Book review |
NERVOUS ACTS: ESSAYS ON LITERATURE, CULTURE AND SENSIBILITY
By George S. Rousseau 2004. Houndmills, Basingstoke: Palgrave
Price: £16.99 Paperback ISBN: 1403934541
THE DOCTOR IN LITERATURE: SATISFACTION OR RESENTMENT?
By Solomon Posen 2005. Oxford: Radcliffe Publishing
Price: £29.95 Paperback ISBN: 1857756096
MADAME BOVARY'S OVARIES: A DARWINIAN LOOK AT LITERATURE
By David P. Barash and Nanelle R. Barash 2005. New York: Random House
Price: $24.00 Hardback ISBN: 0-385-33801-5 Medicine and literature
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Historians of medicine have inevitably been attracted to such literature as an additional source of evidence about attitudes to illness and death, as well as of insights into the social relations of the medical profession, in the past. Certain diseases have attracted particular attention: for instance, the cultural associations of tuberculosis or ‘consumption’ in the Romantic period. ‘Mental’ illness has also been much discussed. In particular, literary depictions of female madness and hysteria have been scrutinized for evidence of the gendered character of medical knowledge and practice. While illness may be a universal of human existence, the way it is represented in the literature of a particular epoch testifies to the degree to which the connotations and experience of disease have varied over time. There are of course perils in this approach, but it has undoubtedly yielded valuable insights.
As well as enhancing our knowledge of the history of particular diseases, literature can illuminate the way in which more general medical and biological theories have influenced the consciousness of an era. The literary naturalism to which Émile Zola aspired sought to blur the conventional distinction between fictional and scientific writing. The subtitle to Zola's Rougon-Macquart novels was the ‘natural and social history of a family’. The cycle is dominated by 19th-century theories of heredity and degeneration as the determinants of human behaviour and destiny. Madness, disease and alcoholism loom large in the novels. In an earlier novel, Zola claimed that he had performed on his characters a procedure analogous to the ‘analytic work’ a surgeon undertook on a cadaver at autopsy. Medical practitioners returned the compliment: Zola was praised for the accuracy of his depiction of an aphasic in Thérèse Raquin.
The essays collected in George Rousseau's Nervous Acts are concerned with how the medical theory of an earlier period—stretching from the end of the seventeenth to the late 18th century—influenced literature. The author maintains that ‘Science and literature were perhaps never closer in their ultimate aims than in the century (1680–1780) that discovered imagination’ (p. 86). Rousseau is, in particular, concerned how the rise of what might be called the ‘nervous body’ is reflected in the prose and poetry of the period. Indeed Rousseau seems to imply that literature had to await this scientific epiphany before it could supply an adequate representation of human nature. Imaginative literature in its turn then proceeded to mould the future shape of formal philosophical or psychological speculation.
The medical revolution that occurred at the turn of the 18th century had, however, consequences that went well beyond the literary realm. Following the publication of Thomas Willis's (1621–75) monumental work on the anatomy and workings of the brain and nerves, the nervous system was ascribed a novel significance for the understanding of the working of the body—and of its mind—in both health and disease. It became commonplace for both medical men and laypersons to ascribe bodily and mental states to the condition of their ‘nerves’. A new ‘nervous self’ formed. This model was as well—if not better—adapted to the explication of the workings of morbid mental states as to the operations of the healthy mind. The differences between men and women and the perceived distinctions between the races were also to be attributed to divergent nervous constitutions. Such ready transmission of scientific developments into popular culture was possible because ‘neuroanatomy ... had not yet broken off—fragmented—from general discourse’ (p. 25). Here we see the origins of a distinctively modern understanding of human nature, one that sees consciousness and identity as the outcome of the workings of the nervous system. The etiolated connotations of ‘nervousness’ and ‘being nervous’ that survive in contemporary usage provide only a faint image of the revolutionary transformation that occurred at the turn of the 18th century. Whether the literary works that Rousseau discusses merely reflected or helped to shape this momentous shift is not entirely clear.
Rousseau has a somewhat elliptical style that sometimes seems better suited to posing questions than answering them. The essays contained in this volume were written over a period of several decades, which may explain the presence of a certain amount of redundancy and occasional inconsistency. It is not always clear whether causal priority in the transformations he discusses lies with ‘science’, ‘philosophy’, or ‘literature’—all, it should be noted, very tricky terms to apply when dealing with the period in question. Rousseau is also a little too eager to draw analogies between early–modern notions of the nerves and 20th-/21st-century neuroscience; some of his comparisons strike me as of dubious validity. Do 20th-century theories of synaptic function really make ‘Enlightenment discourses ... spring back to life’ (p. 211). It is not necessary to be ‘tolerant’ of the fact that the views of an 18th-century author such as Nicholas Le Cat do not altogether tally with current notions. The more interesting question is why the views of the body prevalent in a particular period made sense at the time.
Nonetheless these essays demonstrate an impressive breadth of learning and a determination to unite the study of areas of culture that are too often deemed to be incommensurable. An interdisciplinary approach of this kind enriches our understanding of both science and literature. It may even occasion reflection on the historical roots of some of our most deeply embedded notions of self and personality.
Solomon Posen's The Doctor in Literature is altogether more modest in its ambitions. It is the first of a projected series of volumes exploring the way various aspects of medical practice have been depicted in (mostly) fictional writings. Posen confines himself to works written in or available in English translation—although a number of French sources are included. Even with this limitation there is no lack of material: he points out that there are more than 1000 works of fiction in which doctors figure as principal characters and many more where some aspect of medicine plays a more peripheral role.
