'Have a Book Open on Your Dressing Table'

All the inhabitants of my private pantheon are writers. Even Abraham Lincoln and Louis Armstrong wrote better-than-serviceable prose. Shoulder to shoulder with the more obvious characters – Dr. Johnson, Chekhov, Zbigniew Herbert – is a figure best known as a pioneering, Canadian-born physician: Dr. William Osler (1849-1919). He was co-founder of  Johns Hopkins Hospital and established the first residency program for medical students. He was also a bookman, a musty term I’d like to see resuscitated. A reader, yes, and sometimes a book collector, but without the taint of pedantry or snobbishness. Someone whose sensibility is suffused with books, language and learning. 

About ten years ago I found a third edition (1932) of Osler’s extravagantly titled Aequanimitas, with Other Addresses to Medical Students, Nurses and Practitioners of Medicine, first published in 1904. I paid four dollars for it. The title word means “equanimity” or “imperturbability.” One of the lectures included is “Men and Books,” in which he quotes or alludes to Johnson, Bunyan, Milton, Cotton Mather, Horace, James Russell Lowell, Washington Irving and many doctors. At the end of the volume, Osler adds a “Bed-side Library for Medical Students.” He assures us a liberal education “may be had at a very slight cost of time and money,” urges medical students to “get the education, if not of a scholar, at least of a gentleman,” and suggests:

 

“Before going to sleep read for half an hour, and in the morning have a book open on your dressing table. You will be surprised to find how much can be accomplished in the course of a year.”

 

His Bed-side Library includes the Old and New Testaments, Shakespeare, Montaigne and Plutarch, among others. Elsewhere, Osler calls Burton’s Anatomy of Melancholy “the greatest medical treatise written by a layman.” He spent years searching for the books used by Burton, identifying 580 volumes in the Bodleian and 429 in the Christ Church Library. Osler was not a one-book man. After his death, Osler’s first edition of his favorite book, Sir Thomas Browne’s Religio Medici, rested on his coffin. On the night before his burial, his family was pleased that his body remained in the Lady Chapel at Christ Church, near Burton’s tomb and effigy.

 

I recommend William Osler: A Life in Medicine (1999) by the Canadian historian Michael Bliss. As a physician, we learn, Osler treated William and Henry James, Walt Whitman and James Murray, the founding editor of the Oxford English Dictionary, and he befriended Rudyard Kipling and Mark Twain. I also recommend A Way of Life and Selected Writings of Sir William Osler, which includes pieces on Browne and Burton. In the Browne essay, Osler indulges his love of fanciful convergences:

 

“The Anatomy of Melancholy, which appeared in 1621, must have proved a stimulating bonne-bouche [savory morsel or tidbit] for the Oxford men of the day, and I like to think of the eagerness with which so ardent a student as Browne of Pembroke would have pounced on the second and enlarged edition which appeared in 1624. He may, indeed, have been a friend of Burton, or he may have formed one of a group of undergraduates to watch Democritus Junior leaning over the bridge and laughing at the bargees as they swore at each other. It is stated, I know not on what authority, that Browne practiced in Oxford for a time.”

 

In a pleasing bibliophilic coda, the first biography of Osler was written by one of his students, Dr. Harvey Cushing (1869-1939), the American neurosurgeon. The two-volume work was published in 1925 and Cushing was awarded the Pulitzer Prize for biography the following year. In 2005, Michael Bliss published his biography of Cushing.

 

Osler was born on this date, July 12, in 1849.

'The Periganglionic Spaces of His Grey Cortex'

“With half an hour’s reading in bed every night as a steady practice, the busiest man can get a fair education before the plasma sets in the periganglionic spaces of his grey cortex.” 

I don’t associate reading with self-improvement and have never subscribed to the eat-your-broccoli-it’s-good-for-you school of thought when it comes to books. Reading, especially serious reading of worthwhile books, is its own reward. If you want to ensure your kids remain lifelong aliterates, order them to read, turn it into an obligation and leach all the pleasure from what ought to be one of life’s chief consolations.

 

The sentence quoted at the top is spoken by Dr. William Osler (1849-1919) in Dr. Harvey Cushing’s biography of his former teacher, The Life of Sir William Osler (Oxford University Press, 1925). The thought is preceded by this context provided by Cushing, an eminent neurosurgeon:

 

“He emphasized the importance of reading as a part of post-graduate study. . . . The average non-reading doctor might play a good game of golf or of bridge, but professionally he was a lost soul. The driven or tired practitioner might plead that he could not find the time to read.”

