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Poetry of Caregiving

What is the essence of caregiving? Donald Hall—a former New Hampshire and U.S. poet laureate— found out when his beloved wife, fellow poet Jane Kenyon, was dying of leukemia. He drew inspiration from his memories of the way his mother had cared for elderly relatives. From the tenderness of Kenyon's nurses at DHMC. And from poetry.

By Susan Salter Reynolds

Nursing her I felt alive
in the animal moment,
scenting the predator.
Her death was the worst thing
that could happen,
and caring for her was best.

—Donald Hall
From "Ardor"

Poets are not practical souls, so the standard wisdom goes. But those who fall for that shibboleth have clearly never met Donald Hall. Few people have faced the death of a loved one—surely as practical amatter as lifemetes out—with Hall's tender thoroughness. In 1995, his beloved wife of 23 years, fellow poet Jane Kenyon, died of leukemia. She was 47.

Thirteen years later, it remains a great solace to Hall, the immediate past U.S. poet laureate, that he was able to spend so much time caring for Kenyon while she was dying. "I could be with her all the time," Hall says, "from 6:00 a.m. until 7:00 or 8:00 at night."

Kenyon got much of her treatment at Dartmouth-Hitchcock Medical Center, an hour's drive Eagle Pond Farm in Wilmot, N.H.—home for the couple since 1976 and for members of Hall's family since 1865. Her cancer was diagnosed in January of 1994; she was an inpatient at DHMC for a month of chemotherapy and returned home for an all-too-briefmonth of remission. Then, in March of 1994, the leukemia came back. A bone marrow transplant was her only treatment option. Hitchcock at that time did just autologous bone marrow transplants (using a patient's own marrow after it's been purged of cancer cells), but because Kenyon had acute lymphoblastic leukemia, her own marrow would not work. At the suggestion of Dr. Letha Mills, their Dartmouth oncologist, Kenyon got on the waiting list for a donor transplant at the Fred Hutchinson Cancer Research Center in Seattle and began the agonizing wait for a donor. (Hall and Kenyon became very close to Mills and her assistant, nurse practitioner Diane Stearns, he explains in his 2005 book, The Best Day, The Worst Day. Hall was touched by the fact that Mills made a house call while Kenyon was on her deathbed. And that both of her primary oncologists, Mills from Hitchcock and Dr. Kris Doney from Hutchinson, came to Kenyon's memorial service.)

At last a donor was identified in October of 1994, and the couple flew westward. Hall found an apartment in Seattle but spent all day, every day at the hospital with Kenyon, returning to the apartment only to sleep. When Kenyon entered the sterile cocoon of a laminar air flow room, she was separated from Hall by a thick curtain of plastic. Hall could touch her only by inserting his hands into heavy gloves built into the curtain. Even conversation was difficult because of noise fromthe fans that kept unsterile air from entering Kenyon's room.

Hall and her caregivers were worried that this isolation would be difficult for Kenyon, who had suffered from manic depression for many years. "The nurses in Seattle were also worried about me," Hall admits. "They tried to make me go away for a few days. There was a magical thought I had that if I did everything right, I could keep her."

But it was not to be. Nevertheless, in the process of trying, Hall—who admits to being a total technophobe ("I can't even handle a cell phone," he says)—learned how to run the medical machinery she would need at home and to administer her medications (which at one point amounted to 55 pills a day). "I actually infused her," Hall says proudly, "and I learned how to hydrate her and handle the pumps. After she died, I had lots of dreams that she had died because I had forgotten her medication."

Hall was truly grateful then and is still amazed now by the quality of care they received at both hospitals, particularly from the oncology nurses at Dartmouth-Hitchcock. In the journal Kenyon kept during her 15-month illness, she wrote: "The nurses remind me of Special Collection librarians the way they guard me." In The Best Day, The Worst Day, Hall wrote: "No one medical ever minced words with us; no one condescended or minimized danger."

"They were an extraordinary bunch," Hall says, "the best I've ever known. They were extremely close to the patients and inventive in thinking up new ways to help. They burn out, you know. They become attached to particular patients and again and again watch them die." Hall was aware that the nurses talked among themselves about the couple—having noticed the way he looked at her and how much in love they were.

