East Coker, Section 4 Summary

Lines 327-331

The wounded surgeon plies the steel
That questions the distempered part;
Beneath the bleeding hands we feel
The sharp compassion of the healer's art
Resolving the enigma of the fever chart.

• To start off this section, we hear about a "wounded surgeon" using some sort of steel instrument to help whatever part of the world is "distempered." By this point in the poem, we can just assume that no matter what symbol or metaphor the speaker uses, he's always talking about the pain of the modern world and the individuals living within it. 
• This "wounded surgeon" might remind us of a doctor out on a battlefield in war, doing whatever he can to help someone who's been injured. Similarly, the speaker might feel spiritually wounded by the modern world, and might be trying to save his readers, who've been injured in the same battle. 
• As we feel the hands of this healing surgeon upon us, doing what they can to stop our bleeding, we feel the compassion that motivates what the doctor is trying to do. The "bleeding hands" here, though, could also refer to Jesus Christ being nailed to the cross, which he willingly accepted in order to spiritually "heal" the sins of humanity. 
• As the surgeon or Christ-like figure tries to help us, this figure must also "resolv[e] the enigma of the fever chart"; or like a doctor staring at a chart he doesn't understand, this figure has to figure out the correct way of curing us. This is sort of like what the speaker is doing by trying to find the right combination of words to help our souls through poetry.

Lines 332-336

    Our only health is the disease
If we obey the dying nurse
Whose constant care is not to please
But to remind of our, and Adam's curse,
And that, to be restored, our sickness must grow worse.

• According to these lines, "our only health is our disease." In other words, the speaker is suggesting that the only health we can hope to gain is the health that comes after acknowledging our disease. Further, the "dying nurse" here seems to be another healer whose "constant care is not to please" or make us feel good. Rather, her job is to remind us that health isn't always about feeling good. It's about always remembering that humanity has fallen from its original perfection (Adam's curse), and that the only way we're ever going to be "restored" is for our spiritual sickness to get so bad that we finally have to get up and start doing something about it.

Lines 337-341

    The whole earth is our hospital
Endowed by the ruined millionaire,
Wherein, if we do well, we shall
Die of the absolute paternal care
That will not leave us, but prevents us everywhere.

• It looks like when it comes to the sickness we're all suffering from, "The whole earth is our hospital." And if anyone pays for this hospital, it's God, who probably looks like a "ruined millionaire" to the modern world because he's quickly running out of true worshippers.
• In this situation, we can't succeed without dying of the "absolute paternal care / That will not leave us, but prevents us everywhere." The speaker here seems to criticize our instinct to be followers in the modern world, to take our cue from others ("paternal" fathers) and pretty much do as we're told. 
• Under these circumstances, we might very well succeed, but it won't be an authentic success, because it's always happening under someone else's watchful eye, that "prevents us everywhere" from really finding our own spiritual path. It's not clear here if the speaker is actually criticizing religious people who don't think for themselves here, or modern people who just do what the folks in charge tell them to do. Let's keep reading to see if this is cleared up…

Line 342-346

    The chill ascends from feet to knees,
The fever sings in mental wires.
If to be warmed, then I must freeze
And quake in frigid purgatorial fires
Of which the flame is roses, and the smoke is briars.

• This chill we feel in our modern lives also gives us a sort of hectic fever, which could symbolize the stress and anxiety that comes with not having any solid spiritual ground to stand on. Again, the speaker goes nuts for collapsing the difference between opposites, and says that it seems the only way he (or any of us) can be warmed is if we "freeze and quake / In frigid purgatorial fires." Basically, the only way we'll ever find comfort is if we first go through a really uncomfortable experience, like totally changing the way we think about our lives. 
• In this instance, the speaker says that the fire that purifies us is one where "the flame is roses, and the smoke is briars." In this instance, the speaker brings us back to imagery of the natural world, since he's never willing to let us forget about nature for too long. It is only by painfully setting fire to our egos (hence the smoke and fire) that we'll be able to enjoy our lives in the present moment that's symbolized by nature (symbolized here by the briars).

Lines 347-351

    The dripping blood our only drink,
The bloody flesh our only food:
In spite of which we like to think
That we are sound, substantial flesh and blood—
Again, in spite of that, we call this Friday good.

• Always the one for grand closing statements, the speaker ends Section 4 of "East Coker" with a really vivid stanza about how, in the modern world, our only drink is blood and our only food is bloody flesh. This could mean that we've totally all become cannibals in some sort of post-apocalyptic world. But it more likely means that the blood and body of Christ (which Catholics ritualistically "eat" at mass) is the only thing left to nourish our spirits.
• In other words, religion is what we have to turn back to if we're going to going to find any meaning in our lives. And yet, in spite of this, we tend to think only of our individual minds as the only true reality. The only thing that matters in our lives is our self-interest and personal goals. We do this thinking that we are "sound, substantial flesh and blood," or in other words thinking that we're totally authentic people who are in control of our own lives. 
• Yet in spite of "that" (meaning our own selfishness), we're still willing to refer to the day of Jesus's death as "Good Friday."
• This whole stanza (and whole section of "East Coker") is pretty tough to follow. But basically, the speaker's saying that we need to reconnect with the humility that Christ showed when he offered himself to die for all of humanity's sins. We need to learn to show this kind of humility in our own lives, and more importantly, to feel it in our hearts. This is why it's so important to remember why Christians refer to the day of Jesus' sacrifice as "Good Friday."
• This concludes Section 4 of "East Coker," which is by far the most obviously Christian section of "The Four Quartets" up to this point. All this Christian imagery contrasts pretty sharply with the Buddhist-Taoist-Hindu emphasis of "Burnt Norton" and the beginning sections of "East Coker." We wonder which direction we'll be taken in next…