Phage–Ethics: A Lacanian Reading of Sinclair Lewis’s Arrowsmith

Abstract

Arrowsmith (published in 1925) is an intriguing novel for various reasons, but first of all because this 500–page romance is often regarded as the first real science novel, devoted to experimental laboratory research as a practice, a profession, an ideology, a worldview, a “prominent strand in modern culture” (Schorer 1961, p. 414), a way of life. Named after its key protagonist Martin Arrowsmith, it records an important event in the history of biomedicine: the discovery of the “bacterium–eating” virus: the bacteriophage. But it also addresses a moral ambivalence that runs through biomedicine as a research field, namely the tension between the exacting demands of “pure” research on the one hand and its various (more or less benevolent) applications in medical practice on the other. The novel stages a series of dramatic moral conflicts between the duties of Martin Arrowsmith as a physician (working for the benefit of his patients) and as a researcher (working for the benefit of future generations, of “humankind”), thereby practicing not one but two “impossible professions”. Lewis’s lively descriptions of science communication, priority conflicts, funding strategies, research ethics and laboratory rivalries are still relevant today. First and foremost, however, the novel allows us to discern how, beneath biomedicine’s manifest aspiration to promote human well–being, there is a “deeper” impulse, a disconcerting obsession at work that may prove highly disruptive, not only for test animals, research subjects and patients, but also for scientists themselves. Biomedicine’s fuelling desire, its cupido sciendi (its will to know) is not predominantly to safe, but rather to control life, and the aim of my Lacanian rereading reading is to bring this subliminal dimension to the surface. Lacan’s quadruped will guide our reading:

5.1 Introduction

Arrowsmith (published in 1925) is an intriguing novel for various reasons, but first of all because this 500–page romance is often regarded as the first real science novel, devoted to experimental laboratory research as a practice, a profession, an ideology, a worldview, a “prominent strand in modern culture” (Schorer 1961, p. 414), a way of life.¹ Named after its key protagonist Martin Arrowsmith, it records an important event in the history of biomedicine: the discovery of the “bacterium–eating” virus: the bacteriophage. But it also addresses a moral ambivalence that runs through biomedicine as a research field, namely the tension between the exacting demands of “pure” research on the one hand and its various (more or less benevolent) applications in medical practice on the other. The novel stages a series of dramatic moral conflicts between the duties of Martin Arrowsmith as a physician (working for the benefit of his patients) and as a researcher (working for the benefit of future generations, of “humankind”), thereby practicing not one but two “impossible professions”. Lewis’s lively descriptions of science communication, priority conflicts, funding strategies, research ethics and laboratory rivalries are still relevant today. First and foremost, however, the novel allows us to discern how, beneath biomedicine’s manifest aspiration to promote human well–being, there is a “deeper” impulse, a disconcerting obsession at work that may prove highly disruptive, not only for test animals, research subjects and patients, but also for scientists themselves. Biomedicine’s fuelling desire, its cupido sciendi (its will to know) is not predominantly to safe, but rather to control life, and the aim of my Lacanian rereading reading is to bring this subliminal dimension to the surface. Lacan’s quadruped will guide our reading:

Sinclair Lewis (who was awarded the Nobel Prize for literature in 1930) wrote what is perhaps his best novel in collaboration with science writer Paul de Kruif,² a graduate from the University of Michigan who had worked as a bacteriologist (“microbe hunter”) at the Rockefeller Institute for Medical Research in New York³ and was well underway to become a prominent author himself.⁴ He would publish his (still famous) best–selling book The Microbe Hunters in 1926. Whereas Lewis (son of a general practitioner) was responsible for the descriptions of marital, domestic, professional and civic life in the United States a century ago, De Kruif added the scientific ingredients: the biomedical jargon and the intricate details of laboratory research. But he also portrayed one of the most intriguing characters of the book, namely Max Gottlieb: a “blend” (De Kruif 1962, p. 93, p. 102), “melange” (p. 109) or “amalgam” (Markel 2001, p. 372), − a Mischperson as Freud calls it (1900/1942, p. 299) –, of Frederick G. Novy (De Kruif’s Professor of bacteriology at the University of Michigan) and Jacques Loeb, the famous biologist of German–Jewish descent (1859–1924) who joined the Rockefeller Institute in 1910 (Pauly 1981; Fangerau 2006). Lewis and De Kruif toured the Caribbean together on a “literary safari” (De Kruif 1962), combining furious writing with heavy drinking, collecting ample materials for their masterpiece along the way.⁵ And while De Kruif offered Lewis a crash course in bacteriology, Lewis provided De Kruif with an apprenticeship in non–academic writing.

