From Planet 169

Enter the Vaccum

by David N. Thomas

Biographers often seem to work chronologically, usually leaving until last the death of the person they are writing about. They may have become tired or bored with their subject, and the death probably brings them a merciful release. With their publisher’s deadline approaching, they may find themselves with little time to examine the death thoroughly. Some may also think that their readers are more likely to be interested in the life than its ending, and, as far as Dylan Thomas is concerned, there may even be a conviction that the story is already known — it was the drinking, stupid.

Of Dylan’s early biographers, Constantine FitzGibbon was the most parsimonious in dealing with the death, giving only one page in a three hundred page book. Paul Ferris did the first real research and conclusively indicted morphine as a factor in the death, as well as making the first criticisms of Milton Feltenstein, Dylan’s New York doctor. George Tremlett devoted just a few lines to the death, though six years later he co-authored a whole book on the subject, claiming that Dylan was diabetic. Andrew Lycett’s more recent New Life vividly captures the circus of people and events during Dylan’s last days but his brief analysis of the death itself adds nothing to previous accounts.

Most of his biographers have faithfully echoed the post-mortem report that Dylan died of pneumonia contracted in coma while in hospital, i.e. the pneumonia was a consequence of the coma. But knowing if this is correct depends not just on the post-mortem findings, but also on understanding what was wrong with Dylan before he was admitted to St Vincent’s hospital in New York as an emergency case. His hospital notes would certainly contain such information, but no biographer has ever been allowed to examine them.

Intent on writing something on Dylan’s death, I wrote to St Vincent’s asking to see Dylan’s medical records. The hospital ignored my letters and phone calls. Since Dylan’s daughter, Aeronwy, was legally entitled to see her father’s records, she kindly wrote requesting them. Her letters were also ignored. I was about to admit defeat when I discovered, quite by chance, that a Maryland psychoanalyst, Dr William Murphy, had examined Dylan’s hospital notes in December 1964, and had also discussed them with Dylan’s neurosurgeon, Dr Gutierrez-Mahoney. Murphy had then sent a memorandum detailing the contents of the hospital notes to Constantine FitzGibbon. The memorandum was subsequently deposited in the FitzGibbon archive in the University of Texas.

In summary, Dylan had pneumonia on admission to hospital, as well as bronchitis which was found to be extensive, affecting the entire bronchial tree, both left and right. The bronchitis and pneumonia, as well as his emphysema, impaired Dylan’s breathing, and as a result his brain was starved of oxygen, leading to swelling of the brain tissues, coma and then death. In other words, the coma was the consequence of his pneumonia (and general chest disease), and not the other way round as we have been led to believe.

Dylan’s chest disease went undiagnosed and untreated by Milton Feltenstein, even though he attended Dylan three times in the twelve hours before he was taken to hospital. Feltenstein believed, wrongly, that Dylan had delirium tremens and so injected him with morphine, which impaired Dylan’s respiratory system still further and hastened his collapse. Feltenstein was also partly responsible, together with Dylan’s girlfriend Liz Reitell, for a two-hour delay in getting Dylan to hospital — no wonder that the medical notes record that, on admission, he was “profoundly comatose” with both sides of his brain malfunctioning.

FitzGibbon had been given a copy of the post-mortem report sometime before August 1964. He received Murphy’s memorandum in late December that year, giving him more than enough time to include the medical data in his biography — it was not published until early autumn 1965. But in his one-page treatment of Dylan’s death, FitzGibbon wrote that Dylan’s pneumonia had been contracted while in coma, a statement which he surely must have realised was inconsistent with information in Murphy’s memorandum. FitzGibbon neglected to mention Dylan’s bronchitis, and he said nothing at all to highlight the hazards of morphine when given to a patient with chest disease. He also wrote, falsely, that the post-mortem report gave the cause of death as an “Insult to the brain” i.e. it had been directly damaged by some toxic agent. How did FitzGibbon come to write such a bizarre account?

After Dylan’s death, several of his New York friends suspected a cover-up to protect Feltenstein and Reitell and, by extension, the Young Men’s and Young Women’s Hebrew Association and John Brinnin, who had a duty of care as Dylan’s sponsors and tour manager. George Reavey and John Berryman, for example, questioned the hospital doctors, and Berryman also took external medical advice on the causes of death. FitzGibbon himself wondered if the medical records had been doctored, but Murphy reassured him they had not. But, whether deliberately done or a simple error, the Medical Summary from the hospital that accompanied Dylan’s body to the post-mortem failed to mention that Dylan had pneumonia and bronchitis on admission. So the pathologist, through no fault of his own, wrongly concluded that the pneumonia that had killed Dylan had been contracted during coma in the hospital, and thus Feltenstein was let neatly off the hook.