 

Osler (1849-1919) is one of those fascinating men who turned a non-literary profession into literature, and was himself an inveterate reader, antiquarian and bibliophile. Among his favorite writers were Montaigne, Shakespeare, Robert Burton, Sir Thomas Browne, Sterne, Swift, Coleridge, Keats and Lamb. He wrote nearly as often about books as medicine. I’m not qualified to judge whether this statement by Osler, also from Cushing’s book, is true:

 

“Books are tools, doctors are craftsmen, and so truly as one can measure the development of any particular handicraft by the variety and complexity of its tools, so have we no better means of judging the intelligence of a profession than by its general collection of books. A physician who does not use books and journals, who does not need a library, who does not read one or two of the best weeklies and monthlies, soon sinks to the level of the cross-counter prescriber, and not alone in practice, but in those mercenary feelings and habits which characterize a trade.”

 

I once had a Syrian-born cardiologist who enjoyed talking about Shakespeare's work, including Othello’s final speech: “that in Aleppo once . . .”

 

The Canadian historian Michael Bliss in his William Osler: A Life in Medicine (1999) tells us Osler treated William and Henry James, Walt Whitman, and James Murray, the founding editor of the Oxford English Dictionary. He socialized with Mark Twain and Rudyard Kipling, was partly responsible for getting Gertrude Stein kicked out of Johns Hopkins University (bless him), and even shows up in Finnegans Wake: “The ogry Osler will oxmaul us all.”

 

In 1892, Osler published The Principles and Practice of Medicine, a 1,050-page medical textbook he wrote single-handedly. It remained the standard text for more than 40 years and stayed in print until 2001. Even in a textbook his bibliomania was evident. Bliss writes: “He mentioned historical figures ranging from Hippocrates, Mephibosheth, and Sir Thomas Browne, through Montaigne, Oliver Wendell Holmes, Coleridge, and Swift.”

 

Osler adored Tristram Shandy and in a paper devoted to birth injuries he included a footnote that “directed readers to the ravages of Dr Slop’s forceps . .  .” In addition, Bliss reports: “At times he admitted to whistling that he might not weep, like Uncle Toby in Tristram Shandy.” The biographer quotes this from one of Osler’s letters: “How I should have liked to get drunk with Charles Lamb.”

 

About that quote at the top: Osler refers to the brain and the motor neurons of the autonomic nervous system, located in the spinal cord and brainstem. He’s talking about loss of brain function, dementia, what used to be called senility.

[A reader in the comment section refer to Dr. Richard Selzer, whom I wrote about here.]

`Bibliomania Was the Hobbyhorse'

In the morning I worked in a grade-school library, shelving books and deleting others. The latter was unexpectedly satisfying. I waited for a good opportunity to get self-righteously outraged but it never came. Most of the books were moral tales from the Age of Diversity – awful preachy things unworthy of bright children. I passed the bar code of each castoff under the red light and an alarming red “DELETED” appeared on the computer screen, accompanied by a digitalized squawk. Using a heavy black marker I blotted out evidence of the library’s ownership and added it to the heap destined to go, I was told, to “charity.”

On my break in library limbo I almost finished reading William Osler: A Life in Medicine (1999) by the Canadian historian Michael Bliss. The history of medicine has always interested me more than its theory and practice, and Bliss is a master of documentation. He deploys it gracefully, working rich detail into a fluid narrative, and he isn’t afraid to digress. Bliss suspends the flow to touch on such matters as the 20th century’s Victorian inheritance, the evolving nature of doctor-patient relations, Canada’s cultural ties to England, World War I – and Walt Whitman. It turns out Osler (1849-1919) examined the poet several times at his home in Camden, N.J., introduced by Whitman’s acolyte, the Canadian psychologist Dr. Richard Bucke. Osler, who later came to admire Whitman’s poetry, wrote of him:

“[He] was a fine figure of a man who had aged beautifully, or more properly speaking, majestically, with a large frame and well-shaped, well-poised head, covered with a profusion of snow-white hair which mingled in the cheeks with a heavy, long beard and moustache….I left with the pleasant impression of having seen a splendid old man, and a room the grand disorder of which filled me with envy.”

Bliss informs us Osler also treated William and Henry James, and James Murray, the founding editor of the Oxford English Dictionary. He socialized with Mark Twain and Rudyard Kipling, was partly responsible for getting Gertrude Stein kicked out of Johns Hopkins University, and even shows up in Finnegans Wake: “The ogry Osler will oxmaul us all.” Seldom do I encounter a reader whose temperament and tastes in books are so closely aligned with my own. To encounter such bookish kinship is a pleasing shock, particularly when it comes in the form of a Canadian physician who died 90 years ago. Osler was an antiquarian and bibliophile. Among his favorite writers were Montaigne, Shakespeare, Robert Burton, Sir Thomas Browne, Sterne, Swift, Coleridge, Keats and Lamb. Bliss writes of his years in medical school:

“…Osler was well on his way to becoming a compulsive writer and reader, infatuated with the written and printed word. Or most words – he always remembered reading the [London] Times one October day in 1872 in a Tottenham Court Road teashop and being struck by a statement of John Ruskin’s to the effect that no mind could resist for a year the dulling influence of the daily newspaper.”

