Profound Science and Elegant Literature: Imagining Doctors in Nineteenth-Century America

Profound Science and Elegant Literature: Imagining Doctors in Nineteenth-Century America

Profound Science and Elegant Literature: Imagining Doctors in Nineteenth-Century America

Profound Science and Elegant Literature: Imagining Doctors in Nineteenth-Century America


In 1847, at the first meeting of the American Medical Association, the newly elected president reminded his brethren that the profession, "once venerated," no longer earned homage "spontaneously and universally." The medical marketplace was crowded and competitive; state laws regulating medical practice had been repealed; and professional practitioners were often branded by their lay competitors as aristocrats bent on establishing a health care monopoly. By 1900, the battles were over, and, as the president of AMA had hoped, doctors were now widely venerated as men of profound science, elegant literature, polite accomplishments, and virtue. In fact, by 1900 the doctor had replaced the minister as the most esteemed professional in the United States; disease loomed larger than damnation; and science promised to manage the discord, differences, and excesses that democracy seemed to license.

In Profound Science and Elegant Literature, Stephanie Browner charts this trajectory--and demonstrates at the same time that medicine's claims to somatic expertise and managerial talent did not go uncontested. Even as elite physicians founded institutions that made professional medicine's authority visible and legitimate, many others worried about the violence that might attend medicine's drive to mastery and science's equation of rational disinterest with white, educated masculinity. Reading fiction by a wide range of authors beside and against medical texts, Browner looks to the ways in which writers such as Hawthorne, Melville, Holmes, James, Chesnutt, and Jewett inventoried the collateral damage that might be done as science installed its peculiar understanding of the body.

A work of impressive interdisciplinary reach, Profound Science and Elegant Literature documents both the extraordinary rise of professional medicine in the United States and the aesthetic imperative to make the body meaningful that led many American writers to resist the medicalized body.


What’s a doctor, after all?—A legitimized voyeur, a stranger whom
we permit to poke fingers and even hands into places where we
would not permit most people to insert so much as a finger-tip,
who gazes on what we take trouble to hide; a sitter-at-bedsides,
an outsider admitted to our most intimate moments (birth, death,
etc.), anonymous, a minor character, yet also, paradoxically,
central, especially at the crisis … yes, yes.

—Salman Rushdie, Shame, 1983

The profession to which we belong, once venerated on account
of its antiquity,—its various and profound science—its elegant
literature—its polite accomplishment—its virtues,—has become
corrupt, and degenerate, to the forfeiture of its social position,
and with it the homage it formerly received spontaneously and

—Minutes of the First Annual Meeting of the American Medical
Association, 1847

The world of illness and pain is a foreign land we would rather not visit. We distance ourselves from the sick, and those we anoint as official healers carry the burden of our most ambivalent feelings about the shame and pleasure of living in material, mortal bodies. We may wish to think of the healer as a minor character in our lives, one who lingers in the wings and makes only brief appearances. But we also turn to healers in moments of great need, hoping that they, along with their expertise, wisdom, language, and therapies, will return us to the land of the healthy. Inevitably, then, in every portrait of a doctor, nurse, shaman, or lay healer, we hear a culture negotiating who should have the duty and privilege of entering the sick room, listening to the patient’s story, attending the ailing body, and witnessing at the deathbed.

Medical practice in the United States has two traditions—folk and professional. Throughout the eighteenth and nineteenth centuries, the divide between the two was not rigid. a family might call in a lay healer on one occasion and a “regular” on another, and practitioners turned . . .

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