The sole remaining medical Notebook from Keats's time at Guy's Hospital (from October 1815 to March 1817) is familiar to many of us in Keats Studies, but it's not a text with which we often do anything. To be sure, it is sometimes acknowledged and occasionally commented on. But unlike Keats's letters, which were often originally read for the light they shed on the poems before gradually being recognized as important documents in their own right, the medical Notebook (which Ghosh capitalizes without italicizing) has remained not much more than an interesting source of biographical information. With this annotated edition and carefully researched study, Hrileena Ghosh seeks to re-evaluate it. As she points out,
The medical Notebook's importance is twofold. First, the notes were taken by Keats: they represent a tangible material link to the poet and analysing them may shed light his thought processes and methods of working, as well as for that period in his biography. Secondly, it provides primary evidence of the training offered by the London teaching hospitals, and as such represents the cutting edge of British medical science during the Romantic period. (95)
To both demonstrate the importance of the Notebook and make it a key source for the future study of Keats, Ghosh's study "moves," she says, "from a new edition of Keats' medical Notebook, through editorial commentary and elucidation, to a critical consideration of how the Notebook and his medical career helped shape the poetry Keats wrote while at Guy's Hospital and in the years after" (9). For Keats "as a man and a writer," Ghosh argues, "creativity was fluid--and. . . the qualities that made him successful as a medical student were the qualities that, applied differently, enabled him to write 'verses fit to live'" (7).
After a critical introduction and the annotated Notebook itself, which occupies roughly the first third of the book, Ghosh offers six substantial chapters and a brief conclusion. Chapter 1 examines the Notebook as an artifact, "discussing its provenance, describing it as a bibliographic object, and investigating some of its more puzzling aspects," ultimately arguing that it "was a dynamic repository of evolving knowledge to which [Keats] returned again and again" (3). To show that his "poetic and medical careers overlapped from the start" (119), chapter 2 highlights the poetry Keats wrote while at Guy's Hospital, amounting, by Ghosh's count, to some 39 poems, or "1,749 lines in the reading texts of Stillinger's edition . . . a significant amount of poetry to produce in any 18-month period, and rendered more extraordinary by the fact that Keats was engaged full-time in a demonstrating post" (127). Ghosh then reads the Notebook as a point of entry into the medical milieu of Keats's day: a set of entries showing how, "as a medical student at an elite London teaching hospital, Keats had privileged access to intellectual capital that would influence his life, and, in time, his poetry" (150). Furthermore, comparing Keats's notes with those of his friend and classmate Joshua Waddington, and using both statistics and handwriting analysis, Ghosh argues that the Notebook manifests Keats's "habits of concision, reorganization, and cross-referencing," his "verbal compression, a stress on the natural rhythms and cadences of the English language, and the use of imagery to render its contents memorable"--all features that "prefigure the most distinctive patterns of his poetry" (173). Turning specifically to Endymion, Ghosh finds it linked to the Notebook in "threefold" ways: "it was Keats' longest work; it was written immediately after the period of his association with Guy's and is accordingly most likely to show the influence of his hospital career; and it was a poem that he himself considered 'a test' of his abilities as a poet" (203). Finally, Ghosh shows how Keats's medical training informed the 1820 volume Lamia, Isabella, The Eve of St. Agnes, and other Poems. "[A]t every turn" from composition to publication of these poems, Ghosh argues, "questions related to health, disease, medicine, and death forced themselves upon his attention" (234).
Whatever else the Notebook may be or do, Ghosh finds it exhibiting "features that characterized his mature poetry," notably "attention to the cadence of words" and "balanced and finely tuned prose." Moreover, she writes, "[s]ome of the subjects covered in his medical Notebook feed directly into Keats' poetry, others do so only obliquely," even as "his notes on strictly medical subjects draw in the Classics and the world of liberal politics" (202). Above all, Ghosh contends, the Notebook manifests Keats's essentially poetic powers of concentration: "his ability to concentrate ideas in a sentence or embody them in an image is as evident in his medical notes as it would later be in 'Ode to a Nightingale' or Hyperion. Indeed, some of the most distinctive and recognizable lines in Keats' poems flowed from the imaginative potential of his notes taken at Guy's hospital" (202). Given the signposting and cross-referencing found throughout the Notebook, Ghosh infers that "Keats thought of his medical Notebook as a 'database' to be continually added to" (191), and Ghosh's own careful cross-referencing from the poems and the Notebook not only helps to show how Keats regarded it, but also exemplifies the kind of work that other scholars can do with it. In closing her book by summing up her case for the value of the Notebook, she strongly implies that it is worth further study:
[M]any characteristics of Keats' greatest poetry--the imaginative turns of his poems and plots, the 'concentrations' of his imagery, the precise delineation of extreme emotional states through physical descriptions--can all be found in his earlier poems and in his medical Notebook. If Keats' innate genius flowered most fully during hid 'living year' [1818-19], the inherent qualities which enabled him to write his best poems are seen, as it were, in an unvarnished state in his medical notes, and their gradual adaption and deployment in poetry is visible as early as the Margate summer of 1816. (270)
Though not all readers of Keats will readily accept this assessment of his earlier work, Ghosh's study will surely prompt them at least to re-consider their estimate of the Notebook.
The greatest strength of this book, perhaps, is its heavily annotated edition of the Notebook itself. As Ghosh points out, the "standard" edition, prepared by Maurice Buxton Forman in 1934, struck many of its early reviewers as an interesting example of Keatsiana rather than as a proper scholarly source. Later scholars (notably Donald Goellnicht and Hermione de Almeida) used the Notebook to reconstruct Keats's medical education, or to probe the complexities of his medical milieu. But none or few have scrutinized the Notebook as thoroughly as Ghosh does here.
In the later chapters, Ghosh occasionally shifts her focus from the links between the Notebook and the poetry to the medical milieu of the period. Also, while her readings of the poems are interesting, the connections she draws to the medical Notebook are scarce and not always illuminating. Regarding, for instance, Lorenzo's putrefying head in "Isabella," does it help us to know that Keats's description of the head "betrays his intimate knowledge of the stages of bodily disintegration, surely derived from his days dissecting corpses at Guy's" (255)? To be sure, any effort to link the poetry with the Notebook consistently would be problematic, but one might have expected more links than are offered here.
On the whole, however, readers of Keats--and most assuredly not only those interested in Medicine--will find much of value in Ghosh's book. In clean, precise, and accessible prose that belies the depth of archival research that went into the book's making, Ghosh convincingly makes her case for a new focus on the medical Notebook, adding a fresh and forceful voice to those in the field arguing for renewed attention to the young Keats. If the medical Notebook "was a dynamic repository of evolving knowledge" for Keats, Ghosh's study will be one for us.
James Robert Allard is Associate Professor and Chair in the Department of English Language and Literature at Brock University in St. Catharines, Ontario, Canada.