In 1892, Osler published The Principles and Practice of Medicine, the 1,050-page medical textbook he wrote single-handedly. It remained the standard text for more than 40 years and stayed in print until 2001. Even in a textbook his bibliomania was evident:

“He mentioned historical figures ranging Hippocrates, Mephibosheth, and Sir Thomas Browne, through Montaigne, Oliver Wendell Holmes, Coleridge, and Swift.”

Osler adored Tristram Shandy, and in a paper devoted to birth injuries he included a footnote that “directed readers to the ravages of Dr Slop’s forceps…” In addition, Bliss reports: “At times he admitted to whistling that he might not weep, like Uncle Toby in Tristram Shandy.” The biographer quotes this from one of Osler’s letters: “How I should have liked to get drunk with Charles Lamb.” And this refers to a time late in Osler’s life, after he had settled in Oxford:

“Back in his study at 13 Northam Gardens, Osler would have opened parcel after parcel of books shipped home from the antiquarian shops of France and Italy. Book collecting and the study of medical bibliography was now edging off his agenda the clinical case studies that had long ago overtaken the pathological work. Bibliomania was the hobbyhorse Osler rode for the rest of his days. In a talk about it, he suggested that one of the best features of British life was the tendency of physicians to have hobbies.”

After Osler’s death, his first edition of his favorite book, Browne’s Religio Medici, rested on his coffin. On the night before his burial, his family was pleased that his body remained in the Lady Chapel at Christ Church, near Burton’s tomb and effigy. I found a copy of A Way of Life and Selected Writings of Sir William Osler, which includes the learned, loving essays Osler wrote about Browne and Burton. In the Browne essay, Osler indulges his love of fanciful convergences:

“The Anatomy of Melancholy, which appeared in 1621, must have proved a stimulating bonne-bouche [savory morsel or tidbit] for the Oxford men of the day, and I like to think of the eagerness with which so ardent a student as Browne of Pembroke would have pounced on the second and enlarged edition which appeared in 1624. He may, indeed, have been a friend of Burton, or he may have formed one of a group of undergraduates to watch Democritus Junior leaning over the bridge and laughing at the bargees as they swore at each other. It is stated, I know not on what authority, that Browne practiced in Oxford for a time.”

In a pleasing bibliophilic coda, the first biography of Osler was written by one of his students, Dr. Harvey Cushing (1869-1939), the eminent American neurosurgeon. The two-volume work was published in 1925, and Cushing was awarded the Pulitzer Prize for biography the following year. In 2005, Bliss published his biography of Cushing.

`Have a Book Open on Your Dressing Table'

“For the general practitioner a well-used library is one of the few correctives of the premature senility which is so apt to overtake him. Self-centered, self-taught, he leads a solitary life, and unless his every-day experience is controlled by careful reading or by the attrition of a medical society it soon ceases to be of the slightest value and becomes a mere accretion of isolated facts, without correlation.”

On the self-help shelf in the library bookshop I found a third edition (1932) of William Osler’s extravagantly titled Aequanimitas, with Other Addresses to Medical Students, Nurses and Practitioners of Medicine, first published in 1904. We no longer expect doctors to be literate (or writers to know anything about medicine and science), though recently I interviewed the nation’s top thrombosis man and learned not only that he once treated Mikhail Gorbachev but has read all of Solzhenitsyn in English. At my urging he’s now reading Dead Souls. He had never heard of Osler (1849-1919).

I paid four dollars for the book. On the endpaper in black ink is inscribed “Ralph M. Lechausse, Richmond, Va. 1935.” Below that, in the same hand: “To A.B. – Montreal Oct. 1936.” The identity of “A.B.” is revealed at the bottom of the endpaper in another hand: “A. Bernard Gray.” Tucked between pages 436 and 437 is a memo written on the letterhead of “Eli Lilly and Company, Indianapolis, U.S.A.” It’s dated “Nineteen Thirty-Five,” addressed “Dear Doctor,” and begins:

“Together with congratulations on your attainment of a medical degree, this volume of addresses by Sir William Osler, who adorned your profession in the United States for many years, is cordially presented.”

Here is the third of four paragraphs:

“May you share with him his `relish of knowledge’ and his absorbing love and passionate, persistent search for truth.”

One can hardly imagine the world suggested by this gift and message, even if we dismiss it as promotional boilerplate. It implies respect for a physician dead sixteen years and a pharmaceutical company’s understanding that a collection of his medical addresses might constitute “graft.” Also, that a doctor might be engaged in a “search for truth.”

