“What Deepest Remains”: Jack Coulehan’s The Wound Dresser

Reviewed by Kate Falvey

Walt Whitman’s “The Wound-Dresser” (originally “The Dresser”) from the longer poetic sequence Drum Taps (first published in 1865), remains one of the most hauntingly revealing portraits ever written of war’s horrific casualties, the protracted misery of wounded soldiers, and their tender care. Composer John Adams used “The Wound-Dresser” as the basis for his 1988 piece for voice and orchestra. “The Wound-Dresser,” Adams explains, “is the most intimate, most graphic, and most profoundly affecting evocation of the act of nursing the sick and dying that I know of. It is also astonishingly free of any kind of hyperbole or amplified emotion, yet the detail of the imagery is of a precision that could only be attained by one who had been there.”1

Veteran doctor/poet Jack Coulehan uses Whitman’s poem to reveal and organize his own intimate, affecting poetic memoir of his life in the healing arts and wars. Coulehan’s sixth collection, The Wound Dresser, a finalist for 2016 Dorset Poetry Prize selected by former US poet laureate Robert Pinsky, borrows Whitman’s title and tone; the knowing gravitas of Whitman’s “old man” storyteller infuses the collection. It is a brave choice to make such an iconic poem the conceptual touchstone for a collection, but Coulehan’s understanding of wounds and salves makes this choice beautifully apt. He, too, is an “old man bending” to tell the tales of what he has witnessed as a student, a healer, a traveler, a vulnerable man.

Children ask Whitman’s narrator: “What stays with you latest and deepest? of curious panics, / Of hard-fought engagements or sieges tremendous what deepest remains?” The curious, unwitting young clamor for stories of grit and grandeur, but Whitman’s old Civil War vet offers his recollections stripped of thrills and vainglory. Coulehan, too, presents his memories with forthright, unadorned clarity. What remains through the lyric profusion of incident is a voice certain of suffering and the necessary practice of empathy.

Benignant humility and selfless devotion to the ministry of healing do not come easily or at all. Whitman’s enduring poetic legacy of devoutselfless service stands as a sobering contrast to the more mystically expansive, irreverently cocky version of selfhood pitched in his earlier “Song of Myself.” Coulehan plays a bit with these personae—the untried, unsuspecting youth and the knowing, weary elder—while measuring his own life’s meaning against Whitman’s complex reckonings with human majesty and baseness.

The collection is prefaced with lines from section 48 of “Song of Myself,” attesting not only to both poets’ belief in compassionate action, but also to the limits of dressing mortal wounds: “And whoever walks a furlong without sympathy walks to his own funeral dressed in his shroud.” The image of the walking dead or walking wounded, devoid of sustaining sympathy, at once asserts and undermines the healing power of love. In sympathy with the earth and with others or not, we are still enshrouded with the specter of mortality and can’t veer off the path to death. These prefatory lines are followed by “On Reading Walt Whitman’s ‘The Wound Dresser’,” in which Coulehan positions himself as kin to Whitman’s nurse/veteran. This kinship transcends “sympathy” as an ethical stance and suggests that only another wound dresser can know the magnitude of human suffering on such intimate, visceral, sustained terms.

Also significant here is Whitman’s then radical concept of an equal privileging of soul and body. Section 48 of “Song” leads with: “I have said that the soul is not more than the body, / And I have said that the body is not more than the soul, / And nothing, not God, is greater to one than one’s self is…” which then lead into the lines Coulehan chose for his preface. His poems, therefore, are deepened by Whitman’s presence and the evocation of Whitman’s complex melding of material and spiritual planes. Yet it’s tough to remember the divinity inherent in the corporeal when soaked in reminders of assailable flesh. “From the stump of the arm, the amputated hand,” Whitman writes in “The Wound-Dresser,” “I undo the clotted lint, remove the slough, wash off the matter and blood… .” This is when a resolute practice of empathy needs to be grounded in the expansive democratic self-awareness trumpeted in “Song.” This unflinching awareness permits self-sacrifice and devotion to others and may also be the wellspring of poetic expression.

