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Psychiatry and "Major Literature"

Key Words: Literature and Psychiatry

TO THE EDITOR: The letters about psychiatrists as major authors (1,2), reacting to an excellent article on poetry by Robert Pinsky (3), seem to be misguided in several aspects. To begin with, psychiatry is a fairly young specialty compared with the rest of medicine. How many psychiatrists were around at the time Anton Chekhov wrote his plays and short stories? Not many. Overall, the number of physicians who authored "major literature" (whatever it means—not everybody would consider work by practicing and nonpracticing physicians Archibald J. Cronin, Michael Crichton, or Walker Percy major literature) has not been large, and psychiatry is not the largest medical specialty. Reliable numbers for physician-authors and psychiatrist-authors do not exist, so we do not know how comparable the number of psychiatrists who authored "minor" or "major" literature is to the number for the rest of medicine. Authorship also takes many forms. How many of us know that a well-known present-day political columnist (not a "major" author, though), Charles Krauthammer, authored a classic article on secondary mania (4) in his previous career? Or how many consider the work of psychiatrist–minister M. Scott Peck (The Road Less Traveled) major literature?

This debate is also a bit culturally skewed. It focuses on so-called major literary works and major "national" literatures. I am not so sure whether in the "non-German-speaking lands in the West," Schnitzler does not approach the acclaim enjoyed by Williams or Chekhov, who were mentioned as examples. I agree that he does not reach the acclaim of Chekhov; only a few authors do, and Chekhov "has never attracted anything but admiration" (5). But how many people (and how many psychiatrists) still know the work of William Carlos Williams? Schnitzler, on the other hand, has enjoyed fairly high acclaim among German and non-German-speaking readers and psychiatrists in Europe.

In literatures other than English, there are many examples of well-known authors who are psychiatrists. One of the foremost Portuguese novelists, Antonio Lobo Antunes, is (or at least was at the time of his major literary writings) a practicing psychiatrist. The New York Times Book Review described him once as "A mad amalgam of Dos Passos and Celine." The Czechs have Josef Nesvadba, a well-known psychiatrist–science fiction writer. The Bosnian Serbs have the infamous psychiatrist-poet-nationalist-war criminal Radovan Karadzic. The Egyptians have Nawal El Saadawi, a well-known feminist. The Finns have Veronica Pimenoff. The Swedes have Axel Munthe, author of The Story of San Michele. And the Swiss have Walter Vogt (who switched to psychiatry from radiology), whose book Der Wiesbadener Kongress makes poignant fun of research and academia.

Finally, I feel that the assumption of a special role for psychiatry among medical specialties in regard to major literary writing is specialty-biased. Why do we assume that by "confronting daily the stuff of human narrative, drama, and fantasy, they [psychiatrists] would seem to be uniquely positioned to produce compelling fiction and poetry?" Why do we assume that the tragedy and suffering observed by psychiatrists is unique compared with the observations of other physicians?

Nevertheless, I agree that literary work by psychiatrists is educationally interesting (3) and enjoyable, and that it could and should be used as a teaching tool.

REFERENCES

1. Schwartz M: Psychiatrists as major authors? Academic Psychiatry 2001; 25:239[Free Full Text]
2. Scheurich N: Psychiatrists and the literary canon. Academic Psychiatry 2001; 25:239
3. Scheurich N: Robert Pinsky and the poetry of psychiatry. Academic Psychiatry 2001; 25:173-180[Free Full Text]
4. Krauthammer C, Klerman GL: Secondary mania: manic syndromes associated with antecedent physical illness or drugs. Arch Gen Psychiatry 1978; 35:1333-1339[Abstract]
5. Hensher P: Incomparable naturalism. The Atlantic Monthly, January 2002, pp 126-131

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