The Yale Journal for Humanities in Medicine

W.H. Auden and the Importance of Narrative Interpretation in Medicine:
A Study of “The Unknown Citizen” and “Musee des Beaux Arts”

Lisa Kerr, Ph.D.
liskerr@springmail.com

No reference to medicine exists in W.H. Auden’s poems “The Unknown Citizen” and “Musee des Beaux Arts.” However, each poem poses questions about human relationships that should be of interest to health care providers who wonder: “Who are these people I treat? And how do I read them in order to treat them?” While “The Unknown Citizen” satirizes societies who fail to read beyond the paperwork that has come to define their citizens, “Musee des Beaux Arts” leads the reader to question, “What is one person’s ethical or moral obligation regarding another person’s suffering?” Physicians and nurses, who are regularly faced with the job of interpreting patients’ cases, may find in these two poems reminders that stories offer insights which may aid in patient treatment. In particular, Auden’s poems comment on both the personal tragedies that occur when individual narratives are ignored and the universal narrative of loneliness that characterizes the lives of suffering human beings.

In "The Unknown Citizen," every bureau, office, union, and organization run by the State is given voice, but the individual is not. “Social Psychology workers”(12) find that he was socially popular, “The Press”(14) believe that he read his paper every day, “researchers into Public Opinion”(22) deem his seasonal opinions “proper,”(23) and the State “Eugenist”(26) declares him to have sired the appropriate number of children. Perhaps the  most important of his accomplishments is the one that opens the poem: “He was found by the Bureau of Statistics to be/One against whom there was no official complaint”(1-2). This initial statement introduces the main criterion by which the citizen is being judged—he is rewarded for his ability to conform, to perform no act of which the State might disapprove.

One component of his conformity is silence. The citizen’s silence is developed through the use of passive verbs and omission of the citizen’s voice. The citizen is often described in terms of what has been done to him by the State: He often “was found”(1) by a State agency to have done the right thing. He was declared (18) by another agency to be “fully sensible”(19). Even when the citizen’s actions are described, his voice is never heard. For example, readers are told that “he worked”(7) and “was married”(25), but are never given a glimpse into his intimate thoughts and relationships. The essential narrative of this man’s life, then, is absent. This absence does not necessarily reflect the man’s lack of emotion or spirit but the State’s inability to recognize it.

Importantly, even the citizen’s health care is guided by the principle of conformity. First of all, the citizen is congratulated for leaving behind “policies taken out in his name”(16) that prove he was “fully insured”(16). The citizen has avoided shame and punishment by silently cooperating with the state insurance system. Not only is possessing state insurance a requirement for the model citizen, but also maintaining health is necessary. The implicit disapproval of illness emerges when the State claims that the citizen’s “Health-card shows he was once in hospital but left it cured”(17). The word “but”(17) is the crux of the line, which might be rewritten as, “Although he was once in hospital, he left it cured.” While the use of the word “and” would have created approval for both the hospital stay and the recovery, the use of “but” sets the stay in the hospital (the period of illness) and the recovery at odds: the latter is acceptable, the former is objectionable. In this dehumanized society, which boasts a state Eugenist, one might imagine that the chronically ill are outcasts for whom the State might not erect a monument as fine as the one devoted to our compliant (and generally healthy) unknown citizen.

Ironically, the citizen is deemed a “saint”(4) although the information provided on him sheds no light on his spiritual state. It is the “modern sense”(4) of the “old-fashioned word [saint]”(4) that allows for the community to award him the title. And the modern world in which he lives pays no attention to the mental or emotional health of its citizens. The questions with which Auden ends lead to the ironic theme of the poem: the citizen is unknown because the reader, unlike the State, recognizes that individuals are more than the sum of their social parts. The questions, “Was he free? Was he happy?”(29) remain unanswered. The State does not necessarily think it “absurd” for one to be unhappy but absurd that the State, given all the data they have about their citizen, would not have been aware of his emotional or spiritual unhappiness. The irony—the tragedy—is that they fail to recognize the kind of information they maintain on their citizens does not even begin to delve into issues of human emotion or spirituality.