Arrowsmith portrays the relentless (and potentially disruptive) will to power that drives life science research. Whereas on the ‘manifest’ level biomedicine aspires to do good, there is a “mysterious and unreasoning compulsion” (p. 146) at work that cannot be reduced to purely altruistic motives. This is underlined by a disconcerting quote from Paul de Kruif (who transferred his own research ethos on Martin Arrowsmith) about the “nihilism” of scientific inquiry:

Why had I stopped the study of medicine and switched to bacteriology? … [What did] my years of cool butchery of thousands of rabbits and guinea pigs show but a lack of reverence for life? I was destructive. I was a nihilist, period. For me, the world was too full of people and animals. And having no spark of reverence for all life, I had no ethics (1962, p. 39)

To bring this “deeper” impulse to the fore, I will read the novel from a Lacanian angle, to come to terms with this disconcerting normative “flaw”, this death drive fuelling what is purported to be the “science of life”. But before explaining the design of this chapter more fully, let me first provide an outline of the plot.

5.2 Plot Outline

Like Lewis himself (born in Sauk Centre, Minnesota, in 1885) Martin Arrowsmith grows up in the American Mid–West at the turn of the century, but as a young adult, his biography more closely resembles that of Paul de Kruif (1890–1971). Like him, he is a medical student at the University of Winnemac (≡ Michigan) at Maholis (≡ Ann Arbor), a “factory designed to produce physicians much like the Ford Motor Company produces cars” (Lewis 1925/2002, p. 8). In Lacanian terms: a factory to produce S₂-type professionals. Here, however, Martin becomes infected with the spirit of pure science, personified by Max Gottlieb (≡ Jacques Loeb), a Fremdkörper in professional medicine, because he is a professor of bacteriology rather than a physician, who puts his life in service of an obsession, a fatal addiction, namely “pure”, basic research. His goal is to synthesise antitoxins in vitro to free humanity from the scourge of infectious disease, but also to free laboratory researchers from the laborious use of test animals (as impure and unreliable models). Martin wants to follow in his footsteps and become a bacteriologist himself: a devotee, a believer in the “religion” of science.

But as he meets a female nurse (Leora) and becomes a married man, he has to choose between a career as a general practitioner (that will provide him with social respectability and an income) and the uncertainties of a life devoted to science–for–its–own–sake. Somewhat reluctantly, he opts for the former, thus betraying his true calling, his truth event (the lectures by and conversations with Gottlieb), suppressing his persistent feelings of discontent with heavy drinking. Martin gives in to the reality principle, as it were, allowing himself to become enwrapped in civic, marital and professional life. Yet, he keeps up his habit of spending long and lonely nights tinkering in his home–made laboratory. At a certain point he investigates a local outbreak of cattle disease, publishes his results in the Journal of Infectious diseases and sends a reprint to Gottlieb, who now works as a principal researcher at the McGurk Institute (≡ the Rockefeller Institute) in New York. After reading this article, Gottlieb invites Martin to join him at McGurk and Martin eagerly accepts the invitation.

