The novel follows Martin Arrowsmith from a small Midwestern town to the upper reaches of American research science. As a boy in Elk Mills he reads anatomy in the town doctor’s office, and at the University of Winnemac he falls under the spell of Max Gottlieb, a German bacteriologist who teaches him to distrust easy answers and love the laboratory above the clinic. Martin’s career moves quickly from medical practice into research as a vaccine discovery vaults him from a small-town practice into a prestigious New York institute, and finally to a Caribbean island where bubonic plague is raging. There he faces an ethical conundrum: whether to withhold his unproven cure from half the population to prove it works, or whether to save as many as he can without conclusive evidence. When his wife Leora dies in the experiment, Arrowsmith throws caution to the wind and immunizes everyone, sacrificing his chance at greatness. In the aftermath, he walks away from money, marriage, and fame to chase pure science in a rural cabin, leaving the reader to decide whether he’s really a hero or just a reclusive crank. 

Lewis wasn’t the first American writer to champion medical science. Willa Cather and Oliver Wendell Holmes laid some of this ground first. But biographer Mark Schorer isn’t wrong in saying that “Martin Arrowsmith was a new hero, scientific idealism a new subject, and scientific individualism a new (and rather unscientific) perspective.” And Lewis was probably the first American writer to coauthor a major novel with a scientist, the bacteriologist Paul de Kruif. 

Arrowsmith won the Pulitzer in 1926 (though Lewis refused to accept the award), and the novel was a major factor in the Swedish Academy’s decision to award Lewis the Nobel Prize in 1930. It represents a hard-fought accord between science and art that has vanished from the literary scene today. But it’s hardly a one-note celebration of science. Lewis suggests that once scientific medicine withdraws from public view, the ominous tropes of the nineteenth century may creep back in. 

Like most of Lewis’s novels,  Arrowsmith is filled with overwritten scenes and dialogue riddled with slang. But I’d be curious, if I could teach it to medical students today, how much of themselves they might see in the character of Martin Arrowsmith, a boy from flyover country who nearly rose to medical immortality but crashed, Icarus-like, on his own hubris. 

A Novelist and a Whistle-Blower 

Lewis was immersed in medical culture throughout his young life as the son of a rural physician, but he was not a scientist himself, and never aspired to a career in medicine. His father, Edwin J. Lewis, began his medical training at Rush Medical College in 1875, graduating two years later as an M.D. and eventually opening a small practice in Sauk Centre, Minnesota, where he advertised himself as a physician and surgeon. Memories of his father provided a general basis for the opening scenes of Arrowsmith, set in rural Winnemac (or Minnesota), but Lewis needed to grasp both the passion and methodology of real scientists to create his medical hero. 

Lewis met his coauthor, Paul de Kruif, at a meeting arranged by his publishers. De Kruif held a Ph.D. in bacteriology from the University of Michigan. He had also worked as a researcher at the Rockefeller Institute in New York, but had been fired after the director discovered that de Kruif had published an anonymous exposé of the Institute’s financial corruption and premature publication of scientific results. He was an ideal partner for Lewis, whose satires of the American Midwest elevated skepticism to an ethical ideal. As E. L. Doctorow observes, “Expecting his countrymen to be more than they were, looking for a resonant truth and righteousness, Lewis had found an American spiritual life that could elicit from him nothing more than bitter derision.” Lewis and De Kruif counterbalanced one another professionally, one steeped in medical science, the other in literary art, but they were both truth-seekers, through and through. 

De Kruif was professionally destitute when he met Lewis, having recently lost his position at the Rockefeller Institute. He had seriously jeopardized his chances of finding work in his field, as university bacteriology departments and pharmaceutical companies balked at hiring known whistle-blowers. He needed Lewis and the stimulus of a major literary project as much as the author needed his expertise. 

Lewis gave De Kruif “assignments” during their travels, such as writing a fictional biography of Gottlieb, Arrowsmith’s mentor. The apprenticeship would later pay off for De Kruif, who became a bestselling author of scientific history just one year after the publication of Arrowsmith. His book The Microbe Hunters, which sold over one hundred thousand copies in 1926, alone, was one of the major nonfiction books of the decade. 

