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THE BODY IN THE LIBRARY

By Suhayl Saadi
Contact the author by e-mail at christopher.johnstone@ntlworld.com

The key image in Iain Bamforth’s ‘The Body in the Library: An Anthology of Modern Medicine’ is that of the priest-king and neurologist, Professeur Charcot, striding through fin de siècle Paris, accompanied by his assistants, Babinsky and Giles de la Tourette, his stock defined by equal streaks of genius and petty tyranny, and, in Leon Daudet’s absinthe words, “haunted by some kind of immense dream”. Opening ‘The Body in the Library’ is like embarking on a journey through the melancholy corridors of greatness, cartographed as a long retreat from the supernal. The situation, theory, practice, philosophy, the humour, tragedy, high and low farce, in short the library, of medicine is stripped, expounded, dissected, examined, internalised, externalised, semanticised, romanticised, scanned, microscoped, proctoscoped, magnetised, resonated, howled, raged, infected, bled, cupped, league-tabled, corporatised, hallucinated, dreamed anew, debunked, exploded, imploded, turned around, shaken, mixed and centrifuged with two phials of digitalis and one of laudanum. From 1789 to 2003, seventy authors come at their subject from every conceivable angle. Through essays, poems, novel extracts, short stories, vignettes, letters, biographical excerpts, even a German cabaret sketch, we trip like a lysergic Dante through a long duo-century of Year Zeroes. To quote Portuguese otolaryngologist and diarist, Miguel Torga, from his illuminative and hugely moving diary of the extremes and banality of a 40 year career (humility, sacred paradox, aspects of grace and the terrible frustration of the writer drowning in an ocean of nasal pus), “the universal is the local without walls”. Remember those difficult cuts through cold, dead flesh… the pungent acidity of the Anatomy Hall? Duality and dark silences. And so, we begin to dissect our deconsecrated selves, and simultaneously we roll words into cigar-shapes à la Laennec.

!!Vive La Révolution!!
!!Violation is Revelation!!
!!Violation is Devotion!!
!!Violation is Truth!!

Basic Premise One: Western Medicine is ignorant of its past. Without Baghdad and Salerno, it would not exist. As Bamforth points out, “a bit of comparative ethnography would do wonders for Europe’s parochial physicians”. And his collection is refreshingly non-Anglo-centric. The breadth of his compass evinces the Franco-German, and later, the US, zeitgeist of the revolutionary world of the C19th and C20th centuries where constant change, a necessary forgetting, is the new comforter and where the dialectic of dirigiste and hero in a context of growing technical and philosophical sophistication (an “artificial zoology”) propels the discourse between society, medicine and literature. This is the syncretic narrative by which we have come to define our existence. Many of these writers capture the hallucinatory quality of the doctor, that presence which shifts in and out of the library of the body, simultaneously internal and external to her/himself. Bamforth opens up spaces where the reader can dance with the asthmatic cadences of Proust in his discursively neurotic prodrome of Günter Grass; as with the ‘illiterate’ writer, the best clinician is an ‘imbecile’.

Basic Premise Two: Medicine is inherently a political process. What the Dickens! In ‘The Black Veil’, moralistic old Charlie D sculpts the figure of the liberal doctor-hero, saviour of the dystopolis; the other side of the diaphragm is George Eliot’s portrayal of Doctor Lydgate, the failed modernising surgeon of Middle England (pen-pal, surely, of Charles Bovary). Prefiguring of the work of both Cronin and Che, writers such as Samuel Butler satirised Victorian values and posited the physician as subversive, while Lytton Strachey’s ‘Florence Nightingale’ reads like a hagiography of Saint Theresa of Avila steeped in a fount of unholiest irony. A decade before the onset of World War One, Canadian physician William Osler penned a powerful polemic against nationalism - a message no less relevant today. The power of Anton Chekhov’s tuberculous ‘Letter from Siberia’ resides in the detail; it is quite fascinating to learn that in 1890, in the distant and wind-blistered peninsula of Sakalin, the railway station had a Complaints Book. The psychotic effects of solo general practice in Smolensk in 1916 prompted Mikhail Bulgakov’s short story, ‘The Killer’, where the awful dung and flesh of war makes the reader feel that they can smell, taste, the blood, while in a letter to her sister, novelist and playwright Fanny Burney depicts the “horrour” of her pre-anaesthetic breast operation. As Bamforth says, Medicine is indeed “an education of the senses”. In ‘The Curse of Eve’, Conan Doyle, that “repairer of destinies”, writes like Zola about the immanence of tragedy in the birth of a human being, while Kierkegaard spins an existentialist analysis of ‘demonic’ human singularity in the face of the euphemistic science of the mean. It is salutary to learn that between 1936 and 1976, in Sweden, the sinister eugenicism of ‘Doctor Glas’, the fictional creation of Hjalmar Söderberg, became actual government policy: Knowing Me, Knowing You.

