1926: Arrowsmith by Sinclair Lewis

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Plot Summary:

Arrowsmith tells the tale of Martin Arrowsmith fulfills a lifelong dream of becoming a physician with a passion for research. Combating the forces of ignorance and greed, he relentlessly pursues scientific truth, even in the face of his own personal tragedy.

My thoughts:

Martin Arrowsmith is an ambitious young medical student who rises through medical school, and works in just about every medical field available to him, mostly unhappily, until he is forced out by public opinion or personal dissatisfaction, and finally pursues research and must struggle with the conflict of pure medical research in the face of a devastating epidemic. Sinclair Lewis remains true to his sharp, satirical views of American populations, but instead of limiting it to small towns, like he did in Main Street, he fires his attacks almost indiscriminately, at small towns, larger towns, medical schools, country doctors, city doctors, public officials, and even scientific researchers. But the sarcasm seems tuned down throughout the novel (with a few almost outlandish characters being the exception), and the history of the medical profession in the early 20th century holds it all together in a cohesive whole.

Perhaps it is because I work in the medical field right now, and interact with a number of modern doctors, but this was a fascinating look at what medicine and doctors looked like in the 1910s and 1920s, and what microbiologic and bacteriologic research looked like through the 20s as doctors still struggled to find cures for many of the diseases that still ravaged populations in those days. In this regard, Sinclair Lewis was assisted in his descriptions of the scientific research, and at times even the scientists themselves, by Dr. Paul H. DeKruif, to whom the book is dedicated, and who received 25% of the royalties. DeKruif was a microbiologist and writer, who the next year would publish the bestseller Microbe Hunters, a non-fiction look at some of the most important figures in microbiology and their contributions.

The book is full of details behind the laboratory methods and research that was occurring at the time, obviously influenced by Dr. DeKruif, but Lewis keeps even those medical procedures interesting, in part because it isn’t meant to be an instruction manual, but in part because he often juxtaposes those scientific processes with characters who deride the detail and precision involved in one way or another, which adds a bit of levity, while placing the social critique square on the scoffers. But Lewis came from several generations of physicians, and so the scenes of country doctors and their characters, while reminiscent of some of the scenes in Main Street, now look at those doctors in the changing face of medicine in the United States.

Some of the most memorable characters are also some of the most absurd and frustrating characters in the book. There is the medical professor who gives a speech every year to his students about the importance of salesmanship to the doctor, of convincing patients they need small operations they really don’t need, so they feel appreciated, and don’t feel like their time is wasted going to the doctor. It’s the same professor who, after accepting a job at a medical furnishings company, gives a farewell address to the school about the importance of waiting room furniture in the doctor’s office. There is the public health administrator who creates ridiculous rhymes and jingles to remind the public of basic health safety (“Sell your hammer and buy a horn/But hang onto the old fly-swatter./If you don’t want disease sneaking into the Home/Then to kill the fly you gotter!”).

As Martin bounces around from job to job, he works as a country doctor, where he is ridiculed and pushed out by much of the same spite that Lewis wrote so well in Main Street. So he begins his work as a public official, but he lack of catchy jingles and his tendency to force healthy practices onto people whether they liked them or not, soon finds him kicked out of office. He works for a while as a laboratory technician for a firm that believed that “any portions of the body without which people could conceivably get along should certainly be removed at once,” but finally gets a chance to pursue his first desire in medicine: microbiology research. It is here that the novel really hits it’s stride. Lewis lampoons the rich people who fund the research and want to come around and watch the scientists work in their labs almost as though they are pets. He makes jabs at the scientists who are more interested in prestige and image within the department, and the attitude of publishing quickly without being certain of your results, just to make sure no one else makes the same discovery and publishes earlier. But he also looks with some sort of reverence, on the art of pure science and research, of replicating results, of using control subjects, and of using advances mathematics and chemistry to inform hypotheses.

As Martin pursues this line of research, he discovers a bacteriophage that may prove helpful in treating the plague, and caught up in the politics of the department, is sent off to an island in the West Indies to assist with the outbreak of the plague. He is faced from the beginning with the bureaucratic difficulties of establishing a control group who will not receive what they think will be a miracle cure for the disease, and when he finally begins a pure scientific study of the effect of his phage, he is thrown by his wife’s death and his carefully crafted experiment falls apart and produces inconclusive results as he struggles with the desire to establish the efficacy of his phage, and also to help as many of the infected as he can.

Arrowsmith is, at its core, a celebration of pure science and medicine research that uses the old pseudoscience medical practices, the idea of profit-centric medicine, and the ignorant and uninformed public as punching bags at which Lewis launches a number of satirical and sometimes outright mean attacks throughout the book. While enjoyable in it’s own right, the reliance on a medical field that is almost laughably outdated today could easily detract readers uninterested in medicine, especially historical medicine. But Lewis’s characters and sarcasm throughout make it approachable even for those who don’t know anything of medicine.

Favorite passage:

If in his house there was but one comfortable chair, on his desk were letters, long, intimate, and respectful, from the great ones of France and Germany, Italy and Denmark, and from scientists whom Great Britain so much valued that she gave them titles almost as high as those with which she rewarded distillers, cigarette manufacturers, and the owners of obscene newspapers.

Why you should read it:

While the level of satire is much lower than in his previous work, Main Street, it still shines through in style, as well as providing and interesting, important, and readable look at the history of medicine in the United States in the early 20th Century.

Currently reading: Early Autumn by Louis Bromfield

 

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