Doctors Have Always Gotten a Bad Rap

In their 2013 guide to help physicians curate their online personas, Kevin Pho, M.D., and Susan Gay tell the story of a doctor who, upon Googling herself, finds out that she shares her name with an optometrist accused of deliberately blinding patients. In the age of WebMD, Twitter, and online rankings, the challenges of managing both one’s reputation and the endless stream of misinformation permeating the web have generated new ways of talking about medicine and its practitioners. Skepticism of medical doctors, however, has been around since long before the profession was recognized as such.

The Elisha Whittelsey Collection, The Elisha Whittelsey Fund, 1959

The standardization of technical medical training in universities was a late development in the Middle Ages, in part because many academics considered the activities of wise women and barber surgeons to fall below the study of Aristotelian natural philosophy, astrology, and religious council. Even after universities across Western Europe began teaching hands-on medical procedures, they struggled to obligate patients, including aristocratic and royal patients, to rely exclusively on those with degrees. Well into the fifteenth century, it was inconceivable to mandate that English medical professionals be university-trained. This was because, first, the institutions that gave out these credentials in England, Oxford and Cambridge, were far removed from the most populated areas like London. Second, these urban communities were far too vast to be served by the handful of medical graduates.

The works of two major fourteenth-century authors demonstrate that the skepticism and ridicule with which doctors are often treated to this day existed even as the occupation of the medical professional was still being defined. In his “General Prologue” to the Canterbury Tales, for instance, Geoffrey Chaucer heavily satirizes his Physician, who knows little of the Bible, dresses extravagantly, and reaps financial rewards from the plague. A trained alchemist, he uses his claimed expertise in the scientific properties of gold to benefit from its economic value: “For gold in physic (medicine) is a cordial,/ Therefore he loved gold especially” (1.443-44). Like so many of Chaucer’s professional academics in the Canterbury Tales, the Physician abuses his qualifications in order to line his pockets.

William Langland’s B text of Piers Plowman anticipates the “General Prologue”’s criticism of the Physician. In the last passus, the personification Life seeks out a “phisik” to cure him of Old Age (B.20.169). The “Physician with a furred hood,” to whom Life gives gold “that gladdened his heart,” is similar to Chaucer’s Physician in that, in his greed, he takes advantage of Life’s illness. He plays a greater role in Langland’s allegorical theology when it becomes clear that his craft obscures the need for spiritual healing. The “glass helmet,” or placebo, that he offers Life is an ineffective diversion from the true purpose of Old Age: to direct Life toward virtue and cast out spiritual despair (B.20.172). Just as the Physician of the “General Prologue” has studied a long list of Greek, Arabic, and other medical sources, “but little of the Bible” (1.438), Langland’s “phisik” transgresses in that he displaces spiritual action with medical practice.

L0029312 Woman and doctor talking, Disease man
Credit: Wellcome Library, London. Wellcome Images
images@wellcome.ac.uk
http://wellcomeimages.org
Woman and doctor talking; text from accompanying treatise on scrolls – Woman and doctor hanging a nude woman upside down by her feet from a scaffold over a bucket for suffumigation – Disease man
Ink and Watercolour
1420? MS. 49
Wellcome Apocalypse
Published: –
Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/

Both Chaucer and Langland portray physicians who use the cachet of their expertise to exploit their patients. One of Langland’s earliest adaptors, however, demonstrates that not everyone took such a caustic view. The maker of Piers Plowman Z, takes care to specify that medical knowledge is valuable, and that at least some of its practitioners are worth consulting. In interpolated lines not present in any other version of Piers, Hunger says:

I defame not fysyk (medicine), for the science is true,
But incompetent scoundrels that cannot read a letter
Make themselves masters men for to heal.
But they are master murderers who slay men,
And no leches (doctors) but liars, Lord amend them!
In Ecclesiastes the clerk that can read
May see it there himself and then teach another:
‘Honor the doctor,’ he says, on account of the ‘need.’ (Z.7.260-267)

In this passage, the Z maker is more concerned with the intellectual hierarchy generated by medical knowledge than he is with “fysyk” itself. He criticizes those without what he deems sufficient education, he applies the logic that the misuse of medicine can be fatal in order to encourage the exclusion of the untrained, and he adds to this sense of hierarchy by immediately asserting that “the clerk that can read” should mediate the Bible for his less educated audience. This passage indicates that understanding not just of the medical material, but also of the ethical implications underpinning it, must be mediated by a professional. The Z maker’s frustration is akin to that of many of today’s physicians when their patients diagnose themselves using pharmaceutical commercials and online forums. In the case of Piers Plowman Z, this tension is amplified by the integral nature of bodily and spiritual healing in medieval culture.

