Illness and Creativity: Time is of the Essence

Rosa Geoghegan //

Following their diagnoses with the plagues of their respective societies and milieux, tuberculosis and AIDS, the 19th-century English poet John Keats and the 20th-century French writer Hervé Guibert confronted in their writing their imminent deaths and limited time. There was no mystery as to the outcome of their suffering; Keats, a nurse as well as a poet, had nursed his TB-stricken mother and brother. Similarly, Guibert had witnessed many friends, including the philosopher Michel Foucault, die from the same infection. Yet, despite their death sentences, Keats published over fifty poems in only three years,[1] many of which allude to TB, and Guibert devoted the remainder of his life to recording his battle with AIDS through different media.[2] For Keats and Guibert, their immense suffering and creativity are limited only by their finite time.

Phthisis, the White Plague, the Graveyard Cough, Consumption.  No matter what TB is called, Mycobacterium Tuberculosis has the same devastating effect on the human body.  Killing more people in history than any other microbial pathogen,[3] its origin can be traced to over 150 million years ago.[4] While the Greek physician Hippocrates (460-370 BC) advised against contact with patients suffering from TB, its contagious nature was not verified until 1882 by the German scientist Robert Koch.[5] Before this turning point, TB’s supposedly hereditary nature allowed it to become aestheticized.[6] It was believed that spes phthisica, as named by the Ancient Greeks, heightened sensitivity and induced creativity, thus establishing a positive link between the illness and the young artists and literary figures, such as Keats, who suffered from it.[7] As Clark Lawlor describes it, “consumption was both a sign and a cause” of refined sensibilities and poetic talent.[8] Indeed, Romantic poet Lord Byron, in a letter to his friend, wished to have TB, as it would give him an air of intrigue.[9]  Sontag notes how patients dying from TB became “more beautiful and more soulful”[10] and that death from TB was seen as “decorative, often lyrical.”[11]

In comparison to TB, AIDS is a relatively new disease; it was first recognized in 1981 when homosexual men in the United States began to die from infections that their immune system should have warded off.[12]  Across the world, the ‘gay plague’[13] spread fear, especially in cities like New York and San Francisco.  While TB in Keats’ era infected young and old, rich and poor, AIDS victims were, at first, mainly gay men, intravenous drug users, hemophiliacs, who became infected with HIV because of contaminated blood transfusions, and Haitian immigrants.[14] The prevalence of AIDS in marginalized communities leads to its association with a certain hedonistic or non-traditional lifestyle and some saw it as divine punishment for the rejection of social mores or religious teachings.[15] This association was especially pervasive in discussions that equated male homosexuality and mortality.[16] Sontag also describes a presumed revealing nature to the disease, its confirmation of membership of a certain group, and the supposed culpability of AIDS patients: the infection was linked with deviance, promiscuity, and perversity.[17] Those who suffered and died from AIDS were not romanticized in the same way that TB patients were during the 19th Century. Rather, HIV patients were marginalized and the disease was either ignored or sensationalized.[18]

For Keats and Guibert, the physical changes they underwent due to their poor health prompted creativity and became a source of inspiration.[19] For both of these artists, time was of the essence; Keats died aged twenty-five and Guibert was thirty-six. Their illnesses were chronic, meaning that they were cognisant of the slow but persistent intensification of their corporeal transformations.[20] As a result, the unrelenting nature of time and the transience of life are key themes that occur in the poems When I Have Fears that I may Cease to Be, Ode on a Grecian Urn and La Belle Dame sans Merci by John Keats and the semi-fictitious, semi-autobiographical novel À l’ami qui ne m’a pas sauvé la vie (To the Friend Who Did Not Save My Life) by Hervé Guibert.

When I Have Fears that I may Cease to Be, one of Keats’ most elegiac poems, thematizes the ephemerality of life. The direct link between the poet’s illness and his creative output is expressed in the awareness that death will bring an end to writing: “When I have fears that I may cease to be/ Before my pen has gleaned my teeming brain” (1/2).[21] For Keats, there is no shortage of material, but rather an insufficiency of time, and it is this short term of labor that he laments.[22] He is able to imagine the “high-pilèd books” (3) he could produce, but he is fearful that his premature death will prevent him from fulling his potential: “I may never live to trace/ their shadows” (7/8). The brevity of his existence is compounded by his isolation; in life Keats’ illness prevented him from marrying, and in death, he was separated from all that he sought to achieve in life: “then on the shore/ Of the wide world I stand alone, and think/ Till love and fame to nothingness do sink” (12-14).  When I Have Fears that I may Cease to Be describes the extent to which Keats aimed to defy the physical and temporal constraints of his diagnosis and create something that would, unlike him, withstand the test of time.

