In January this year, the UK's Telegraph newspaper hailed George Eliot`s novel, Middlemarch, as the greatest novel in the English language, and one that should be part of everyone`s essential fiction reading. It is by all accounts a romance novel, but George Eliot's masterpiece,also looks keenly at the changing role of the doctor in 19th century England.
It was a time when doctors were not respected and barely tolerated in respectable society. Indeed, intelligent men from good families went into the clergy. But a growing class of doctors, particularly those trained in Paris, were agitating for greater professionalism and intellectual rigour in the practice of medicine.
Greater Professionalism for Doctors
Middlemarch is set in the 1820s. The august medical journal The Lancet, is already in existence and is mentioned by the novel`s reforming doctor, Dr Tertius Lydgate. At the time, the journal was calling for greater professionalism for doctors, and also for coroners to be medical specialists.Then, a coroner was usually a lawyer. Through Dr Lydgate, the reader learns that doctors in the early 19th century were little more than pill-pushers as it was where they earned their greatest income. We are told that "quackery prevailed in medicine".
Much to Dr Lydgate`s frustration, nobody sees the need for change. Certainly not the doctors, who cannot rely on their wealthy patients to actually pay for housecalls, nor the patients, who believe that a doctor only has their best interests at heart if they are prescribed pills, and the more, the better.
More in keeping with modern practice, Dr Lydgate believes a patient is best able to tell the doctor what is wrong with him, and the doctor's chief duty is to observe and catalogue. Oftentimes, the body will heal itself of disease if it is given time to rest and heal, Dr Lydgate says. This is why doctors should also be interested in pathology and anatomy. "The dark territories of Pathology were a fine America for a spirited young adventurer," the narrator observes.
Middlemarch also describes the dawn of medical specialisation, with Dr Lydgate working with a benefactor to establish a specialist "Fever Hospital" so that such patients can be treated seperately.
Lydgate`s Medical Crusade Fails
Emotionally obtuse, Dr Lydgate cannot quite understand why his beliefs do not win him more converts and friends among his medical colleagues. It is not surprising that he ultimately fails in his single-minded crusade to revamp medicine in Middlemarch. He is ultimately defeated by financial worries and his unsatisfactory marriage to the wrong woman, the spoilt and petted village beauty.
Unfairly dogged by a scandal which arises out of the unfortunate timing of a payment, he leaves Middlemarch tfor London, to pursue his medical practice along more conventional lines. He dies at 54, financially successful, but secretly convinced that he has sold out his research ideals for filthy lucre.
Virginia Woolf famously described Middlemarch as ``one of the few English novels written for grownups``, but it is also an interesting piece of writing that sketches the dawn of a changing medical profession.
Indrani Nadarajah - Indrani Nadarajah is a journalist with 15 years international experience. She has written extensively on the Australian and Asian ...
