For those of you who have the yearning to step into the time machine and go back to see what life, and specifically the medical profession, was like in the Midwest back in the early 1900s, let me recommend for your reading pleasure Sinclair Lewis’s Arrowsmith.
Arrowsmith is the story of a young doctor by the name of Martin Arrowsmith, who was born and raised in the town of Elk Mills in the state of Winnemac. Don’t bother looking for Winnemac on a map; you won’t find it. This state is a fictitious creation of Sinclair Lewis; it covers northern Indiana and perhaps a little of northwest Ohio.
Martin Arrowsmith was drawn into medicine from early in life when he served as the unofficial assistant to the local doctor. He went to medical school at the University of Winnemac, where he adopted the venerable (if not downright quirky) Max Gottlieb as his early mentor and came under the influence of his devotion to pure science. This was completely at odds with the way medicine was practiced in the early 1900s. In those days there was not the prevalence of rigorous scientific methodology that you find in medical practice nowadays; instead everything was strictly based on hearsay and anecdotal evidence–a doctor would prescribe such-and-such treatment because he had heard that so-and-so had tried it and experienced good results.
Arrowsmith’s devotion to science is put to the test at every step of the way in his subsequent career. There are very long seasons of his life where it seems that he has lost it completely and is just muddling along as best he can–first as a country doctor in North Dakota, then as a public health official in a midsize Iowa town, then as part of a prestigious commercial clinic based in Chicago. But eventually he manages to get a research paper published and in so doing reconnects with Max Gottlieb, who by this time is working for a prestigious New York foundation which has given him a lab for pure research. In reconnecting with Gottlieb he rediscovers his passion for pure science; this sets us up for Arrowsmith’s journey to a plague-stricken tropical island which serves as the climax of the story.
Arrowsmith is an extremely intelligent and engaging presentation of the state of the medical profession in the early 1900s. But from a literary standpoint, it has a couple of flaws which are serious enough that I cannot allow them to pass without comment.
The first has to do with the plot of this story. There isn’t any. It is simply a chronicle of events in the life of one young doctor which add up to a story. To be sure, there is a structure to this story. Sinclair Lewis is a satirist by trade and his stories are very loosely structured; this is his most serious and most structured work. All of the characters whom we meet during Arrowsmith’s time in medical school reappear later on in the story. And there is a point where the action starts to pick up and move toward a definite climax. All the same, there is no plot. Missing here is the sense that this progression of events is purposeful, or that there is any element of conflict in the story–that Arrowsmith did A because of B which led to C which caused Arrowsmith to respond by doing D which led to E, etc…all the way up to the climax. We do get the sense of plot and conflict during the sequence leading up to Arrowsmith’s expedition to the West Indies, but other than that this is simply a chronicling of events in the life of one young doctor without regard for plot or conflict.
The other pronounced flaw in this story is in the character of Arrowsmith. Here we have a character who is presented as a passionate crusader for science, but this element of his character coexists with a whole host of other competing and conflicting impulses. In the early going, we see only brief snippets of passion for science intermixed with depictions of Arrowsmith’s social life and love life. We see his awkwardness as a lover and his attempts to fit in with the other members of his class and his fraternity at medical school, which meet with limited success. Arrowsmith wants to fit in and be like the other fellows, but has difficulty at it and doesn’t seem to understand why–or that there should even be a reason for his difficulty. He fails to grasp that his passion for science sets him apart from his fellows, or that it should. There is no attempt by Sinclair Lewis to resolve these conflicting strands of Arrowsmith’s character, no attempt to explain why a doctor with a passion for science would want to fit in and be like others around him or why he would fail at attempting to do so; instead these conflicting strands of character are just there, coexisting. Arrowsmith is passionate about science and he also wants to fit in and be like others. Big deal. Get over it.
The same treatment of Arrowsmith’s character applies later on in his professional life when, for long stretches of time he allows his passion for science to slide to the back burner, behind first the desire for an easy practice, then the desire for prestige, power, and money. And eventually Arrowsmith is drawn back to his first love, his love of science. But here we see a man struggling with whether or not to devote himself to the love of science, and this undercuts his depiction as a passionate crusader for science. And we are given no indication of why someone with Arrowsmith’s passion for science should be tempted, and sidetracked for long seasons of life, by the love of money and prestige or the desire for an easy practice. Instead these competing impulses just coexist within Arrowsmith’s character. They’re there. That’s all there is to it. Deal with it.
To sum up, Sinclair Lewis is one of the great American writers of all time, and Arrowsmith is one of his greatest works. There are some serious literary flaws which cannot escape my attention, but on the whole it is a must-read for anyone who values the writing of Sinclair Lewis or who is interested in learning what life, and specifically the medical profession, was like in the Midwest in the early 1900s.