The anticipated shortness of Keats’s life is juxtaposed with enduring beauty in Ode on a Grecian Urn. This ode laments the transience of life and is somewhat escapist, in that it suggests that this impermanence can be negated by the permanence of art that “cannot fade” (19).[23] The urn, preserved in all its glory, represents the longevity and endurance that Keats, in his suffering, wished for: “Thou still unravish’d bride of quietness,/ Thou foster-child of silence and slow time” (1/2). Unlike human beings, the urn and its beauty are immortal.  Scholars have suggested that the passion of the figures depicted on the urn is similar to the pseudo-recovery and excitement that consumptive patients experienced just before death.[24] The symptoms of TB, Sontag writes, are deceptive; liveliness, flushed cheeks “and an upsurge of vitality”.[25] Ode on a Grecian Urn underlines that art perpetuates beauty and life: “Thou shalt remain, in midst of other woe/ Than ours, a friend to man” (47/48). Ultimately, however, the urn only represents an idealized version of reality. It is a “silent form” (44), presenting an unattainable image that fails to capture the vivacity, nuances and intricacies of life.

Keats’ most obvious reference to his ailment appears in the poem La Belle Dame sans Merci. The central femme fatale of the ballad can be interpreted as a personification of tuberculosis, while the knight who is “alone and palely loitering” (2), is her victim. Keats’ description of the knight is unsettlingly prophetic of his own approaching demise. There is a notable lack of life and vivacity in this poem: “The sedge has withered” (3), “no birds sing” (4) and the knight is “so haggard and so woe-begone” (6).  Keats creates an atmosphere that invokes his own suffering as the third stanza reflects many of the symptoms of TB, like fever, malaise, and sweating: “I see a lily on thy brow,/ With anguish moist and fever-dew,/ And on thy cheeks a fading rose/ Fast withereth too (8-12).[26] The knight initiates a relationship with La Belle Dame, an allusion to the attractiveness of TB. This hints at Keats’ willingness to be portrayed as a “victim to consumptive creativity”[27] and a martyr “who had sacrificed himself for the good of the religion of literature”.[28] Keats’ acceptance of his messianic image resonates with Byron’s wish to have TB.

La Belle Dame sans Merci highlights the inescapability of a chronic illness. Once the knight is in the clutches of La Belle Dame, there is no possibility of leaving “her Elfin grot” (29). The paradoxical allure and danger of La Belle Dame indicate the strange attraction and fetishization of TB patients in the 19th Century. It is unsurprising that Keats links TB with an undeniable attraction in La Belle Dame sans Merci, because, during his life, TB was so often portrayed as a disease of love and passion.[29] Like other “pale kings and princes” (37), Keats was not only “starved” (41) by La Belle Dame but also completely enamored of her.  Keats’ utilization of TB as his muse in La Belle Dame sans Merci denotes the link between illness and inspiration.

Just as Keats was representative of the link between artists, the intelligentsia, and TB, so Guibert, because of his lived experience and the candor of his discourse, came to be seen as an authority on AIDS.[30] For both men, it was vital that they take advantage of their shortened lives because, as fellow French author and critic Francis Marmande noted, AIDS accelerated things.  For Guibert, detailing the effects of AIDS on his body was a way of dealing with his fear of death.[31] 

À l’ami qui ne m’a pas sauvé la vie (1990) focuses on the lack of treatment for AIDS and the absence of support from those around Guibert.[32] Just as Keats found poetic inspiration in TB, so Guibert is motivated in his writing by the hope of a cure. He fixates on death, while paradoxically believing that he will survive:

I had AIDS for three months. More precisely, for three months I believed I was condemned to die of that mortal illness called AIDS… something completely unexpected happened that convinced me I could and almost certainly would escape this disease, which everyone still claimed was always fatal. (15)

Undoubtedly, Guibert, writing in the age of modern medicine, had more hope for a cure than Keats did. However, his relationship with medicine was not strictly positive. A striking feature of the text is the disconnect between the clinical language of Guibert’s doctors and the language he uses to describe his own body: “At the moment when I’d felt so weakened by my illness, the disease had actually been in remission, because my T4 count had risen to more than 550, in a bracket close to the normal range” (183). This feature contrasts with Keats’ poetry where there is no such juxtaposition of medical jargon and sensuous descriptions. This contrast reflects the differing temporal contexts and genres, as well as the general acceptance of the connection between TB and increased creativity, an association that did not exist for AIDS.[33] As Sontag notes, TB was a ‘soft death’, devoid of shame or humiliation; AIDS was a hard death, associated with stigma and the premature decline of the body.[34]

