Lesley Thulin // The conversation surrounding biosecurity following the recent outbreak of coronavirus has prompted scholars to suggest the urgency of the medical humanities, a multi-disciplinary field that seeks to bring humanistic thinking to the clinical encounter. With the uptick in reported incidents of anti-Asian racism, a spate of violent protests related to epidemiological misinformation, and the prospect of a lurching global economy, coronavirus exceeds the disciplinary confines of microbiology. As Julian Sheather writes, “The outbreak of a serious infectious disease is not just a biomedical event. It affects people and their communities. It has meaning. It provokes passions. It drives people apart; it brings strangers together. Overwhelmingly it is a human event.”
The idea of approaching illness and disease as a “human” event isn’t new. Medical schools are pushing to integrate the humanities into their curricula, while hospitals are incorporating narrative medicine, a clinical approach that prioritizes cultural competence in the doctor-patient relationship, into clinical practice. Despite the relative newness of medical humanities and narrative medicine, however, their synthesis of the sciences and the arts precedes the humanities’ interdisciplinary turn, reaching back to at least the pre-disciplinary knowledge culture of the early nineteenth century.
One of Jane Austen’s favorite novelists, the Anglo-Irish writer Maria Edgeworth, participated in such thinking. As a product of the Lunar Enlightenment, Edgeworth wrote during a historical moment in which the boundaries between science and literature were blurred. Until 1750, James Chandler argues, “science” denoted “any systematically achieved knowledge, but especially…the various branches of philosophy” (Chandler 87). “Literature,” on the other hand, referred to “book learning, to polite or humane reading, especially in classical languages and literatures,” until the mid-nineteenth century (Chandler 88). After 1850, “science” would pertain to specific fields, such as physics and chemistry, while “literature” would become known as “a kind of writing that makes a special claim on our imagination and taste” (Chandler 88).
Although Edgeworth’s novel Belinda (1801) was published when the categories of science and literature were still in flux, it presents analogies between the good reader and the effective medical practitioner, as well as the good reader and the healthy layman. As a novel of manners that incorporates an illness narrative, Belinda chronicles the reform of Lady Delacour, a socialite who forsakes domestic life for the thrills of masquerades and public duels. But she harbors a terrible secret: Lady Delacour suspects that she is dying of breast cancer, yet refuses to submit to a proper medical examination. Instead, she numbs herself with quack-prescribed laudanum and develops a taste for Methodism. With the encouragement of her mentee, Belinda Portman, Lady Delacour finally allows the learned—and licensed—Dr. X to examine her, revealing that she’s cancer-free.
As a diagnostician, Dr. X relies on careful observation, suggesting its affinity with close reading—specifically, what Eve Kosofsky Sedgwick describes as paranoid reading, a hermeneutics of suspicion that relies on a “tracing-and-exposure” tactic (Sedgwick 124). Before Lady Delacour permits his examination, Dr. X sees through her façade, observing that her gaiety “does not appear…that of a sound mind in a sound body” (Edgeworth 115). As Edgeworth tells us, Dr. X is “[a]ccustomed to study human nature,” having developed a “peculiar sagacity in [the] judging of character” through his reading (Edgeworth 125). Known for his “great literary reputation” (Edgeworth 111), Dr. X brings the sensibility of an attentive reader to his clinical practice by thinking it “full as necessary…to attend to the mind as to the pulse” and suspects that Lady Delacour has lost her grasp on reality (Edgeworth 316). Ever the empiricist, however, he reserves judgment until the physical examination, demonstrating a habit of mind that, Ian Watt reminds us, would not only have been inculcated in scientific training, but also would have been formally reflected in the rise of the novel.
But Dr. X’s tracing-and-exposure tactic can only take him so far. As Edgeworth’s original sketch for Belinda states, Dr. X’s character is based on Dr. John Moore, a Scottish physician and novelist who was celebrated for his benevolence and insight into human nature. However, Moore’s own writing—even when it dabbled in romance—aimed “always to correct and reform” domestic matters, assuming a legislative role (Prevost and Blagdon xix).
Moore’s corrective vision for the novel is homologous with Dr. X’s role within Edgeworth’s plot, which reaches beyond that of a careful reader. After he uncovers Lady Delacour’s obsessive misreading of Methodist texts, invoking the religious tradition’s association with nervous distemper, Lady Delacour asks him to recommend a better librarian. Instead, Dr. X recommends a clergyman, convincing Lady Delacour of a chaplain’s merits by deferring to poetry: he recites a verse about the parson from Chaucer’s Canterbury Tales (1387). Adopting Moore’s moralistic attitude toward literature, Dr. X occasions Lady Delacour’s conversion from dissipation to virtue.
As his invocation of Chaucer might indicate, Dr. X draws from his non-medical education to care for Lady Delacour, calling to mind contemporary medical education’s aspiration to “treat the spiritual, emotional and physical aspects of…patients” (Kollmer Horton 3). But his regulation of Lady Delacour’s reading and insistent introduction of the chaplain evince his disciplinary orientation toward literature, shifting, perhaps, from the position of a good reader to that of a bad literary critic.
Bringing a specifically literary knowledge to his practice, Dr. X models how some of the habits of humanistic inquiry can contribute to medicine—to a point. As Sedgwick suggests, a strictly paranoid reading risks an ethical dead end. “Simply put,” she writes, “paranoia tends to be contagious; more specifically, paranoia is drawn toward and tends to construct symmetrical relations, in particular, symmetrical epistemologies” (Sedgwick 126). Dr. X’s paranoid reading mutates into dogmatic prescription, while the current strain of paranoid, anti-humanistic thinking about infectious disease seems to proliferate more quickly than its microbial counterpart.
Chandler, James. “Edgeworth and the Lunar Enlightenment.” Eighteenth-Century Studies 45.1 (Fall 2011): 87-104.
Edgeworth, Maria. Belinda. Oxford: Oxford UP, 2008.
Kollmer Horton, Mary E. “The orphan child: humanities in modern medical education.” Philosophy, Ethics, and Humanities in Medicine 14.1 (2019).
Rev. F. Prevost, and F. Blagdon, Esq. Beauties of Dr. John Moore; Selected from the Moral, Philosophical and Miscellaneous Works of That Esteemed Author. To which are added, a new biographical and critical account of the doctor and his writings; and notes, historical, classical, and explanatory. 2nd ed. London: Printed for B. Crosby and Co. Stationers Court, Paternoster Row By J. G. Barnard, George’s Court, Clerkenwell, 1803.
Sedgwick, Eve Kosofsky. Touching Feeling: Affect, Pedagogy, Performativity. Durham and London: Duke UP, 2003.
Sir Thomas Lawrence, Dr John Moore, 1730 – 1802. Physician and author. Courtesy of National Galleries, Scotland.