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.

Deor’s Dark Elegies

Panel Depicting Weland from the Franks Casket, an 8th century Anglo-Saxon chest made of whale’s bone and inscribed with runes, now in the British Museum.

In translating and reciting Deor, I took more artistic liberties than in previous translations of Old English poetry. Because the translation and recitation are their own discrete projects, I will discuss each separately, beginning with my translation.

Translation: “Deor’s Dark Elegies” by Richard Fahey

Tackling a translation of the anonymously titled Old English poem editors refer to as Deor, I chose to focus on a few features that mark this poem as unique in the corpus—especially the episodic structure and the operative elegiac mood of the piece.

In my translation “Deor’s Dark Elegies” I have adapted the structure of the poem, dividing each stanza both by a title and a refrain to emphasize the episodic quality of this particular Exeter poem, rather than simply the refrain. This required me to morph the syntax in places in service of enhancing the episodic structure of the piece.

Unlike the one other poem considered ‘heroic’ in the Exeter Book (Exeter Cathedral Library MS 3501), editorially titled Widsith—which is more of a list of heroes and peoples—Deor alludes to numerous legends, usually focusing on the tragedy befallen the tale’s protagonist. In a sense, Deor represents a series of subnarratives—a catalogue of heroic experience and existential crises, met ultimately with the grim realization that all earthly things fade into obscurity under the unrelenting passage of time. So proclaims the refrain: that passed away, may this too.

Fatalism is generally considered to be a familiar, even indigenous, concept for the pre-Christianized Scandinavian and Germanic peoples, it could alternatively be argued that the philosophy articulated in Deor may be drawn from the theology of Boethius’ De consolatione philosophiae, which is translated by King Alfred into Old English before the compilation of the Exeter Book and remained intellectually influential in medieval England, eventually inspiring the famous Geoffrey Chaucer to produce Boece, a translation of the text, over three hundred years later.

Deor employs what might be described as an ‘elegiac mode’ operating in other Exeter Book poems as the narrator reflects on the transitory nature of human existence. In this way it reminds the reader of other so-called Old English elegies in the Exeter Book, such as The Wanderer (which Seamus Heaney translates and recites as does our own Maj-Britt Frenze) and The Seafarer (which Ezra Pound translates and recites) that likewise reflect on transitory life, but imply the final Christian consolation of heaven in line with Boethius and notably absent in Deor. Instead, a somber tone—pervasive throughout Deor—is one of the poem’s signature features. Therefore, in translating Deor, I attempt to preserve both the elegiac tone of lamentation and hardship as well as the darkening mood, which swells ultimately to include also the narrator, his own darkening days and personal tale of suffering and sorrow.

Recitation and Creative Adaption: Deor

Having collaborated with my twin brother, Boston sound artist and producer Thomas Fahey, my Deor ‘recitation’ became more of a sound art piece than a proper recitation of an Old English poem. The slow, methodic reading of the Old English alliterative meter and alludes to the tradition of Old English recitation, exemplified by Ezra Pound’s recitation of his Seafarer and intellectually grounded by the work of scholars such as Albert Lord and Miles J. Foley.

Nevertheless, many of the features emphasized in my translation were used to inspire the audio piece. As with the translation, structure and mood were organizing principles of the project. We placed emphasis on the refrain, and complemented the recitation of the Old English with samples and effects that create a shifting aural landscape—evoking the sound of an anvil-stroke, ravens, wolves, horses galloping, a woman moaning and a child crying—all of which corresponds with haunting imagery from various episodes of the poem.

While composing Deor, I decided I would expand the project and approach other recitations of Old English poetry in similar fashion in my future work. For this reason especially, any comments or feedback would be most welcomed and appreciated!

Richard Fahey
PhD Candidate
Department of English
University of Notre Dame

Reading Sir Gawain in the Digital Age

The advent of e-books has prompted discussion about the experience of reading and its relationship to a material text. Opponents of digital books speak fondly of holding a book in hand, the ability to feel the weight of the object and physically see yourself progress through the text. There is a sense of something lost when this object changes form, when paper becomes plastic, when clicking replaces page-turning, when your sense of place in the text is measured by percentage rather than pages.

Illumination from Sir Gawain and the Green Knight in British Library, Cotton MS Nero A.x, f. 90v

Of course, changes in the way in which we materially experience reading have been going on far longer than the recent shift to digital media. The book versions of older texts are in many ways even more distant from their original form than digital books are to their print ancestors.

While some these changes are  obvious to the readers—the illuminations, the particular handwriting, the spacing of the text on the page—editors of print editions also make choices that are less apparent. Sir Gawain and the Green Knight provides an interesting example of how much print can transform a medieval manuscript, as seen in the editors alterations of the bob and wheel form. In this form, the stanza ends with two short lines (the bob) followed by four rhyming lines (the wheel):

 

The editors follow this form exactly, but as Kathryn Kerby-Fulton notes in Opening Up Middle English Manuscripts, the placement of the bob is not as regular in Gawain as modern editions would lead us to believe. Instead, the bob is written in the margin, often not directly before the wheel. Compare the following:

Modern Edition (eds. Andrew and Waldron)

Bot he defended hym so fayr þat no faut semed,
Ne non euel on nawþer þay wysten
Bot blysse.
Þay laʒed and layked longe;
At þe last scho con hym kysse,
Hir leue fayre con scho fonge,
And went hir waye, iwysse. (1551-1557)

Manuscript

Sir Gawain and the Green Knight, lines 1521-1558. Note the placement of the bob “bot blysse” two lines above the bob. British Library, Cotton MS Nero A.x, f. 111v

As Kerby-Fulton argues, this fluid placement of the bob changes our understanding of certain passages, since it can often be attached to several lines and still be grammatically correct. Andrew and Waldron translate the modern version of lines 1552-3 as “nor were they aware of anything but pleasure.” In the original text, however, the placement of the bob would render the line “But he defended him so fair that no fault seemed but pleasure.”

The placement of the bob obviously has some impact upon our understanding of the poem. But what about that illusive “reading experience”? The modern editions fundamentally change this as well. Imagine, for a minute, that you are a medieval reader. When you read the bob, do you hear it exactly where it is placed? Do you hear it where the modern editor would move it to? Or do you hear it after multiple lines? Perhaps your eye floats out to it on several occasions, placing it in multiple positions and playing with its flexible meanings. Gawain, after all, is a poem of playful language and deceit, and the poet is noted for his use of puns in Pearl.

No modern edition has been printed that maintains the manuscript’s irregular placement of the bob. The solution, then, is to turn back to the manuscript: to printed facsimiles, but also, perhaps counterintuitively, to digital scans of the original pages.

Jane Wageman
MA Candidate
Department of English
University of Notre Dame

Works Cited

Andrew, Malcolm, and Ronald Waldron. The Poems of the Pearl Manuscript: Pearl, Cleanness, Patience, Sir Gawain and the Green Knight. University of California Press, 1982.

Kerby-Fulton, Kathryn, Maidie Hilmo, and Linda Olson. Opening Up Middle English Manuscripts: Literary and Visual Approaches. Cornell University Press, 2007.