Keats does not explicitly confront sickness in the same way that Guibert does.  The French author’s aim is to intimately describe the effect his illness has on him. Using the genre of autofiction, he takes it upon himself to document the state of his body. Bodily documentation had been important to Guibert even in his pre-diagnosis works.[35] Guibert was a renowned photographer who used film as a medium for depicting human individuality.  In the last few years of his life; he also used it to capture his relationship with AIDS.[36] The mirror played an important role in Guibert’s photos, just as it does in the novel,[37] as it is the way Guibert is able to examine himself: “I felt death approaching in the mirror, gazing back at me from my own reflection, long before it had truly arrived to stay” (21). Guibert’s subjective and sensuous self-inspection contrasts with the medical gaze of the doctors who study their patients:

Muzil [the name by which Guibert designates Michel Foucault] spent a morning in the hospital having tests done, and he told me he’d forgotten how completely the body loses all identity once it’s delivered into medical hands, becoming just a package of helpless flesh, trundled around here and there, hardly even a number on a slip of paper, a name put through the administrative mill, drained of all individuality and dignity (37).

Whereas Guibert reflects on his emotions and feelings, Muzil describes how, under the watchful eye of doctors, he becomes a patient like any other, whose feelings and sentiments are dismissed in favour of scientific knowledge and tests.

Michel Foucault understood that the medical gaze was an intervention that decides and classifies while rendering the patient passive and silent.[38] The medical gaze, through surveillance and exhaustive examinations, becomes a tool of control.[39] It is sadly ironic that Foucault suffered a fate that was central to his own research and reflections on biopower and the medical disciplining of the body. Guibert’s own experiences of methodical examination echo Foucault’s comprehension of medical rituals: “He would check the soles of my feet, the skin between my toes, delicately inspect the opening of the ever-so-sensitive urethra” (25). However, while medical examinations seek to regulate and control, Guibert fights against this management of his body by appropriating medical jargon and turning the ‘writerly gaze’ onto the doctors.[40]  

Keats’s poems present us with an outlook on life which, because of his diagnosis, is filled with a sense of urgency and a necessity to write all he can before it is too late.  Not only is his death inevitable, but it will happen sooner rather than later.  His poems were inspired by the tragedy of his fate and allude to his sickness, suggesting that, Keats found comfort in creativity.  His poems reflect on the durability of beauty, a permanence that he lacks in this life.  Guibert’s autofiction also plays with time, exploring what it means to be suspended, by an incurable illness, between life and death. Like Keats, he transforms pain into meaning through his confrontation with his own mortality. Guibert’s writing has a more overtly political edge, which stems from the stigmatization of his illness.  Moreover, living in an age of medical advancements, he is less willing than Keats to accept his fate. Nonetheless, for both writers, the lack of a cure, and stubborn hope of survival, mean that they use their art to achieve an impact and a legacy that extends beyond their own lifetimes.

Author: Rosa Geoghegan is a student in the Dual BA Programme between Columbia University and Trinity College Dublin, where she studies European Studies.  From Dublin, Ireland, she is currently in her senior year at Columbia. Rosa’s research interests include modern European history, politics, languages and literature. 

Image: John Lavery’s 1923 Portrait of Hazel Lavery Began in 1892 as a portrait of Mary Burrell. Wikipedia Commons.

Works Cited:

Almeida, Hermione de. Romantic Medicine and John Keats. New York: Oxford University Press, 1991.

Boire, Nicholas A, Victoria Avery A Riedel, Nicole M Parrish, and Stefan Riedel. “Tuberculosis: From an Untreatable Disease in Antiquity to an Untreatable Disease in Modern Times?” Journal of Infectious Diseases & Preventive Medicine 1, no. 2 (2013): 1-11.

Booth, James. “Keats: Ode on a Grecian Urn.” Critical Survey 6, no. 1/2 (1973): 59-64.

Daniel, Thomas M. “The History of Tuberculosis.” Respiratory Medicine 100, no. 11 (2006): 1862-1870.

Foucault, Michel. Discipline and Punish: The Birth of the Prison. Harmondsworth: Penguin, 1975.

—. The Birth of the Clinic: An Archaeology of Medical Perception. London: Tavistock Publications, 1972.

Greene, Warner C. “A history of AIDS: Looking back to see ahead.” European Journal of Immunology, 2007: 94-102.