One of Osler’s lectures is titled “Men and Books,” from which the passage quoted above is taken. In it he quotes or alludes to Dr. Johnson, Bunyan, Milton, Cotton Mather, Horace, James Russell Lowell, Washington Irving and many physicians. Osler writes: “I should like to see in each library a select company of the Immortals set apart for special admiration.” At the end of the volume, perhaps to clarify that by books he means more than just medical texts, Osler adds a “Bed-side Library for Medical Students.” A liberal education, he assures us, “may be had at a very slight cost of time and money.” He urges medical students to “get the education, if not of a scholar, at least of a gentleman,” and suggests:

“Before going to sleep read for half an hour, and in the morning have a book open on your dressing table. You will be surprised to find how much can be accomplished in the course of a year.”

Here is Osler’s prescription for a liberal education:

I. Old and New Testament.
II. Shakespeare.
III. Montaigne.
IV. Plutarch’s Lives.
V. Marcus Aurelius.
VI. Epictetus.
VII. Religio Medici.
VIII. Don Quixote.
IX. Emerson.
X. Oliver Wendell Holmes—Breakfast-Table Series.

[An eagle-eyed reader in Dallas informs us that Dr. A. Bernard Gray, an orthopedic surgeon, died last March at the age of ninety-eight: "During his lifetime of medical practice he treated many patients who were unable to pay, and performed many unique and creative surgical procedures.  Bernard was not only a man of great professional accomplishment and dedication, he was a loving patriarch.  His family was his greatest pleasure." Read his complete obituary here.]

Radio Days

Imagine a time when a professor of classics at Columbia University was given a weekly radio show and the only stipulation was that he confine himself to “books of a high standard or else open up some question of broad literary or social interest.” The time was 1952, the professor was Gilbert Highet (1906-1978) and the show was broadcast Tuesday evenings at 9:05 p.m. on WQXR in New York City. It aired on hundreds of stations in the U.S. and Canada, picked up by the Voice of America and BBC, and ran through 1959. Highet edited his radio talks into essays and published them in five volumes: People, Places, and Books (1953), A Clerk of Oxenford (1954), Talents and Geniuses (1957), The Powers of Poetry (1960), and Explorations (1971).

His best known book is probably The Classical Tradition: Greek and Roman Influences on Western Literature (1949), but the one I remember most fondly is Poets in a Landscape (1957). On an impulse I took the first three volumes of Highet’s radio essays from the library and have been pecking through them in search of subjects that interest me but also trying to project myself into the mind of a radio listener in 1952 (the year I was born) who tuned in to such fare. Even as edited for print, Highet’s essays are conversational, not scholarly. There’s a suggestion of educated folksiness about them, but he never condescends and often makes flattering assumptions about listeners’ literacy that would never work today.

Friday was the first day of summer, so I started with “Summer Reading” from Talents and Geniuses. Without identifying them further, Highet mentions Tolstoy, Mann, Hemingway, Céline, Malaparte, Spengler and Toynbee, among others. All are names most common readers would have recognized in the nineteen-fifties, even without having read their work. I confess the notion of “summer reading” has never made sense to me, but Highet ignores my bafflement. He assumes summer means leisure: “Peaceful evenings. Lazy week-ends. And, sometimes, quite long periods of emptiness. Vacant days,” and so on. I’ve never experienced anything like that in my life.

Highet moves on to an anecdote. He and his wife took a house on Cape Cod one summer, and the only book he packed contained the complete works of “an interesting Roman poet whom I had never really read.” It was a rainy summer and Highet claims he first read 20 years’ worth of Readers Digest he found in the house – all 240 volumes. Who in the book-chat business today would admit such a lapse? Then he took up his Roman poet, whom he read start to finish without explanatory notes or criticism:

“…it is also valuable to push directly through the works of a good author, trying to see them as a single creation, appreciating their wholeness and their uniqueness and leaving the details for later study.”

This is marvelous advice which I have followed only a few times (Shakespeare, Proust). Highet recommends it to his listeners/readers seeking suggestions for summer reading: Choose an “important author” and read all of his or her work. He argues that such a regimen helps readers to “escape from themselves.” As an alternative, he suggests reading about “one single important and interesting subject: for instance, the paintings of the cave men; or the agony of modern music; or the rebirth of calligraphy; or recent theories of the creation and duration of the universe.” Also excellent advice, but I’ve never been able to follow it for long. I get diverted and follow tributaries and leave the Mississippi behind. Here’s his third idea:

“…we might read a large selection of poems and prose passages selected in order to illuminate one single aspect of the world. One such volume would go into a pocket or a handbag and yet last all summer.”

