Scottish Literature and Medicine

Thursday, 03 May 2018

From 1900 to 2100

Medico-Chirurgical Hall

Professor Kenneth Calman, Chancellor of the University of Glasgow and Chairman of the National Library of Scotland

Sir Kenneth Charles Calman is a graduate of the University of Glasgow who lectured in Surgery before his appointment to the Cancer Research Chair of Oncology in 1974. He became Professor and Dean of Postgraduate Medical Education in 1984. In 1989 he was appointed Chief Medical Officer at the Scottish Office Home and Health Department. He was Chief Medical Officer at the Department of Health in London from 1989 to 1991 and worked in the Department of Education and Science and its successors from 1991 until his appointment as Vice-Chancellor and Warden at the University of Durham in 1998. He was awarded a KCB and an honorary DSc in 1996.


The President introduced the evening’s speaker, Professor Sir Kenneth Calman, Chancellor of the University of Glasgow & Chairman of the National Library of Scotland, to give his lecture entitled ‘Scottish Literature and Medicine’.

Professor Calman admitted to a long-standing interest in literature and remembered reading short stories on medical themes by John Brown while a medical student. Much later, when teaching Medical Ethics alongside a Professor of Moral Philosophy, he had sometimes used medically themed literature as a basis for discussion. Years later, when he returned to Glasgow, he enrolled for a MLitt degree with ‘Scottish Literature in Medicine’ as its title. He graduated in due course and went on to publish a book based on his Masters’ thesis entitled, ‘A Doctor’s Line: Poetry and Prescriptions in Health and Healing’. (Sandstone Press, Dingwall; 2014). He also showed a recently published book of his own poetry ‘Afterthoughts’ (Kennedy & Boyd (Zeticula), London; 2017). The rest of his presentation consisted largely of readings and commentary from these two volumes.

He began with a short story entitled ‘Rab and his Friends’ written by Edinburgh GP, John Brown around 1859, describing the tale of a woman undergoing breast surgery in the days before anaesthesia, while her husband and their dog, Rab, looked on. The story powerfully told of the courage and stoicism of the patient – and how much this impressed the onlooking students.

Professor Calman then suggested that literature can also be an important way of showing people when they are going wrong and illustrated this point by reading the poem ‘The Drunkard’s Raggit Wean’ written in 1855 by Glasgow tailor James Crawford. The verses went on to be oft-repeated by supporters of the Temperance Movement and indeed some 17,000 copies were sold with a few years of its publication. The words forced readers or audiences to move beyond complaints against the folly of alcohol excess by involving them in considering the plight and misery of the unfortunate child. The phenomenon of ‘acrasia’ was described - meaning continued action against one’s better judgement which, of course, could fit the chronic alcoholic’s situation.

Sir Kenneth then moved on to share two separate literary accounts of doctors. The first was a poem entitled ‘The Doctor’ by Alexander Smart, a native of Montrose, who worked as a compositor in Edinburgh. The verses were included in several compilations of poetry for the young, including ‘Wee Willie Winkie’s Nursery Songs of Scotland, 1859’. It praises a good and diligent doctor, each verse ending with the couplet ‘An’ t werena for the doctor, my bonnie bairn might dee’. This is contrasted with a different story altogether, taken from a much more contemporary source, the novel, ‘The Trick is to Keep Breathing’, by Scottish writer Janice Galloway, first published in 1989. She writes a fictional dialogue between a patient and the hospital doctor she has asked to see for an explanation of why she is being kept in hospital; the pair have a completely dysfunctional conversation when the doctor refuses to comprehend the patient’s perspective and anxieties.

Professor Calman then delivered a series of extracts from the works of Robert Burns, firstly illustrating the theme of prevention and early diagnosis. The 5th stanza of ‘The Address to the Unco Guid’ describes the easy progression from social drinking to debauchery and bemoans the lack of forethought for adverse consequences on health and wealth of overindulgence.

He then moved on to Death and Dr Hornbook – a poem describing a hopeless doctor who nevertheless takes money for his services and who is sufficiently conceited about his skills that he claims he can make an accurate diagnosis without even seeing the patient, simply by smelling the patient’s ‘shite on a kail blade’. (For all that this was meant to expose Dr Hornbook as a charlatan, Sir Kenneth could not resist pointing out how the antics of Burns was unnervingly prescient of the highly regarded Scottish Bowel Screening programme introduced some 200 years afterwards!)

The audience were next treated to the closing lines of Burns epic adventure, ‘Tam o’ Shanter’ expounding the caution that when prone to overindulgence, ‘Ye may buy the joys o’ drink, ower dear!’ From teaching a lesson, to learning in general, the next excerpt was from The (first) Epistle to J Lapraik, written in April 1785, in which Burns decries the contrived conceit of classical schooling as inferior to ‘ae spark o’ nature’s fire’.