Grigorenko, Elena L, and Mei Tan. “Biomedicine, Creativity, and the Story of AIDS.” In The Cambridge Handbook of Creativity across Domains, by James C Kaufman, Vlad P Glăveanu, & John Baer, 226-246. Cambridge: Cambridge University Press, 2017.

Guibert, Hervé. To the Friend who did not Save my Life. Pasadena: Semiotext(e). 2020.

Hallett, Michael A. Activism and Marginalization in the AIDS Crisis. New York: Routledge, 1997.

Hecht, Jamey. “Scarcity and Poetic Election in Two Sonnets of John Keats.” ELH 61, no. 1 (1994): 103-120.

Jurecic, Ann. Illness as Narrative. Pittsburgh: University of Pittsburgh Press, 2012.

Keats, John. La Belle Dame sans Merci. 1819.

—. Ode on a Grecian Urn. 1820.

—. When I Have Fears that I may Cease to be. 1848.

Lawlor, Clark. Consumption and Literature: The Making of the Romantic Disease. London: Palgrave Macmillan UK, 2006.

Mahoney, Dennis, and Terence Chorba. “Romanticism, Mycobacterium, and the Myth of the Muse.” Emerging Infectious Diseases 25, no. 3 (2019): 617-618.

Novau, Marta Sábado. “Representation of the Self and Disease: Writing, Photography and Video in Hervé Guibert.” Humanities 8, no. 4 (2019): 1-16.

Orban, Clara. “Writing, Time, and AIDS in the Works of Hervé Guibert.” Literature and Medicine 18, no. 1 (1999): 132-150.

Piggford, George. “In Time of Plague: AIDS and Its Significations in Hervé Guibert, Tony Kushner, and Thom Gunn.” Cultural Critique 44 (2000): 169-196.

Radetsky, Michael. “John Keats and Tuberculosis.” The Paediatric Infectious Disease Journal 20, no. 5 (2001): 535-540.

Rendell, Joanne. “A Testimony to Muzil: Herve ́ Guibert, Foucault, and the Medical Gaze.” Journal of Medical Humanities 25, no. 1 (2004): 33-45.

Sharp, Paul M, and Beatrice H Hahn. “Origins of HIV and the AIDS Pandemic.” Cold Spring Harbor Perspectives in Medicine 1, no. 1 (2011): 1-22.

Smith, Hillas. “John Keats: Poet, Patient, Physician.” Reviews of Infectious Diseases 6, no. 3 (1984): 390-404.

Sontag, Susan. AIDS and its Metaphors. New York: Farrar, Straus and Giroux, 1989.

—. Illness as Metaphor. New York: Farrar, Straus and Giroux, 1978.


[1] Hillas Smith. “John Keats: Poet, Patient, Physician.” Reviews of Infectious Diseases 6, no. 3 (1984): 390.

[2] Clara Orban. “Writing, Time, and AIDS in the Works of Hervé Guibert.” Literature and Medicine 18, no. 1 (1999): 132.

[3] Thomas M. Daniel. “The History of Tuberculosis.” Respiratory Medicine 100, no. 11 (2006): 1862.

[4] Ibid.

[5] Ibid. p 3.

[6] Clark Lawlor. Consumption and Literature: The Making of the Romantic Disease. (London: Palgrave Macmillan UK, 2006). 135.

[7] Dennis Mahoney and Terence Chorba. “Romanticism, Mycobacterium, and the Myth of the Muse.” Emerging Infectious Diseases 25, no. 3 (2019): 617.

[8] Clark Lawlor. Consumption and Literature: The Making of the Romantic Disease. (London: Palgrave Macmillan UK, 2006). 178.

[9] Thomas M. Daniel. “The History of Tuberculosis.” Respiratory Medicine 100, no. 11 (2006): 1864.

[10] Susan Sontag. Illness as Metaphor. (New York: Farrar, Straus and Giroux, 1978). 17.

[11] Ibid. 20.

[12] Paul M. Sharp and Beatrice H Hahn. “Origins of HIV and the AIDS Pandemic.” Cold Spring Harbor Perspectives in Medicine 1, no. 1 (2011): 1.

[13] Ann Jurecic. Illness as Narrative. (Pittsburgh: University of Pittsburgh Press, 2012). 8.

[14] Ann Jurecic. Illness as Narrative. (Pittsburgh: University of Pittsburgh Press, 2012). 7. Warner C. Greene, “A history of AIDS: Looking back to see ahead.” European Journal of Immunology, 2007: 94.

[15] Ann Jurecic. Illness as Narrative. (Pittsburgh: University of Pittsburgh Press, 2012). 8.

