Using Literature To Teach Ethical Principles in Medicine: Of Mice and Men and the Concept of Duty

^Using Literature To Teach Ethical Principles in Medicine: Of Mice and Men and the Concept of Duty Edward E. Waldron One of the exdting aspects of teaching literature to medical students is the challenge to find new ways to discuss literature, ways that have connection to the immediate needs of the students as well as to their continuing intellectual and emotional development. Using literature to teach prindples of medical ethics is, I have found, particularly interesting. It is espedally so when one uses literature that, at first glance, has little to do with medidne per se. Using literature to expose students to a variety of value systems and to examine how characters function within those systems in a given work, and from there expanding discussion to prindples of medical ethics, seems a natural extension of an approach to literature I have used for years. One way to examine the themes of a work is first to explore the value system of the work and then to determine the relative placement of characters on a continuum determined by whether, or how well, they meet the criteria of that system. The value system might be a reflection of our sodety's system, or it might have its own codes of acceptable behavior, often at odds with the larger value system. Let me illustrate with an example or two from John Steinbeck's Of Mice and Men. At the core of this tale of two bindle stiffs (single-migrant workers) traveling together in California is their makeshift "fambly." George and Lennie have a unique relationship. Unlike the other bindle stiffs, they have companionship; they have someone who cares. They are different, as Lennie tells George, " 'because I got you to look after me, and you got me to look after you. ... "^ In the course of the novel, the dream Literature and Medicine 7 (1988) 170-76 © 1988 by The Johns Hopkins University Press Edward E. Waldron 171 George and Lennie carry in their minds and hearts like a religious relic, to have a place of their own where they can " 'live off the fatta the Ian' ' " (p. 15), comes ever doser to a reality. It becomes possible because it is extended to others. When Candy, the old one-handed ranch hand who is relegated to doing dean up work, overhears their redtation, he asks to join in, offering the money that has eluded George and Lennie. Even Crooks, the lonely blade stable hand, is momentarily drawn into the dream. Qearly, one very positive part of the value system of this novel concerns how one relates to others: bringing people together is a positive; driving them apart, on the other hand, is a negative. The most positive force in Of Mice and Men is Lennie, the innocent man-child. He is the true keeper of the dream, for with his death, as George knows, the dream will die, too. It is Lennie who breaks the barrier between Crooks and the others for a moment and makes the bitter stable hand believe that he can escape his loneliness. That belief is quickly shattered by the appearance of CurÃ-eos wife, the most negative force in the novel. Just as Lennie serves to bring men together, Cm-ley's wife seeks to keep them apart so they will talk to her. " 'If I catch any one man, and he's alone/ " she tells Lennie, Crooks, and Candy, " Ί get along fine with him. But just let two of the guys get together an' you won't talk' " (p. 85). To meet her selfish needs, she has to drive the men apart. This value of bringing men together in an environment that promotes isolation—ranch hands do not ask questions of each other as part of their code—is reflected in a minor way in the two whorehouses in town. Susy's place offers companionship to the hands, while Clara's place is strictly business. As Whit tells George, the guys can go to Susy's place and just talk, if they want to, and her liquor is twenty-five cents a shot, while Clara serves watered down drinks at thirty-five cents a shot, and she does...