This week’s Annals contain an essay about Montaigne by Alan Wasserstein, entitled “Lessons in Medical Humanism”. Montaigne is generally credited with inventing the literary form called the “essay”, a word which contains a nice ambiguity – an attempt (essaie) to discuss ideas, but also an assay of the reader. Montaigne’s Essays are full of direct assertions, which are bold in themselves but are deliberately not built up into a systematic argument. The final effect is both lively and also, in the end, tolerant and confiding. When Montaigne essays a topic he shares the attempt with the reader; it moves to and fro, like real life. And this is a central theme in Montaigne: nothing is static, nothing is absolute, nothing remains the same for ever, least of all the thought and life of a human being. He mocks the idea that the French language of his time is the best it has ever been, and should be fixed by rules – leapfrogging the Academicians who came two hundred years afterwards, and in the process arriving next to us as a contemporary and a friend.
In the midst of a century of bloody religious conflict, he keeps his counsel, with occasional ironic asides about people who behave as if they alone have access to the truth. His attitude to doctors is exactly similar:
“If your Physitian thinke it not good that you sleepe, that you drinke wine, or eate such and such meates, Care you not for that; I will finde you another that shall not be of his opinion.” (translation by John Florio, 1603)
Little has changed. Wasserstein’s essay on Montaigne deals largely with the piece from which this is taken, his final Essay, On Experience. He argues that Montaigne’s constant bouts of renal colic mellowed his earlier, elitist Stoicism, making him into a broader and more compassionate humanist. Maybe. I wish mine would do the same. I agree with him more when he makes Montaigne the centre of his plea for the exercise of empathy in the practice of medicine. To see the same patients for twenty years or more, to live with one’s mistakes, to handle uncertainty and exercise compassion – this is the Montaignean task we set ourselves in general practice.
In another week of government initiatives about diet and alcohol, I will end with a quotation from “On Vanitie”:
“Good stomackes are simply served with the prescriptions of their naturall appetite. So do our Physitions, who, while they tie their patients to a strick’t diet of a panada [boiled bread] or a syrope, feed themselves upon a melone, dainty fruits, much good meat, and drinke all maner of good Wine”.