During his (initially quite unsuccessful) research there, he coincidentally discovers a strange invisible “something”, a mysterious “principle X” which destroys bacteria, and he decides to study it meticulously, in accordance with the rigorous methods of his mentor. Unfortunately, while Martin is still engrossed in his analyses, experiencing serious inhibitions when it comes to putting his findings to paper, Felix d’Herelle of the Pasteur Institute announces his discovery of what he refers to as the “bacterium–eating” virus, the bacteriophage. After recovering from this serious drawback (the loss of priority), Martin is urged by Gottlieb to continue his phage research, but to focus on practical applications instead, using these predators of bacteria as “allies” in the war against disease. When the fictitious Caribbean island of St. Hubert is struck with bubonic plague, and McGurk is called upon for help, Martin is sent there (accompanied by his wife Leora and a drinking companion, the public health specialist Sondelius) to conduct a field trial designed to determine whether “phage” can effectively be employed in fighting lethal pathogens. The result is a moral clash between the island’s administrators (who had expected a life–saving doctor) and Martin’s own objective as a scientist, intent on using the population as “material” for his trial. Thus, he finds himself confronted with an ethical dilemma: as a physician, it is his duty to vaccinate as many inhabitants as possible, but as a researcher, he is in need of an (untreated) control group to demonstrate the effectiveness of his vaccine. This means: dividing the coloured, illiterate population of a village into two equal halves: the saved and the doomed.

Initially, he remains loyal to the experimental rigour instilled in him by Gottlieb, but after the tragic death of both Sondelius and his wife the physician in him gains the upper hand and he contaminates the experiment that was supposed to bring him everlasting fame. He still manages to publish his results, but tampers with his sloppy data so as to make his story sufficiently convincing. He becomes married again, this time to an affluent socialite widow who kindly provides him with a lavishly equipped laboratory of his own. Yet, utter dislike of the social life of the New York elite, in combination with marital unease, presses him to leave both wife and child behind and to escape to the wilderness of Vermont, where, together with another disgruntled colleague, he lives out his mania for “pure” research, virtually undisturbed, in an isolated forest cabin.

In the following sections, key dimensions of the novel will be subjected to a Lacanian reading, treating Martin Arrowsmith as a case study (Fallgeschichte). Successively, I will focus on: (a) the organisational and occupational hazards of a biomedical career; (b) the cupido sciendi of pure science as a “divine madness”; (c) Martin’s grand moment of discovery (the bacteriophage as the intrusion of the “real”); (d) the core medical–ethical dilemma (the bacteriologist as a physician and as a researcher) and (e) cabin science: Martin’s escape to a reclusive, scientific Walden, the novel’s final act.

5.3 Medical Practice and Its Discontents

For young Martin Arrowsmith, becoming a doctor involves an extended process of socialisation into the medical profession. Although courses in bacteriology and immunology are indispensable ingredients of his training, they nonetheless represent something which, in essence, remains at odds with professional medicine, namely basic research: science for the sake of science (seeing human beings as research subjects rather than as patients). The pure scientist (Max Gottlieb) is an oddity on the campus, eager to recruit a small number of students (the “elect few”), − or even one single student, Martin –, luring him away from a normal professional career, converting him to the spirit of pure science.⁶ Due to Gottlieb, one could argue, Arrowsmith becomes a science novel, rather than a medical novel (i.e. a novel featuring a practicing physician).

Thus, Arrowsmith depicts a failed process of socialisation. Martin continues to waver between the world of medical professionals (from country doctors up to metropolitan hospital surgeons) on the one hand and the international subculture of “pure” scientists on the other: nomads really, contemptuous of “worldly success” (p. 11), speaking a strange, artificial language, migrating from one laboratory to the next, convening at international conferences and publishing dense quantitative analyses in esoteric journals. Sooner or later, Martin will have to choose between the “profane” world of medical practice and the “sacred” world of laboratory work, with McGurk, the “immaculate” laboratory, towering as the ultimate “sanctuary” of science (p. 310): a “Heavenly laboratory in which good scientists may spend eternity in happy and thoroughly impractical research” (p. 147).

