Irritating fictional doctors: Dr Gregory in F Scott Fitzgerald’s “Gretchen’s Forty Winks” and the balanced life

A while back I posted about the less-than-busy doctors of Victorian detective fiction. Another medical archetype of fiction is the irritatingly bluff doctor. While Dr Gregory in F Scott Fitzgerald’s short story “Gretchen’s Forty Winks” is a minor character, he encapsulates a certain cheery complacency.

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This story is not among Fitzgerald’s best. An awful lot of Fitzgerald’s writing was for money, in the midst of a chaotic life. There’s nothing wrong with this – remember Dr Johnson’s dictum that no man but a blockhead writes except for money. However, “Gretchen’s Forty Winks” is no Great Gatsby. There is also much that would now be deemed sexist, not to mention casual gaslighting and slipping of Mickey Finns within the marital relationship . I firmly believe that Of course, no doubt there is much we find unexceptional or even virtuous in our own culture which will in nearly a century seem laughably unethical.and also some by-the-way flashes of Fitzgerald’s acuity and brilliance. It also has some historical interest as an portrayal of what might have been seen as a “balanced life” in 1924.

The story was published in the Saturday Evening Post of March 15, 1924.

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It is a rather heavy handed spoof of the cult of the “balanced life” (nowadays we would say work-life balance). The protagonist, Roger Halsey, is an advertising man, who has struck out for himself having left “the New York Lithographic Company.” We meet him coming home to his wife Gretchen. Fitzgerald writes thus of their marriage: “it was seldom that they hated each other with that violent hate of which only young couples are capable, for Roger was still acutely sensitive to her beauty.” Halsey has to work for forty solid days to obtain “some of the largest accounts in the country”, to the disappointment of his wife – “she was a Southern girl, and any question that had to do with getting ahead in the world always gave her a headache.”

His wife introduces Halsey to George Tompkins, an interior designer and devotee of the “the balanced life.” An irritated Halsey asks for a definition:

“Well’ – he hesitated – probably the best way to tell you would be to describe my own day. Would that seem horribly egotistic?”

“Oh  no!” Gretchen looked at him with interest. ‘I’d love to hear about it’

‘Well, in the morning I get up and go through a series of exercises. I’ve got one room fitted up as a little gymnasium, and I punching the bag and do shadow-boxing and weight-pulling for an hour. Then after a cold bath – There’s a thing now? Do you take a daily cold bath?’

‘No,’ admitted Roger. ‘I take a hot bath in the evening three or four times a week.’

A horrified silence fell. Tompkins and Gretchen exchanged a glance as if something obscene had been said.

‘What’s the matter?’ broke out Roger, glancing from one to the other in some irritation. ‘You know I don’t take a bath every day – I haven’t got the time.’

Tompkins gave  a prolonged sigh.

‘After my bath,’ he continued, drawing a merciful veil of silence over the matter, ‘I have breakfast and drive to my office in New York, where I work until four. Then I lay off, and if it’s summer I hurry out here for nine holes of golf, or if it’s winter I play squash for an hour at my club. Then a good snappy game of bridge until dinner. Dinner is liable to have something to do with business, but in a pleasant way. Perhaps I’ve just finished a house for some customer, and he wants me to be on hand for his first party to see that the lighting is soft enough and all that sort of thing. Or maybe I sit down with a good book of poetry and spend the evening alone. At any rate, I do something every night to get me out of myself.’

Roger is unimpressed. As the story progresses, he keeps to his exacting work schedule, until he nearly has secured a major account. Gretchen has chafed all along at the economising, and the night before a crucial submission forces another dinner with Tompkins. At this, Roger and Tompkins end up having a blazing row, simmering with the fury of the man who suspects he be becoming a cuckold:

“‘Are you implying my work is useless?’ demanded Tompkins incredulously.

‘No: not if it brings happiness to some poor sucker of a pants manufacturer who doesn’t known how to spend his money'”

SPOILER ALERT!

