George Bernard Shaw
The Doctor and The Prince
Originally entitled An Improbable Fiction and part of a book called Doctors' Delusion
I recently ran across this terrific story in an anthology.
The story was written long ago by GB Shaw,
who was not a physician but had a keen awareness of medical practice.
His insights are like those of Voltaire who never practiced medicine.
(Roscoe Pound, who was trained in botany and never practiced law,
was said to have been America's greatest legal mind. Think about that.)
The present piece was written almost a hundred years ago,
but synopsizes many of the concerns discussed in People Medicine.
upon a time, in the country of the Half Mad, which was cut off from the
western end of Europe in prehistoric times to prevent the inhabitants
from injuring any but themselves, the King fell ill. As he had always
been well spoke of, and had established very kindly relations with his
subjects, his illness caused a great increase of their affection for
him and his family. All the married women saw in the Queen a wife
anxious about her husband, with a sick-bed to provide for. All the men
saw in the King a fellow-man suffering as they themselves had suffered
or might at any moment have to suffer. For sickness is a Great
Leveller, and consequently a great breeder of sympathy added to
loyalty, the nation was in such a state of concern about the King as
had never before arisen within living memory. Naturally, the case being
one of dangerous illness, it was to the doctors that the nation turned
for help and reassurance.
Now in the country of the Half Mad the doctors had long before this taken the place of the medieval Church. There was a law that when a man was ill he must on pain of punishment send for his parish priest; but this law had been so long disregarded that only a few specialists in Church history knew of its existence. Its place had been taken by a law that when there was sickness in the house the doctor must be sent for, and that if the doctor said that any part of a sick child’s body must be cut out its parent must have that done at once whether they approved or not, or else be haled before a magistrate and heavily fined, or, should the child have died, committed for having killed it.
To such powers as this were added extraordinary privileges. For instance, doctors were licensed to commit murder with impunity, provided they did it either administering poison or by using knives of a particular shape in such a manner that the victim did not die until he or she had been put in bed. Not only was no inquest held and no indictment brought against the do, but he was actually paid for his labor, and sometimes invited to the funeral.
As the Half Mad were so jealous of their liberties that a priest could not even order a father to have his child baptized, it will be seen that this strange people, though half sane on the subject of priests, were wholly mad on the subject of doctors, willingly granting them powers which they had denied to their Kings at the cost of revolution and civil war.
Now the doctors, being no worse than other people, did their best to prove worthy of their extraordinary trust by using it for the relief of the sick, and making it impossible for anyone to become a doctor except by years of study to qualify him for his duties. But as the Half Mad, whilst bowing down with the deepest reverence to the condition of conscience which they supposed these studies to confer, would not pay a doctor anything until they were actually ill and threatened with death, the doctors were mostly poor, and would have starved altogether if the nation had been in a reasonably healthy condition. Thus their duty to themselves and their wives and children was to keep their patients ill as long and as often as possible; to persuade them that they were dangerously ill when there was nothing the matter with them that their recuperative powers could not cure; and even to deprive them of as many of their limbs and organs as they could without killing the goose that laid the golden eggs. On the other hand, their duty to their parents and their country was to do exactly the contrary, and strive to their utmost to produce a state of things in which doctors would starve.
Now in the kingdom of the Half Mad, people always ended by believing what they wanted to believe, no matter how much it might be contradicted by facts; and so it had come about that the doctors, though they were as kindly and honorable as could reasonably be expected, and sometimes very clever, had built up an elaborately reasoned ingenious series of mechanical explanations of all the diseases, giving them impressive names, and setting forth the treatments and operations and medicines proper to them, until at last they could do almost anything with a patient except cure him or even allow him a fair chance of curing himself. Thus the calling of a doctor to the sick-bed was rather a pious ceremony enforced by law that a proceeding from which any relief to the patient could be expected. But the patient would die in their hands; and this was very necessary for the settlement of the affairs of the patient who had any affairs to settled.
With a Faith (for such it was) in this condition, naturally there were Heresies in all directions. New methods of treating disease were discovered; but the doctors took so long to learn the old ones that they had not time for new ones. Even the surgeons had to do without any manual training and picked up their art as the father of a family picks up the art of carving a turkey. So, instead of adopting the new methods, they excommunicated the new practitioners and all their accomplices. Only, as the heretics either cured their patients or at least did not kill them by obsolete and barbarous treatments, the doctors, when they were ill themselves, often resorted to the heretics for treatment.
