The doctor-patient relationship is the primary way medicine is both practised and experienced: patients go to the doctor when they are sick, think they may be sick, or are scared of becoming sick. The doctor is a highly-educated professional with a specific purpose in society, yet is exposed to a broad cross-section of society through his multiple, idiosyncratic, and nuanced interactions with patients. The relationship between doctor and patient is therefore integral to how medicine is practised, experienced, and represented, but the doctor-patient encounter is also influenced by medical epistemology. The doctor-patient encounter could be one based on paternalism, information, interpretation, or deliberation.
When medicine is studied through the lens of literature, and medicine is read with an awareness of its cultural and social position, the doctor-patient relationship can also be seen as one based on confession: the medical encounter opens with the patient’s account of their illness. This is interpreted by the doctor, increasingly transformed into a case history, in order to suggest a diagnosis and treatment. A story is read; a patient is read and diagnosed. Doctors therefore often relay a great deal of information about their patients: but what can patients tell us about their doctors?
The most well-known French literary depiction of a doctor-patient relationship is Molière’s Le Malade imaginaire (The Imaginary Invalide, or The Hypochondriac) (1673). The play centres on the hypochondriac, Argan, who tries to marry his daughter off to Thomas Diaofirus, the son of the physician Monsieur Diaforius. Thomas is about to become a physician, and thus Argan hopes that by marrying into a medical family he will have free access to their services.
Le Malade imaginaire is a biting satire on the medical profession, highlighting the greed, quackery, and obscurantism of its practitioners. Argan’s apothecary and physician happily charge him for so-called healing agents such as rhubarb, sugar, whey, and pomegranate syrup. Although these remedies do nothing for Argan since all his maladies are imaginary, his apothecary and physician continue to attempt to bleed him (financially) dry. The quackery of doctors is denounced by Argan’s brother, who states that ‘all the excellency of their art consists in pompous gibberish, in a specious babbling, which gives you words instead of reasons, and promises instead Of results’ (‘toute l’excellence de leur consiste en un pompeux galimatias, en un spécieux babil, qui vous donne des mots pour des raisons, et des promesses pour des effets’) (Act 3, Scene 3). Molière’s other medical plays, such as L’Amour médecin (Dr. Cupid) (1665) suggest the inherently fraudulent nature of the medical profession since Clitandre disguises himself as a doctor in order to meet with his lover. As Argan’s brother states in Le Malade imaginaire, ‘most of them have some knowledge of the best classics, can talk fine Latin, can give a Greek name to every disease, can define and distinguish them; but as to curing these diseases, that’s out of the question’ (‘ils savent la plupart de fort belles humanités, savent parler en beau latin, savent nommer en grec toutes les maladies, les définir et les diviser; mais pour ce qui est de les guérir, c’est ce qu’ils ne savent point du tout’) (Act 3, Scene 3). The success of Molière’s fake doctors suggest that the profession is easy to imitate and therefore superficial and untrustworthy.
The Diaforius father and son are also held to be guilty of obscurantism: they oppose new ideas and scientific progress in order to adhere to ancient medical practices. Monsieur Diaforius enumerates his son’s values:
Above all things, what pleases me in him, and what I am glad to see him follow my example in, is that he is blindly attached to the opinions of the ancients, and that he would never understand nor listen to the reasons and the experiences of the pretended discoveries of our century concerning the circulation of the blood and other opinions of the same stamp.
Mais sur toute chose qui me plaît en lui, et en quoi il suit mon exemple, c’est qu’il s’attache aveuglément aux opinions de nos anciens, et que jamais il n’a voulu comprendre ni écouter les raisons et les expériences des prétendues découvertes de notre siècle, touchant la circulation du sang, et d’autres opinions de même farine. (Act II, Scene 5).
Diaforius father and son both reject William Harvey’s discovery of the circulation of blood. Although the thesis was initially opposed by physicians, by the time of Le Malade imaginaire it would have been highly unusual for a doctor to continue to dispute its validity. For Molière, then, doctors prioritise financial reward over professional integrity, patient care, or scientific advancement.
What is most fascinating about Molière’s Le Malade imaginaire, however, is that the play centres on the comic hypochondriac, thus concerning itself directly with how doctors and patients interact with one another. The opening scene depicts Argan going through his bill from the pharmacist, the extent of which testifies to the importance that he places on his own health. When arguing with his brother over the trustworthiness of physicians, Argan asks him if he believes in medicine in the same as he would if he has asked if his brother believed in God. Medicine is a question of both materiality and money as well as spirituality and money. Molière’s focus on a hypochondriac also allows the play to focus on the meaning and manifestation of disease. Characters repeatedly testify to Argan’s good health: in the first act Argan chases his maid around the stage during a moment in which that he forgets that he can only walk with a cane. His maid suggests that he may be mentally and not physically sick, whereas his brother diagnoses Argan’s condition as ‘an obsession with doctors’ (‘une maladie des médecins’) (Act 3, Scene 3). In Molière the doctor-patient relationship is the central way in which the medical profession is interrogated and satirized, but by focusing on a patient and his experience the play also questions the meaning of medicine and the nature of disease.
Doctors are more than just their medical books: the doctor-patient relationship highlights that medical epistemology is always filtered through practitioners’ interactions with their patients and, in the case of Molière, doctors and patients must therefore be placed under examination.
Sarah Jones, Oriel College
Bibliography & Recommended Reading
Lawrence Brockliss and Colin Jones, The Medical World of Early Modern France (Oxford: Clarendon Press, 1997.
Ezekiel J. Emanuel and Linda L. Emanuel, ‘Four Models of the Physician-Patient Relationship,’ JAMA. The Journal of the American Medical Association, 16 (1992), 1-9.
Jean-Baptiste Molière, The Imaginary Invalid, Charles Heron Wall (trans.) (London: CreateSpace Independent Publishing Platform, 2014).
Jean-Baptiste Molière, Le Malade imaginaire in Œuvres completes, t. II (Paris: Éditions Gallimard, 1971) pp. 1073-1178.
 Ezekiel J. Emanuel and Linda L. Emanuel, ‘Four Models of the Physician-Patient Relationship,’ JAMA. The Journal of the American Medical Association, 16 (1992), 1-9.
 Lawrence Brockliss and Colin Jones, The Medical World of Early Modern France (Oxford: Clarendon Press, 1997.
 In-text references refer to Molière, The Imaginary Invalid, Charles Heron Wall (trans.) (London: CreateSpace Independent Publishing Platform, 2014). For the French-language version see Molière, Le Malade imaginaire in Œuvres completes, t. II (Paris: Éditions Gallimard, 1971) pp. 1073-1178.