Dylan Thomas Cause Of Death, Dylan Thomas, the great lost Welsh poet of his century, was killed not by his heavy drinking but by the mistakes and oversights of his physician, according to new evidence in a biography to be published on Monday. The book discloses that Thomas was found to be suffering from pneumonia by doctors who examined him when he was admitted in a coma to the New York hospital where he died in November 1953 shortly after his 39th birthday.
The discovery calls into question 50 years of assumptions that the author of Under Milk Wood and enduring poems on the holy innocence of childhood died from an alcoholic “insult to the brain” – the result of a binge in which, as he allegedly boasted, he drank “18 straight whiskies; I think it’s a record”.
The pneumonia was found nearly 24 hours after the writer first complained to a companion in a New York hotel that he could not breathe and was “suffocating”. But – instead of investigating a chest infection when told of these symptoms – his personal physician, Dr Milton Feltenstein, a celebrity doctor, diagnosed Thomas as suffering from delirium tremens, a drinker’s condition.
Dr Feltenstein injected the poet with three doses of morphine, which the biographers say would have had the effect of further depressing his breathing. After the third dose, Thomas’s face turned blue and he went into coma.
He was driven to St Vincent’s hospital, New York, where doctors took three hours to restore his breathing, using artificial respiration and oxygen. By then the poet’s brain was irretrievably starved of oxygen. He remained in deep coma and died four days later.
Pneumonia was one of three causes of death given at Thomas’s postmortem examination, along with brain swelling and a fatty liver. However, previous studies have assumed that the lung infection developed during his coma in hospital. The newly discovered evidence comes in a summary of medical notes made by the two junior doctors who admitted him to St Vincent’s.
The new book, Dylan Remembered 1935-53, is written jointly by David Thomas, author of a praised biography of Thomas’s earlier life, and Dr Simon Barton, primary medical care officer for Cornwall. Summarising their findings they conclude: “The medical notes indicate that, on admission, Dylan’s bronchial disease was found to be very extensive, affecting upper, mid and lower lung fields, both left and right.
“The bronchitis and pneumonia, as well as his emphysema, impaired Dylan’s breathing, and as a consequence his brain was starved of oxygen, leading to swelling of the brain tissues, coma and then death.
“Over the long term, Dylan’s smoking, drinking, poor diet and sleeping problems created a general debilitation in which the bronchitis and pneumonia could take hold. But Dylan’s chest disease went undiagnosed and untreated by Milton Feltenstein, in the days before Dylan was admitted to St Vincent’s.”
Dr Feltenstein believed, wrongly, the authors suggest, that Thomas had delirium tremens but, instead of admitting him to hospital, he injected him with morphine. The established medical thinking, then as now, is that morphine should be given to patients with chest disease only with the utmost caution.
The authors add that, if the medical notes had become known earlier, “we would have been spared over 40 years of lurid speculation about alcohol/drugs being the cause of Dylan’s coma and death”.
Dr Feltenstein died in 1974. All those who treated Thomas at St Vincent’s hospital are now dead. The hospital did not reply to letters from Thomas’s daughter, Aeronwy Thomas Ellis, David Thomas and Dr Barton asking if it still had medical files on the case. This week the hospital did not respond to inquiries from the Guardian.
The notes about Thomas’s admission are summarised in a memorandum written by Dr William Murphy, a Maryland physician who was allowed to examine the poet’s hospital papers in 1964 on behalf of his widow, Caitlin Thomas.
Dr Murphy, now dead, sent the memorandum to an earlier Dylan Thomas biographer, the late Constantine Fitzgibbon. David Thomas was told of its existence by a friend of the poet’s and traced the memorandum to Fitzgibbon’s archive in a Texas university.
The memorandum note: “A short [X-ray] film suggested bronchial pneumonia, although the intern’s [junior doctor's) note of the radiologist's report was not strongly stated". Mentioning another doctor with whom he discussed Thomas's death, Dr Murphy adds: "I did not attempt to pin him down as to the relationship of the morphine injection to the coma and the pneumonia. But it is quite apparent that it could do no good in either respect. The rationale of this form of medication continues to escape me".
David Thomas and Dr Burton put the details of Thomas's case to Bernard Knight, emeritus professor of forensic pathology at University of Wales medical college. Prof Knight's verdict was: "Death was clearly due to a severe lung infection, with extensive advanced bronchopneumonia. The pre-existing acute chronic bronchitis could be quite sufficient to flare up into a full-blown [pneumonia] … The severity of the chest infection suggests it had started before admission to hospital”.
Possible light is thrown on the reluctance of the two junior St Vincent’s doctors, William McVeigh and F. Gilbertson to state their diagnosis of pneumonia strongly in the admission notes by a 1977 study of Thomas’s death by George Tremlett and James Nashold.
These two writers interviewed Dr Gilbertson, who said Dr Feltenstein had pressed on them his diagnosis that the poet suffered from an alcoholic coma.
They add: “McVeigh and Gilbertson were stunned by Feltenstein’s intransigence in the face of what, to them, was clear evidence that he was wrong. They later heard that Feltenstein also forbade any other doctors to become involved in the case”.
Dr Feltenstein made his diagnosis of alcoholic damage after being told by Thomas’s companion in the hotel of his boast that he had drunk 18 straight whiskies.
David Thomas and Dr Burton say that in fact the evidence appears to be that he had drunk eight whiskies. They raise the possibility that it was the last of his lifetime of colourful statements which proved fatal to him.
·Dylan Remembered 1935-1953, volume 2, by David N. Thomas and Simon Barnes, 2004, published by Seren (£12.99).