Sinclair Lewis’ Arrowsmith: Why everyone should read this 1925 medical novel

By Noortje Jacobs

For my research, I came across the Pulitzer Prize winning novel Arrowsmith, written by Harry Sinclair Lewis (1885-1951) in 1925 and based upon the experiences of the (by now) famous bacteriologist Paul de Kruif (1890-1971). One of the most widely read medical novels of the twentieth century, Arrowsmith has often been lauded as a source of recognition and inspiration for both medical doctors and scientific researchers. While this explanation for the novel’s enduring influence is probably true, I hope to argue in this blog post that the strength of Arrowsmith rather lies in those passages which move away from the portrayal of ‘the Scientist’ as morally superior human being and instead highlight the difficult tension between scientific ideals and social existence.

The 1925 novel Arrowsmith by Harry Sinclair Lewis is probably one of the most influential pieces of medical fiction written during the twentieth century.[1] The 450-page novel famously chronicles the life and struggles of Martin Arrowsmith, a young doctor born in the late nineteenth century who has grown up to become a firm believer in the importance of epidemiology and bacteriology for the progress of medicine and health. From the first page onwards, it is clear that Martin is destined to become a ‘great scientific researcher’, interested more in the mysteries of immunology and physical chemistry than in the queries of the individual patient. To realize his potential, however, the young doctor first has to purge himself from the intoxicating influences and temptations of American social life in the early twentieth century. Fundamental insecurities as well as attractions of recognition, social power and financial security make Martin stray from his path for about 445 pages, before he can devote himself purely to the pursuit of scientific truths.

Why is it that a story about germs and laboratory tests was to leave such an impression on its readers that it remains widely read and acclaimed almost a century after its first publication? As the M.D. Howard Markel wrote in 2001:

My battered paperback copy of Arrowsmith is annotated throughout with the same pen-scrawled comment: “Still true!” I am hardly alone: from its publication to the present, countless men and women have been inspired to pursue careers in research because of Martin’s intense devotion to science.[2]

Apparently, Lewis’ 1925 typification of the medical profession touched upon certain core themes of the (Western) organization of medicine and health that allowed the novel to transcend the specific context in which it was written. As such, Martin Arrowsmith could become a source of recognition and inspiration for medical doctors and scientific researchers situated within very different spatial and temporal contexts.

This, at least, is the explanation suggested on the back cover of the 2008 edition of Arrowsmith: “Part satire, part morality tale, Lewis’s Pulitzer Prize-winning novel illuminates the mystery and power of science while giving enduring life to a singular American hero’s struggle for integrity and intellectual freedom in a small-minded world”.[3] In this blog post, however, I want to argue that while it is true that Lewis mainly intended his novel to function as a satirical morality tale, it is the tragic undertone to Martin’s werdegang as scientist which makes Arrowsmith such a powerful source of reflection upon the relationship between science and society.

The development of Arrowsmith as a satirical morality tale

The work of Harry Sinclair Lewis is remembered for its satirical representation of American society and culture. In Lewis’ most famous novels, like Main Street (1920) and Babbitt (1922), the main characters and story-lines all serve to critique middle-class American life with its focus on consumerism, conformity and organized religion.

Also in Arrowsmith, the element of satire is defining for each of the characters and career-paths Martin comes across in those first 445 pages. As Martin’s Alma Mater, the University of Winnemac, is for example described on pages 6 and 7:

It is not a snobbish rich-man’s college, devoted in leisurely nonsense. It is the property of the people of the state, and what they want – or what they are told they want – is a mill to turn out men and women who will lead moral lives, play bridge, drive good cars, be enterprising in business, and occasionally mention books, though they are not expected to have time to read them.[4]

At the same time, however, Arrowsmith also marks a clear break with Lewis’ earlier satirical work. As the novelist himself wrote to a friend and publisher in 1921: ‘Perhaps [my next novel will not be] rebellious as ever, … but the central character heroic’.[5]

Although Lewis initially planned to write this heroic novel against the backdrop of the Christian labour movement, he decided to centre the story around a scientific researcher when he was introduced to the bacteriologist Paul de Kruif in 1922.[6] De Kruif, who was later to become famous with popular science books as The Microbe Hunters, had at the time just been fired from the Rockefeller Institute for Medical Research, after it was discovered that he had anonymously published a four-part polemic about the state of scientific medicine in the United States in which he ridiculed the methods and organization of that very same Rockefeller Institute.[7] Together Lewis and De Kruif developed the idea to write a morality tale about scientific medicine in the early twentieth century.