Just a few years before Arrowsmith was published, Sigmund Freud (1921/1940) developed his views on socialisation in Group psychology and the analysis of the ego (“Massenpsychologie und Ich–analyse”). How can an organised group of people (an “organised crowd”) sustain itself in view of the fact that, for individuals, participation comes with a price: they must relinquish private interests and short–term rewards to pursue distant goals that can only be collectively achieved? How can self-centredness, individualism and discontent in modern mass societies be overcome? For Freud, the key to understanding the functioning of well–organised groups (as opposed to unorganised groups, i.e. crowds or mobs, who are intimidating, but prone to panic) is identification. Groups need leaders: paternal figures like Sebastian Bloch in the previous chapter, embodying the collective ideal and endowed with sufficient charisma and prestige for anonymous group members to identify themselves with them. And this is precisely the weakness of professional medicine as depicted in Lewis’s novel, − and the cause of Martin’s failure. The various father–figures (representatives of organised medicine) are relentlessly ridiculed, one after the other. Only Loeb escapes the pervasive atmosphere of satire.

In the early twentieth century, group behaviour had become an urgent topic. Societies were becoming mass societies; modern media were creating mass audiences; politics had become the domain of mass movements; and even science itself was expanding in scope and scale: new universities were established and new types of scientific institutions were founded (such as the Rockefeller Institute, founded in 1901). The question how to manage and organise large groups was not a purely academic one.

In Arrowsmith we see a chronic tension/collision between two types of groups (two types of callings), highly dependent on one another, and yet apparently mutually exclusive, namely (impure) medical practice and basic (pure) research. For Martin, there are many incentives for choosing a medical career: the income and respectability of the profession, the possibility of marriage and of upward social mobility, in combination with the public acknowledgement of its relevance. Yet, what is lacking, to a deplorable extent, are inspiring personalities. One by one the father–figures in Lewis’s novel (representing medicine and public health) are ridiculed as hypocrites, endorsing unsubstantiated claims and leading uninspiring lives. On top of that, Martin himself is not a good physician at all, lacking “bedside manners” and communicative skills, while his drinking habits are symptomatic of his ambivalence: his repressed yearning for pure inquiry.

Gottlieb, by contrast, seems to stand out as a beacon of integrity, a scientific prophet, a window into the future. Their first meetings give rise to “imprinting”, as it were. No matter how hard Martin tries to “repress” his admiration for his hero, his exposure to Gottlieb prevents him from developing a whole–hearted commitment to medical practice. Indeed, although he had “given up Gottlieb–worship and his yearning for the laboratory … something of Gottlieb’s spirit remained” (p. 115).

Having mesmerised Martin during his lectures, and subsequently during the laboratory hours they spent together, Gottlieb continues to draw Martin towards him.⁷ Gottlieb considers “medical science” a contradiction in terms. He is a genuine scientist, devoting his life to intellectual aspirations, willing to work excessively hard and to accept the risk of failure. Martin is in awe of Gottlieb, the ideal “father figure” he is looking for (Parry 2008, p. vii), an ego–ideal or intellectual conscience, encouraging him to work harder. Indeed, Gottlieb “indoctrinates him into the religion of a scientist” (p. viii).

Already during the very first lecture he attends, a rapport is established, and Martin identifies himself with his life–long mentor. The novel describes how, at the beginning of the lecture, Professor Max Gottlieb is about to assassinate a guinea pig with anthrax germs, displaying his masterful technical dexterity, claiming that “technique is the beginning of all science” (p. 36). As Lewis phrases it, the class was “a mob” (p. 35), “shuddering” (p. 36) in response to the idea that even a small sample of anthrax bacilli could easily produce a lethal infection. But Martin is simply enthralled by Gottlieb. Indeed: “Martin Arrowsmith already saw himself doing the same experiment and, as he remembered Gottlieb’s unerring fingers, his hands curved in imitation … He had begun, perhaps in youthful imitation of Gottlieb, to work by himself in the laboratory at night” (p. 38/9). He mimics and copies Gottlieb’s words and gestures. And via Gottlieb, who studied with Helmholtz and idolises Koch, Martin extends his identification to his master’s masters.