Their love was almost as famous as their poetry. In 1993, Bill Moyers made an Emmy Award-winning documentary about the couple called A Life Together. Kenyon was 19 years younger than Hall; the two had met when she was a student of Hall's at the University of Michigan. The irony of her untimely death—despite the fact that she was somuch younger than he; despite the fact that he'd had colon cancer which, in 1992, had metastasized to his liver; despite the fact that he'd been told then that he had only a one-in-three chance of living three years—does not escape him to this day.

Kenyon could not talk much in the final stages of her illness, he says, so he would simply sit beside her, writing. But then she'd pipe up from her bed. "Perkins!" she would say (that being Kenyon's pet name for her husband), "What are you writing?"

"I read the poem 'Without' to her at her bedside," Hall remembers, "and she said, 'You've got it, Perkins!'" In the final weeks before Kenyon's death, the two spent hours each day discussing and choosing and editing poems by Kenyon that would be published in a posthumous collection titled Otherwise. (When she died, Kenyon was the poet laureate of New Hampshire—a role that Hall had held from 1984 to 1989.)

What made Hall such a good caregiver? Was it something in his childhood? He recalls that while he was growing up, ill family members would be brought home to Eagle Pond Farm. Hall watched his mother care for her mother, as her ancestors before her had cared for their parents. And Hall and Kenyon later cared together for their own aging mothers. He was an only child who received the "total attention" of his parents. "I learned," he says, "how to be mother-like."

Hall also used writing to get through Kenyon's dying. He calls himself an elegiac poet, and in a sense this has always been the case—even before Kenyon fell ill. From the time he began writing poetry, at age 12, he has written about the family homestead in Wilmot, where his great-grandfather settled in 1865. He calls it the "poetry house," because it was there, as a boy, that he listened avidly to his grandfather's stories and first came to believe in the evocative power of words. He has always, as a poet and essayist and storyteller, been fascinated with the passage of time—with the march of generations and with the particular understanding of death that comes to those who watch the seasons carefully, year after year.

"In college, they called me the cellar-hole poet," he once said, referring to the ghostlike holes in the ground that dot the woods of New England, remaining visible long after the houses that stood above them have burned or rotted. That's because, he explains, "I wrote about loss. I was full of it. I hayed in fields that had once been thick with pine."

But writing about Kenyon was different. Writing during her illness became a kind of life raft. While she was dying, he began writing the first collection of poems about life without her, called Without. He finished it in the year following her death. The title poem in the collection begins this way:

we lived in a small island stone nation
without color under gray clouds and wind
distant the unlimited ocean acute
lymphoblastic leukemia without seagulls
or palm trees without vegetation
or animal life only barnacles and lead
colored moss that darkened when months did

hours days weeks months weeks days hours
the year endured without punctuation
february without ice winter sleet
snow melted recovered but nothing
without thaw although cold streams hurtled
no snowdrop or crocus rose no yellow
no red leaves of maple without october

—Donald Hall
From "Without"

During that year, Hall talked and talked and talked about Kenyon to everyone he encountered. Writing, too, was a salve for his grief. "The impulses to talk and to write are similar," he tells me, "but writing is more helpful. I could revise my grief, go over it." The attempt to understand death, or at least come to terms with it, is, he suggests, one of the main ingredients in all writing.

Soon after Kenyon died, Hall began speaking at hospitals and has continued to do so. He even gave a talk at Medical Grand Rounds at Dartmouth-Hitchcock Medical Center—a setting usually reserved for lectures about the latest diagnostic or treatment innovations. "I talk about emotions and the many expressions of grief, including the emotions that poetry can carry, in the hopes that it will be useful to other people," he says.

As he explains this, we—interviewer and interviewee—sit talking in his living room, surrounded by his remarkable art collection. It includes a Henry Moore sculpture, several Andy Warhol prints, a signed de Kooning, and a Picasso etching. He has just returned from a week in London, where he did a reading with the British poet laureate, Andrew Motion. Hall looks tired after a year as the U.S. poet laureate—a year of running around the country, sitting for countless interviews, appearing on numerous radio and television shows.

Now, he says, "I come back to this house, in which I have felt so much emptiness since her death, and because I can't work, I find myself with nothing to do." After 12 years of writing primarily about Kenyon, Hall found himself, in 2007, for the first time in his life, unable to write. "For so many years I was writing poems about Jane. I've become more and more naked as a poet, particularly after Jane's death. Then I came to the end of that. Something has changed, and language doesn't come to me anymore."