The idea of a morality tale comes from medieval morality plays in which the characters personify abstract qualities, such as virtues or vices, which through the turn of events are confronted with one another and prompt the main protagonist to choose a Godly life over one of evil (i.e. a moral lesson thus is to be drawn).[8] This typification indeed aptly applies to Arrowsmith. As one reads on the back cover of the 2008 edition: “Destined to become a physician and a researcher, [Martin] discovers that societal forces of ignorance, greed, and corruption can be as life-threatening as the plague”.[9] The character of Martin Arrowsmith thus personifies the world of science – a pure but frail world whose enduring existence is threatened by the corrupting influences of society.

The becoming of Martin as ‘Scientist’…

Martin’s struggle against societal vices in favour of the virtue of scientific inquiry takes up most part of the novel. Already in one of the first chapters, the young Martin is introduced to the world of science by Max Gottlieb, Winnemac’s professor of bacteriology who was born and educated in Germany (of course[10]) and, to say the least, a bit of a mystery to the university students (“It was said that he could create life in the laboratory, that he could talk to the monkeys which he inoculated, that he had been driven out of Germany as a devil-worshipper or an anarchist, and that he secretly drank real champagne every evening at dinner”).[11] While Martin immediately desires to become a follower and servant of Gottlieb, his teaching regime initially proves to be too hard for the young student, who struggles with the recognition of his fellow students, of the other teachers and most of all of women.

Leaving ‘Gottlieb’s shadow’ (the original title of the novel[12]) to pursue the down-to-earth nurse Leora Tozer, Martin is led down a path that takes him through the gamut of medical occupations available in early twentieth century America. He in turn assumes the position of a hospital intern, country doctor, public health advocate and pathologist at a surgeon’s clinic before he returns to the scientific arms of Gottlieb, who has by then come to assume a leading position at the McGurk Institute in New York (a fictional recreation of the Rockefeller Institute).

On this journey, Martin encounters what we would nowadays consider the dominant stereotypical representations of the medical profession during the early 1900s. The general practitioner in the country side whose main interest it is to build up a large clientele; the zealous hygienist who hopes to save the nation by destroying dirt and sloth (‘Boil the milk bottles or by gum, You better buy your ticket to Kingdom Come!’)[13]; the surgeon who readily cuts and hopes to make 10.000 dollars a year; and the gentleman scientist who is mainly interested in social status – each pass in review while Martin discovers his abilities as a biomedical researcher who hopes to develop a bacteriophage which may prevent and cure the bubonic plague.

These satirical stereotypes not only serve to ridicule the majority of the American medical profession in the early twentieth century. They also personify those vices which each biomedical researcher apparently has to overcome if he is to make a lasting contribution to the world of science. De Kruif and Lewis strongly agreed that too many societal influences corrupt science.[14] According to medical historian Charles Rosenberg, for example, De Kruif considered ‘no development within American science to be more dangerous than its growing ‘barrack spirit’ (thereby destroying the spontaneous creativity of the individual researcher)’.[15] Similarly, Lewis declined the Pulitzer Prize he won for Arrowsmith in 1926, because ‘he did not believe in contests for writers’ (although he did accept the Nobel Prize for literature in 1930).[16]

The analogy to medieval morality plays is further strengthened by the representation of science as ‘Science’: i.e. by choosing a scientific life, Martin is in many ways choosing ‘a Godly life’. Science is presented as a form of revelation; as a type of truth one’s individuality dissolves in when committing oneself to the realization of its end. Thus, it is when Martin starts to realize his potential as scientific researcher at McGurk that he actively starts to ‘pray the prayer of the scientist’:

God give me unclouded eyes and freedom from haste. God give me a quiet and relentless anger against all pretence and all pretentious work and all work left slack and unfinished. God give me a restlessness whereby I may neither sleep nor accept praise till my observed results equal my calculated results or in pious glee I discover and assault my error. God give me strength not to trust to God![17]

To achieve this state of self, however, Martin has to give up everything which makes him Martin – a tragic undertone to Lewis’ 1925 novel which is not often remarked upon by those who have reviewed the book as ‘an inspiration for those who aim to pursue careers in research’. For despite Martin’s resurrection as ‘Scientist’, it is hardly an overstatement to say that Arrowsmith does not have a particularly happy ending (spoilers ahead!).