 

 

 

After ejecting Tompkins from his house, Roger resorts to obtaining something unmentioned from the local drugstore, and putting “into the coffee half a teaspoonful of a white substance that was not powdered sugar” before giving it to his wife. He also hides all her shoes in a  bag.

This allows him to spend all night working on the account (not before giving his grumpy landlord the bag of shoes as a guarantee, having missed that month’s rent) with ultimate success. A contrite Gretchen awakes after a full day going missing from her life thanks to her husband’s deployment of white powder, and so distressed is she at finding her shoes missing that Roger agrees to take her to the doctor.  Enter Doctor Gregory, a man for whom the word ‘confidentiality’ has no meaning:

The doctor arrived in ten minutes.

‘I think I’m on the verge of a collapse,’ Gretchen told him in a strained voice.

Doctor Gregory sat does on the edge of the bed and took her wrist in his hand.

‘It seems to be in the air this morning.’

‘I got up,’ said Gretchen in an awed voice, ‘and I found that I’d lost a hole day. I had an engagement to go riding with George Tompkins -‘

‘What?’ exclaimed the doctor in surprise. Then he laughed.

‘George Tompkins won’t go riding with anyone for many days to come.’

‘Has he gone away?’ asked Gretchen curiously.

‘He’s going West.’

‘Why?’ demanded Roger. ‘Is he running away with somebody’s wife?’

‘No,’ said Doctor Gregory. ‘He’s had a nervous breakdown.’

‘What?’ they exclaimed in unison.

‘He just collapsed like an opera-hat in his cold shower.’

‘But he was always talking about his – his balanced life,’ gasped Gretchen. ‘He had it on his mind.’

‘I know,’ said the doctor. ‘He’s been babbling about it all morning. I think it’s driven him a little mad. He worked pretty hard at it, you know.’

‘At what?’ demanded Roger in bewilderment.

‘At keeping his life balanced.’ He turned to Gretchen. ‘Now all I’ll prescribe for this lady here is a good rest. If she’ll just stay around the house for a few days and take forty winks of sleep she’ll be as fit as ever. She’s been under some strain.’

Dr Gregory’s utter disregard for confidentiality is impressive in its brazenness (and if he could make a house call in ten minutes he is himself presumably impressively non-busy) but, for me, the height of his irritatingness is still to come:

‘Doctor,’ exclaimed Roger hoarsely, ‘don’t you think I’d better have a rest or something. I’ve been working pretty hard lately.’

‘You!’ Doctor Gregory laughed, slapped him violently on the back. ‘My boy, I never saw you looking better in your life.’

 

“slapped him violently on the back” – truly Dr Gregory is a prince among doctors… (the phrase also pops up in James Herriot

As for the more general spoof of “the balanced life”, it is surely wise to reflect moderation in all things is wise, especially moderation. A suspicion of overly-programmed approaches to nature and leisure underlies my mild suspicion of “forest bathing” One of the founders of The Idler once wrote about having a breakdown due to his frenetic life of writing and talking about the wonders of idleness.

But it might also be wise to recall that Fitzgerald’s book of autobiographical writings was called The Crack-Up.

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“#Sleeping, as we all know, is the most secret of our acts.”- #Borges and #sleep in #literature

I have blogged both here and on my other blog quite a few quotes from novels and other literature on sleep. I have found these passages capture a sort of phenomenology of sleep as effectively as any clinical text. In this post I use a quote from Jorge Luis Borges as the starting point for a more general, although ultimately quite personal, discussion of literature and sleep and other altered states of consciousness.

Séamus Sweeney

Sleeping, as we all know, is the most secret of our acts. We devote a third of our lives to it, and yet do not understand it. For some, it is no more than an eclipse of wakefulness, for others, a more complex state spanning at one and the same time past, present, and future,; for still others, an uninterrupted series of dreams. To say that Mrs Jáuregui spent ten years in a quiet chaos is perhaps mistaken; each moment of those ten years may have been a pure present, without a before or after. There is no reason to marvel at such a present, which we count by days and nights and by the hundreds of leaves of many calendars and by anxieties and events; it is what we go through each morning before waking up and every night before falling asleep. Twice each day, we are the elder…

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Michael Gove and the Science of Beauty and Emotion

This is yet another stimulating blog post from Finding Nature. I know where the author is coming from in the structure of the post – pointing out the falseness of the dichotomy between the affective attraction to nature Gove discusses and science.