Coulehan makes plain where his own sympathies lie. After summarizing Whitman’s “The Wound-Dresser” for the NYU LitMed database, Coulehan concludes with this commentary: “For those who argue that nurses and physicians ought to develop detachment and ‘clinical distance,’ this poem is a kick in the pants.”2 And in an article for the University of Toronto Medical School’s Artbeat blog, Coulehan explains his Whitmanesque pull toward emotional engagement with patients: “From the beginning I resisted the idea that doctors should foster detachment in order to achieve objectivity. For me ‘detached concern’ is an oxymoron. What can empathy be, if not a form of human connection? How can a person be caring or compassionate in the context of emotional distance? At the same time, I often found myself frustrated, dejected, and angry, sometimes even wanting to run away from it all.” 3

This last statement, in particular, provides a gloss on the poems in The Wound Dresser, for which the “human connection” in Whitman’s “The Wound-Dresser” is Coulehan’s starting point and journey’s end. In his “On Reading Walt Whitman’s ‘The Wound Dresser,’” Coulehan reverently imagines and knowingly follows Whitman’s medico, incorporating some of Whitman’s own words and cadences into what is not only an homage to Whitman, but a testament to the author’s own “cot to cot” travels among the desperate and the dying. Coulehan’s poetic rendering of his reading of Whitman’s work becomes a poetic enactment of his own life in medicine and art. At the end of Coulehan’s poem, it’s as if the mantle has been passed from healer to healer: “You remain / tinkering at your soldier’s side, as I step / to the next cot and the cot after that.” His vigorous sympathy with Whitman blends with his own experience and practice; the “I” in Coulehan’s poem moves, as does Whitman’s “I,” ever “onward” into new rounds of pathos, loss, futility, humility, and heroic acts of sympathy.

“On, on I go, (open doors of time! open hospital doors!)” begins section three of Whitman’s “The Wound-Dresser.” The image of stepping towards the endless demands of suffering patients at the close of Coulehan’s “On Reading Walt Whitman’s ‘The Wound Dresser’” opens the doors, so to speak, to the varied moods and scenes in this absorbing collection. Coulehan opens the doors of time and the doors of the hospitals he’s practiced in to reveal, through the magic of his “rogue imagination” (“Ockham’s Razor”), the worlds of those patients and their doctor’s interior life. The collection has four sections (as does some versions of Whitman’s poem), with a general “onward” movement from youth to old age. The first section is centered on initiation into the practice of medicine and the toll it takes on the practitioner as he reckons with the whelming sea of troubles he is tasked with, if not ending, then Vladimir,” Mrs. Melville in “The Exterior Palace,” their diseased spleens and hearts and joints, their lymphomas, strokes, and tumors, are exposed in stark, relentless detail. In “The Secret of the Care,” the first poem in this section, the young doctor is likened to a priest (“In those days I wore vestments to the clinic”). What will be life-long tussles with faith and doubt and the limits of a doctor’s healing powers are introduced as core themes:

…I palpated

Their abdomens, balloted their livers,

and listened to respiratory crackles,

while disguising the depth of my doubt

with kindly, but serious look.

Also revealed in this first poem is the complexity of the young doctor’s “surprised” discovery of his play of emotional responses to the variety of patients he is bound to care for: “It was difficult. I was surprised to find / how much I disliked some of the patients— / rude and demanding, manipulative, violent and dense.” The poem ends with what will be an ironic foreshadowing: “It’s bound to get easier, I thought.” And, of course, it never does. Discerning the poetry in these encounters—in these people—requires a dogged effort toward sympathy as “the language of the body” (“The Rule of Thirds”) is read and expressed.

The doctor in these poems is no one-dimensional saint. He is, however, alert to the telling detail, the human idiosyncrasies of his plethora of patients, and the inevitable numbing of the heart that can come when dressing so many gaping wounds. In “Palpation,” the glasses “pincered” in the hand of a woman the young medical student has just examined are dropped but not picked up as “Myers” hurries his students “to another case.” In “Percussion,” Myers is oblivious to his patient’s discomfort as “she keeps trying without success / to cover her nakedness with a sheet.” There is unexpected attraction (“The Silk Robe”), repulsion (“Lift Up Your Heart”), and the strange intimacy of doctor/patient relationships, encapsulated in the closing lines of “Take Off Your Clothes”: “And you, my intimate companion, / you were consigned to endure the suspense/of me reading a narrative in your flesh.”

Section One closes with ghosts crowding the hospital halls in “Skinwalkers.” More ghosts waft into the next sections, as deaths continue to “accumulate” and “traces of sympathy” remain. The second section veers through medical history and its entanglements with social and religious history. It begins with ancient burial rites and ends in a 12th century Egyptian monastery with the “Icon of the Heavenly Ladder of St. John Klimakos,” in which an image of one fallen monk, “reaches to the very rim / of damnation, his finger nearly poking / into heaven, seeking compassion.”

Whitman’s ghost, always near, hovers over the appalling story of “McGonigle’s Foot,”4 in which a hapless Irish immigrant, one of the “lower orders of the race” is deemed too “coarse” to feel pain, so is subjected to an amputation sans anesthesia. This incident occurred during the Civil War years when thousands of amputations were performed (mostly with available chloroform, however), operations Whitman witnessed firsthand. In “Aesculapius Writes His Memoirs,” the god of medicine speaks with wry irreverence about his origins and fate:

the god of healing –

a bum job with few

benefits, many burdens –

eternally pestered,

always on call.