Posen's stated goal is to identify recurring themes in the depiction of doctors and their relations with patients. He maintains that such motifs can be traced in writings throughout history from classical to modern times. The focus of the present book is on the degree of ‘Satisfaction or Resentment’ that both medical practitioners and patients derived from their interactions. Posen has compiled some 1500 passages drawn from 600 works to explore these issues. These have been organized thematically into chapters with such headings as ‘The Physician's Fee’, ‘The Bedside Manner’, and ‘The Physician's Social Status’. Rather than provide extended extracts from his selected works, Posen opts to connect brief passages with his own expository text. Often the same book will crop up in more than one chapter because it bears on several of the themes the author wishes to illustrate.
The end result is a book that is both enjoyable and informative to read. Those interested in the literary depiction of the patient–doctor relationship will in particular find this a valuable resource. I, for one, was intrigued to learn that Georges Simenon's The Patient contains an account of the neurological examination of an aphasic written from the patient's point of view. Posen is careful to point out that ‘Literary representations of doctors and their activities are not historical or medical records’ (p. 2). Nonetheless, a work such as George Eliot's Middlemarch can yield valuable insights into the varieties of 19th-century medical practice.
Posen's method and conclusions do give rise to some misgivings. Each chapter concludes with a brief summary of what has been learned from the preceding discussion. Thus at the end of the chapter on ‘The Bedside Manner’ we are told that ‘While some fictional physicians conduct themselves suitably towards their patients, many do not’ (p. 93). Such desultory remarks are fairly typical of the conclusions at which Posen arrives. Given the vast labour that has clearly gone into this enterprise such results seem oddly inconsequential; one might reasonably hope for more penetrating insights. In part, the problem derives from the detachment of works written in widely separated places and periods from their contexts. Posen may maintain that there are certain universal themes that transcend time and space. Thus quotations drawn from very disparate works can serve to illustrate the same point. The full import and interest of any piece of literature can, however, only be derived from a close attention to the historical setting from which it emerged. A reading of Gustave Flaubert's Madame Bovary is, for instance, much enhanced by knowledge of 19th-century theories of female hysteria. It may perhaps be unfair to expect this level of analysis from a book that professes to be a work of reference, not an academic monograph. A certain unease is, however, occasioned when a 20th-century novelist's depiction of the views of an 18th-century practitioner are cited with no apparent sense of the interpretative issues that arise (p. 217).
David Barash and Nanelle Barash's Madame Bovary's Ovaries is something of an oddity. The authors maintain that literary criticism is in need of some grand unifying interpretative perspective. In their view, such a source of insight is to be found in the findings of contemporary evolutionary biology. While human nature may have been somewhat modified by civilization, ultimately we remain the products of the evolutionary past indelibly encoded in our DNA. Literature of all epochs and locales, if it is truly ‘great’, must in some way reflect the truths of this universal human essence. In the authors' words, ‘Even the loftiest products of human imagination are, first of all, emanations of that gooey, breathing, eating, sleeping, defecating, reproducing, evolving, and evolved creature known as Homo sapiens’ (p. 8). The reason why certain venerable works, such as the plays of William Shakespeare, are still seen as relevant is precisely because they provide faithful representations of aspects of our biological being. This somewhat ahistorical view of literature makes for some strange bedfellows. We, are for instance, advised that Homer and Marcel Proust are ‘of one blood’ (p. 33), despite the manifest differences between the two (leaving aside the question of whether ‘Homer’ was an individual author or merely a label attached to a collective literary tradition).
Barash and Barash do not claim that evolutionary theory should provide the sole resource for understanding literature, but insist that it does offer ‘a useful tool to add to each reader's kit’. The only test of such a proposal is how useful the proffered tool proves in practice. The authors subject the works of authors ranging from Jane Austen to Mario Puzo to a Darwinian analysis. It has to be said that the results are not impressive. It is no doubt in the case that at some, rather banal, level Shakespeare's Othello is ‘about’ male sexual jealousy—a trait that is not exclusive to humans, and which can be accounted for in terms of an instinct to ensure the transmission of an individual's genes. In other words, ‘The truly important thing about Othello wasn't the color of his skin, his age, or his war record. Rather, Othello was all about sperm; Desdemona, eggs’ (p. 15).
While this summary has the advantage of being concise, it hardly constitutes much of a recommendation to view or read the play. Indeed it serves rather to drain the work of the fascination and richness that it undoubtedly possesses. Moreover, it is far from clear that disquisitions about sexual dimorphism among primates, or even a helpful footnote on the versatility of the avian cloaca, do much to enhance our understanding of a complex, challenging, and ultimately inscrutable, text. What can the Darwinian say, for instance, that will explicate the malice of Iago? No doubt some tortuous analogy to competitive behaviour among bull elk (urine spraying?) could be contrived. But this still leaves the same question of what if anything is gained by the exercise.
The authors adopt a jaunty, sometimes flippant, style. Emma Bovary, we are told, was promiscuous ‘because deep inside (in the DNA of her brain) she heard a subliminal Darwinian whisper that tickled her ovaries...’ (p. 101). Such joviality strengthens the lurking suspicion that they are not altogether in earnest. Let us hope so. If, on the other hand, this is a serious assertion that biologists should in future diversify their efforts into literary criticism, then the advice must be do not give up the day job.
Wellcome Trust Centre for the History of Medicine, University College London, London, UK
Email: s.jacyna{at}ucl.ac.uk
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