apprenticeships were – not involving the Society of Apothecaries. His master was a man of good reputation. Hammond came from a family of medical men and had trained at Guy’s and St Thomas’s Hospitals, in London, which would offer John Keats the advantage of connections when he followed his master to the same hospitals after his apprenticeship ended.

The Hammonds’ house was a large country residence, but Keats was not to share accommodation in this family home. Instead, he and one other apprentice lived above the brick built surgery and dispensary Hammond had built in the grounds, which was typical of many another apothecary’s premises.  A ground floor room was panelled with wood and shelving on a dresser, where Hammond prepared and stored his medicinal preparations.

The biographies of the other men in Death, Disease & Dissection suggest the kind of life Keats would have been required to live under Hammond, and some of it would certainly have frustrated him. Tasks included cleaning and dusting, sorting bottles, and filling some with leeches, and rolling pills, which could become mundane if the master did not offer the apprentice interesting new tasks to develop their skills and give them the chance to take greater responsibility. Keats resented tasks such as sweeping floorboards and holding Hammond’s horse whilst waiting whilst his master went into a house to treat a patient. 

Over time Keats would have been able to watch and learn as Hammond dressed wounds, removed teeth and diagnosed minor complaints, such as constipation. Knowledge of more serious illness, and the chance to treat it would have come in time and Keats may have seen ‘fractures, dislocations, gunshot wounds, intestinal obstructions, tapeworms, burns and scalds, difficult births , congenital malformations, tumours, convulsions, gout, accidents, diseases, hernias and so on’ (Nicholas Roe Keats). 

Hammond would have set fractures, amputated limbs, removed bladder stones and attempted to repair hare lips – all ‘minor’ conditions that could be attempted with success at this time. Of course, each procedure would have been undertaken without anaesthetic. A well-trained apothecary would, be required to gain experience in surgery on the wards of teaching hospitals, be more skilled with patients and have a greater knowledge of general medicine and minor surgery than more specialised physicians trained solely at the university medical schools.

After an apprenticeship that may have ended early, and with not a little animosity on both sides, John Keats registered at Guy’s Hospital in London on Sunday 1st October 1815. He would have signed the necessary paperwork in the Counting House, handing over the fee of one pound two shillings to cover a twelve month period. The next day he registered as a surgical pupil for the same period, at the cost of twenty five pounds and four shillings. 

He found lodgings close to the hospital, at 28 St Thomas Street in Southwark, or the ‘Borough’ (a building now marked by a blue plaque and a mere 100 metres from the foot of The Shard). In 1815 this was  a notoriously squalid area; streets of dilapidated timbered tenements, open ditches full of foul waste and prostitutes and thieves commonplace in what Keats described as ‘a beastly place in dirt, turnings and windings’. Situated as it was at the southern end of London Bridge, along the main road into Kent, the roads were jammed with coaches and wagon loads of provisions making their way in and out of the City.

Keats’s lodgings in St Thomas Street. Image: Suzie Grogan.

Keats’s landlord was a tallow chandler by the name of Markham who rented out study bedrooms and a sitting room to students. John first shared with two much older and more senior students, Frederick Tyrrell and George Cooper, but when they had finished their studies Keats asked George Wilson Mackereth and Henry Stephens to share his rooms to cover the £63 per year rent, a sum well above his sole means.

Despite later and somewhat disparaging comments by Henry Stephens (also profiled in Death, Disease & Dissection), it seems Keats was a successful student. He didn’t skip lectures; he attended classes in anatomy (which he apparently loathed), dissecting the decaying bodies often provided by local ‘resurrection men’; and he passed his examinations to become a member of the Society of Apothecaries when many others, including Henry Stephens failed first time. He was also appointed as a ‘dresser’ relatively early in his studies, a role which required skill and a strong constitution, to cope with the horrors of early 19th century surgery, especially as he was assigned to William Lucas Junior, described by the famous surgeon Sir Astley Cooper as ‘neat handed but rash in the extreme, cutting amongst most important parts as though they were only skin, and making us all shudder from the apprehension of his opening arteries or committing some other horror’.

In the early 19th century, operations were rushed affairs, for speed was vital to stem the copious bleeding and prevent the patient, lying restrained on the wooden table at the centre of the operating theatre, dying of shock: there was no proper anaesthesia. The semi-circular operating theatres at Guy’s and St Thomas’s were too small to cope with the crush of students keen to get a glimpse of a great surgeon at work.  

Following an operation it was left to the dresser to dress the wound. He would continue to do so daily in order to prevent, as far as was possible in the days before anti-septic, infection setting in.

John Flint South, student at nearby St Thomas’s during this period and future President of the Royal College of Surgeons, described in detail the duties of a dresser: 
He attended to all the accidents and cases of a hernia which came in during his week in office, and he dressed hosts of out-patients, drew innumerable teeth, and performed countless venesections, till two or three o’clock, as might be, till the surgery was emptied…. When the surgeon arrived the dresser on duty would show him, among the outpatients, any case about which he needed further help or which he thought advisable to be admitted, as likely to issue in an operation….Cases of strangulated hernia, retention of urine, and other accidents, were admitted at the discretion of the dresser.

The dresser would carry a ‘plaster box’, from which he would take plasters and bandages to dress the patients’ wounds as instructed by his surgeon, and he would also administer any drugs prescribed. The dresser would also be responsible for calling a surgeon should an emergency arise, and at night they might be responsible for dealing with these major cases themselves.

Keats’s statue at Guy’s Hospital, sitting in a surviving alcove from old London Bridge.
Image: Suzie Grogan.

It is not known for certain why Keats gave up medicine in 1817, although it was obviously not because he did not have the constitution or application for it. He was, however, developing a poetic life away from the horrors of the big London teaching hospital. His friend, Charles Brown, later suggested that far from being too sensitive to the horrors of early 19th century medical treatments and the sights and smells of the hospital ward, it seems Keats took Astley Cooper’s warnings about the importance of a single-minded and dedicated devotion to surgical duty to heart, and considered that a fear of harming a patient, allied with his increasing interest in a career in poetry, excluded him from a career as a surgeon, even though he was only a few months from qualification.

Keats was set apart from his contemporaries at Guy’s by a life away from his medical studies, one that was nourishing him intellectually, in an entirely different way. He had to make a choice, and he chose to be poet.

---

Suzie Grogan’s new book on Keats – John Keats: Poetry, Life and Landscapes – was published last month (Jan 2021). Her previous books: Death, Disease & Dissection: The working life of a surgeon-apothecary was published in October 2017. Her first book, Dandelions and Bad Hair Days: Untangling lives affected by depression & anxiety came out in 2012, and her first with Pen and Sword – Shell Shocked Britain: The First World War’s legacy for Britain’s mental health – was published in 2014.

Her website www.suziegrogan.co.uk. You can follow her on Twitter as @keatsbabe.