Indeed, De Kruif learned literary craft so well that it’s impossible to know who wrote certain passages in  Arrowsmith. Take, for instance, the scene where Martin realizes that he is about to make a potentially groundbreaking scientific discovery about the behavior of bubonic plague. Late at night, alone at the McGurk Institute (the fictionalized Rockefeller Institute), Arrowsmith simply can’t wait to process his lab results: 

At a hectic run, not stopping for lights, bumping corners and sliding on the too perfect tile floor, he skidded down the stairs and galloped through the corridors to his room. […] 

Then he forgot…war, night, weariness, success, everything, as he charged into preparations for an experiment, his first great experiment. He paced furiously, rather dizzy. He shook himself into calmness and settled down at a table, among rings and spirals of cigarette smoke, to list on small sheets of paper all the possible causes of suicide in the bacteria. 

Lewis and De Kruif collaborated so intimately that the scientist began to write like the novelist and the novelist began to think like the scientist. They should have shared the honors that followed, but Lewis insisted on crediting De Kruif more as a fact checker than as his equal. 

Cruelty or Cure? 

It’s hard to imagine language like this from a doctor now, but Martin Arrowsmith dedicates himself to the search for “the Why that made everything so.” Impatient with memorizing facts, he “wanted to look behind details and impressive-sounding lists of technical terms for the causes of things, for general rules which might reduce the chaos of dissimilar and contradictory symptoms to the orderliness of chemistry.” Arrowsmith believes in precise technique, but he’s also emotionally invested in the work, demonstrating an almost fanatical belief in the scientific method. 

His defining characteristic is his curiosity, which helps him crack riddles others see as mere aberrations. Lewis writes, to this effect: 

Now in Martin Arrowsmith there were no decorative heroisms, no genius for amours, no exotic wit, no edifyingly borne misfortunes. He presented neither picturesque elegance nor a moral message. He was full of hasty faults and of perverse honesty; a young man often unkindly, often impolite. But he had one gift: curiosity whereby he saw nothing as ordinary. 

When he sees something weird in his test tubes, he says, “Now there was some cause for that, and I’m going to find out what it was.” This is how Arrowsmith discovers the X Principle. He tells his wife Leora that it could lead to the cure of every germ disease, which overstates the case, but it is a major scientific breakthrough—not only for Martin, but potentially for humankind. 

Arrowsmith’s X Principle is a remarkable development in the novel. Perhaps for the first time ever in American fiction, Lewis invites a reader to participate in the euphoria of scientific discovery, rooting for the medical scientist as he plugs away in the laboratory. Later he causes a stir among the farmers in Wheatsylvania, the little town where he briefly sets up a private practice, by curing a seemingly unstoppable blackleg epidemic with an original vaccine prepared in the makeshift laboratory at the back of his doctor’s office. The vaccine requires several experimental dry-runs, but Martin works on the project after hours, glad to be searching for the root cause—the Why—of the disease. 

Later, Arrowsmith travels to St. Hubert, a fictional Caribbean island, to test the X Principle on a population besieged by bubonic plague. Verifying the efficacy of his bacteriophage would require a control group, which would mean denying the remedy to a portion of the populace. Is it more compassionate to inoculate everyone with an unproven (but promising) remedy or to withhold treatment for conclusive proof, thereby guaranteeing the health of future generations? It’s an important ethical question, but one that politics ignores. It’s hard to name a doctor today who is both publicly promoting scientific knowledge and defending human rights in quite this way. 

Arrowsmith develops a high-stakes debate over humanitarianism. One doctor argues that temporary cruelty does not justify eventual compassion; accordingly, he refuses to receive the preventive bacteriophage inoculation until the entire population of St. Hubert has been immunized. Arrowsmith’s mentor, Gottlieb, insists that true humanitarianism requires establishing irrefutable scientific facts. Gottlieb corners Arrowsmith before he leaves for St. Hubert and delivers one of his longest speeches of the novel. The St. Hubert experiment is Martin’s chance to become a “Great Man,” and Gottlieb intensifies the pressure: 

Be sure you do not let anything, not even your own good kind heart, spoil your experiment at St. Hubert. I do not make funniness about humanitarianism as I used to […]. So many men, Martin, are kind and neighborly; so few have added to knowledge. You have the chance! You may be the man who ends all plague […]. 

