“There was always something eerily mature,” writes literary critic Alan Jacobs about the young W.H. Auden (Jacobs Reference Jacobs2022). The 20th-century English poet was authoritative, lyrical, yet also fragmentary and disjunctive; he “caught native English poetry by the scruff of its neck” and “pushed its nose sharply into modernity…” (Heaney Reference Heaney1987). In the 1920s and early 1930s, Auden applied this “hard-bitten, aggressively up-to-date” style to the social concerns of his time – economic inequality, war, and psychological turmoil, concerns which gripped and pressed him into anxiety, dread, and sorrow. His tone was mesmerizing, at times apocalyptic, as he fought against these forces.

But that tone began to change. In 1936, soon after his 29th birthday, Auden completed “Death’s Echo,” a poem whose voice and preoccupations mark a development not only in Auden’s poetic vision but also in his relationship to death and time (Auden Reference Auden and Mendelson1991). The poem is divided into four stanzas, each composed of two distinct sections. In the first section, a person or group of persons offers an observation or plea about life, as in the opening stanza:

The Arcadians in this first stanza are shiningly optimistic, yet nowhere in their reveling do they account for mortality, tragedy, or plain bad luck. As Auden grew older, he became increasingly impatient with illusory utopias and the denial of human limitation, and we see something of this when Death sends his “low answer” in a grinning, foreboding tone that drifts like a shadow across the idyllic pastures. He says to farmer and fisherman:

This pattern is repeated in the second stanza, where travelers “think in their hearts” about mountain air and bathing beaches, until “Death’s coercive rumor/In that moment starts”:

Death’s echo grows more forceful with each stanza. It began as a “low answer” in the first and a “coercive rumor” in the second. By the third, it becomes an “enticing echo” and finally, in the fourth, the “woods and their echoes ring” like parrots with “Death’s reply.” The ultimate stanza contains a doubling of Death’s response; after dreaming idealists have sung through the night about “ladders let down from heaven,” he finds the utopians sober in the morning and offers his final echo:

Death is nothing in this poem if not a disenchanter. For him, mortal joy is not only temporary, it is illusory. If our analysis ended here, we would conclude that Auden was either a nihilist (“not to be born is the best for man”), a hedonist (“dance while you can”), or simply bitter about mortality. But thankfully, Auden’s developing perspective on death offers something else to a world in need of healing. The reality of death persuades Auden, somehow, toward hope.

To understand Auden’s relationship to mortality, it is helpful to recall that personified Death – a dancing Death, no less – almost explicitly evokes the tradition of the Danse Macabre, a medieval religious symbol intended to prompt reflection on the brevity of life (Aucoin Reference Aucoin2021). Death, in the Danse Macabre, is often depicted as a skeleton twirling raucously with people from across the social hierarchy – from “the pope down to a newborn baby” – and his purpose is, in large part, to encourage pious behavior on the part of religious viewers (Aucoin Reference Aucoin2021).

In “Death’s Echo,” Auden manages to incorporate and reform these elements of the Danse Macabre. His personified Death is, as in the Medieval period, a dancer, and eager for partners, but he does not actually dance with his human speakers and his tone is more ironic than holy. In depicting Death, Auden is interested neither in the momentary pursuits of hedonism nor the dogmatic assertions of Medieval religiosity (Arendt Reference Arendt1975). Throughout the period in which “Death’s Echo” was written, the poet was concerned, above all, with hope (Mendelson Reference Mendelson2017).

Three years prior to “Death’s Echo,” Auden completed “Paysage Moralisé” (French for “Moralized Landscape”), a poem in which perfectionist dreams for a world without death are laid aside for something more human (Auden Reference Auden and Mendelson1991). Instead of ignoring death and suffering, here Auden transforms them into a source of healing:

The son of a doctor, Auden understood the inevitability of suffering and death, and in “Paysage Moralisé” he neither denies nor celebrates their chilling presence. Understanding that “sorrow is everywhere,” writes Edward Mendelson, the poet “hopes instead that it may melt – change its form, become available for use, make a vineyard of the curse” (Mendelson Reference Mendelson2017). His true goal is not, in truth, to make us dance while we can, but to persuade us to heal, to warm those who are close to death precisely because they, and we, are mortal.

While an undergraduate at Oxford, Auden carried himself “as a doctor and teacher among his patients,” an amateur psychoanalyst for his anxious friends (Jacobs Reference Jacobs2022). Oliver Sacks, who befriended the older Auden in New York, remembered him as “a sort whom everyone confides in and trusts; the very image of a wise and decent, old-fashioned [general practitioner]” (Greene Reference Greene2015). It was this warmth that opened him toward quiet, uncelebrated generosities later in life, as when he unceremoniously financed an expensive, medically necessary surgical procedure for a friend who could not afford the care (Mendelson Reference Mendelson2014). This was Auden’s true “formal order,” his “dance’s pattern”: a steady and reliable attention to the needs of others, especially the marginalized and the vulnerable.

“Death’s Echo” remains, in many ways, extremely relevant to our medical moment, particularly to palliative care practitioners and their patients. As the COVID-19 pandemic moves progressively further from its most intense, most uncertain days, many high-income countries have reentered something that approximates “normal life.” The recent proximity to mortality – in the newspapers and in social and professional life – has, for many people, slowly faded, replaced by the usual collection of goals and anxieties that have long constituted much of daily existence. A great deal was said during the early months of the pandemic about how such publicly mourned death might alter, might bring new life to our conversations and practices around death; but now that people can quite literally go dancing again, what is the appeal of dancing with Death?

One of the more interesting challenges for palliative care practitioners, new and old, in the coming years may indeed be the creative task of shaping the intense glare of death from the early years of the pandemic into a sustained but unpanicked gaze, a relationship that responds to the circumstances of health and life as a dancer responds to the music. This is not so different from the challenges extant prior to the pandemic, which were imposing enough. But if people today have fresh in their minds the experience of social distancing, of feeling the stakes of infection and mortality rates, of halting holiday gatherings for the sake of older family members, perhaps we are a bit (thankfully, only a bit) closer to the medieval setting in which the Danse Macabre held deep cultural relevance. What this means in practice is an open question; but in context, this poem and the poet’s corpus suggest that an awareness of our human fragility necessarily entails a responsibility not to seek our own comfort or protection – not to dance while we can – but, in fact, to actively care for our patients in the face of death. For the palliative care practitioner, this is of course the nature of the job: like poetry, a creative task.

Auden famously insisted against telling other people how to live their lives. He will not tell us what, exactly, to do with his poem. But one of his most famous lines, written 3 years after “Death’s Echo,” gives us a strong sense of his deepest desire: “We must love one another or die” (Auden Reference Auden1940).