For me, this poses the same difficulty as Highet’s second suggestion. I enjoy a good anthology but I pursue the selections that interest me to the exclusion of others. A dollop of, say, Swift or Coleridge, only stimulates my appetite for more. Highet’s final suggestion:

“…one might decide to spend the summer with a single great or at least a single interesting man. For example, every doctor should know The Life of Sir William Osler by Harvey Cushing, and after reading that fine book he would enjoy himself if he went on to read Osler’s own writings. Osler never tired of complaining that most doctors had minds too limited and too confined to the physical symptoms which they observed in the routine of their practice. He kept trying to enlarge his own mind and spirit, and his books will therefore enlarge the mind and spirit of his readers, whether they are of the medical profession or not.”

I like this idea best. Take note of the grand assumptions, almost unthinkable today, that Highet casually makes: “Every doctor should,” “he would enjoy himself,” “his books will therefore,” and so forth. Highet lived in a happier, healthier world in which scholars could safely assume substantial numbers of common readers sought pleasure and “self-improvement” in the books they read, and that they would find it. My own resolution for summer reading is Osler and Cushing, and we’ll see which tributary I end up following.

`I Would Rattle His Pedestal'

“Decided to give William Carlos Williams one more chance out of simple Christian charity. Reread half a dozen of his doctor stories, and no, I can live very well without W.C.W. They are slapdash and carelessly wrought. I would rattle his pedestal.”

I would as well. Most writers today are overrated but few as extravagantly so as Williams. He reminds me of the musical illiterate who sits at the keyboard plinking, without a thought for others in the room. His influence has inspired thousands of tin ears to imitate his anorexic lines in poems and prose.

For me, the sentiment quoted above reads like an echo of a twenty-three-year-old conversation. It comes from Diary (Yale University Press, 2011) by Richard Selzer, the retired surgeon and professor at Yale. In 1992, I interviewed him by telephone when he published a memoir, Down from Troy: A Doctor Comes of Age. Troy, N.Y., where Selzer was born in 1928, is just up the Hudson River from Albany. I worked as a reporter for that city’s newspaper, and read the book as local history. Selzer’s father was a general practitioner in Troy. The only thing I remember from the memoir is Selzer’s description of the contents of the senior Dr. Selzer’s medical bag: worthless. The effectiveness of medical science in the first half of the twentieth century was more wishful than real.

A few weeks later, Selzer came to a small town outside Troy to give a reading from his new book. I got there early and we took a walk. I brought up the topic of doctor-writers – Keats, Sir William Osler, Chekhov, Louis-Ferdinand Céline, Walker Percy – and I recall two of his judgments. In brief: Sir Thomas Browne, good. William Carlos Williams, bad. At least on this matter we were copasetic.

I’m skimming Selzer’s Diary. Unless one is already smitten with the author, one reads diaries, journals and collections of letters in search of small dazzlements or points of irritation. With a middling writer, expectations are low. Selzer’s mind and prose are not that interesting, and like most published diaries, his is a vanity project. He is a little too impressed with his own insights, but does tell a good story about surgically removing Robert Penn Warren’s gallbladder and a stone from his bile duct in 1954.

'Eating the Heart Out of a Subject'

While speaking with an engineering student the other day, I recounted to him the fate of Mr. Krook, brother to Mrs. Smallweed in Bleak House, who burst spontaneously into flames and was reduced to a heap of ashes. He listened patiently and when I finished asked, “Who is Dickens?” I was reminded of the time twenty years ago, while working for a university in upstate New York, when I mentioned to an engineering professor Kipling’s 1902 short story “Wireless,” one of his best. He replied, in effect, “Who’s Kipling?” 

I won’t fulminate about these men. Both are intelligent and personable. The student is still an undergraduate and likely to do well in life. Ignorance of once-popular English literature won’t hold him back, though I marvel at how far we have descended in a mere century. Incrementally, decision by decision, educators and others, abetted by parents, have made aliteracy the default setting for our brightest kids. This has nothing to do with the brouhaha over the “Two Cultures.” We’re left with less than half a culture.

 

One of the great synthesizing minds of that culture is the Canadian-born physician Dr. William Osler (1849-1919), who helped found Johns Hopkins Hospital and established the first residency program for medical students. This admirer of Robert Burton and Laurence Sterne, in Aequanimitas, with Other Addresses to Medical Students, Nurses and Practitioners of Medicine (1904), wrote a prescription for a liberal education:

 

I. Old and New Testament

II. Shakespeare

III. Montaigne

IV. Plutarch’s Lives

V. Marcus Aurelius

VI. Epictetus

VII. Religio Medici

VIII. Don Quixote

IX. Emerson

X. Oliver Wendell Holmes -- Breakfast-Table Series

 

You can quibble with specifics, but you get the idea. Osler’s suggestions find applications far beyond medicine – and engineering. Incidentally, Osler befriended Rudyard Kipling. I’ve written about him several times. In a 1921 lecture, “The Student Life,” he writes:

 

“Divide your attentions equally between books and men. The strength of the student of books is to sit still—two or three hours at a stretch—eating the heart out of a subject with pencil and notebook in hand, determined to master the details and intricacies, focusing all your energies on its difficulties. Get accustomed to test all sorts of book problems and statements for yourself, and take as little as possible on trust.”   