You must not be just a good doctor at St. Hubert. You must pity, oh, so much the generation after generation yet to come that you can refuse to let yourself indulge in pity for the men you will see dying. 

As I write this,  doctors are taking to Instagram to protest insurance companies who deny patients coverage for life-saving procedures. We’re having a hard enough time helping people now; no one is talking about the generation after the generation yet to come. But this is what Lewis imagines in Arrowsmith’s unorthodox heroism: by withdrawing from society into the laboratory, as he does to prepare his blackleg serum or to discover the X Principle, Arrowsmith has a chance to become a legendary benefactor of public health. But is the greatest degree of human compassion possible only through momentary cruelty? 

Arrowsmith’s heroism might have been lost on the popular audience had Lewis seen the St. Hubert experiment through to the end. Instead, Lewis creates a strategic compromise. First, he sets up the conditions of the experiment, outlining arguments for and against denying the vaccine to portions of the St. Hubert population; this lends credibility to Martin Arrowsmith as a scientific physician by highlighting the complexity of his choice. Then Lewis derails the experiment with the accidental death of Arrowsmith’s wife Leora, who dies suddenly of plague. Stricken with grief and guilt (because he had been entertaining adulterous thoughts at the time of her death), Martin begins administering his serum indiscriminately to the people of the island, compromising the scientific integrity of his results, but demonstrating his capacity for emotion. 

After Leora’s death, he returns to the self-destructive behavior of his vagrancy during medical school, drinking heavily and acting as if he no longer cares about knowledge or the accompanying reward of fame. Lewis writes: “[…] all day, Martin injected a line of frightened citizens, in the Surgeon General’s office,” during which time he “had a bitter satisfaction in throwing away all his significance, in helping to wreck his own purposes.” In the end, no one knows whether the plague disappears from St. Hubert as a result of “phage or rat-killing or Providence.” The result is tragic by Gottlieb’s standards, but it further endears Arrowsmith to readers, whom Lewis manages to educate about the ethical quandaries of research science while introducing the research scientist, himself, as a man of passion and human weakness. 

Arrowsmith loses his chance to enter the historical record alongside scientific greats such as Pasteur, but Lewis reinforces his heroic stature on the human level. Alongside characters like Hawthorne’s Rappaccini who becomes so obsessed with science that he forgets humanity, Arrowsmith’s capacity for emotion in the heat of his greatest experiment is extraordinary. In fact, I’d like a little more evidence that grief, for today’s doctors, is as powerful as scientific curiosity, profit, or personal branding. We could use more reminders that science happens in social contexts and that it is vulnerable to the weaknesses and biases of those who do it and the systems that support it. 

A Flawed Hero 

Arrowsmith is a bildungsroman—the first to show how an ordinary person becomes a scientific hero—but it borrows from other literary forms, such as the epic and the portrait of the artist. 

Martin is raised in a small town called Elk Mills, where he is the “unofficial” assistant to Doc Vickerson, the self-styled “plug doc” and alcoholic who has managed to compile the first museum of natural history in the county. In a drunken speech, Vickerson tells the young Arrowsmith to get all the training he can in the sciences in order to realize his full potential as a physician. “Set a high goal,” he admonishes Martin. “Don’t let things slide. Get training. Go college before go medical school. Study. Chemistry. Latin. Knowledge!” A nice little pitch for the liberal arts, even if it sounds quaint to us now. 

The University of Winnemac is Arrowsmith’s portal to opportunity, where preparation for medical school consumes his life. His entire identity revolves around his education, where “the purpose of life was chemistry and physics and the prospect of biology next year.” Arrowsmith’s junior year of college is set in 1904, and the descriptions he hears of Gottlieb, his professor of bacteriology, reflect lingering stereotypes of the medical scientist as a rogue. Rumors about Gottlieb suggest that “he was doing terrifying and costly experiments which probably had something to do with human sacrifice. It was said that he could create life in the laboratory, that he could talk to the monkeys which he inoculated, that he had been driven out of Germany as a devil-worshiper or an anarchist.” 

