books · narrative medicine · neuro

Dickens and Parkinson

I am making my way through Charles Dickens’ Little Dorrit for a class on the Victorian novel.  The Victorian novel concerns itself with society, not illness per se, so imagine, dear Reader, my surprise at coming across this:

Turning himself as slowly as he turned in his mind whatever he heard or said, he led the way up the narrow stairs. The house was very close, and had an unwholesome smell. The little staircase windows looked in at the back windows of other houses as unwholesome as itself, with poles and lines thrust out of them, on which unsightly linen hung; as if the inhabitants were angling for clothes, and had had some wretched bites not worth attending to. In the back garret–a sickly room, with a turn-up bedstead in it, so hastily and recently turned up that the blankets were boiling over, as it were, and keeping the lid open–a half-finished breakfast of coffee and toast for two persons was jumbled down anyhow on a rickety table.

There was no one there. The old man mumbling to himself, after some consideration, that Fanny had run away, went to the next room to fetch her back. The visitor, observing that she held the door on the inside, and that, when the uncle tried to open it, there was a sharp adjuration of ‘Don’t, stupid!’ and an appearance of loose stocking and flannel, concluded that the young lady was in an undress. The uncle, without appearing to come to any conclusion, shuffled in again, sat down in his chair, and began warming his hands at the fire; not that it was cold, or that he had any waking idea whether it was or not.

‘What did you think of my brother, sir?’ he asked, when he by-and- by discovered what he was doing, left off, reached over to the chimney-piece, and took his clarionet case down.

‘I was glad,’ said Arthur, very much at a loss, for his thoughts were on the brother before him; ‘to find him so well and cheerful.’

‘Ha!’ muttered the old man, ‘yes, yes, yes, yes, yes!’

Arthur wondered what he could possibly want with the clarionet case. He did not want it at all. He discovered, in due time, that it was not the little paper of snuff (which was also on the chimney-piece), put it back again, took down the snuff instead, and solaced himself with a pinch. He was as feeble, spare, and slow in his pinches as in everything else, but a certain little trickling of enjoyment of them played in the poor worn nerves about the corners of his eyes and mouth.

(Little Dorrit, ch. 9)

Frankly, that’s a better description of Parkinson’s disease than I’ve read in any neurologic textbook. James Parkinson wrote “An Essay on the Shaking Palsy” in 1817, when little Charles was still in short trousers. This annoys me, because wouldn’t be awesome if the first description of a disease comes not from the medical but from the literary world? Nevertheless, kudos to Dickens for being so observant.  (And by the way, Arthur Conan Doyle: you are a physician; surely you can do better than “brain fever” when you need to off a character.)

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books · MS-2

After the exam, I went down to the Strand to buy myself some quality reading material.  18 miles of books, and mostly half (or more!) off.  It’s like Ali Baba’s cave for me.

I picked up a couple of novels inside, but they also have these great 48 cent carts outside that are stuffed with used books.  I acquire all kinds of interesting finds there.  Like today: a 1970 copy of Understanding Medicine, written by some Brit whose author biography notes that he “worked with so-called maladjusted children” before going to med school.  He also has a German-born wife!  The scandal!

It’s quite an amusing read, a sort of precursor to the pop medical books you see these days in Borders and B&N.  I am hoping to come across something flat-out wrong, like maybe a reference to leeches or the vapors — something to show me that medicine used to be a hopeless tangle and nowadays, with our immense knowledge of signaling pathways, we have a Superior Understanding of the mechanism of disease.  But actually, the book seems pretty decent: straightforward and correct.  I admit that I am a little shocked.  People knew things before the Internet?  Really?

In short: a good find, especially for the price.  It will go very nicely with my first edition copy of Lewis Thomas’s Lives of a Cell, acquired around this time last year for the same price.