Erica Machulak, Ph.D.
English Department
University of Notre Dame

References and Further Reading

Chaucer, Geoffrey. The Riverside Chaucer. Edited by Benson, L.D. and Robinson, F.N. 3rd ed. Boston, MA: Houghton Mifflin Co, 1987.

Chen, Pauline W. “Doctors and Their Online Reputation.” New York Times, March 21, 2013. https://well.blogs.nytimes.com/2013/03/21/doctors-and-their-online-reputation/.

Dumas, Geneviève, and Faith Wallis. “Theory and Practice in the Trial of Jean Domrémi, 1423–1427.” Journal of the History of Medicine and Allied Sciences 54, no. 1 (January 1, 1999): 55–87.

Fuller, Karrie. “The Craft of the ‘Z-Maker’: Reading the Z Text’s Unique Lines in Context.” Yearbook of Langland Studies 27 (2013): 15–43.

Getz, Faye. Medicine in the English Middle Ages. Princeton, NJ: Princeton University Press, 1998.

Kerby-Fulton, Kathryn. “Confronting the Scribe-Poet Binary: The Z Text, Writing Office Redaction, and the Oxford Reading Circles.” In New Directions in Medieval Manuscript Studies and Reading Practices Essays in Honor of Derek Pearsall, edited by Sarah Baechle, John J. Thompson, and Kathryn Kerby-Fulton, 489–513. Notre Dame, IN: University of Notre Dame Press, 2014.

Langland, William. Piers Plowman: The B Version: Will’s Visions of Piers Plowman, Do-Well, Do-Better and Do-Best. Edited by George Kane and E. Talbot Donaldson. London: Athlone Press, 1975.

McVaugh, Michael. Medicine before the Plague: Practitioners and Their Patients in the Crown of Aragon, 1285-1345. Cambridge History of Medicine. Cambridge, UK; New York: Cambridge University Press, 1993.

Pho, Kevin, and Susan Gay. Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices. Phoenix, MD: Greenbranch Publishing, 2013.

Rawcliffe, Carole. Medicine & Society in Later Medieval England. Stroud, England: Alan Sutton Pub., 1995.

Rawcliffe, Carole. Urban Bodies: Communal Health in Late Medieval English Towns and Cities. Woodbridge, Suffolk: The Boydell Press, 2013.

Rigg, A.G., and Brewer, Charlotte, eds. Piers Plowman: The Z Version. Studies and Texts 59. Toronto: Pontifical Institute of Mediaeval Studies, 1983.

Sounds of Medieval London

If you and I were to go for a stroll through the streets of London—let’s say, one summer afternoon in 1392—what kinds of sounds would we hear?

City of London with Tower Bridge and Tower of London, Royal 16 F II, f. 73r; poems by Charles, due of Orléans, Bruges, third quarter of the 15th century, courtesy of the British Library

According to William Langland’s late fourteenth-century poem Piers Plowman, we might hear a cacophony of street cries including the shouts of cooks and tavern-keepers: “Hote pyes, hote! / Goode gees and grys! Ga we dyne, ga we!” (Prol. 228-35). (Incidentally, London’s street cries have been featured in musical compositions from Renaissance madrigals to twentieth-century composer Luciano Berio’s “Cries of London.”) But if we happened to be in London at just the right moment, we might hear something remarkable—the arresting sounds of a procession.

Religious procession at Saragossa, Royal 16 G VI, f. 32v, Chroniques de France ou de St Denis, Paris, after c. 1332 and before c. 1350, courtesy of the British Library

A procession–broadly defined as a group of individuals moving along a specific route to a certain destination–would capture our attention in numerous ways. As Kathleen Ashley has written, processions offered a “fusion of sensory experiences, or synaesthesia” (13). Indeed, they were both visually compelling, featuring canopies, torches, reliquaries, crosses, and flowers, and also aurally compelling, with singing voices, ringing bells, and the sounds of lutes, drums, and cymbals.

