Of the five Pulitzer Prizes for Letters and Drama in 1926, two went to medical topics: Arrowsmith by Sinclair Lewis and The Life of Sir William Osler by Harvey Cushing. Lewis would eventually win also a Nobel Prize. Cushing, a neurosurgeon, never did, despite dozens of nominations.
Tale of Two Physicians
Arrowsmith is a classic bildungsroman or ‘coming of age’ novel, in this case, the young physician as anti-hero. Cushing’s biography of Osler, on the other hand, is a paean to the wisdom of a full and esteemed career.
“Cushing accepted his prize hoping that Osler’s benevolent bedside manner would overshadow Arrowsmith’s glorification of medical research.” This contrast epitomizes the words of another Pulitzer winner that year, the poet Amy Lowell: “Youth condemns, maturity condones”.
Osler was internationally famous. He co-founded Johns Hopkins Hospital, gave his name to at least eleven eponymous conditions and first characterized pneumonia as “the old man’s friend”. He was revered.
The fictional Dr. Arrowsmith was a soul in search of a religion. He found it in medical science, after first embracing then rejecting life as a private practitioner and public health officer. He struggled with scientific duty versus compassion when assigned to test his new bacteriophage treatment for the plague, which took the one true love of his life, the nurse he married early on. The story ends when he leaves a new family behind and commits to unfettered laboratory research—in a cabin in Vermont with the one colleague who shares his vision.
Stories Behind the Stories
We now turn to the true stories behind this story. Scientific medicine had captured the imagination of the public in 1925, perhaps akin to present day notions about tech entrepreneurs. Bacteriophage, one of the characters in Arrowsmith, had recently been discovered and was the big hope during the pre-antibiotic era. And the public was cheering the heroism of the men and dogs that risked their lives to deliver diphtheria antitoxin to Nome Alaska—the “Great Race of Mercy” that made the sled dog Balto a hero worthy of a statue in Central Park.
At this point, Lewis was already famous, thanks to Main Street. His next topic, medicine, came at the behest of two admirers: the journalist HL Mencken and Dr. Morris Fishbein editor of JAMA. They introduced him to Dr. Paul DeKruif, a bacteriologist—not yet known as a writer (Microbe Hunters) he had been recently fired from the Rockefeller Institute over his book Our Medicine Men.
We now know that DeKruif bestowed authenticity to Arrowsmith by borrowing from the real world of medicine. The University of Winnemac is DeKriuf’s alma mater (and mine) the University of Michigan. Dr. Gottlieb is an amalgam of the famed Drs. Frederick Novy/Jacque Loeb. The McGurk Institute is the Rockefeller Institute.
A dramatic highlight comes when Arrowsmith is found praying in his lab: God give me…freedom from haste…anger against pretense…nor [shall I] accept praise till my observed results [are validated]…” As Dr. Markel, Professor of Medical History, observes in his engaging essay on Arrowsmith “Sadly, today one cannot fathom a research scientist praying for anything so noble when there are patent applications…to fill out and stock options to consider.”
Son of a Physician
Lewis, the son of a physician, unmasks in Arrowsmith both the sacred and profane faces of the medical profession. His depictions are timeless. The physician reading today would recognize every persona and every dilemma.
Martin Arrowsmith has been portrayed on radio, film and television by the likes of Ronald Coleman, Spencer Tracy, Orson Welles and Tyrone Powers.