- Frances Burney and the Doctors: Patient Narratives Then and Now by John Wiltshire
This important and uncomfortable book explores in detail the experience of illness of various kinds, generally serious and life-threatening, and the accompanying experience of undergoing treatment for that illness, either successfully or not. Such experiences can be from the point of view of the patient or from the perspective of carers or relatives of the patient. Inevitably, they involve interactions with doctors of different kinds, either positive or negative, endorsing or, sadly, distressing. In some accounts, especially in modern times, the patient is herself or himself a doctor, providing thereby a uniquely privileged and uniquely deprived view—deprived because the individual, with their own specialist knowledge and mode of operation, is transformed into the object of other professionals’ sometimes very differently handled authority. None of this makes for pleasant reading.
Wiltshire, of course, is a leading authority on Burney, and it is her prolific journalizing that provides the bedrock for the different accounts that are discussed, all of them fascinating in their distinct ways. Burney’s pathographies, or illness [End Page 123] narratives, include the first period of George III’s madness, when she served as Keeper of the Robes to Queen Charlotte; her account of the king’s developing state overlaps with Burney’s own deterioration through exhaustion, deprivation of company, of air and exercise. As the king recovers, Burney sinks further into physical and emotional weakness, working on until she finds the courage to petition the queen to be released from her position, after which she gradually recovers. One of the people who most sustains her, fittingly, is Dr. Francis Willis, the controversial mad-doctor whose arrival sees the gradual turning of George’s condition. He and Burney got on well, and during this dark time, as Wiltshire puts it, “Just a visit from this man, embraced with his warmth, his comedy, his friendship, would do her good” (p. 88). This contrasts markedly with some of the other physicians she encounters during later pathographies. While Mr. Ansell, the local apothecary who undertakes the smallpox inoculation of the D’Arblay’s infant son Alex in 1797, is polite and kindly, her own dramatic mastectomy in Paris in 1811 presents her with mixed medical behavior. The “eminent army surgeon” (p. 112), Dominique-Jean Larry, is attentive and communicative, while the civilian physician, Antoine Dubois, called in at her husband’s insistence, is abrupt, talks over her head, and fails to communicate such basics as the number of people who will be present at the operation—“7 Men in black” including two pupils (p. 116). As a patient she, in spite of her voiced objections, finds herself disturbingly reduced to the level of an object, while the actual operation, performed without anaesthetic, is intensely prolonged and painful. Her observation afterward is revealing: opening her eyes, she sees “My good Dr Larry, pale nearly as myself, his faced streaked with blood, & its expression depicting grief, apprehension & almost horrour” (p. 124). Then, as she nurses M. D’Arblay in his final painful illness, this time in Bath, there is the trusted and considerate apothecary Mr. Hays and the quite different army surgeon, William Tudor, whose “looks were even forbidding; they were grave to austerity, & comfortless to rigour” suggesting, correctly, “a cold & hard Character” (p. 134). There follows a kind of battle between Burney as carer and optimist against Tudor’s unforgiving realism and, before long, the Catholic Church and its insistence on administering the last sacrament. Again, it is Burney who is sidelined as medicine and religion get their inevitable way.
The book is concerned with patient narratives “then and now,” and Wiltshire concludes with two chapters on modern-day pathographies—themselves as disturbing as what he has dealt with by Burney. They include Simone de Beauvoir on the death of her mother; David Rieff on his mother, Susan Sontag, succumbing to cancer; and Kay Redfield Jamison, herself a physician specializing in mental illness, narrating her own disturbing...