This fascination for scientific truth hampers his professional career, causing a chronic sense of ambivalence: “Martin remained doubtful, he admired the insistence on the physician’s immediate service to mankind, but he could not forget the cool ascetic hours in the laboratory” (p. 119). As a symptom of this ambivalence, he insists on having a makeshift laboratory of his own where he continues his habit of conducting experiments, usually at night, although this is barely tolerated by his social environment, first of all his wife. This dynamics is captured by Lacan’s quadruped:

His research position at McGurk (where he joins his ego–ideal again), his dramatic expedition to the Caribbean and, finally, his retreat into the woods are all instances of a return of the repressed. Having been exposed to the quest for pure science, he cannot really become socialised into normal civil society any more. Indeed, in Arrowsmith, bacteriology is presented as an infectious affliction, spreading from the laboratories of Pasteur and Koch into the United States, with researchers such as Gottlieb as carriers or vectors.⁸ As Freud argues in Group psychology and the analysis of the ego, there is a strong desire in infected individuals to confer their infection to others, for why should they alone be excluded from the benefits of social life and condemned to an ascetic existence of toil and hardship (p. 134)? But what exactly makes laboratory research so ‘infectious’ (for individuals ‘susceptible’ to it), so alluring?

5.4 Cupido sciendi: Pure Science as a Divine, Infectious Madness

Arrowsmith contains numerous descriptions of biomedical research settings, with racks of test–tubes, Bunsen burners, constant temperature baths, centrifuges, autoclaves, notebooks and so on, but this in itself does not explain the fatal attraction these loci of discovery exert on individuals such as Martin. Rather, what attracts him in science is the aura of a quasi-religious calling. This is underlined by an improvised sermon by Gottlieb, with Martin (who has just entered McGurk) “at his feet” (Doctorow 2008, p. 453), explaining that science, extremely demanding and error–prone, is essentially a religion:

I make many mistakes. But one thing I keep always pure: the religion of a scientist. To be a scientist [is] like mysticism … it makes its victims all different from the good normal man… The scientist is intensely religious – he is so religious that he will not accept quarter-truths, because they are an insult to his faith… he is a man that all nice good–natured people should naturally hate! … [The authentic scientist is] the only real revolutionary… He lives in a cold, clear light… Not all the men who work at science are scientists. So few! … To be a scientist [there are] two things you must do: work twice as hard as you can, and keep people from using you. I will try to protect you from success … May Koch bless you! (292/293)

Science means perseverance, loneliness. Research had not yet evolved into the large-scale pre-programmed phenomenon it became today. Discoveries were made by solitary individuals at their benches, preferably after hours, during the night.⁹ McGurk encourages individuals to pursue their goals in splendid isolation. Research is pure, researcher-driven, and intolerant towards the “quarter-truths” abounding in the real world outside the lab.

As a general practitioner struggling in the fuzzy, dreary outside world, Martin tried to forget about Gottlieb and his imperatives (S₁ in the lower-left position), but his super-ego continues to haunt him like a phantom. As a doctor, Martin is deprived of something, − and of someone. The repressed attachment continues to cast a shadow¹⁰ and his ego is split into two halves: on the one hand the married, heavy drinking professional, on the other hand the would-be researcher, tormented by his intellectual conscience (his ego–ideal), failing to live up to his true vocation ($ in the lower-right position). His entering McGurk as a research associate entails a moment of euphoria and triumph, of reconciliation and atonement: a spiritual “inflammation”. He and Gottlieb (the “demon” of pure science) are finally on speaking terms again, while Martin can overcome his paralysing dividedness ($ → S₂), can restore his integrity (literally: his wholeness), can wholeheartedly identify himself with his role as researcher and constitute himself convincingly as a moral subject.

