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A Mutual Responsibility

In 1935, the poet A. E. Housman, then in his middle seventies, read Arnold Bennett's novel Clayhanger (1910), recognizing from a description in it that he had the symptoms of "Cheyne-Stokes breathing" Â— sleepless nights spent in paroxysms of failure of breath. Housman knew then that he would not live many more months. That a reader would learn his medicine from a novel is an arresting, but common, occurrence. Other than through the social give-and-take of conversation, most nonmedical people acquire their medical knowledge, and their ability, such as it turns out to be, to interpret the phenomena of their own bodies, from reading imaginative literature, such nonfiction as biography and history, and dramatizations of that writing in television and film. If for no other reason, that should be sufficient to put writers on their mark to do their homework as carefully as did Arnold Bennett. Fiction writers may feel that they need only be true to their invention and that they can indulge in wild extravagances of every kind for which they can find appropriate words. When novelists do so with medical matters, however, it may be at the risk of their readers. Biographers and historians have truth itself, so far as that can be determined, as their muse. But it is not enough to assume that motives and actions can easily and simply be attributed to such familiar impulses as politics, religion, lust, greed, or any other of dozens of conscious choices or logical reactions. The body (including the brain) behaves in strange ways when a part falters, and untrained observers may not know it. Biographers, who often do not have sufficient knowledge even to be suspicious about potential medical matters, must learn to become more and more questioning. And physicians must recognize a duty to guide when consulted by writers with legitimate subjects and problems. The writer innocent of clinical knowledge may be read by the Housmans of today and tomorrow.