Elsevier

The Lancet

Volume 358, Issue 9290, 20 October 2001, Pages 1361-1364
The Lancet

Literature and Medicine
Literature, medicine, and the culture wars

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What kind of capability?

Medicine is dominated by problem-solving; it is a profession that thrives on capability. You can't be a doctor if you don't know how to do things ("Qui ne sait agir n'est pas médecin”), wrote Jean Starobinski who studied medicine before becoming a professor of comparative literature.1 Literature, by contrast with medicine, has to make do with what John Keats, apothecary's assistant, famously called negative capability: “when man is capable of being in uncertainties, Mysteries, doubts, without

What is language using us for?

Some theorists—and theory is the way some academics in the humanities rationalise their existence—believe life is ruled by repressive mechanisms embedded in language itself. This insight can be traced back to the anthropologist Claude Lévi-Strauss, who interpreted Marx in the 1950s not as a political messiah, but as a sociologist. The rather austere Lévi-Strauss, influenced by his intellectual heroes Jean Jacques Rousseau and Emile Durkheim, set out to study differences between cultures in the

Two notions of culture

Scruples about language and context is one thing; linguistic correctness another. Gone are the days when people felt morally obliged to be intelligent. Matthew Arnold famously defined culture as “the best that has been thought and written": such is high culture, and so extreme has been the reaction against excellence that we can easily imagine a society without any culture in this sense at all. (Oddly enough, wanting to excel in sports carries no taint of elitism.) High culture depends on

The fallacy of unmediated art

Along with a tendency to see individual acts of creation as culturally constructed, there is a compensatory pull towards what is “lived on the pulses” (Keats again)—for the spontaneous, instinctive, and deeply felt, for the kind of immediacy we experience listening to music. “Authentic” is an adjective, I've noticed, that crops up time and again in articles about doctor-writers. It suggests a peculiar literal-mindedness, or even philistinism: this is the Real Thing, we are being told, this is a

The fallacy of art as therapy

Literature in medicine is presented as medicine rediscovering its roots in the humanities. In the 19th century most of the traffic was one-way, from medicine to literature: Honoré de Balzac and Emile Zola were fascinated by doctors' methods of observation. It may be the case, however, that parts of medicine are now being colonised by an academic growth industry: creative writing departments. Self-esteem being sacrosanct, there is an irresistible need to claim that creative writing not only gets

Warriors and victims

So-called illness narratives have emerged in such bulk since the 1980s as to create a literary genre inside the academy: life writing.9 This, despite the fact that the generation of those who write such narratives has never been healthier. Affluence has emptied life of its substance. Nowadays middle-class intellectuals have so little experience of illness, physical disability, or even death in the family that they feel obliged to cast themselves in the guise of survivors. These are genre

The uselessness of art

Art is pretty much useless: that is its glory and its higher morality, as Coleridge understood it. W H Auden famously said “poetry makes nothing happen”. He was reacting to Shelley's exaggerated claim that “poets are the unacknowledged legislators of the world”. But surely Auden was overstating the case? A poem or a novel can, like anything else in life, affect us deeply. What matters is that the language is disinterested. “We hate poetry that has a palpable design on us” (Keats again). In an

Discretion: a virtue?

Lastly, it may be recalled that the Hippocratic Oath binds doctors to a certain discretion about other people's lives, if not their own. People respect doctors, among other reasons, because they are discreet. Silence should not necessarily be regarded as something archaeological. After all, being a good doctor may mean turning one's back on the one-sided development of a talent,13 quixotism, or even the reflexive masochism of the writer who “runs howling to his art” (Auden again). Medicine is a

In defence of the reader

The accuser is god of this world, William Blake said. Stand Keats' definition on its head and it would seem to bear out Blake: the critic is capably negative. Critics tend—infuriatingly—never to be at a loss for an explanation, though, as I've suggested, it is still the poets who do the real work. Let me say that the impulse behind this particular attempt at understanding is not negative: it may be a virtue to know what our values are, even if the traditions they come from are in desuetude or

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