Charting Dante: The Inferno and Medical Education

^Charting Dante: The Inferno and Medical Education Anne Hunsaker Hawkins . . . you may need to strain to hear the voice of the patient in the thin reed of his crying —John Stone, "Gaudeamus Igitur: A Valediction"1 In this essay I will discuss some of the remarkable parallels between Dante's Inferno and contemporary medical education. Such a comparison is not simply an academic exercise: its relevance is immediate and practical . Teaching literature to medical students has proved immensely successful —so much so that it has generated its own canon: texts such as Tolstoy's The Death of Ivan Ilych, Chekhov's "Ward Number Six," and William Carlos Williams's "The Use of Force" are commonly taught in medicine-and-literature courses. In general, the works studied are directly concerned with medical issues: the dying patient, chronic illness, suffering, the encounter of doctor and patient, the roles assigned physicians and sick persons by their cultures and by themselves. I would like to suggest that this canon be extended to include works that have nothing to do with hospitals or doctors or even illness. Many of the great books of Western literature, if read and studied in a certain way, can become available for medicine-and-literature courses—even a work so apparently remote from contemporary medicine as Dante's Inferno. At first glance, the differences between these two subjects would seem to be vast: the text is a fourteenth-century allegorical Italian poem; the context is the American teaching hospital in 1992. And these differences are indeed major: medieval versus modern, the world of Christendom versus the world of medicine, the theories, models, and constructs of religion versus those of science. Moreover, the two seem diametrically opposed in their subjects: sin and its punishment are the themes of Dante's Inferno, whereas illness and its treatment are central Literature and Medicine 11, no. 2 (Fall 1992) 200-215 © 1992 by The Johns Hopkins University Press Anne Hunsaker Hawkins 201 to medical practice. Indeed, it could be argued that the Purgatorio would be a much more appropriate choice for comparison because the torments inflicted in purgatory are intended, not to punish, but to cure the soul of its sins and because suffering here is undertaken voluntarily as a kind of healing pain. In addition, the sinners of the Purgatorio actually progress through its various ledges; they are not condemned to any one place for all eternity, as they are in the Inferno. But it is the Inferno, not the Purgatorio or the Paradiso, that seems the most accessible to a modern audience; moreover, the Inferno best exemplifies what I will call the casestudy method—learning about a particular nomothetic category by exposure to and analysis of the actual human beings who embody that abstraction. In maintaining that there are grounds for a comparison between the Inferno and contemporary medicine, I am not in any way condoning the view that disease is a sign of sinfulness or the notion that treatments given patients are often torments inflicted as punishment—though such views are, regrettably, a part of the legacy that has come down to us under the general rubric of Western culture. What I propose here is an analogical study of the Inferno—a reading that considers the text analogous in certain ways to the world of medicine. Thus Dante's journey through Hell can be seen as analogous to the medical student's journey through medical school, or even to the physician's maturation and development in his or her profession; sin can be seen as analogous to disease; punishment in Dante's system can be viewed as analogous to medical treatment. An analogical reading such as^ this is one that assumes an overall likeness between two constructs, or systems, and then proceeds to explore the meaning of those likenesses as they unfold in the developing textual narrative. On the literal level, the Inferno describes the journey of the pilgrim Dante into and through Hell. Reading the Inferno is primarily an act of the imagination: the reader must descend with Dante the pilgrim down through the nine circles of the inferno and learn, by experiencing it, the topography that is itself the...