Diagnosing Literary Genius: A Cultural History of Psychiatry in Russia, 1880-1930 (review)

This treatise begins and ends with, and intermittently wanders back to, the puzzle set by "pathography": "the life and character of an individual or community as influenced by disease" (Oxford English Dictionary). Alexander Pope overrode the puzzle in his tribute to poetic art for helping him through "this long disease, my life": that famous metaphor (in an "Epistle" to his doctor) disdains the brutal facts of his case—a humpback dwarf with matchstick legs, chronic headaches, asthma, and dropsy—and resonates with poetic readers regardless of their medical histories. Pathography claims to take such metaphors back to brutal sources—to tabes dorsalis, for example, which is invoked (p. 20) to explain Gogol's art. Hence the puzzle of this treatise: What do such diagnoses of literary genius reveal, beyond the presumptuousness of the diagnosticians? Very little, Irina Sirotkina seems inclined to respond. She might well have wound up with the words of Dr. Chekhov's Nina at the end of The Seagull, as she tries to make sense of her life and stumbles on images, repeating in bewilderment "ne to," "No, not that."

Much of this book, as the subtitle indicates, reviews the history of the psychiatric profession in Russia from 1880 to 1930, and in so doing it wanders away from the author's central theme. It comes back to that theme in summaries of psychiatrists' pathographies of great writers, principally Gogol, Dostoevsky, and Tolstoy. Thus Sirotkina touches on classics of fictive art as crucial tests of truth in this or that claim of pathography. Psychiatrists, I discover, added little to the rival interpretations of those classics in Russia, the world's first "developing" country, and in "developed" countries, where they are also avidly studied. Sirotkina dismisses pathographers' disputes over, say, Gogol's Dead Souls, declaring that they "misunderstood the meaning of the novel, which portrayed the emerging capitalist era" (p. 37). She never explains that gesture toward an interpretation of the novel in the "Marxist" or "developmental" manner, nor does she explain the allegation of tabes dorsalis in the author, or how, if he had that disease, it might have shaped Dead Souls. Hence a persistent sense that pathography has been a dead end.

The case of Dostoevsky is especially challenging, partly because his medical history is heavily documented, for he was hypochondriac as well as epileptic, demanding much medical attention—a dependence on claims of science that he mocked in his fiction. Notes from Underground opens with the paradox of a nasty man so individualistic, so insistent on self-sufficiency, that he will not seek medical help for pain in his liver. He says he is "sufficiently superstitious to respect medicine," and therefore he refuses dependence on it. The ironic mockery of oneself that pervades modernist fiction is in that brush-off of scientific claims, along with an agonized demonstration that literary art is no such blessed refuge as premodernist classics envisioned. Literary scholars have illuminated Dostoevsky's landmark creations, including their medical sources. (See especially James L. Rice, Dostoevsky and the Healing Art: An Essay in Literary and Medical History, 1985.) Sirotkina's report of pathographies by Russian psychiatrists adds little beyond evidence that the kowtow maneuver I associate with Freud was a common routine: we scientists of the mind must labor to prove what literary genius merely intuits; with that, the psychiatrist feels free to mount his hobbyhorse and rock to his heart's content.

Similarly in the case of Tolstoy, who prided himself on vigorous health, though he was obsessed with death as the cancellation of purpose and meaning in life. His Confession laid that out as evidence of the need for religion, so vividly that William James, who suffered from analogous melancholy, made the Russian's "sicksouled" testimony a central...