…and Martin’s destruction as a sociable human being

In their determination to prove that science and society do not mix, Lewis and De Kruif were willing to sacrifice their main character, at least as a human(e) individual, on the altar of ‘Science’. After page 445, Martin ends up living in the woods, having deserted his (second) wife, his child and all others who bound him to society. As it is written on page 447: in the woods Arrowsmith came to be ‘stronger and surer – and no doubt less human’.[18] Like the Augustinian nun who joins the convent, Martin has to give up his individuality in order to be able to embody that which is larger than him – which is in Martin’s case the pursuit of ‘Science’.[19]

Simply interpreting Arrowsmith, therefore, as a satirical morality tale which provides its readers with the appropriate moral guidance for the successful pursuit of a scientific career (the secular version of a Godly life), neglects that the novel in many ways also presents its readers with a bleak vision on the possibility of having a scientific life while remaining a sociable human being. The great Gottlieb eventually descends into madness, and Leora Arrowsmith-Tozer – the love of Martin’s life – literary falls prey to science as she dies from a culture of Bacillus Pestis so carelessly spilled from a test tube in Martin’s laboratory. Apparently, the God of ‘Science’ cannot allow Martin to be a scientist and a loving husband at the same time. He has to choose, and when he proves unable to do so, it is ‘Science’ that decides for him. For after losing the one person who ever understood and accepted him as the faulty human being he was (“He found in [Leora] a casualness, a lack of prejudice, a directness, surprising in the daughter of Andrew Jackson Tozer. […] She was indeed the first girl to whom he had ever talked without self-consciousness”)[20], Martin is finally ready to part with his desire to become a well-esteemed member of American society (ironically at the very same moment that he turns into one).

The second unsettling undertone running through this chain of events is that the concept of choice itself turns out to be an illusion. That Martin should end up living in the woods, alienated and misunderstood, seems to have been his destiny all along, determined for him before he was even born. This reading, at least, is in hindsight supported by the somewhat out of tone opening chapter of the novel, which narrates – in only nine sentences! – the life of a fourteen year old homeless girl who is never to return to the story afterwards:

“Nobody ain’t going to take us in,” she said. “We’re going on jus’ long as we can. Going West! They’s a whole lot of new things I aim to be seeing!” She cooked the supper, she put the children to bed, and sat by the fire, alone. That was the great-grandmother of Martin Arrowsmith.[21]

Why Arrowsmith remains a must read

One can wonder which message it is that Arrowsmith sends its readers with its final portrayal of Martin (“I feel as if I were really beginning to work now”, said Martin [on p. 450!]. “This new quinine stuff may prove pretty good. We’ll plug along on it for two or three years, and maybe we’ll get something permanent – and probably we’ll fail!”). Perhaps we should not even ask ourselves what the novelist Lewis and the bacteriologist De Kruif intended with Martin’s reincarnation as ‘Scientist’.

My own suggestion is that precisely because the fit between ‘the sociable human being’ and ‘the true scientist’ remains an unresolved puzzle in Arrowsmith that it has become such a strong piece of reflection for those who want to engage with the role of medicine in modern societies. I encountered the novel during my research into the history of human experimentation and medical ethics in the Netherlands after the Second World War. Martin’s adventures in the West Indies (where he unsuccessfully tried to test the efficacy of his bacteriophage against the Bacillus Pestis while entire villages are succumbing to the Black Death) provided Dutch medical doctors with ample material for reflecting upon one of the most fundamental dilemmas of biomedical research: ‘Are we to take care of the individual sick or of the sick in general?’.[22] Arrowsmith did not provide these doctors with any straightforward answers, nor did it function as a morality tale which justified their devotion to scientific research. It rather served to illuminate that ethical difficulties are at the core of medicine, regardless of whether it is pursued as science or as art, and that a choice for either of the two comes with loss (and this in turn made them advocate the necessity of the humanities within the existing Dutch medical curricula).[23] Precisely because Lewis was capable to make that visible, Arrowsmith remains a must read for those who allow science to be a human activity.

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Noortje Jacobs is a PhD-researcher in the field of medical history located at Maastricht University. For her research, she charts the rise of medical ethics committees in the Netherlands after the Second World War and connects this historical development to the rise of the professional (medical) ethicist during this same period.