'How Much Can Be Accomplished'

Cleveland is traditionally divided between East Side and West Side. I’m a West-Sider, though I haven’t lived in the city since 1977. The designation suggests working-class neighborhoods, many of them Slavic. Ethnicity was important, and not usually in the sense of bigotry. I was second-generation Polish on my father’s side, which made me a Polack even though my mother was second-generation Irish. No one called me a Mick, despite my first name, and no one seemed to care that I was a Polack. The neighbors were Slovak, Czech, Ukrainian, Polish and Slovenian. The arrival of an Italian family in the neighborhood – including my classmate, Mario Lombardo -- was a notable event. 

My brother is a patient in the oncology unit of the Cleveland Clinic on the East Side. When I was a kid, the Clinic was a rumor, like the East Side itself. I remember passing it on the way to the Cleveland Museum of Art. Now it’s vast – 170 acres, and all the usual ratings rank it highly. I remember being encouraged to resent the East Side, thinking it was inhabited by snobs – a very human thing to do. Now I’m staying in one of its affiliated hotels. Every time I got lost on Monday, a doctor, nurse or volunteer (including a recent Boston University grad who is applying to medical schools) gave me directions. I don’t expect graciousness, patience and a smile in a hospital.

 

This spirit reminds me of a great hero of medicine, Dr. William Osler (1849-1919), a Canadian native. He was co-founder of Johns Hopkins Hospital and established the first residency program for medical students. He was also a bookman. A reader, yes, and sometimes a book collector, but without the taint of pedantry or snobbishness. Someone whose sensibility is suffused with books, language and learning. Years ago I found a third edition (1932) of Osler’s extravagantly titled Aequanimitas, with Other Addresses to Medical Students, Nurses and Practitioners of Medicine, first published in 1904. The title word means “equanimity” or “imperturbability.” At the end of the volume, Osler adds a “Bed-side Library for Medical Students.” His suggestions include the Old and New Testaments, Shakespeare, Montaigne and Plutarch, among others. He assures us a liberal education “may be had at a very slight cost of time and money,” urges medical students to “get the education, if not of a scholar, at least of a gentleman,” and suggests:

 

“Before going to sleep read for half an hour, and in the morning have a book open on your dressing table. You will be surprised to find how much can be accomplished in the course of a year.”

 

That BU grad who gave me directions was carrying a copy of Bleak House.

'Tell Me That I Have to Die'

Too many deaths and near-deaths of late. What a silly thing to say, as though the cessation of life should be evenly distributed according to some algorithm of happiness. Consider a friend, a former newspaper colleague in upstate New York. Her first marriage ended in divorce – a sort of death. Her second husband, a friend of mine, died miserably of multiple sclerosis more than twenty years ago. She thought she had lost her third husband last weekend – diabetes, multiple coronary and circulatory problems, massive nose bleeds, a premature release from the hospital. 

W.H. Auden’s father, Dr. George Auden, was a physician, and he often expressed interest in medicine and respect for good doctors. In the posthumously published Thank You, Fog (1974), in a section titled “Shorts,” Auden offers his comic vision of the ideal physician:

 

“Give me a doctor partridge-plump,

Short in the leg and broad in the rump,

An endomorph with gentle hands

Who'll never make absurd demands

That I abandon all my vices

Nor pull a long face in a crisis,

But with a twinkle in his eye

Will tell me that I have to die.”  

 

Bluntness, when honest and well-informed, is never hurtful. I’ve had too many doctors who euphemize and pussy-foot and deliver what they think are pep talks, which leave me feeling worse. I once had a Syrian cardiologist with whom I could discuss Shakespeare (“that in Aleppo once . . .”). I actually looked forward to seeing him. He never patronized me. In 1969, Auden published “The Art of Healing,” dedicated to his recently dead personal physician and friend, Dr. David Protetch. In the ninth stanza he writes:

 

“For my small ailments

you, who were mortally sick,

prescribed with success:

my major vices,

my mad addictions, you left

to my own conscience.”

 

I want treatment suggested, not mandated. His touch must be simultaneously light and authoritative – one of several reasons why I prefer nurses to doctors. Under the entry for “Medicine” in A Certain World: A Commonplace Book (1970),  Auden writes:

 

“I can remember my father, who was a physician, quoting to me when I was a young boy an aphorism by Sir William Osler: ‘Care more for the individual patient than for the special features of his disease.’ In other words, a doctor, like anyone else who has to deal with human beings, each of them unique, cannot be a scientist; he is either, like the surgeon, a craftsman, or, like the physician and the psychologist, an artist.”