He holds his hands out, palms up, and shakes his head. "I've had more attacks of grief this spring. She would have been 60 this year. When I turned 60, she had a big party for me." It's clear from hearing Hall talk, from seeing the emotions that flicker across his face, that the assumption that grief dissipates with time is only partially true. Certainly the simplistic notion of "closure," when one is talking about the death of a soul mate, is ridiculous.

Could it be that Hall's duties as U.S. poet laureate are what made writing impossible? Hall shakes his head no. "I've always been hypomanic," he says. "Time is never the issue." Indeed, since graduating from Harvard and then Oxford in the early 1950s, Hall has never stopped. He has written 15 books of poetry, 12 collections of essays, two children's books (including the 1979 Caldecott Medal-winner, Ox-Cart Man), several plays, and countless introductions, magazine articles, and critical reviews. He has won many, many prizes for his work, including the National Book Critics Circle Award for Poetry in 1988 and two Guggenheim Fellowships.

It was Kenyon who persuaded Hall to leave his tenured faculty position at the University of Michigan, move to Eagle Pond Farm, and support himself with freelancing.

"I was terrified about money," he recalls. "Jane had grown up in a family of freelancers; she was ready to chain herself in the root cellar if necessary," to convince him to make the move.

After they settled in New Hampshire, "we were in this house together all day long, though we tried to keep as separate as possible while working. My study was in the northwest corner of the house, hers was on the second floor in the northeast corner. She'd work on poems first thing, or her translations of Anna Akhmatova's poetry. I'd write freelance pieces for magazines and other essays in the morning and poetry in the afternoon." They would meet for lunch and a nap in the middle of the day. "It was a folie a deux," Hall says.

In The Best Day, The Worst Day—which is subtitled Life with Jane Kenyon—Hall wrote: "Three hundred and thirty days a year, we inhabited this old house and the same day's adventurous routine. What we did: love."

After Kenyon's death, Hall became very aware of the days passing; each new thing done alone felt like another blow. "In the first year, I'd catch a glimpse of her somewhere. Then that changes. The magical thinking ends. For the most part, . . . since she died, I've done all the same things we used to do together."

Kenyon's study, which remains as she left it, still contains manuscripts and unpublished materials that Hall has yet to go through. "I wonder what she'd write about . . . ," he begins, and leaves the end of the thought dangling.

One of the most difficult times for Hall was when some of Kenyon's papers were taken to the University of New Hampshire Library. "It was as if the body were being taken away again," he says. In most regards, however, the house is the way it was when the two lived there together. In fact, Hall continues, 13 years later, to find things that were Kenyon's—a box of abandoned poems, an old phone list in her handwriting, a row of herbs in the kitchen with her lettering on the labels. Each such discovery tugs him back to her absence.

Hall and Kenyon—who had not been religious before their move to New Hampshire—attended a local church together after they settled in Wilmot. So has faith been a consolation for Hall? "Her faith," he says, "was stronger than mine." He attends church more for the community than the communion. Art, he feels, has been more the important source of succor for him.

On the black marble monument that guards Kenyon's grave, in a cemetery just five miles from Eagle Pond Farm, Hall inscribed some lines from one of her own poems. They are from a poem that she wrote in 1992—when it was Hall whose body was in cancer's grip, when she believed that he was probably going to die:

I believe in the miracles of art, but what
prodigy will keep you safe beside me?

—Jane Kenyon
From "Afternoon at MacDowell"

In his 1992 book, Their Ancient Glittering Eyes, Hall wrote about old poets he had known, and writers in general, getting old. He recently reread the book in preparation for a speaking engagement. "When writers are young," he says, "they are driven by dissatisfaction, by a desire to get it right. They are ambitious. But when death is imminent, they lose that ambition and then their desire to write. Theymay, as Thomas Hardy wrote, lapse into doggerel, or, like Wordsworth, write more and more about despondency and madness."

Listening to Hall talk about depression and the inability to write, one wonders if he ever contemplates his own death.

Is this poet—who has spent so much time in death's company, both in life and on the page—afraid of death? "I am," he admits, "afraid of the act of death. I am not afraid of the deaths of others."

It saddens Hall to think that he will die, as he puts it, "without a wife." It's a phrase that sounds at once old-fashioned and timeless, almost biblical, as though he means the word "wife" in its most expansive sense—friend, helpmeet, partner, lover.

As though he is caring for her still.

Susan Reynolds is a staff writer and columnist for the Los Angeles Times, for whose pages she has also written about Hall's work. This is her first feature for Dartmouth Medicine.

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