Doctors' bodies of literary works

Culture Shock:The divide between art and science is being bridged by an ever fewer number of literary doctors

JB Lyons, who died on October 25th at the age of 85, was notable for two things he was and one he was not. He was both a distinguished consultant physician at St Michael's and Mercer's hospitals in Dublin, specialising in neurology, and a writer and critic, specialising in James Joyce. What he was not was all that unusual. Lyons, who explored the borderlands between writing and medicine with erudition and acuity, was part of a long tradition of literary doctors, and his death may mark the end of an era in which medicine and literature were not regarded as incompatible pursuits. If so, the result will be an impoverishment, not just of literature, but arguably of medicine too.

For three centuries, since the great Sir Thomas Browne wrote Religio Medici, which manages to be both a literary and a medical classic, doctors have had a disproportionate place in literary history. Three of the greatest playwrights of the 19th century were doctors. Georg Buchner, who invented modern theatre with Woyzeck and Danton's Death, was a professor of anatomy. His small body of works - he died at 23 - includes the paper On Cranial Nerves. Arthur Schnitzler, when he was not writing acerbic plays such as La Ronde, was a consultant laryngologist. And, of course, Anton Chekhov practised medicine for eight years.

The French novelist, Louis-Ferdinand Céline, was a doctor. The wonderful Czech poet Miroslav Holub was an immunologist. The American essayist Oliver Wendell Holmes was professor of medicine at Harvard. The poet William Carlos Williams was a GP. The novelist Walker Percy was a doctor until he himself was stricken with TB. In England, figures as diverse as Robert Bridges, Somerset Maugham and the inventor of the thesaurus, Peter Roget, all had medical training. In popular fiction, there is AJ Cronin and of course Arthur Conan Doyle, who modelled Sherlock Holmes's methods on the diagnostic techniques he learned in his own medical training. More recently, a polymath like Jonathan Miller has juggled theatre, medicine and psychiatry without dropping too many balls.

In Irish literature, there is the opthalmologist Sir William Wilde, father of Oscar, but an important writer in his own right; the novelist Charles Lever, and the surgeon, poet and memoirist Oliver St John Gogarty. The paediatrician Robert Collis, a crucial figure in the career of Christy Brown, wrote plays, among them, Marrowbone Lane, the pioneering denunciation of poverty in Dublin. Beyond them, there have long been figures such as Lyons or - thankfully still with us - the wonderfully erudite cardiologist Eoin O'Brien, president of the Irish Heart Foundation, who, in addition to 600 papers on hypertension, has written the single most important study of Samuel Beckett's relationship to his Irish roots, The Beckett Country, and published Beckett's first novel, Dream of Fair to Middling Women.

It is hard to generalise about the impact of such a diverse range of literary doctors, but it may not be too much of a stretch to say that there is a characteristic medical tone in some of this literature. With the obvious exception of the anti-Semitism that disfigures the legacy of both Céline and Gogarty, there is a common note of rational analysis. The verb "to anatomise" applies in both literary and medical fields and it applies to the searching, scrutinising gaze of a Buchner, a Holub, a Chekhov or a Schnitzler. There is also a tendency to see things as they are rather than as they are supposed to be, a distrust of rhetoric and the kind of frankness about sexuality that made Schnitzler such a shocking figure. But there is also a sense of compassion, an interest in the humanity of the individual, a non-judgemental embrace of the weaknesses, delusions and fortitude of real people that reaches its height in Chekhov.

If doctors have been good for literature, the reverse is also true. The broader tradition of doctors who read novels and poems, who were open to the kind of education in humanity that great literature provides, surely created good medicine. It did much to temper the narrow focus on the disease, rather than on the patient. Literature is, amongst many other things, a training in open-mindedness, in the art of entering into another person's mind and seeing things from their point of view. It has to have had a humanising effect on many doctors.

And the fear now must be that this tradition is petering out. The points race winnows out the generalist. The relentless demands of medical education leave little time to read anything but textbooks. The pace of medical change means that even qualified doctors are expected to constantly update their knowledge and skills. In an increasingly specialised field, even a medical generalist is regarded with increasing suspicion ("general surgeon" is becoming a term of abuse), so God knows how a doctor who writes poetry, or essays on Joyce, is seen by their peers.

Perhaps all of this is an inevitable consequence of the growth of knowledge that has made it ever more difficult for any individual to straddle the divide between the scientific and the artistic. But it does represent a double loss - of the dispassionate mind that doctors have brought to writing and the imaginative sympathy that literature has added to medicine. That's a wound that may be hard to heal.