Teaching Notes: Public Health in Sinclair Lewis's Arrowsmith

I'm currently teaching a general education course here at UT, one focused on the medical humanities. That course and its design will probably merit its own post at some point (maybe not until next semester, though, after I reteach it), but for now I want to discuss the novel I assigned.

Arrowsmith by Sinclair Lewis

Originally published: 1924
First read: January 2013
Acquired: June 2014
Previously taught: September 2014
Retaught: September 2024

Originally my thought was to play to my strengths by doing short science fiction about medicine. But as things were getting down to the wire, I wasn't sure if I would have enough short stories to teach without having to do a lot of research to prep the class... research I honestly didn't have time to do. But then I cast my mind back and remembered Sinclair Lewis's Arrowsmith, a novel I taught a decade ago in a class on the novel post-1900. A whole 450-page novel about a doctor trying to find his way in the world! What could be better for using up a month of course time? But also giving us a lot of very relevant things to discuss.

So I put in my book order, and when the semester rolled around, I taught the book. In my link above, you can get a sense of the kind of things I was interested in last time around, and I did do some of that this time, too: Arrowsmith as bildungsroman, Arrowsmith as exemplar for the realist project.

But the big change in the world since the last time I taught Arrowsmith (other than the fact that college students can't cope with a 450-page book anymore, even across three weeks) is, of course, that we have all lived through a major public health crisis... and Arrowsmith is all about public health. Martin Arrowsmith spends a lot of time working in a public health department, trying to convince people to behave rationally in the face of scientific evidence... a struggle we have all now witnessed firsthand. 

I remember making jokes to my class in 2014 about the inanity of the songs Martin's boss at the public health department comes up with to communicate public health messages. At the time, these seemed like goofy 1920s nonsense. But in the 2020s, we did all this! Martin's struggle to get people to put aside their petty prejudices in favor of collective action is something we all saw in real time. I realize now, of course, that Lewis must have been thinking (at least in part) of the Spanish flu, and a student pointed out to me that he was probably also inspired by "Typhoid Mary."

So there was a lot of fruitful material for discussion here. I paired a lot of our course texts with episodes of Radiolab as a way of letting my class get to interesting issues in detail without forcing me to assign a bunch of other reading. I paired Arrowsmith with three:

• "The Great Vaccinator" (3 Dec. 2020). This episode is about Maurice Hilleman and the creation of the mumps vaccine, the quickest created vaccine prior to COVID, as well as seven others routinely given to children today. I thought of Arrowsmith as soon as I first heard this episode back when it came out because it discusses some of the ethical issues of double-blind testing. When Hilleman did polio vaccine testing, he had to do so in the knowledge that he was letting some kids suffer who might have not suffered if they hadn't been given the placebo—the exact dilemma Martin faces at the climax of Arrowsmith when he can only give half the inhabitants of St. Hubert the bacteriophage that will save them from the plague.
• "Every Day Is Ignaz Semmelweis Day" (1 Apr. 2020). This episode is about Ignaz Semmelweis, who invented handwashing in a maternity ward in nineteenth-century Vienna. It's a neat episode about the development of something so commonplace now that most people know little about. Semmelweis reminds me a lot of Martin, in that I would argue the personality attributes that make him good at science are also the same attributes that made him bad at convincing other people to use his discoveries. Semmelweis alienated a lot of people when he tried to get them to adopt handwashing... but if he hadn't had that drive and arrogance, could he have discovered it to begin with?
• "Playing God" (21 Aug. 2016). This episode is about triage, going through three main stories: 1) the way triage decisions were made in a New Orleans hospital during Katrina, 2) an attempt to devise triage guidelines using citizen input, and 3) a medical reporter's failure to adhere to the guidelines. Arrowsmith isn't really about triage per se, but both triage and medical testing on humans (I would argue) come down to something Robert Krulwich says at the end of the episode: "what you've hit upon here is an impossible piece of human business. Rationing, triage, whatever you call it, is an inhuman act which humans are trying to do, but the fact of their humanity makes it impossible. We have a God role and nobody fits it." Arrowsmith is all about Martin's attempt to deny his humanity so he can fit that God role. This is both necessary to providing medical care (as "Playing God" highlights)... and utterly impossible.

I don't know that my students loved Arrowsmith, but I think it teaches very well in that it's got a lot of great medical issues in it that are very teachable. I don't know that I would teach the book every time I teach this class (I am toying with an alternative), but I definitely will reteach it when I teach the class again next semester at least.