By Iain Bamforth

In this pithy abecedarium, surgeon and poet Iain Bamforth takes a detailed examine the clash of values embodied in what we name medicine—never completely a technological know-how and not rather the artwork it was. Bamforth brings his broad event of medication worldwide, from the high-tech American clinic of Paris to the group future health facilities of Papua, with his enticing curiosity within the stranger manifestations of clinical concerns in terms of paintings, literature, and culture—such because the mysterious “Stendhal’s syndrome,” which prompted 106 travelers in Florence to be hospitalized as a result of an overload of elegant Renaissance art.

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Its title? ‘On imaginary states of health’, with an epigraph from Claude Bernard: Les gens bien portants sont des malades qui s’ignorent. Well people are sick people who don’t know it yet. 38 This is a motto about the unwitting patient in all of us, and it turns out, ominously, to be the most telling line in the play. There are already some subtle worrying signs about Knock. He doesn’t know the church feast-days, not even Michaelmas, which is when Dr Parpalaid’s patients are in the habit of paying him.

He has made a discovery, and it isn’t medical but mythic. In the great Lie, wrote Hitler, there is always a certain force of credibility. It is the powerful who smile this way: it is a signal of their ironic treatment of social conventions, as if laws existed only for the stupid. Knock has found a way to deflect hubris. By deflecting it from himself, he obliges Nemesis to visit those who take him at his word. Nemesis is userfriendly and not at all dramatic, ladies and gentlemen, for these are modern times—Nemesis is the realisation that desire is both prerational and manufactured to the highest quality standards.

The nuciform sac turns up in another guise in Axel Munthe’s hugely successful, if hugely self-regarding, volume of reminiscences from the same decade, The Story of San Michele (1929), in which he tells how, when working in a private practice, the fashionable diagnosis of colitis, invented precisely to save patients from the scalpels of surgeons like Mr Cutler Walpole, ‘spread like wildfire all over Paris’. Munthe, a young Swede who qualified in Paris at the unheard-of age of twenty-two, was once called ‘the most fascinating man in Europe’: his persuasive bedside manner brought him a large clientele of largely wealthy patients whom he believed should be made to pay for the poorer (Knock has a system of ‘means-testing’ too).

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