Gottlieb, whose name translates literally from German as “Godlove” and more accurately as “Beloved God,” recalls the master-apprentice relationship typical of the bildungsroman through his mentorship. From his introduction in the Winnemac scenes, Gottlieb remains the dominant influence on his young protégé throughout the remainder of the novel. When Arrowsmith asks to be admitted into his course before having taken all of the prerequisites, Gottlieb says: 

There are two kinds of students the gods give me. One kind they dump on me like a bushel of potatoes. […] The other kind—they are very few!—wish a liddle [sic] bit to become scientists, to work with bugs and make mistakes. Those, ah, those, I seize them. I denounce them. I teach them right away the ultimate lesson of science, which is to wait and doubt. Of the potatoes, I demand nothing; of the foolish ones like you, who think I could teach them something, I demand everything. (11) 

He goes on to tell Arrowsmith that he must take physical chemistry before he will be ready for bacteriology; this is the difference between true scientists and imitators. Gottlieb’s first public experiment, an inoculation of guinea pigs with anthrax repulses many of Arrowsmith’s classmates, but the young Martin later imagines himself repeating experiment: “as he remembered Gottlieb’s unerring fingers, his hands curved in imitation.” 

But Arrowsmith needs flaws if he is to be taken seriously as a character, and he nearly destroys himself at several crucial moments in the narrative. The same restlessness that fires his curiosity is also his potential undoing—binge drinking makes him careless in the laboratory and lack of sleep makes him belligerent. When Gottlieb reprimands him for a series of avoidable errors, Arrowsmith’s defiant response nearly ends his medical career. The medical dean decides to suspend rather than expel him, and Martin is temporarily exiled from the University that has been the primary touchstone for his identity as a young adult. 

But Arrowsmith’s flaws show that the most promising benefactors of public health sometimes seem the most misanthropic by nature. For Lewis and De Kruif, two idealists who effectively replace religion with science, pure science requires complete devotion. This is a high standard that none of Lewis’s characters fully attains; it’s in their failings that he endears them to readers, unveiling the joys and heartaches of a scientist, making the doctor’s emotional life known. 

Back to the Lab, Out of the World 

If the novel were to end in St. Hubert with Martin Arrowsmith doling out medicine to everyone in sight, it might be a story about compassion defeating cold-hearted science. Leora would be a martyr and Martin would be a widower, unselfishly serving humanity. But the story doesn’t end there: Martin marries Joyce Lanyon, a wealthy woman from New York, and briefly celebrates the birth of a son before divorcing Joyce, abandoning his son, and withdrawing to a remote cabin to dedicate his life to research. Arrowsmith is hard to like as a deadbeat father and cultural isolationist. Why, after taking such pains to help us understand the beauty and importance of science through Arrowsmith’s life, would Lewis turn his hero into such a miserable person? Is that really what science does to the heart? 

Lewis leaves us with a paradox. Nearly all of Arrowsmith’s flaws are scientific virtues: his brutal honesty, his distaste for wealth, his comfort with solitude. But  Arrowsmith’s  most troubling implication is that the medical scientist might give up trying to communicate with the public at all, choosing, instead, the uninterrupted calm of the laboratory, where discoveries happen unseen. When that happens, we’re thrown back to the distrust of the nineteenth century. Are the researchers devoted to unlocking the great Why beneath physical things today doing it for themselves or for humanity? Are they Arrowsmiths or Rappaccinis? 

The public story of medicine is a balancing act. It requires careful translation of facts into culture. It’s hard work, and it never ends. It’s much easier for suspicion to prevail. 

That’s why I see  Arrowsmith as a miracle. Think about what it took for that book to exist. It took a Paul de Kruif: a researcher with enough integrity to sacrifice financial gain for truth-telling. And it took a Sinclair Lewis: a kindred spirit who was willing to make an artist of a lab scientist. 

In Martin Arrowsmith, the scientific physician comes of age as a character, no longer a shadowy villain, but an artist in his own right: a figure whose potential for greatness or failure extends the medical narrative to the full scope of human experience. 

Web photo: Wiki Commons

The nature of phantom limb pain has bedeviled amputees and bewildered physicians and surgeons for centuries; up to 87% of amputees experience it during their lifetime. Consistently effective treatments remain elusive. Biomedical texts on the subject are at once complex and speculative. Olga Tokarczuk, in her 2018 novel, Flights, imagines what phantom limb pain could be like for someone, and the desperate search for relief it can produce. 

