King's Dialogues: Literature and Medicine

The King's Dialogues in the Humanities is a series of lectures held from time to time at King's College in the University of London. The lectures are generally given by internationally celebrated figures. Typically, a scholar who has crossed a disciplinary boundary—often against prevailing orthodoxies—explains why he or she did so, reflecting, perhaps, on issues of interdisciplinary permeability and miscibility; but the formula is flexible enough to allow for individual variation.

In 2005 the theme chosen was Literature and Medicine to mark the launch at King's of what is believed to be the world's first master's program in the field.¹ Eight lectures were given by leaders in our field: George Rousseau gave his personal view of the history of literature and medicine as seen from a literature department. Oliver Sacks discussed narrative genre and the case history. Rita Charon elucidated the poetics of house calls. Ron Britton asked what psychiatry and psychoanalysis can learn from literature. Richard Horton used what he called Elizabeth Gaskell's "literature of public health" to make an impassioned plea for a contemporary counterpart, a literature of global health centered on the plight of Africa. Sally Shuttleworth compared the portrayal of childhood in nineteenth-century psychiatry with literary depictions of the child. Brian Hurwitz considered the representational forms of clinical case histories. And Shlomith Rimmon-Kenan discussed what literary theory might learn from illness narratives.

The excitement that ran through the room on lecture nights was felt beyond these occasions. Although they attracted a fair share of London's specialists in our field, lectures were open to the public and not just to members of the university; they were dialogues not only between scholars but also between scholars and the wider world. The setting was historic. All the lectures except one took place in a room that from the fourteenth through nineteenth centuries was the Rolls Chapel in Chancery Lane, where for the last hundred years the Magna Carta has been displayed—a fitting symbol of the intellectual enfranchisement at which the series aims. Reassuringly, perhaps, the funerary monuments of former Masters of the Rolls—senior judges who held custodianship of the parchment records of the Court of Chancery—could be glimpsed behind the podium.

We are fortunate to publish three of the lectures here for the first time. The dialogical character of Richard Horton's lecture was perhaps most complex. Though they lived in what was undoubtedly a progressive social era, Victorians liked to take a "long" view of social advancement. The age teemed with ingenious reformers, many of whom achieved the difficult feat of pleasing the privileged and extolling the plight of the needy at the same time. The compromises on which these achievements were based sometimes strike us as unbalanced and even shoddy. Edwin Chadwick (1800–90) proposed to "solve" the problem of child labor by recommending an eight-hour day for children under thirteen, complemented by three hours of education. Employers desperate to avoid restrictions on adult labor applauded him, and Chadwick's proposal was rushed into law. The consequence—not quite unforeseen—was the beginnings of free schooling for children. The same Chadwick who would go on to become a hero of public health as the author of the Report on the Sanitary Condition of the Labouring Population of Great Britain (1842) played no negligible part in framing one of the most detested pieces of "reforming" legislation of the whole nineteenth century: the Poor Law Amendment Act of 1834. Charles Dickens's outrage against the countless humiliations this piece of legislation visited on the poor can be seen in the opening chapters of Oliver Twist (1837–38), in which destitute and helpless young boys are herded into workhouses and sold off to funeral undertakers when they complain. (He was still railing against the Poor Law in 1865 in Our Mutual Friend.) But Chadwick, once secretary to the legal reformer and philosopher Jeremy Bentham, was proud of the Poor Law Amendment Act, going so far as to claim credit for its most infamous provision: the requirement that...