Tuesday, September 18, 2012

To be (a doctor) or not to be? That is the dilemma.

During the summer, the National Theatre chose to stage the "Doctor's Dilemma" by Bernard Shaw. Set in London of the early 20th century, the play is a critic on the dangers of privatised medical practice, at a time when NHS wasn't yet founded.

The main character of the play is a newly honoured doctor, Sir Colenso Ridgeon, who has developed a revolutionary new cure for tuberculosis by inoculating the pathogen to the patients. Serendipitously, the first successful attempt in immunization against tuberculosis took place in 1906 by Albert Calmette and Camille Guérin, the same year as the play was first staged. However, Bernard Shaw's inspiration of his hero was the bacteriologist Sir Almorth Wright who developed an anti-typhoid vaccine in 1892. 

Bernard Shaw has been very critical of his contemporary health system (or the lack of one) and of doctors, in general. He questioned whether doctors are men of science; "It does happen exceptionally that a practicing doctor makes a contribution to science; but it happens much oftener that he draws disastrous conclusions from his clinical experience because he has no conception of scientific method, and believes, like any rustic, that the handling of evidence and statistics needs no expertness". He was skeptical about statistical illusions; "here may be a doctor here and there who in dealing with the statistics of disease has taken at least the first step towards sanity by grasping the fact that as an attack of even the commonest disease is an exceptional event, apparently overwhelming statistical evidence in favour of any prophylactic can be produced by persuading the public that everybody caught the disease formerly". He underlined the surprises of attention and neglect, the power of "fashion" on the chosen therapies and he suggests a more equal and fair system.

However, he managed in his play to expose the lethal absurdity of the medical service without treating the doctors as caricatures. 
The satire is sharp and lines like: 
"I've tried these modern inoculations myself. I've killed people with them; and I've cured people with them; but I gave them up because I never could tell which I was going to do",
"I have forgotten all my science:what's the use of my pretending I haven't? But I have great experience: clinical experience; and bedside experience is the main thing, isn't it?"
 or  "I know your surgeons and their like. They've found out that a man's body's full of bits and scraps of old organs he has no mortal use for. Thanks to chloroform, you can cut half a dozen of them out without leaving him any the worse, except for the illness and the guineas it costs him"
manage to set the scene about how doctors were seen at the beginning of the last century with a very elaborate sense of humor.
Bernard Shaw by Einar Nerman, a swedish artist who moved to London in 1921 and chronicled its social and artistic life for 19 years.

The Doctor's Dilemma is a very interesting and a witty depiction of the medical science of the early 20th century that inspired William Beveridge to lay the foundation for the National Health Service, although I must admit that I got bored of the romantic part of the play.

No comments:

Post a Comment