Flights centers mostly on the narrator’s travels among different places and across different times. It comprises mostly packets of individual story vignettes and fragments; some short, some long; some fictional; some real, some both. And though many different stories are told with many different characters about many different subjects, something about travel connects them all.  

Certain preoccupations manifest themselves in various parts of the book. One in particular concerns the technical aspects of preserving human body parts, which comes into play in a story fragment involving phantom limb pain. The main character is Philip Verheyen, who is a real historical figure known as a renowned Flemish surgeon and anatomist of the late seventeenth and early eighteenth centuries, and as the author of Corporis humani anatomiae (1710).  

As Tokarczuk tells the story, Verheyen was twenty-eight-years old in 1676 during his second year of university in Leiden when he scraped his left calf on an exposed nail of the stairway leading to his rented lodgings. His pants were torn and his skin broken. Though the injury seemed minor at first, it evolved into a raging infection that later required below-the-knee amputation.  

With the care of his landlady, Verheyen recovered after which he was seen “tapping his peg over the uneven paving stones of Leiden,” to attend lectures on the subject of anatomy at the university medical center.” (p. 195) In a matter of a few weeks after the amputation, however, the pain started. 

The pains came at night as his body was relaxing and slipping across the uncertain boundary between waking and sleep…He would have the impression that his left leg was numb, and that he absolutely had to get it into the right position—he felt his toes tingling, an unpleasant sensation. He fidgeted, half conscious. He wanted to move his toes, but the unperformability of that movement awoke him completely. He would sit on the bed, tear the blanket off himself, and look at the aching place—it was some thirty centimeters below the knee, there over the rumbled sheet. He would close his eyes and try to scratch it, but he touched nothing, his fingers combed the void in despair, giving him no relief. (p. 203) 

In imagining how Verheyen could respond to his desperation for relief, Tokarczuk draws on his intense interest in preserving human body parts. Before the amputation, he begs the surgeon to “preserve the removed leg.” (p. 193) The surgeon followed Verheyen’s detailed instructions for preparing his amputated limb by placing it “in a glass vessel filled with a balm of Nantes brandy and black pepper.” (p. 193) Verheyen kept it “on his headboard or stretched scarily out on the table.” (p. 196) Eventually, he looks to it as a possible source of relief. 

Once, in a fit of despair, when the pain and itching were driving him mad, he stood and with trembling hands lit a candle. Hopping on one foot, he moved to the table the vessel with the cut-off leg [rested]…He extracted the limb and in the candlelight tried to locate in it the reason for the pain…He sat down on the floor, stretched his legs out before him, and laid the amputated limb on the place just below his left knee. He closed his eyes and groped for the painful place. His hand touched the cold piece of flesh—but could not reach the pain. (pp. 203-204) 

Verheyen’s maneuvers and observations did not provide him relief. With his medical training, he begins thinking about mechanisms that could be causing this excruciating and frustrating phenomenon. 

What is it that awakens me, when I feel pain and suffering, since my leg has been separated from me and is floating now in alcohol? There is nothing pinching it, no reason for its suffering, no such pain that can be logically justified, and yet it exists. Now I look at it and simultaneously feel in it, in the toes, unbearably hot, as though I were submerging it in hot water, and this experience is so real, so obvious, that if I were to shut my eyes, I would see in my own imagination the bucket of water overly heated and my own foot submerged from toes to ankle. I touch my bodily existing limb in the guise of a lump of preserved flesh—and I don’t feel it. I feel, meanwhile, something that does not exist, it is in a physical sense an empty place, there is nothing there that might give any sensation whatsoever. The thing that hurts does not exist. A phantom. Phantom pain. (p. 208)  

He comes up empty. 

Tokarczuk cannot imagine Verheyen would let the issue lie and accept it simply because he is without an anatomical or pathophysiological explanation. She knows that before he began his schooling in medicine, he was studying theology towards becoming a Catholic priest. In fact, in the book and in his real life, the amputation disqualified him from Catholic priesthood. So, Tokarczuk brings his theological training into thoughts he could have about this phenomenon that is torturing him from spiritual realms, and in this way leaving Verheyen to contemplate the mind / body relationship. He concludes, “The body is something absolutely mysterious.” (p. 209)  

It still is.  

