PREFACE
Most people have experience of illness and everyone dies, so it is hardly surprising that matters of medical interest or concern are frequently to be found in literature. Many doctors have been writers, and many writers were the children of doctors: Flaubert, Dostoevsky and Proust spring to mind, but there have been others. Whole shelves of books have been written about the relationship of Shakespeare to illness and medicine.
Somerset Maugham, who trained as a doctor and whose first book recounts his experiences as a medical student delivering babies in the slums of London (he retained his licence to practise for decades after he gave up medicine so that he could continue to prescribe for himself), believed that a medical training was excellent for a writer because a doctor both enters the most intimate details of a patient's life and yet keeps at a distance, the observing eye never sleeping. The combination of empathic intimacy with distance – or ice in the heart, if you prefer - is just what a writer needs.
But if doctors observe patients, patients observe doctors – which they, the doctors, are sometimes inclined to forget. The doctor is therefore an important figure in many stories, and though I have done no scientific survey, I suspect that more portrayals of doctors are critical than admiring. The more-or-less useless doctor is a frequent figure in Chekhov, perhaps the greatest of all short-story writers. An active member of the profession himself, he was a close and not uncritical observer of his colleagues. (‘Medicine is my lawful wedded wife and literature is my mistress,’ he once wrote. ‘When I tire of one, I fly to the other.’)
Then, of course, there is illness itself. In the recent epidemic of Covid-19, many were the recommendations that, in our idleness, we should read Boccaccio, Defoe, Manzoni, Giono, Camus, among others, who made of epidemic disease the occasion of their work. Illness and mortality are made the moral teacher of humanity: we know that the deathbed is the only place in which Ivan Ilyich would ever survey his life.
Many writers had prolonged struggles with disease (‘this long disease, my life’ wrote Alexander Pope, which was not a whine of self-pity, but rather a pithy summing-up of his experience on earth). In the twentieth century, writers such as D.H. Lawrence, Katherine Mansfield and George Orwell were lost to tuberculosis at a young age: perhaps the intensity or urgency of what they wrote was in part a consequence of their chronic illness that kept mortality before their eyes.
Whether illness has any message for us is an open question. Some say yes, others say no: illness is just what it is, the working out of a pathological process in the human body, with no more moral lessons than the force of gravity has.
Nevertheless, as an essential experience of human existence, illness and the response to illness has been, and will always be, an important stimulus to reflection on what, in shorthand, is called the meaning of life, as I hope the following stories amply demonstrate.
Theodore Dalrymple
Copyright © 2021 by Edited by Theodore Dalrymple. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