'Confortable, Companionable, and Catholic'

It’s nice to have one’s unspoken and probably dubious thoughts confirmed. Most of the parlor games I indulge in are confined to my skull, never to be inflicted on the world. Then along comes Paul Jordan-Smith:

“One of the most fascinating occupations ever invented for the idle bookman is that curious speculation which concerns itself with attempting to elect, out of all the libraries in the world, the single volume which would yield the most permanent satisfaction to one cast upon a desert island.”

This is the first sentence of Jordan-Smith’s Bibliographia Burtoniana: A Study of Robert Burton’s ‘The Anatomy of Melancholy’ with a Bibliography of Burton's Writings (Stanford University Press, 1931). I remembered him from another Burton connection. In 1975, a friend showed me his 1927 edition of The Anatomy of Melancholy edited by Floyd Dell and Jordan-Smith, the first edition with the Latin translated (by Jordan-Smith). I had known of Dell through his dealings with Sherwood Anderson and Theodore Dreiser, and thought of him as a minor left-wing Chicago writer. Years later I bought a copy of their Burton. Jordan-Smith continues:

“And I believe that I, and at least two others, have at last settled the matter—for ourselves—by  choosing (not without longing eyes cast at Montaigne, Rabelais, Anatole France, Thomas Hardy, et cetera ad infinitum), as the most confortable [sic], companionable, and catholic of all good books, old Robert Burton’s The Anatomy of Melancholy.”

Jordan-Smith goes on to parade the names of the book’s eminent admirers: Dr. Johnson, Sterne, Keats, Lamb, Thackeray, Byron and Dr. William Osler. (I would add Anthony Powell and Alexander Theroux.) I no longer remember who or what introduced me to Burton’s Wunderkammer. I was a freshman and it might have been a stray reference in one of the writers just cited. I remember reading the Anatomy in an old three-volume edition borrowed from the university library. I always had a taste for books elastic enough to hold almost anything, and those that deliver equal parts question and answer. The Anatomy is on my short list of desert-island volumes, alongside others by Montaigne, Shakespeare, Johnson, Boswell, Gibbon, Melville, Proust. What do these books share? Apart from bulk, inexhaustibility. Imagine the poor soul who chooses the thriller du jour as company. Within hours the book is useful only as kindling.

Jordan-Smith’s book is less scholarship than celebration. Like many a one-book man, he is besotted with his author. He notes that Burton quotes roughly a thousand writers in the Anatomy and lists, alphabetically, the 122 most often cited, from Achilles Tatius to Zanchius. It’s a meta-book, a one-volume library, a dense core sample of one man’s learning and wit. It’s the sort of book Max Beerbohm called “dippable-into.” Jordan-Smith writes:

“Let, then, the man who intends setting sail for his secluded island home, where the sound of the motor horn and the whistle of the factory are not heard, take with him this incomparable volume of wit and wisdom, that he may know the delight of following that ‘fantastic old great man’ through his imaginary peregrinations where he steps from Atlantis into Eden and Eldorado, crosses the Southern Seas into the Unknown Austral Land, walks over China with Marco Polo, sports with hippogriff and mantichore [sic], flies from the callous folk in the island of Choa (where they ‘Oslerize’ the aged), and vaults into the Empyrean. He will then learn what ‘a most incomparable delight it is to melancholize, and build castles in the air . . .. led round about a heath with a Puck in the night.’”

`Like What I Expect an Angel to Look Like'

On the cover of the Jan. 11, 2012, issue of the Journal of the American Medical Association is Holbein’s portrait of Thomas Cromwell. In his accompanying essay on the painting, Dr. Thomas Cole writes of Cromwell’s likeness: 

“He looks like the sort of person who takes pride in his ability to get things done. His skin is pale (as though he spends most of his time indoors), his gaze penetrating, and his expression formidable—a poker face that reveals nothing. He could be plotting against his enemies, reading the mind of the king [Henry VIII], or preparing a brief for the law courts.” 

I gazed at Holbein’s painting and read Dr. Cole’s gloss while sitting in the hospital waiting room, waiting to have blood drawn. The magazine selection was narrow – JAMA, People – so I was pleased to see the hospital encourages customers to consult the profession’s best-known publication, a sort of Consumer Reports for the halt and lame. More than twenty years ago, covering medicine for a newspaper in upstate New York, I subscribed to JAMA and read everything in it I came close to understanding. Despite the noun-rich jargon and its embrace of political correctness, I enjoyed the journal’s veneer of William Osler-like civility and learning. 

In the same issue as Cole’s essay, in the “Humanities” section,  JAMA publishes under the rubric “Poetry and Medicine”  a poem by Joannie Kervran Stangeland, "Mantilla." I’m not sure I understand much of it but I like “An old woman said an apple / should never be eaten alone. / Could this be Biblical?” The question, I assume, is rhetorical. Stangeland concludes with “Later you can set out the Manzanillas.” The last word, from the Spanish for “little apples,” refers to a Spanish sherry. 