London would have seen many different kinds of processions—all of them with distinctive sounds. There would be royal processions creating an atmosphere of splendor and pomp.

Queen Isabel entering Paris; Harley 4379, f. 3r; Jean Froissart’s Chroniques; Bruges, between c. 1470 and 1472, courtesy of the British Library

Often (as in the image below) musicians would accompany these regal processions, and sometimes dancers would also perform.

King in a cart escorted by mounted musicians, Harley 4372, f. 79v, Valerius Maximus’s Les Fais et les Dis des Romains et de autres gens, trans. by Simon de Hesdin and Nicolas de Gonesse, Normandy, c. 1460-1487, courtesy of the British Library

Religious processions would also pass through the streets, celebrating various holy days (e.g., Christmas, Easter, and Corpus Christi). These often featured ringing bells and chanting voices, and such sounds were thought to ward off demons and elicit divine grace.

Corpus Christi Procession with a Bishop carrying the monstrance under a canopy, Harley 7026, f. 13r, Lectionary, England, c. 1400-1410, courtesy of the British Library

Of course there were funeral processions, where corpses were carried through the streets as mourners wailed and bells tolled–undoubtedly an almost constant sound during the time of the plague. As the popular medieval philosopher Boethius wrote, “The cause for weeping might be made sweeter through song” (8).

Funeral procession of Queen Jeanne, Royal 20 C VII, f. 200r, Chroniques de France ou de St Denis, Paris, last quarter of 14th century, courtesy of the British Library

Like Langland, Chaucer infuses his writing with the sounds he experienced in London, and in the Prioress’s Tale, he specifically incorporates the sounds of processions.

In the beginning of the story, the clergeon sings the antiphon Alma redemptoris mater as he walks to school and back home: “Ful murily than wolde he synge and crie” (553). It is a kind of solo procession.

[iframe width=”560″ height=”315″ src=”https://www.youtube.com/embed/kIXNIZxXwoI” frameborder=”0″ allowfullscreen]
Later, we find a foreshadowing of the clergeon joining a heavenly procession of virgin martyrs where he will follow “The white Lamb celestial” and “synge a song al newe” (581, 584).

Towards the end, the clergeon’s body is carried through the streets to the abbey “with honour of greet processioun” (623). Miraculously, he continues to sing the Alma, serving as the musician at his own funeral.

It seems fitting that such a series of processions should take center stage in the Prioress’s Tale since the Prioress herself would have come from a nunnery where processions formed a significant part of life. In fact, we have medieval documents (e.g., the Barking Ordinal) that provide instructions for nunnery processions. As the image below suggests, these processions would have been aurally compelling. Notice the one nun pulling the bell rope and the others singing from books with musical notation.

Illustration of a Procession and (above) Mass in a Nunnery, Yates Thompson 11, f. 6v, “Traité de la Sainte Abbaye,” France, c. 1290, courtesy of the British Library

We can add a new dimension to our understanding of life in the Middle Ages by reconstructing some of the sounds of the streets of medieval London. Such sounds have not altogether died away. In closing, here is a performance from the 2015 Mummer’s Parade in Philadelphia — a parade with roots reportedly dating back to the Early Modern period.

[iframe width=”560″ height=”315″ src=”https://www.youtube.com/embed/n0w0MiATTF8″ frameborder=”0″ allowfullscreen]
Ingrid Pierce
PhD Candidate
Department of English
Purdue University

Sources

Ashley, Kathleen and Wim Hüsken. Moving Subjects: Processional Performance in the Middle Ages and the Renaissance. Amsterdam, Atlanta: Rodopi, 2001.

Chaucer, Geoffrey. The Wadsworth Chaucer, formerly The Riverside Chaucer. 3rd ed.
Ed. Larry D. Benson. Boston: Wadsworth, 1987.

Langland, William. Piers Plowman: A New Annotated Edition of the C-text. Edited by
Derek Pearsall. Liverpool: Liverpool University Press, 2008.

Reynolds, Roger. “The Drama of Medieval Liturgical Processions.” Revue de Musicologie   86.1 (200): 127-42.

Yardley, Anne Bagnall. Performing Piety: Musical Culture in Medieval
English 
Nunneries. New York: Palgrave, 2006.