Professor Calman next turned to some representations of scientific knowledge in verse. A piece by Jimmy Black was in the form of a prayer, more or less encouraging the reader to shun the fanciful folly of science and simply ‘mak sure yer maw’s a woman!’ We then had a reading of the lyrics of former Rutherglen Academy English Teacher and songwriter, Adam McNaughtan’s song ‘Cholesterol’. Featuring lines like ‘Who would like tae grow old eating St. Ivel Gold?  I’d rather eat butter and die’, it reminds us of the natural resistance to public health advice (more acrasia?).

Perhaps, it was suggested, role modelling is a potential way around such non-compliance – and we moved on to Liz Lochhead (b Lanarkshire, 1947) and former National Poet for Scotland or ‘Makar’. Sir Kenneth read her poem about all the things that her ‘Auntie was famous… for’ reminding us about the breadth of, sometimes outrageous, attributes for which role models can be memorable and emulated!

Turning next to environmental concerns, an unattributed poem was read about the plight of the River Clyde in its heyday of industrial pollution where the only salmon to be found would be traces in cans floating downstream among the myriad debris. This led, in turn, to thoughts about the pursuit of favourable quality of life – and a return to Burns with an excerpt from The (first) Epistle to Davie in which, not for the only time, Burns decries the importance of titles and wealth, concluding instead that ‘The heart ay’s the part ay, that makes us right or wrang’.

Then we had a few final snippets from ‘A Doctor’s Line’ including reference to the difference between the condition of man and mouse, the ‘wee, sleekit, cowrin’, timrous beastie’ – driven from his house but presumed to be living only in the present while man has the added burden of ruminating on past disappointments and fearing future failures. Robert Fergusson, a mid-18th Century Edinburgh poet who died when only 24, with a reference similar to Burns on true wealth in the words ‘ragged coat, weel contented’. Finally, in similar vein, Allan Ramsay (the elder) was mentioned for his early 18th century line ‘he that has just enough can soundly sleep’.

Professor Calman then read several poems from his own collection of poetry published in October 2017 as a volume titled ‘Afterthoughts’. He first shared his witty insights on the world of committee meetings – that has been such a major part of his working life and had him travelling near and far. His ‘Address to Medical Students’ has often formed part of his comments at graduation ceremonies and encourages graduands to be holistic and patient-centred in their future work. He told the story of how finding an early operation note from his days as a surgical registrar led to the poem ‘My First Time’, reminding him both of his trepidation at the prospect of operating and his subsequent elation when reviewing the recovering patient a few weeks later.

One of his afterthoughts was occasioned by the sight of a station-wise mouse running around among the rails in London’s Euston Station, evoking a modern-day parody of Burns’ murine classic from over 200 years before. Memories of a family dog led to verses on ‘Clearing up after Mungo’, this one useful to include at the Veterinary graduation ceremony. He closed with a personal appreciation of the restorative power of time spent at his Brodick holiday home under the title ‘Feeling Peely Wally’.

There then followed a question and answer session on Professor Calman’s works and views including discussion of rhyming versus non-rhyming poetry (we were told the former is much harder to write and the latter works better when read aloud). There were some exchanges on the importance of narrative in medicine and concern that modern medicine and its ways may have discouraged development of the important art of storytelling. The case for making creative writing a routine part of medical undergraduate training was considered. There is apparently some emerging evidence for a view that engagement in the arts produces better doctors – perhaps a link has not been sufficiently widely studied yet. The use of stories in teaching medical ethics seems entirely appropriate in giving issues context and  human perspectives and all agree that stories are often more memorable, even years later, than the traditional academic content of teaching presentations.

A story came from the floor describing from an individual who confessed to having been intimidated by arts and literature at school; at a time when there were examination results to be achieved, it was easier to be assured of abilities in mathematics and science with their precise answers than to develop any confidence in the seemingly intangible vagaries of higher English. A fear was expressed that today’s assiduous attempts at sound educational and clinical governance, via arrays of tick boxes with ever increasing complexity and granularity, perhaps means that nowadays, the need is greater than ever, to ensure that those in training for medical careers are not only given explicit permission, but also encouragement, to explore the arts. Professor Calman responded by referring to the ‘Contagion Theory of Behaviour Change’ – suggesting that it would be necessary to get the ‘right infection’ to spread the desired enlightenment. Over all, he believes that things are improving and hopes that the value of literature in medicine will be increasingly appreciated, valued and shared.

The President delivered a vote of thanks and closed the meeting.

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