This was the state of things when the King fell ill. He had twelve doctors to attend him; and when there was no sign of his being cured, his people became anxious and said, “A single doctor is generally sufficient to kill one of us, so how can the King survive twelve doctors?”
Then the King’s son, who was at the other side of the world among the black savages (for he was very tired of the white ones), came flying, sailing, and express-training at an amazing speed back to his father, and spoke with the King’s chief physician, who was so delightful a person that his patients were often cured by his mere appearance in the bedroom. The Prince knew that the father’s case must be most serious since it resisted the presence of this great healer and the influence of the King’s faith in him.
And the Prince said to him: “Doc, the King my father does not seem to be getting any better. Is it not possible to ge a move on?”
“In what direction, sir?” replied the chief physician.
“In the direction of getting him up and about,” said the Prince.
“Everything is being done that can properly be done,” said the physician. “If your Royal Highness has not confidence in our knowledge and devotion --”
“Stow that,” said the Prince. “Your devotion is all right, but your knowledge is bunk.”
“Bunk!” exclaimed the chief physician, highly scandalized.
“Well, perhaps not all of it,” said the Prince, feeling that he had gone a little too far, “but I cannot help knowing what everyone knows, and that is that according to your own best men nine-tenths of your official notions are fit only for the dustbin. I have a heap of letters, books, pamphlets, and magazines here which have been sent me; and they have disturbed me very much.”
“I have not read these documents,” said the physician. “If your Royal Highness can suggest any measure we have omitted, my opinion is at your service.”
“Drugs, now?” said the Prince. “Drugs are bunk, are they not?”
“Undoubtedly, from a purely secular point of view, drugs are bunk,” said the physician, “but in the case of a royal patient I could not possibly take the responsibility of withholding form His Majesty the official remedies from our materia medica.”
“But,” said the Prince, “there is a way of giving drugs in infinitesimal quantities to which all the latest discoveries and scientific speculations point as the right way.”
“Infinitesimals,” replied the physician, “are used only by homeopaths: that is, by empirics who, being ignorant of the nature of disease, merely treat its symptoms. If you bring a Chinese patient to a homeopath, he will treat him for yellow fever.”
“Do you really know the nature of disease any more than a homeopath does?” said the Prince.
“Certainly,” said the physician. “I have passed an examination in pathology, and written books about it. What a strange question!”
“What is the nature of my father’s complaint”” said the Prince.
“It is what we call pleurisy,” said the physician.
“I know that,” said the Prince. “I know its name; and I know it symptoms. What is its nature?”
“If I knew that,” said the physician, “perhaps I could cure it.”
“Then pathology is bunk,” said the Prince, who had picked up this expression from a famous motor-car manufacturer, who had applied to History. “Let us call in a homeopath.”
“Unfortunately,” said the physician, “the only one in London whose reputation and success would satisfy public opinion has not been admitted to our communion; and if I discussed the case with him i should be excommunicated.”
“Well,” said the Prince, “they say a lot of trouble comes from spinal displacements. What about my father’s spine?”
“It looks all right,” said the physician.
“But there are chaps who are trained to feel whether it is all right or not,” said the Prince. “There is a machine that will register on a galvanometer displacement that nobody can feel.”
“I never heard of it,” said the physician. “I can assure you that these people who feel spines are almost all ignorant Americans who have spent two years in mere manual training instead of in the study of pathology.”
“All the same,” said the Prince, “they bring off cures occasionally; so why not call one in?”
“I should be excommunicated if I were seen speaking to one,” said the physician.
“Why not do it yourself?” said the Prince. “You are a surgeon.”
“I have not had the two years’ training,” said the physician, “it is not part of our official surgery.”
“Official surgery is a wash-out,” said the Prince. “What about testing my father’s blood for radiation? That can be done by a rheostat, can’t it? And there is some method of neutralizing the rays that sometimes cures, isn’t there?”
“But it was discovered by an American,” said the physician.
“I am prepared to overlook that if my father’s health can be restored by this method,” said the Prince.
“Impossible,” said the physician. “He was not only an American, but a Jew.”
“I understand he was a proper doctor all the same,” persisted the Prince.