 

Richard II’s P.R. Disaster: Depictions and Characterizations of the King

King Richard II would not be considered a widely popular king. Coming to power in 1377 when he was ten years old, advised by councils though influenced most notably by his uncle John of Gaunt with whom he later had a falling out, the king’s power and ability to rule remained suspect throughout his reign. What power he did wield was often put to the test by such events as the Peasants’ Revolt of 1381, the threat of plague, and political upheaval, all of which led to frequent characterizations as a boy hampered by his youth and unfit to rule effectively.[1] Medieval depictions and illustrations of the king demonstrate how many people after his reign may have seen him: young, naïve, unmanly, and stupid. And after Richard II was eventually deposed in 1399 when he was 32 years old, a certain amount of relish and schadenfreude seeped into illustrated post facto portrayals of the king.

A quick survey of these depictions reflects the king’s public image as it was held after his deposition. Images of a young Richard II characterized him in keeping with the knowledge of the coming debacles that England was to experience during his reign.

Historiated initial ‘R’ with Richard II, combined with a full foliate bar border, at the beginning of his statutes; England, c. 1436; BL, Harley 5233, f. 141r

Seen here, the king peers over his own statutes with droopy, disinterested eyes, perhaps with a hint of uncertainty. A large forehead, exaggerated ears, a sallow face, and a weak chin each underlines the not-so-subtle caveat to these statutes: take them with a grain of salt, and proceed with caution.

Detail of a miniature of King Richard II of England banishing the Earl Marshall and the Earl of Derby; Jean Froissart, Chroniques, Bruges, c. 1470-1472; BL, Harley 4380, f. 148r

The second image portrays the young king banishing two earls, and we observe his features – a round face, slight frame, dull eyes – set against the prominent features of the earls, seen here to have more pronounced jawlines and chins. Though the eyes of the court are fixed on the king, the faces register blank expressions; the scribes, on the other hand, look dreadfully miserable.

Such characterizations carry over to scenes of the king in action as well.

Detail of a miniature of Richard II knighting Henry of Monmouth in Ireland; Jean Creton, La Prinse et mort du roy Richart, Paris, c. 1401 – c. 1405; BL, Harley 1319, f. 5r

As Richard knights Henry of Monmouth of Ireland, the king’s regal attire and armor dwarf his frame, his protruding lips frown, and though the new knight leans respectfully over his horse, the horse itself glares obstinately at Richard’s horse, who has adopted a pose of weakness or subservience with eyes closed and knee bowed.

Miniature of Richard II giving instruction to the earl Marshal and another man, with a partial border; Jean Froissart, Chroniques, the Netherlands, last quarter of the 15th century; BL, Royal 14 D VI, f. 303r

We see the king’s slight frame again when he instructs an earl and another man, two figures who side with one another, one firmly clutching a staff between them and the king, and the other with hands raised in a possible protest or confrontation.

The next three images depict Richard II in disguise and captivity, his power wrenched away from him.

Detail of a miniature of Richard II at Conway, disguised in a priest’s cowl; Jean Creton, La Prinse et mort du roy Richart, Paris, c. 1401 – c. 1405; BL, Harley 1319, f. 19v
Miniature of Richard II being delivered to the citizens of London; Jean Creton, La Prinse et mort du roy Richart, Paris, c. 1401 – c. 1405; BL, Harley 1319, f. 53v
Detail of a miniature of Richard II being placed in the Tower of London; Jean Froissart, Chroniques, Bruges, c. 1470 – 1472; BL, Harley 4380, f. 181v

In each scene here, the king’s head is hanging low, bowed down and resigned to the fate that had befallen him. Though every illustration in this post date after Richard II’s deposition, these last three portrayals of the king carry a hint of gravitas to color these images. Although the king’s poor reputation held a long legacy, the images of his fall from the throne perhaps indicate that, regardless of his disastrous reign, public opinion of what befell him took into account his misfortune with at least a small amount of empathy–not as a king but as another mere mortal, subject to the same bad strokes of chance or fate as those he ruled, incompetence and all.

[1] Christopher Fletcher. Richard II: Manhood, Youth, and Politics 1377-99. (Oxford: Oxford University Press 2008), 2.

Jacob Schepers
PhD Candidate
Department of English
University of Notre Dame