David Payne: Dickens and doctors

David Payne Dinah Birch’s recent review of Claire Tomalin’s biography of Charles Dickens celebrates the “exuberant variety” and “multiplicity” of his life. He reinvented himself constantly – child labourer, solicitors’ clerk, journalist, editor, actor, philanthropist, social reformer, and a novelist who like Chaucer and Shakespeare, came to represent his age. Birch could easily have defined Dickens in terms of the professions he rejected – he was urged to enter Parliament, and, if you consider the attention Tomalin pays in her book to Dickens’ interest in health and medicine, a medical career may have beckoned. Certainly there is an established critical interest in Dickens and medicine (a colleague attended a conference on the subject earlier this year). Dickens’s fondness for the doctor might also be demonstrated by the fact that his pen spares the profession the biting social commentary reserved for lawyers and civil servants in his fiction. There is no medical equivalent of the Circumlocution Office, and no medical negligence claim equivalent to Jarndyce vs Jarndyce.

But where did Dickens’ interest in medicine come from? Perhaps his own sickly childhood triggered a fascination not only with his own mental and physical wellbeing, but of others also. One turning point seems to have taken place in 1838 when the 26-year-old author attended a mesmerism demonstration organised by John Elliotson, a founder of University College Hospital and a follower of Thomas Wakley, founder of The Lancet. Mesmerism, according to Ellitson’s Wikipedia entry, was then vying with phrenology for scientific authority.

Dickens became hooked. Three years later in Genoa, he met the banker Emile De La Rue, whose wife Augusta suffered from a nervous disorder. According to Tomalin, Dickens was “ready to play the doctor” despite having no medical training. Augusta was put into a “sleep like trance” and asked about her childhood experiences. The “treatment” had a positive effect. She told the author she was sleeping better. Dickens, famously susceptible to needy women, became emotionally involved. He suffered sleepless nights on her behalf, and confessed to her husband that she was somehow “being part of him.”

But then he suddenly detached himself from her, and taught her husband (unsuccessfully, it appears) how to mesmerise Augusta himself. They remained friends, but Augusta’s condition soon returned, and she rejected Dickens’ suggestion that she become a patient of Elliotson’s because she had heard that some of his patients had psychiatric disorders.

Dickens’ faith in the medical profession made him, like Queen Victoria,  an early advocate of chloroform. This may have been due in part to his need for surgery himself, in 1841, for a fistula. Eight years later he insisted that his wife Catherine be given it when her eighth child was delivered. In 1847 Sir James Simpson had championed the anaesthetic properties of chloroform for childbirth and surgery in a BMJ paper.

But back to Elliotson, who became the Dickens family doctor. I’m writing this blog at BMA House in Tavistock Square, built on the site of a house lived in by Dickens before he cruelly walked out on his wife Catherine and decamped to Gadshill Place, Kent. Elliotson lived nearby (in a house now inhabited by the actor Rupert Everett).

Everett, of course is an actor and writer whose books are unashamedly autobiographical. A bit like Dickens, I suppose.

David Payne is editor, bmj.com