In our own era of boundless stratification, G. K. Chesterton’s tirade against social utopianism as misguided anthropomorphic therapy poses the question: “What is wrong that we do not ask what is right?” How apt that in ‘Poem 443’, Emily Dickinson already had lain bare the semiotic dilemma of knowledge as happiness. Following WW1, in the shocking night café, Gottfried Benn drinks Turkish black with Dali and draws hard the dark-eyed circles of objectification: the great medical dreams of the C19th have been melted by the firestorm, down to “the only molar of a whore”. The Jesuitical triumphalism of Jules Romains’s character, Knock, is clearly a parable of political dictatorship. In more hermeneutic vein, Kafka exploits the ‘rum and snow’ insecurities of the night-visiting doctor in the immediate confines of the patient’s and their relatives’ thinking, to set in motion an elemental tautology of blame and devotion: “It can’t be made good, ever again”. Brecht and others condemn the medical profession’s cosy alliance with the bourgeoisie, while William Carlos Williams’s harrowing story of infant death during the Great Depression is told without sentiment, straight as the gleam in a dead child’s eyes, prose as only a poet can write it. We can no longer be so honest about our mistakes.

Alfred Döblin’s reflective musings in the clinic mirror in Berlin; writer-as-doctor and doctor-as-writer; construct a Borgesian dialectic of the self which makes possible the compartmentalisation necessary for great literature, while Robert Musil’s witty 1929 critique of psychoanalysts as “soul improvers”, prefigures the (hieroph-)antics of Woody Allen. Continuously conscious, Virginia Woolf explores the relationship between illness and the hyperawareness of language, and the interplay of this relationship with the “make-believe, the concealing, cautious respectability” of health; this fevered, intra-textual Bloomsbury semiotic is the fleeting, mystic psalmody of our world. In 1936, Gottfried Benn engages imaginatively with the New Science of quantum mechanics and uncertainty, applying its principles to the complex, ineluctable subject of… warts. The body as inner principle, metaphysical blueprint, oh, and diorama of capitalism/materialism/utilitarian positivism. Never again will I look at a Wart Clinic in the same way!

Like Flaubert, W. H. Auden came from a medical family. In his poem, ‘The Art of Healing’, he says,

“Healing”
Papa would tell me,
“is not a science,
but the intuitive art
of wooing Nature.”

Going even more ‘Complementary’, R. D. Laing’s visceral vignettes of Glasgow rock you back with their tenderness and humour. From Torga’s diary entries, through Laing’s pictures to John Berger’s lucid depiction of rural Middle England in the 1960s, we learn that “remoteness has little to do with mileage. It is a reaction to economic power.” In Berger’s view, the GP “becomes his patients’ objective memory, because he represents their lost possibility of understanding and relating to the outside world, and because he also represents some of what they know but cannot think”. This sounds like a definition of the role of the writer in society. Ex-priest and anti-medical establishment icon, Ivan Illich took over in the 1970s where Laing had left off, but Anthony Daniels’s obituary takes care not to throw the baby out with the bathwater.

Basic Premise Three: Medicine is humour; Medicine is death. Through tales of twenty-four urine collections, loculated psychoses, the terrified pomposity and self-regarding seriousness of www.hypochondriasis.com, the growing need for illness as both fable and social interlocutor, Gogol’s itinerant nose, the buffoonery of pokers and prodders and hawkers of ray machines and nostrums, the devils dancing like snakes on the tails of hypodermics, the seeping medicalisation of life and literature, Paul Valéry’s Socrates who announces: “Flight… is in the nature of physicians”, I, the reader, feel that my head must be made of wood (but then, I’m just a writer), never having known what a ‘texticule’ was (let alone dared say it) until I read this book. I blame it on the process of Embourgeoisment delineated brilliantly by Jean Reverzy in his texticule, ‘The Doctor and Money’:

The monotony of his occupation, the most demanding of all, is also a threat to his intelligence. The automatism of saying the same things over and over again has reduced him to this paradoxical situation: he is a man attached to the bourgeois values of fame and fortune who, nevertheless, in practicing his profession, observes at every moment life escaping him, beyond capture.