Web image generated with Dall-E 2

What makes The Magician so unique as a novel is its depiction of writing as an all-encompassing creative activity that consumes the author’s full psychic energy and that emerges out of his personal struggles as an individual. It would be impossible to affix The Magician to the back cover of all editions of Buddenbrooks or The Magic Mountain. Tóibín offers more than a page of scholarly references to help a reader gain background knowledge about Mann, his life, and the times. But if you are interested in what it might have been like for Thomas Mann to compose these monumental works, Tóibín’s book might offer the best entry point into Mann’s artistic mind and his creative persona.  

The novel covers the full panorama of Mann’s life, from his somewhat pampered childhood in Lübeck, Germany, to his final years spent in the German expatriate community of Los Angeles. The writer’s camera is laser focused on ground level details and refuses to zoom out to the big picture and lose its granular tone. The texture of the bourgeois lifestyle of the Mann family is captured in all its minutia including rowdy family meals, community engagements, and professional insults. One can almost feel the temperature rise and the climate change as Mann and his family move from Munich to Princeton and finally to Pacific Palisades. Mann exerted very tight control over his daily routine and one senses his absence on the page as he withdraws to his private study every morning after breakfast to write without any interruptions. We are excluded from this sanctuary just like his wife and children as they waited for him to emerge after lunch for his afternoon walk and some playtime with them.

Mann was more than a prominent novelist. He was a winner of the Nobel Prize in Literature in 1929, globally recognized and one of the most famous personalities of his time. He hobnobbed with dignitaries and the leading figures of the pre-World War II era, including Einstein and FDR. They parade across the pages of the novel with all their foibles and idiosyncrasies. Tóibín details Mann’s tempestuous relationship with Agnes Meyer, a leading figure in high society along the New York-Washington DC corridor. I had to look her up to learn that she was a well-known journalist and civil right activist and Katherine Graham’s mother to appreciate her impact on the world during the 1930s and 40s. 

The most striking feature of the book is the intimate recounting of Mann’s tortured struggles with his sexual orientation, which infiltrated his fiction from the very beginning of his career. He never denied his homoerotic longings and Tóibín delicately describes the many occasions during his long life when Mann was overwhelmed with desire for a particular man and his secretive attempts to act on his cravings. But he was a man of his era and was forced to submerge his identity as a gay man most of the time. The emotional cost of a life lived closeted on the one hand, and as the married father of six children on the other, is readily apparent. Reading The Magician motivated me to reread Death in Venice and made me realize the courage it must have taken for Mann to portray Aschenbach’s tragic story in such complex but precise prose, to reify his own emotional turmoil without sanctimony or defensiveness. Tóibín’s prose is the ideal conduit to channel the roiling interface between the Mann of the larger world and the inner literary mind of a flesh and bones historical human being. 

The Magician is an engrossing reading experience that also has special salience for followers of the MedHum website, which explores the role of the individual in a changing society. A key element that drives the narrative forward is Mann’s engagement with the political developments in Germany over the long period spanning from the lead-in to World War I, to the outbreak of hostilities in August 1914 and again in September 1939 and the devastating war years, and ending with the rebuilding of his native country. At the start, Mann saw himself as heir to a tradition of German intellectual excellence and nobility. He took great pride in his country and patriotically defended the decision to go to war against France, Britain, and Russia in August 1914. However, he recognized the dangers posed by the Nazi seizure of power and openly decried the degradation of public life. Mann felt the Nazi destruction of the German cultural heritage as a personal betrayal. Mann recognized early on the brutality of the antisemitic legislation and the attacks on his Jewish colleagues. He was forced to weigh loyalty to country against the defense of universal humanistic principles and he struggled to find a path forward between these competing ideals.  