However, I do wonder if an emphasis on “what science tells us about connection, beauty, emotion, meaning and compassion” does run some risk of unweaving the rainbow a little. One of the findings of Miles Richardson and others is that factual knowledge about nature – identification of species and so on – is not correlated with emotional connection. As knowledge based activity often underpins nature education, this can mean opportunities for connection are missed. But could something similar happen if we only value nature connection Because These Peer Reviewed Papers tell us its ok to do so?

Finding Nature

In ‘The Unfrozen Moment – Delivering A Green Brexit,’ Secretary of State Michael Gove sets out his vision on the future of our natural environment. In this speech, and at the Green Alliance event a week earlier, I was struck by the recurring themes of beauty, emotion, meaning and compassion. Four aspects of our relationship with the natural world that our recent research has linked to improving our connection with nature – see my blog and the open access paper for more detail. It is great to hear the Secretary of State speaking from the heart. However, the speech, see excerpt below, infers a distinction between such themes and science. Having evidence based policy makes sense. This blog points out that there is science of beauty, emotion, meaning and compassion and this should also form part of the evidence base that informs environmental policy.

“I grew up with an emotional attachment…

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When technology doesn’t take: Update on #EdoBlocks and #Flic

From my other blog, some thoughts on technologies that initially seemed cool and impressive and very much fun/useful…but months later haven’t really become part of life. Think of all those unused wearables and the graveyards of cool-seeming but underused technology…. and wonder why is it underused? It the fault in our stars, or in ourselves?

Séamus Sweeney

A while back, I blogged enthusiastically about Edo blocks. These are Lego-ish blocks made of cardboard. At the time, they had proved great fun to make. They seemed to be a wonderful addition to play. And yet, months later, they moulder unused by actual children, taking up space.

Similarly, I blogged about Flic, a “wireless smart button” which again seemed just wonderful initially. And yet, again months later, Flic is largely unused. In this case, Flics was all too attractive to small children who rapidly disassembled them. The user interface of the Flic app was very easy to use, and as my blog post seemed to indicated there were all sorts of exciting potential uses. And yet, and yet …

In the initial assembly of the Edo blocks, it was rather slow going, and my children were more attracted by the cardboard box the Edo blocks came in than…

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Information underload – Mike Caulfied on the limits of #Watson, #AI and #BigData

From Mike Caufield, a piece that reminds me of the adage Garbage In, Garbage Out:

For many years, the underlying thesis of the tech world has been that there is too much information and therefore we need technology to surface the best information. In the mid 2000s, that technology was pitched as Web 2.0. Nowadays, the solution is supposedly AI.

I’m increasingly convinced, however, that our problem is not information overload but information underload. We suffer not because there is just too much good information out there to process, but because most information out there is low quality slapdash takes on low quality research, endlessly pinging around the spin-o-sphere.

Take, for instance, the latest news on Watson. Watson, you might remember, was IBM’s former AI-based Jeopardy winner that was going to go from “Who is David McCullough?” to curing cancer.

So how has this worked out? Four years later, Watson has yet to treat a patient. It’s hit a roadblock with some changes in backend records systems. And most importantly, it can’t figure out how to treat cancer because we don’t currently have enough good information on how to treat cancer:

“IBM spun a story about how Watson could improve cancer treatment that was superficially plausible – there are thousands of research papers published every year and no doctor can read them all,” said David Howard, a faculty member in the Department of Health Policy and Management at Emory University, via email. “However, the problem is not that there is too much information, but rather there is too little. Only a handful of published articles are high-quality, randomized trials. In many cases, oncologists have to choose between drugs that have never been directly compared in a randomized trial.”
This is not just the case with cancer, of course. You’ve heard about the reproducibility crisis, right? Most published research findings are false. And they are false for a number of reasons, but primary reasons include that there are no incentives for researchers to check the research, that data is not shared, and that publications aren’t particularly interested in publishing boring findings. The push to commercialize university research has also corrupted expertise, putting a thumb on the scale for anything universities can license or monetize.