Auden, whose father was a distinguished physician, certainly had broader social issues in mind when he composed this poem in 1940; however, his incisive view of dehumanizing systems introduces many questions that may be applied to health care: Does the current health care system dehumanize patients? Do health care providers label patients who self-advocate as nuisances? Do providers expect patients not to challenge their own treatment much the same way that the citizen “never interfered”(28) with the teachers who provided his education? Do doctors and other health care providers value patients’ stories as a means of tailoring health care to individual needs? Should they?

In “Musee des Beaux Arts,” Auden describes a story of universal human suffering. The poem provides an observation of how human suffering takes place, unnoticed, while those untouched by suffering carry on with daily rituals and obligations. Auden’s poem is based upon the painted Landscape with the Fall of Icarus by Pieter Brueghel the Elder. The painting depicts the Icarus of Greek mythology falling into the sea after having, famously, attempted to fly to the sun on wings of wax and feathers. Unexpectedly, the viewer has to search for Icarus, who appears in the background of the painting as a tiny pair of legs, the rest of his body already submerged under water. In the foreground of the painting, a farmer tills his fields, and just behind him a shepherd tends to his flock. Not far from Icarus’ disappearing legs, a small ship sails. None of the other figures in the painting give any indication that they have noticed the fall of Icarus.

Observing the painting, Auden remarks, “About suffering they were never wrong,/The Old Masters; how well they understood/Its human position; how it takes place/While someone is eating or opening a window or just walking dully along”(1-4). He praises Brueghel for his keen portrayal of “how everything turns away/Quite leisurely from the disaster”(14-15) because for everyone other than Icarus, the tragedy was “not an important failure”(17). Even the men on the ship, who “must have seen/Something amazing, a boy falling out of the sky”(19-20) press on with their duties. They have “somewhere to get to”(21) and they “sail calmly on”(21). This final image of men who observe the tragedy and yet remain unmoved suggests that human beings not only fail to share in the suffering of others but that they choose to ignore it out of necessity or convenience.

The Old Masters’ ability to read the subtext of human experience sets them at odds with the State in “The Unknown Citizen,” which can read only the prosaic. Yet, written in the same year, both poems relay a disturbing idea: Humankind tends to ignore suffering in order to preserve normalcy. This theme introduces another set of interesting questions for health care providers: To what extent is the health provider’s function a role of compassion, a role that helps ease the suffering and isolation of others? Is compassionate behavior a personal choice or the ethical duty of health providers? How might “compassionate behavior” be defined for practical use among providers? How invested in patients can providers afford to get while maintaining personal wellbeing?

And what about the figure of Icarus?

While Icarus has traditionally been a figure of hubris, the boy who failed to recognize his human limitations, perhaps he may also be viewed as figure of striving and hope. He is the only character in Auden’s two poems who casts off mediocrity in search of superiority. Is this a futile goal? Are the goals of personal interaction and human compassion futile as well in a world where, as Auden sees it, human beings are destined to fail, suffer, and die alone? If so, what is the importance of reading Auden’s poems? What is the purpose of trying to “read” and connect with patients? Why must we study suffering if we cannot cure it?

Perhaps the Old Masters of art and literature provide guidance in this area. For even Auden, with his ability to both recognize the truth of human suffering in visual art and translate that truth into literature, proves through his efforts that the desire to explore the human condition through reading and writing stories of suffering as well as triumph and even banality is one of the greatest human urges. And what if the same stories are told throughout generations and across cultures and no answers are ever reached?

Anton Chekhov, who was hailed as a genius of the short story and was also, coincidentally, a physician, believed that it was not the writer’s job to impose a moral on his characters’ stories; he had only to present their dilemmas accurately: “The artist is not meant to be a judge of his characters and what they say; his only job is to be an impartial witness.” Another great writer, Henry James, once advised writers, “Try to be one on whom nothing is lost.” Perhaps health care, like literature, might also be seen as a process that is not solely about providing answers but about a commitment to listening to, looking at, and rethinking human beings and the stories they tell with their words as well as their bodies.

Works Cited
W.H. Auden. “Musee des Beaux Arts.” Literature: A Portable Anthology. Gardener, Janet E., Beverly Lawn, Jack Ridl, and Peter Schakel, eds. New York: Bedford/St. Martin’s, 2004.
W.H. Auden. “The Unknown Citizen.” The New Millenium Reader. 3rd ed. Hirschberg, Stuart and Terry Hirschberg, eds. New Jersey: Prentice Hall, 2003.

Published: February 25, 2007