Beauty (and the medical beasts)

Some things never change

BMJ Published 02 September 1995      Cite this as BMJ 1995;311:634

Who the deepest has thought loves what is most alive, Wide experience may well turn to what’s best in youth, And the wise in the end will Often bow to the beautiful.–Friedrich Holderlin

The eyes seem unfocused and the face is gaunt; sensing his pain is part of the experience. Comprehending Van Gogh’s self portrait is not possible without knowledge of the suffering that racked his muse and drove him to self mutilation and suicide among the alien corn. Beethoven composing the delicate Eighth, knowing his deafness would never allow him to hear it performed; Karen Carpenter’s voice dripping like golden honey over the airwaves while she was tortured with insecurity and anorexia. The great works of art are inseparable from the artists who constructed them; their creations are a mirror in which they see their own distorted features.

Friedrich Holderlin was labelled as mad in a time that had no patience for the untypical and the different. If you read his life story, it is evident that he was not insane until he was treated as such, and that he was broken by this treatment. The gruelling and humiliating experiences in the mental clinic resound in his poetry; the before and after are like two different people, the despair in the later poems as distinct as a fingerprint. The only drugs available for his treatment then were belladonna and digitalis; non-drug management included straitjackets, long forcible immersions in a cage filled with cold water, and the Autenrieth mask, which was applied to stop patients from screaming.

Many of his poems are obscure fragments, and full of metaphors which are almost beyond the understanding of the ordinary mind, suckled on Jasons and Kylies and reared to applaud the obvious and the banal. However, some truths are eternal, if unpalatable, so it should be no surprise that an 18th century social misfit from Germany could articulate so consummately a feature of all medical social columns.

The quotation above this column inspired me to formulate Farrell’s Law No 1: In any photograph of any medical meeting, the good-looking ones are always the drug reps. Don’t accuse me of male chauvinism; this law applies to all known sexes. If the guy has a firm jaw and a smooth suit, if the girl is slim and chic, they ain’t one of us.

Let’s face it: as professions go, we are not renowned for our physical perfection. But why should nature be so bloody unfair? Why are we inflicted with the jowls and the double chins? It’s as if there is something in our genetic make up which says to itself early in life, “OK, so my face isn’t going to be my fortune, I’ll have to try some other device to ensure the perpetuation of my genes; I’ll work like the divil.”

And this becomes a self fulfilling prophecy; throughout our careers beauty becomes more and more elusive. We develop big arses from all the time we spend sitting studying and we get bad skin from being indoors and eating greasy canteen food.

We do have a consolation, however; as our genes have carefully calculated, eventually their plan will come to fruition. After all, isn’t power the ultimate aphrodisiac?


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