As Hitler rose to power, were Mann’s instincts right that this would bring calamity to Germany, or should he have had trust in his fellow citizens that things would right themselves? How much could Mann rely on his interpretation of unfolding political events and his prediction of what the future would look like? Once the Nazis consolidated their dictatorial control of the Reich and set out on a course for total war and extermination of the Jews, should Mann have been a strident and outspoken opponent of the regime or should he have worked more discreetly behind the scenes? Should he have remained in Germany and risked his own life and the safety of his family, especially his wife’s Jewish relatives, or sought refuge in America, where he could serve as a champion of cultural enlightenment and world peace? How does one weigh the facts and decide on an effective course of moral action? How does one choose among imperfect options? 

Like all of us, Mann was forced to anticipate events and make painful decisions—decisions that would play out over time and have consequences for others– in real time and with only partial or inaccurate data. Much like the case with physicians and other health care professionals, most of these decisions will work out well, some will be imperfect, and a few will even be wrong. Tóibín’s novel, history as fiction, vividly illustrates the human predicament of living while moving forward with uncertainty and anxiety because full clarity only comes in retrospect — something that doctors understand because they experience it nearly every day in encounters with their patients.  

The Magician – Reading by Colm Tóibín & Conversation with Friedhelm Marx at the Thomas Mann House 

The Magician: A Novel 
Colm Tóibín 
New York: Scribner, 2021, 512 pages  

Photo of Thomas Mann generated from Wikicommon Photos

German physicist Wilhelm Roentgen discovered X-rays in 1895 and received the inaugural Nobel Prize in Physics in 1901. One of the earliest X-rays he took was of his wife’s left hand. Her initial reaction to viewing the image was fright, accompanied by the proclamation: “I have seen my death!” Roentgen did not want the mysterious rays named for him. Instead, the letter X was chosen. Lobdell intriguingly contemplates the power, allure, value, and mystery conjured by that letter. X is employed as a warning symbol, a sign for measurement (2” x 4”) and multiplication, an indication of deletion. There is an X chromosome, X-rating, X-Files, the X-Men, and of course the platform X (formerly known as Twitter).

After their discovery, the use of X-rays spread rapidly even though pioneers of the technology tragically suffered from (often) fatal radiation poisoning and cancer. During World War I, Marie Curie designed mobile X-ray units placed in vans (dubbed “Little Curies”) that delivered the technology and its ability to rapidly diagnose injuries to the battlefield. 

Beyond the significance of establishing an accurate medical diagnosis, Lobdell explores the impact that X-rays have on so many aspects of human culture – literature, cinema, art, language, and even political cartoons. Society now had a different way to view life. Looking inward took on a new meaning. Notions of transparency and exposure merited rethinking. Getting an X-ray was paradoxically an impersonal and intimate act that raised concerns about voyeurism and privacy. Yet a desire to “see inside oneself” became quite popular.

For a time, a kind of X-ray “mania” swept America. The comic book hero Superman made his appearance, and X-ray vision was one of his many super powers. The shoe fluoroscope was a popular device to visualize how a customer’s feet fit properly into shoes during the 1920’s -1960’s. Chest X-rays were widely utilized to screen for tuberculosis from the 1930’s thru the 1960’s. Cabinet X-ray machines to view the contents of luggage and backscatter passenger scanning became fixtures at airports (examples of how X-rays suggest “security”).    James Bond sported X-ray glasses in the film, The World is Not Enough. In 2021, an emoji of a chest X-ray became available. 

X-ray, a small book that punches above its size and weight, is part of the Bloomsbury Academic publisher’s series titled “Object Lessons” that explores “the hidden lives of ordinary things.” Other medically-relevant texts in this series include Doctor, Pill, Pregnancy Test, and Tumor. 

These days, most people are accustomed to being X-rayed – radiographs taken in the ER following an accident or fall, routine dental X-rays, getting X-rayed at the airport, a chest X-ray done for a persistent cough. Some folks are reasonably concerned about the risks of radiation and the overutilization of this technology. Yet ultimately, subjecting yourself to X-rays is a risk-reward calculation that promises diagnosis, maintenance of health, or security in exchange for limited exposure to radiation and permission to intrude on privacy. Lobdell pens a clear, big picture of a surprisingly many-sided subject. The result is a glowing and penetrating examination of the importance, meaning, and influence of X-rays on not just health but all facets of life.  

X-ray by Nicole Lobdell
New York and London: Bloomsbury Academic
2024
121 pages
ISBN 9781501386701