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Vol. LIX, No. 1
January 12, 2007
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Practicing ‘Medicine for the Soul’
Lecture Looks at Medicine, Healers Portrayed on Stage

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To develop an enviable bedside manner, doctors might consider attending the theater. Historically, some of the most compassionate, effective models of medical care are seen in fiction on stage, according to recent National Library of Medicine lecturer Dr. Angela Belli.

“The human body under stress has been a source of speculation for dramatists since the first plays were presented before an engaged public,” she said, noting that Sophocles, in 409 B.C., offered one of the earliest portrayals of a warm and fuzzy physician in Philoctetes. A professor of English at St. John’s University in New York City, Belli discussed “The Art of Medicine on Stage: An Historical Perspective,” at a seminar hosted by NLM’s History of Medicine Division. “In an age when the powers of the human healer were restricted by a paucity of knowledge,” she said, “often the intervention of a god was the sole means of bringing about healing, at least on the stage. For Philoctetes the healing process begins with the power of love and compassion.”

Continued...


A view from Rockville Pike shows construction of the new two-level Visitor Center, one of three components of the Gateway project.

Dr. Angela Belli made the case for physicians learning from their fictional counterparts in theater.

It was centuries later, Belli noted, in a non-fiction document—the first Code of Medical Ethics— that Thomas Percival advised his fellow physicians to “unite tenderness with steadiness.”

In the code, the writer contrasts “coldness of heart—often a consequence of emotional detachment in practitioners—with the tender charity that the moral practice of medicine requires.” What Percival is arguing for, Belli said, “is clinical empathy, the skill that enables physicians to understand what patients are actually experiencing and to unite them both in trust and respect.”

Seven works of Shakespeare—in which eight health practitioners are portrayed—set high standards for in-depth insight into what patients want in their caregivers, she said, as well as what caregivers should strive to be in the complex role of healer. Unique perceptions in his plays, Belli observed, could reflect the fact that many of the medical characters in the Bard’s work were said to be based on the lives of real people. In addition, his son-in-law was a physician who probably influenced medical aspects of the work. Indeed, Shakespeare’s knowledge of maladies provided realism and authenticity to his plays.

Belli said human kindness can be a balm for suffering when science falls short—at least according to many playwrights. “In the absence of scientific data to effect a medical cure, the skill of compassion is particularly beneficial. The therapeutic value of touch” as well as insight into the emotions and mentality of people who are ill—centuries later studied as psychotherapy— can be traced to historical stage dramas, she continued.

“Shakespeare created practitioners who met the challenges of a medical system in which diagnosis was often inaccurate and prognosis problematic,” she said. “His doctor figures—particularly those who succeeded in producing some measure of well-being—are often credited with possessing secret potions or mysterious drugs. In fact, their secret is those curatives which even now current practitioners are in the process of discovering—compassion, empathy, love. Our current culture benefits from unprecedented scientific progress that has prolonged life and reduced suffering.

Machaon was a physician described as compassionate in Sophocles’ play, Philoctetes.

Machaon was a physician described as compassionate in Sophocles’ play, Philoctetes.

Nevertheless patients often feel their health care is lacking an important element. They experience practitioners as not [being] carefully attentive to them as persons, [but treating them] merely as objects that happen to harbor a disease. Such physicians fail to exhibit the quality with which Shakespeare endows his physicians.” Many modern physicians, she suggested, lack “medicine for the soul.”

Noting “a vital need to practice such medicine,” she said the medical community has in recent years begun exploring the increased effectiveness of care in health care. Belli cited a number of contemporary dramatists who are taking up where Sophocles and recognized-master Shakespeare left off: Current playwrights are “using their craft to examine these issues from the perspective of the humanist.”

She offered several examples of 20th century works in which medical personnel try—with varying degrees of success—to balance compassion with clinical skill: Edward Albee’s 1959 The Sandbox looks at how a family deals with the health and aging issues of an elderly relative; William Hoffman’s As Is, in 1985 one of the earliest plays to tackle the subject of AIDS, highlights the ways some in the medical community coped with patients; Cheryl West’s 1993 Before It Hits Home explores the same disease from a different perspective—a black male patient being treated by a white Jewish female physician; and Margaret Edson’s 1999 Pulitzer Prize-winning Wit contrasts the cold clinical insensitivity of a research fellow with the warmth of a nurse who “nourishes and sustains” a difficult patient contending with terminal illness.

“In our age,” Belli said, “the stage illusion has been shaped by two intersecting currents, one scientific and one artistic.” As technology advanced the use of diagnostic instruments and other devices in medicine, she explained, scientists began to explore psychological motivation and other mental aspects of healing.

Between Shakespeare’s era and current times, Belli pointed out, such “naturalists” as Emile Zola “brought the scientific view into the theater,” maintaining that “drama could explore social realities.” Seminal playwrights such as August Strindberg, Anton Chekhov and Luigi Pirandello, she said, further showed how “scientific observation could shape drama.”

Reviewing the dramas discussed, Belli concluded, “it’s clear that a social dynamic informs the work. Certainly contemporary creations are defined by a culture that varies notably from those of Shakespeare and Sophocles—particularly in the area of health care. [Still] they reflect images that audiences may locate on ancient Greek and Elizabethan stages. The question of influence must remain speculative. [Perhaps] Sophocles and Shakespeare arrived at similar conclusions based on their profound understanding of human nature.

“What is beyond doubt is that [both] were insightful to the point of creating healers who could offer some direction to practitioners in our time,” she said. “Classical texts on medical ethics occupy a place on the desks of medical students. I would recommend the addition of some good plays to complete the list of required reading.” NIH Record Icon

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