[16] George Piggford. “In Time of Plague: AIDS and Its Significations in Hervé Guibert, Tony Kushner, and Thom Gunn.” Cultural Critique 44 (2000): 180. Clara Orban. “Writing, Time, and AIDS in the Works of Hervé Guibert.” Literature and Medicine 18, no. 1 (1999): 172.

[17] Susan Sontag. AIDS and its Metaphors. (New York: Farrar, Straus and Giroux, 1989). 26.

[18] Michael A. Hallett. Activism and Marginalization in the AIDS Crisis. (New York: Routledge, 1997). 3.

[19] Michael Radetsky. “John Keats and Tuberculosis.” The Paediatric Infectious Disease Journal 20, no. 5 (2001): 538.

[20] Clara Orban. “Writing, Time, and AIDS in the Works of Hervé Guibert.” Literature and Medicine 18, no. 1 (1999): 138.

[21] Jamey Hecht. “Scarcity and Poetic Election in Two Sonnets of John Keats.” ELH 61, no. 1 (1994): 116.

[22] Ibid. 119.

[23] Ibid. 60.

[24] Hermione de Almeida. Romantic Medicine and John Keats. (New York: Oxford University Press, 1991). 119.

[25] Susan Sontag. Illness as Metaphor. (New York: Farrar, Straus and Giroux, 1978). 13.

[26] Nicholas A. Boire, Victoria Avery A Riedel, Nicole M Parrish, and Stefan Riedel. “Tuberculosis: From an Untreatable Disease in Antiquity to an Untreatable Disease in Modern Times?” Journal of Infectious Diseases & Preventive Medicine 1, no. 2 (2013): 7.

[27] Ibid.

[28] Ibid. 140.

[29] Susan Sontag. Illness as Metaphor. (New York: Farrar, Straus and Giroux, 1978). 22.

[30] Clara Orban. “Writing, Time, and AIDS in the Works of Hervé Guibert.” Literature and Medicine 18, no. 1 (1999): 132.

[31] George Piggford. “In Time of Plague: AIDS and Its Significations in Hervé Guibert, Tony Kushner, and Thom Gunn.” Cultural Critique 44 (2000): 180.

[32] George Piggford. “In Time of Plague: AIDS and Its Significations in Hervé Guibert, Tony Kushner, and Thom Gunn.” Cultural Critique 44 (2000): 180. Clara Orban. “Writing, Time, and AIDS in the Works of Hervé Guibert.” Literature and Medicine 18, no. 1 (1999): 139.

[33] Dennis Mahoney and Terence Chorba. “Romanticism, Mycobacterium, and the Myth of the Muse.” Emerging Infectious Diseases 25, no. 3 (2019): 617.

[34] Susan Sontag. AIDS and its Metaphors. (New York: Farrar, Straus and Giroux, 1989). 38.

[35] Joanne Rendell. “A Testimony to Muzil: Hervé Guibert, Foucault, and the Medical Gaze.” Journal of Medical Humanities 25, no. 1 (2004): 42.

[36] Clara Orban. “Writing, Time, and AIDS in the Works of Hervé Guibert.” Literature and Medicine 18, no. 1 (1999): 133.

[37] Marta Sábado Novau. “Representation of the Self and Disease: Writing, Photography and Video in Hervé Guibert.” Humanities 8, no. 4 (2019): 7.

[38] Michel Foucault. The Birth of the Clinic: An Archaeology of Medical Perception. (London: Tavistock Publications, 1972). 89. Joanne Rendell. “A Testimony to Muzil: Hervé Guibert, Foucault, and the Medical Gaze.” Journal of Medical Humanities 25, no. 1 (2004): 36.

[39] Michel Foucault. Discipline and Punish: The Birth of the Prison. (Harmondsworth: Penguin, 1975). 209.

[40] Joanne Rendell. “A Testimony to Muzil: Hervé Guibert, Foucault, and the Medical Gaze.” Journal of Medical Humanities 25, no. 1 (2004): 43-44.

Editor’sNote: This essay is part of a collection that grew out of a course on illness and francophone literature, culture, and history at Columbia University. Each essay speaks to the range of epidemics and medical encounters in France and the French empire that the course covered — from the plague outbreak in Marseille in 1720, to recent outbreaks of Ebola in West Africa, to the class’s own context of COVID-19. Offering new perspectives on these topics, the essays demonstrate how a pedagogical focus on illness can engage students in thinking about how literature might spark ethical and political reflection, and about how colonialism and race function as driving forces of history.

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