“No doubt,” said the physician, “but the treatment would involve attaching His Majesty to the electric light switch; and public opinion would never tolerate that.”
“Public opinion be blowed!” said the Prince. “Do you suppose I am going to let my father lose a chance because people are fools? Besides, we can use a private battery.”
“It may not be,” said the physician. “This discovery reached us only about a dozen years ago, and is not yet recognized by our Vatican. I dare not take the responsibility of experimenting on the King with a treatment that has not been proved by at least fifty years’ experience.”
“Proved to do what?” said the Prince. “To cure the disease?”
“To have stood the test of being taught in our medical schools as the logical and appropriate treatment,” said the physician.
“Do the patients recover under your logical and appropriate treatment?” said the Prince.
“Sometimes,” said the physician. “Quite frequently.”
“They might do that if they had no treatment at all,” said the Prince.
“That is true,” said the physician. “The recuperative power of the human organism is marvellous. Quacks take advantage of that, I am sorry to say.”
“I am not satisfied about all this,” said the Prince. “It seems to me that my father, just because he is a king, is cut off from the benefit of all the new discovers and treatments that are available for the meanest of his subjects.”
“I exhort your Royal Highness to be patient,” said the physician. “Your royal father is in the hands of God.”
“You mean that we should call in a Christian Science practitioner?” said the Prince.
“Most certainly not,” said the physician. “I and my colleagues would be obliged to withdraw at once if such a person were admitted to the palace.”
“Another wash-out,” said the Prince.
“Not at all, said the physician. “We should not object to a visit from His Majesty’s domestic chaplain; though of course we could not allow him to treat the case; and anything in the nature of a consultation would be out of the question.”
“In short,” said the Prince, “my poor father is in the hands of your confounded Vatican. However, I suppose we must make the best of it. I should like to call in your Pope for a consultation.”
“We should have to tell him what to say beforehand,” said the physician. “You see, he was qualified more than half a century ago, and may not be quite up to date.”
“But I have looked him up in Who’s Who,” said the Prince, “and he has ninety distinctions and qualifications, entitling him to a dozen medical letters after his name. I attach great importance to a lot of letters because I have nothing else to go by.”
“As I myself have only six, you naturally consider his opinion twice as valuable as mine,” said the physician.
“Well, if the letters don’t mean that, they don’t mean anything,” said the Prince.
“Precisely,” said the physician.
“Then your Pope is another wash-out,” said the Prince. “Ae there any laymen on your Vatican council to represent my father and all the other patients?”
“A notorious enemy of our profession has succeeded, after years of agitation, in having one layman appointed,” said the Prince.
“Officially, no,” said the physician.
“But unofficially -- as between man and man?” pleaded the Prince.
“Since your Royal Highness is good enough to admit me to that footing,” said the physician, “I am bound to say, as between man and man, that the exclusion of laymen from a body whose business it is to safeguard the general interests of the laity against the sectional interests of the medical profession is only one out of the many instances of the almost incredible incapacity of the Half Mad for taking care of themselves. In respect of the art of life, our people must be set aside as unqualified practitioners.”
“This is a world of bunk,” said the Prince, “and the boasted capacity of my father’s subjects for self-government is the biggest bunk of the lot. But my father’s life is in danger. I appeal to you to throw over your silly Vatican and be a friend to us in our need. If they give you the sack you shall have a dukedom and a pension of a hundred thousand a year. Tell me what is the most up-to-date scientific treatment for my father?”
“I have already ordered it,” said the physician. “And you will be glad to hear it will involve no conflict on my part with my colleagues.”
“Splendid!” said the Prince. “I will never forget this proof of your sympathy and devotion. What is the treatment?”
“The seaside,” said the physician.
“The seaside!” cried the Prince. “You call that the latest! Why, it is what my great-grandmother would have recommended.”
“Yes,” said the physician, “but not for the true scientific reason. She thought that benefit arose from change of air.”
“Then what does it arise from? said the Prince.
“That,” said the physician, “is a professional secret which i can impart to you only under a solemn pledge that it shall go no further.”
“I give you my word of honor,” said the Prince. “What will the seaside really do to cure my father?”
The physician stooped to the Prince’s ear, and whispered. “It will get him away from the doctors.”
Shortly afterwards, the king recovered.