Monday, June 13, 2022

Revisiting Camus' The Plague in Pandemic Times


In the course of sending out eTOCs, I stumbled upon the following editorial from the NEJM this week:

Klass P. "It's Hardly Credible" - Medical Readers and Literary Plague. N Engl J Med. 2022 Jun 11. doi: 10.1056/NEJMp2119103. Epub ahead of print. PMID: 35687048.  Link to this article.

 

It's written by a physician re-reading The Plague by Albert Camus as an adult, after having assigned it to students in a medical humanities class in 2021-- an apt topic for pandemic times.  Although she read the novel in high school, she could not remember much about it.  Now re-reading it as an adult, she read it with her "doctor brain" and couldn't figure out why the attending physician in the novel never prescribed the sulfa drugs, the antimicrobials of the day that would have cured people and stamped out the plague.

It's interesting to read her response, knowing what she knows, and how doctors think and the conflicts between the literal vs. literary mind.  Of course, maybe Camus can be forgiven -- He was a writer and a philospher who wrote a magnificent book about existentialism, not a physician keeping up with cutting edge treatments for bubonic plague.    After all -- There was no internet, no PubMed in 1947.  He probably did not have access to Index Medicus, or the French equivalent. 

It's also fascinating to know that others have contemplated this question about why Dr. Rieux, the protagonist of the novel, never prescribed available sulpha drugs to patients during this outbreak in the 1940s.  Were these meds even available in his part of the world?  Were supply chains so disrupted during WWII that he would not have gotten them even if he tried to procure them?

This man even goes so far as to call it literary malpractice:

Deudon EH. A case for literary malpractice: the use of Camus's The Plague in American medical schools. Linacre Q. 1988 May;55(2):73-80. doi: 10.1080/00243639.1988.11877958. PMID: 11650149.  PubMed link.


She also cites the World Health Organization's Plague Manual as  evidence for what the world knew about treating bubonic plague at the time.  

Klass's piece is an interesting article, revisiting medicine in literature with a what-would-you-do take on it.  Of course, if Dr. Rieux had treated patients with standard therapy for the times, we would not have the existential story where things get so bad, and people are pushed to the brink that you see their true characters ...  I suppose he could have set the story in another time period BEFORE sulpha drugs?

Take a look ... and tell me what you think!

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