Ah, yes! Three o’clock, Friday afternoon. Staring into the needle eyes of a spaced-out, consumerist junkie prompts the metaphysical question (probably sounds better in French): Why am I here? Berger’s ‘Clerk of their Records’ also showed me just why it is I loathe those DIY/gardening/cookery/occupational TV programmes that over the past decade seem to have drowned our screens in a welter of apotropaic ordure. It is both aetiology and symptom; an overwhelming ocean of inarticulacy, a loss of “spoken proverbial traditions” with no “opportunity of discovering the existence of a written cultural heritage”. The corollary of this resides in Dr Bert Keizer’s eloquent condemnation of the tyranny of the evidence-base in its blind application to the dying, an autocracy of thought stemming from an inability to comprehend the nature, philosophy and poetry of death.

As the C20th wears thin, death turns numinous. Through Orwell’s “dark patch” of fear that lies just below the surface in a French public hospital, Louis-Ferdinand Céline’s urban dystopic ‘Voyage to the End of the Night’, the ‘familiar stranger’ of Dezsö Kosztálanyi, Ceronetti’s “apparition of matter”, and an intensely moving excerpt from Camus’s great Stendhalian parable, ‘The Plague’, we are brought by Jean Stafford before the countenance of “pain… that passes words”.

Basic Premise Four: Medicine is now post-modern. As Bamforth says: “The body was removed from the library long ago; it is the library in the body which is now our preoccupation”. In this spirit (in this body), Gael Turnbull wheels us on a renga platform through a month in practice in a Worcestershire market-town, and Dannie Abse’s uterus wanders from white coat to purple mantle. Oliver Sachs delves into the interstitial neuro-anthropological narratives of holistic rationality bequeathed him by Kurt Goldstein in opposition to the nostrums of mechanistic medicine, while in the spirit of Dadaist doctor, Richard Huelsenbeck and in search of Reich’s orgone, microscopist Miroslav Holub methodically drives his “silver bulldozer” over darkness’s edge; no wonder Susan Sontag argues, cogently and convincingly as always, of the powerful significations of metaphor in medicine. In the swaying scriptorium of bodies that is the waiting room, as well as on the inner shrine of the consulting table (up by the certificates and the family snapshots), Martin Winckler’s nakedly honest ‘Afflictionary’ should be a required text.

Beyond the span of all bibliothèques, where even Vesalius’s skeleton has crumbled to dust, there is not Thantos, Mors, Anubis, Azrael, Yama or Hel, but Dr Jonathan Kaplan, ‘Working Underground’ amidst the airless sterility, the inhuman resources, of corporate Occupational Health. Dieu! You have to be positively psychedelic to survive in environments like those!

Stealing minutes in the usual way, I read part of ‘The Body in the Library’ one melatonin-deprived night at 04:32 a.m.; other bits were imbibed in the dark heart of a building built to resemble a Venetian jewel box; yet others, I partook in the midst of my own, physical library while simultaneously immersed in acid music: One book makes you larger, and one book makes you small…

In his eloquent Introduction, Bamforth sets the works in historical context and draws up the philosophical parameters of their inclusion: “Medicine is indeed a library, but it has to be read in the right way”. In making his selection, prudently he has avoided the Whig tale, the soap opera, the tedious homily and any whiff of puerile ‘medical’ humour. The melodrama of chirurgery, for example, is well-represented but not overdone, and always, is viewed through literary eyes. He has allowed many different voices to come through, some belonging to the famous, others to the obscure. And drawing, perhaps, on theological precedent, all the narratives are pitched at that strange, glimmering region which lies somewhere between philosophy and flesh, the place we call humanity. This book makes you larger.

Oh, and do remember to laugh – but not too loudly. You might wake Maître Charcot.

Iain Bamforth’s book The Body In The Library: A Literary History of Modern Medicine is published by Verso, £20.00

Suhayl Saadi’s first novel Pyschraag is published by Black and White, £12.99

www.suhalysaadi.com

Other hoolet online articles by Suhayl Saadi can be found at:
hoolet edition 46 - Review of "The Blue Moon Book"
hoolet edition 37 - Keats 'n' Me
hoolet edition 32 - Words of Healing
hoolet edition 31 - Book Review: ‘Lanark; A life in 4 Books‘ by Alasdair Gray
hoolet edition 30 - ‘The Burning Man‘ by Suhayl Saadi - Reviewed by John Montgomery
hoolet edition 29 - The Fall

hoolet is the magazine of RCGP Scotland. It is supported intellectually, financially and emotionally by RCGP Scotland.

This issue maintained by Robert Hallam.