In “Shaker Light,” an essay collected in The Hunter Gracchus (1996), Guy Davenport recalls the entwined apple and pear trees that stood in a yard around the corner from his house in Lexington, Ky., growing in a “double spiral.” Throughout his work, Davenport treats apple and pear as primal symbols embedded in Western culture. In the Shaker essay he writes, “Apple is the symbol of the Fall, pear of Redemption. Apple is the world, pear heaven. Apple is tragic.” Like Joyce, Davenport venerates true symbols, and treats them with the respect due reality. He concludes the essay with these lines: 

“The day before yesterday this intertwined apple and pear were in full bloom. In every season these trees have been lovely, in autumn with their fruit, in winter a naked grace, in summer a round green puzzle of two kinds of leaves; but in spring they have always been a glory of white, something like what I expect an angel to look like when I see one. But I shall not see these trees again. Some developer has bought the property and cut down the embracing apple and pear, in full bloom, with a power saw, the whining growl of which is surely the language of devils at their business, which is to cancel creation.” 

Born Nov. 23, 1927, Davenport died on this date, Jan. 4, in 2005. I don’t have it here, but in a letter he wrote to me around 1991 after I’d sent him the draft of an essay I was working on, Guy reminded me not to be beholden to anyone, not even to my own “mind-forg’d manacles,” only to the words. David Myers puts it like this in Thursday’s barn-burner of a post: 

“For the writer (whose best readers are among the dead), freedom is an absolute.”

'For My Small Ailments'

Empathy, in some quarters, is becoming quite fashionable. Clearly, my doctor has been benefiting from professional development. When he enters the examination room we shake hands, he moves a chair to face me and sits almost knee-to-knee. This is to eliminate any suggestion of hierarchical intimidation. He looks me in the eye when I answer his questions and nods his head approvingly. I don’t mean to make fun of the guy but he’s a middle-aged physician acting like an earnest, eager-to-please resident. It’s faintly comical but I appreciate the effort. It beats the alternative – the doctor who appears impatient, distracted, bored or even contemptuous. Years ago, I expressed to a doctor my displeasure at undergoing a digital rectal exam of the prostate. His response, without a trace of irony or wit: “You better hope you stay out of prison.” Good advice, Doc.

While researching a story I’m putting together at work, I reviewed several medical journals and happened unexpectedly on “Clinical Empathy for the Surgical Patient: Lessons From W.H. Auden’s Prose and Poetry,” published in 2021 in Annals of Surgery. Before they get to Auden, the authors endorse the practice of “‘emotional resonance’ with a patient’s symptoms and suffering [and] the action of ‘checking back’ with the patient to confirm or correct this shared understanding.”

 

Auden’s father was a physician and the poet often expressed interest in medicine and respect for good doctors. In 1932 he published the long poem The Orators: An English Study, from which the authors of the journal article extract “Letter to a Wound,” in which the speaker addresses his wound as though it were a jealous lover. His visit to the doctor doesn’t go well. “The surgeon,” our authors write, “his only source of hope, excused himself from the narrator’s experience of suffering. In contemporary terms, the surgeon failed to co-author the narrative of illness with the patient and the narrator is dominated and defeated by the narrative of this experience.” In the vernacular, the surgeon is an uncaring jerk. “Letter to a Wound” is a failed satire, not a good poem.

 

In 1969, Auden published “The Art of Healing,” dedicated to his recently dead personal physician and friend, Dr. David Protetch. In the ninth stanza he writes:

 

“For my small ailments

you, who were mortally sick,

prescribed with success:

my major vices,

my mad addictions, you left

to my own conscience.”

 

Protetch represents the opposite approach to treating patients from the one described in “Letter to a Wound.” “Dr. Protetch’s understanding that he cannot fully comprehend or cure the most intimate of his patient’s torments,” the authors write, “is the essence of clinical empathy—the choice to surrender and support, rather than overpower and control the patient’s narrative of illness.” That “narrative” business is a little heavy-handed, a lapse into academicese, but we get the idea. As a patient, I want treatment suggested, not mandated. The best doctors’ touch is simultaneously light and authoritative – one of several reasons why I generally prefer nurses to doctors. Under the entry for “Medicine” in A Certain World: A Commonplace Book (1970), Auden writes:

 

“I can remember my father, who was a physician, quoting to me when I was a young boy an aphorism by Sir William Osler: ‘Care more for the individual patient than for the special features of his disease.’ In other words, a doctor, like anyone else who has to deal with human beings, each of them unique, cannot be a scientist; he is either, like the surgeon, a craftsman, or, like the physician and the psychologist, an artist.”

 

Auden was born on this date, February 21, in 1907 and died in 1973 at age sixty-six.