From Empathy to Epistemology: Robert Montgomery Bird and the Future of the Medical Humanities

In autumn 1841, the physician and novelist Robert Montgomery Bird (1806–1854) delivered what must have been a dispiriting introductory lecture to a cohort of new medical students.¹ In “The Difficulties of Medical Science,” Bird explained, “All sciences are, and of necessity must be, imperfect”—the troubles with medicine were “only greater and more numerous” (15). Emphasizing “the impossibility of carrying our physiological explorations beyond a certain point” (15), Bird states the case directly: “It is physically impossible we should know many things it would delight Medicine to know” (9).

Bird highlighted medicine’s epistemological and methodological challenges: “How shall we trace the mechanism of a disease? how shall we follow even the operation of a remedy, through the darkness of a microcosm of which we are so ignorant?” (15–16). Factors hindering physical experimentation included the impossibility of observing healthy, functioning organs, our imperfect senses, the incommensurable uniqueness of human bodies, and the problem of reproducing results. “We have no window of Momus,” he stressed, “to give us vistas of living pathology” (16). This declaration provides an alternative within a lament. By invoking the classical figure Momus who teased Hephaestus for making the human body without a window unto the heart, Bird invites his students to integrate their classical learning into their medical understanding (classical education was then a prerequisite for medical education). In echoing a request from the god of satire, Bird asked his students to think critically about the profession.²

It may have been physically impossible to access many medical truths, but this playwright and novelist understood the imagination and literary form to offer additional avenues of inquiry in an era when literature proposed medical theory and doctors experimented imaginatively. Like many physicians before him, Bird turned in his medical writings to the classics, Shakespeare, and more recent poets and wrote in literary form to access additional means of medical knowing. I argue that literature allowed nineteenth-century doctors to assay medical hypotheses that were otherwise difficult to test for physical or ethical reasons. Here I build on the work of Rita Charon, Cristobal Silva, and Priscilla Wald who powerfully demonstrate medicine’s narrative structure, as well as that of Russ Castronovo, Justine Murison, and Bryan Waterman who compellingly show how medical models shaped the period’s literature, to analyze a discursively permeable world in which doctors used fiction to produce original medical knowledge, especially when medical philosophy and physical experimentation failed to produce satisfying results.³ Indeed, through the mid-nineteenth century, medical theory used a broader variety of knowledge practices that depended more on the mind of the individual thinker than on an objective detachment. Before C. P. Snow’s famous “two culture” split, fiction did not merely represent medicine; fiction also wrote it.⁴

No figure better illustrates this practice of imaginative experimentation than Bird, whose novel Sheppard Lee: Written by Himself (1836) is a work of medical theory that experiments with the related concepts of sympathy and pain using humanistic methods. Confronted with the limitations of medical epistemologies like philosophy and empiricism, Bird turns to the literary—to a picaresque novel in which he can come to know a variety of bodies intimately through metempsychosis (the movement of a spirit between bodies) to experiment with physiology and living pathology as physical experimentation could not. Sequentially reanimating a series of corpses, Bird’s protagonist investigates the degree to which sympathy can be the central force linking bodies and body parts in Jacksonian America. Through this form of inquiry, Bird engages sympathy as both epistemological tool and subject of inquiry, testing general concepts through local particularity. Bird’s sympathy is capacious—distinct from eighteenth-century “fellow feeling” and twentieth-century empathy—ultimately grounded in its medical root “with suffering” (Dunglison 588). In an epilogue, I explain how Bird’s radical conclusions about health and unity in Sheppard Lee productively complicate our notions of empathy and the humanities in medicine today. Illuminating some difficulties of contemporary medical science, particularly with regard to empathy and pain, this essay concludes by calling for...