The settings for the meditative poems grouped in Section Three range over the globe from Alaska to Long Island, Viet Nam to Kosovo, Cambodia to Brazil. They chronicle gunshot wounds, privation, and war-made atrocities, offering weary observations about evil, violence, and an endlessly suffering humanity. In “Deliver Us From Evil,” the potency of sacred magic fades with time like an old landscape painting so that “evil is nothing but ordinary.” In “Cesium 137,” Brazilian children play with cesium from an abandoned hospital and “revel in its phosphorescence”:

This is the treasure they had hoped

to discover, the cairn of their small lives

burst open – beyond their parents’ drab

existence, their loveliness aglow at last.

Then the children die in agony, “hour by hour, consumed by innocence/and radiant desire.”

The collection culminates in personal history, the poet’s Irish Catholic roots, his own illnesses and the odd dislocation of being on the other side of the stethoscope. In “Role Model,” the memory of being examined as an adolescent by a clumsy, insensitive doctor prompts “a thirst to prove the quack / completely wrong, to master / my own medicine.” Such self-mastery has, of course, as these poems make plain, demanded much more than acquiring a better bedside manner, though true sympathy with suffering as epitomized by Whitman’s wound-dresser is an aspirational constant. Whitman returns in the penultimate poem, “Walt Whitman Reflects on His Doctor’s Bedside Manner,” as a cantankerous “old rat that must be allowed to die/in his own way.” Not much has changed from the early awakening suggested in “Role Model.” The old man in the guise of Whitman is still challenging the inadequacies of clinicians who are not sufficiently sympathetic to the gulf between them and their patients:

The man tinkers

with platitudes and conceals his thoughts.

In his gospel of encouragement

I’m supposed to be agreeable and dumb

while he puts the best construction

on what’s happening.

The final poem, “Retrospective,” a sonnet to resigned old age, is somewhat elegiac in tone, plaintive but not piteous. Here, the poet doctor admits his recall is keen but not exacting:

Only scattered synaptic charts

of his internship remain, etched in myelin,

a few of them deeply. Nonetheless, a dried

umbilical cord connects that powerful womb

to the aging man, across a gulf as wide

as imagination.

Time has, as Whitman’s wound-dresser admits to his young audience, faded the pictures, foregrounding only what is “deepest,” which is human connection and genuine acts of mercy. Whitman’s old vet explains that his reminiscences are born “in silence, in dream’s projections / While the world of gain and appearance and mirth goes on… .” He cautions the young: “[s]o soon what is over forgotten, and waves wash the imprints off the sand….” but ends with this lasting image of remembrance:

Thus in silence in dreams’ projections,

Returning, resuming, I thread my way through the hospitals,

The hurt and wounded I pacify with soothing hand,

I sit by the restless all the dark night, some are so young,

Some suffer so much, I recall the experience sweet and sad,

(Many a soldier’s loving arms about this neck have cross’d and rested,

Many a soldier’s kiss dwells on these bearded lips.)

In “Retrospective,” Coulehan “doubts there’s a thread / to follow… ./to a solution” for pain that cannot be pacified. But like the 19th century wound-dresser’s memory of dying men’s kisses, Coulehan’s final words in his 21st century “Wound Dresser” are an acknowledgment of “His ally, hope” which isn’t—but nevertheless has to be—sufficient.

1. As cited in Sarah Cahill, “The Wound Dresser.” John Adams’ Earboxhttps://www.earbox.com/the-wound-dresser/ Whitman himself famously nursed thousands of severely wounded soldiers during the Civil War.

2. Jack Coulehan, “Walt Whitman’s ‘The Wound Dresser.’” NYU School of Medicine Literature Arts Medicine Database http://medhum.med.nyu.edu/view/941

3. Jack Coulehan,“Confessions of a Poetry Doctor.” ArtBeat. Undated. https://utmedhumanities.wordpress.com/confessions-of-a-poetry-doctor-jack-coulehan/

4. See Martin S. Pernick, A Calculus of Suffering: Pain, Professionalism and Anesthesia in Nineteenth-Century America (Columbia University Press, 1985) for a full account of McGonigle’s ordeal and subsequent death, and Mary T. Phillips’ 1993 article in Society and Animals, “Savages, Drunks, and Lab Animals: The Researcher’s Perception of Pain” for a discussion of the selective use of available anesthesia based on scales of perceived social worthiness.