Doctors in Western literature

The Doctor in Literature is physician–author Solomon Posen’s take on how the doctor, as received by patient and society, is represented in Western literature. It is the first of four volumes in the same vein, the others examining the doctor’s personal life, medical career choices, and selected issues such as physician–nurse interactions, abortion, male and female doctors, and sexual fantasies and encounters.

Described as a reference guide highlighting 1500 passages from over 600 texts (virtually all available in English), this volume is compiled from Posen’s lifetime of reading with an eye toward literary portraits of physicians. He has identified eleven facets of the physician–patient–society encounter and organised the book around these, with chapters addressing, for example, physician fees, the doctor’s time, bedside manner, emotional distance between doctor and patient, and litigation, as played out by medical characters in literature across the ages.

This is not an anthology, for excerpts from literature frequently run but a sentence or two and serve Posen’s points rather than those of cited texts’ authors. Nor is it an annotated bibliography of literature depicting doctors, or even the index that the author suggests medical scholars need, for references are embedded in Posen’s assertions and one must go to endnotes for full information.

While documenting “astonishing” constancy in physician–patient relations over two and a half millennia (eg, patients like doctors who are willing to help, society resents doctors’ fees), Posen’s conclusions may be over-engineered. Having excluded texts that employ allegory or symbolism or that portray doctors who traffic in metaphor (psychiatrists, he says) or dark arts or who misbehave as criminals or clowns, he chiefly cites works in which doctors exhibit what he terms “recognizable medical behavior.” His readings of fictional doctors who meet his criteria are straightforward but sometimes sufficiently colored by his own lenses as to miss authors’ satire or social criticism.

As a result, Posen’s composite view of medical practice is inherently conservative, and his typical doctor — even more than society’s — is white, male, paternalistic and active rather than contemplative, irreligious, devoted more to profession than family, socially powerful, and resentful of political or institutional control. More historically and culturally nuanced aspects and ethical tensions of the doctor–patient–society triad tend to go unaddressed here, even though many of the cited literary works do take them on.

Marcia D ChildressDirector, Program of Humanities in Medicine University of Virginia School of Medicine Charlottesville, VA, USA