In other words, there’s not enough information out there, and what’s out there is generally worse than it should be.

You can find this pattern in less dramatic areas as well — in fact, almost any place that you’re told big data and analytics will save us. Take Netflix as an example. Endless thinkpieces have been written about the Netflix matching algorithm, but for many years that algorithm could only match you with the equivalent of the films in the Walmart bargain bin, because Netflix had a matching algorithm but nothing worth watching. (Are you starting to see the pattern here?)

In this case at least, the story has a happy ending. Since Netflix is a business and needs to survive, they decided not to pour the majority of their money into newer algorithms to better match people with the version of Big Momma’s House they would hate the least. Instead, they poured their money into making and obtaining things people actually wanted to watch, and as a result Netflix is actually useful now. But if you stick with Netflix or Amazon Prime today it’s more likely because you are hooked on something they created than that you are sold on the strength of their recommendation engine.

Let’s belabor the point: let’s talk about Big Data in education. It’s easy to pick on MOOCs, but remember that the big value proposition of MOOCs was that with millions of students we would finally spot patterns that would allow us to supercharge learning. Recommendation engines would parse these patterns, and… well, what? Do we have a bunch of superb educational content just waiting in the wings that I don’t know about? Do we even have decent educational research that can conclusively direct people to solutions? If the world of cancer research is compromised, the world of educational research is a control group wasteland.

Piece on cardiac surgery in Times Literary Supplement

In the current TLS I have a review of two books on cardiac surgery. One is Stephen Westaby’s  memoir of his career, the other is Thomas Morris’ historical perspective.

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The full text is not freely available online, so here is the bit the TLS have made available to tease you all:

It is tempting to place Stephen Westaby’s Fragile Lives, a memoir of his career as a heart surgeon, in the category the journalist Rosamund Urwin recently called “scalpel lit”; following Atul Gawande’s Complications (2002) and Henry Marsh’s Do No Harm (2014) and Admissions (2017), here is another dispatch from a world arcane even for the majority of doctors. To some degree, Westaby’s book follows the Marsh template. In cardiac surgery as in neurosurgery, life and death are finely poised, and even minor technical mishaps by the surgeon, or brief delays in getting equipment to theatre, can have catastrophic consequences.

Like Marsh, Westaby, a consultant at the John Radcliffe hospital in Oxford, is jaundiced about the bureaucracy of health care and the mandatory “training” imposed on even the most experienced practitioners – “writing my personal development plan at the age of sixty-eight”. Now that death rates are published by the NHS,…

Makes you want to read the whole thing, does it not?

As it happens, Henry Marsh’s Admissions is reviewed in the same issue by George Berridge.

#WorldListeningDay, the silence of the organs, and the sound of health

It is World Listening Day

You are invited to participate in World Listening Day 2017, an annual global event held on July 18.

This year’s theme is “Listening to the Ground”
“Sometimes we walk on the ground, sometimes on sidewalks or asphalt, or other surfaces. Can we find ground to walk on and can we listen for the sound or sounds of ground? Are we losing ground? Can we find new ground by listening for it?”—Pauline Oliveros (1932-2016)

 

The French surgeon René Leriche defined health as “life lived in the silence of the organs.” Of course, this can be disputed.

Leriche’s insight was expanded on by Georges Canguilhem, whose philosophical approach to health and illness I personally have found fruitful.

The sound of healthcare settings is a different thing. Gordon Hempton in his book One Square Inch of Silence refers to much literature on the relation between noise and health, and a literature already exists on soundscapes in hospitals.   Hospitals are noisy places