But in his new position, new challenges, new threats to his integrity await him, precisely because of the exclusiveness of the scientific calling. In Arrowsmith the ethos of science is described as a divine madness, θεία μανία, as Plato phrased it (Phaedrus, 244–256). Inside their laboratory, similar to Plato’s philosophers, scientists behold a realm of truth which is invisible for untrained senses, a transcendent region only discernible for the initiated mind, although there are many who, after much toil and hardship, leave the field without gaining even a glimpse of this higher reality (248B). Because of their desire for truth, true scientists cannot sleep at night. They must distance themselves from the common “herd” of mankind; ignore their neighbours, who rebuke them for apparently having gone mad. In Arrowsmith this madness, rather than providing access to a “higher” realm (of ideas), as in Plato, allows Martin to open up a “deeper” realm of microbial life, only accessible via microscopes. The topology has changed: rather than striving upwards, the modern scientist aims to dive deeper, but a similar amount of persistence is required. Only those who, like Martin, persevere in their tedious, repetitive activities will experience the “joy” (p. 43), the “rapt quietude” (p. 125), the “beautiful precision and dullness” (p. 40) of laboratory work. They will “sink blissfully into the laboratory” (p. 270), “beyond sounding in their experimentation” (p. 305), so that their lab temporarily becomes a “perfect world” (p. 295).

On the verge of the discovery of his “principle X”, Martin becomes completely absorbed in his work. He forgets about night and day, becomes unconscious of the world, and completely exhausts himself, until he goes literally mad: “He was completely fagged, perhaps a little insane” (p. 326). Indeed, he works himself into a state of “neurasthenia” ($ in the lower-right position):

Martin watched himself, in the madness of overwork, drift toward neurasthenia…From irritability he passed into a sick nervousness in which he missed things for which he reached, dropped test–tubes, gasped at sudden footsteps behind him. … Then he was obsessed by the desire to spell backward all the words which snatched at him from signs… At last Fear closed in on him. [It began] with terror of the darkness. Footsteps in the hall were a creeping cutthroat…. When in the street below he did actually see a man standing still, he was cold with panic. Every sky glow was a fire…He knew absolutely that his fears were absurd, and that knowledge did not at all keep them from dominating him. Till the safe dawn brought back a dependable world (p. 332/3)

All this is captured by the Lacanian quadruped:

As a consequence of his fatigue, he suffers from a wide range of symptoms, the by-product (in Lacanian terms) of his devotion: insomnia, agoraphobia, claustrophobia, siderodromophobia (i.e. the fear of railway journeys) and, most of all, anthropophobia (the fear of meeting other humans), and yet he realises that, sooner or later, his crazy experiment will turn “from overwhelming glory into sane … routine” again (p. 335), so that S₂ (the balanced, impassive agent of university discourse) will be restored. What is it that, during this episode of self-imposed mental suffering, reveals itself to him? What is this “gold” which he seems about to find (p. 336)?

5.5 The Bacteriophage as the Intrusion of the Real

Arrowsmith makes it sufficiently clear that experimental laboratory work is oftentimes quite tiresome and repetitive. Researchers redo their experiments over and over again, under various conditions, in order to confirm and verify their results. As World War I is gliding into its final, most sinister Act, Martin quietly attends the beautiful, grapelike microbes named staphylococci which he cultivates in vitro, representing the S₂ agent of university discourse.¹¹ All of a sudden, something completely unexpected happens, thwarting his expectations rather dramatically. What went wrong?

The purpose of laboratories is to keep the unexpected and disturbing at bay, allowing researchers to achieve maximal control over nature. The experimental setting is designed to immunise experiments against disturbances and intrusions (noise). The real world (out there, beyond the confines of the lab) is kept at a safe distance. Research facilities are purified, streamlined versions of reality, devoid of debris, processing tiny, artificial samples of nature that can be meticulously studied, such as strains of bacteria in test-tubes, carefully cultivated, protected, isolated, and also controllable and predictable to a considerable extent, with the help of measurements, technical equipment and mathematical equations.

But now, in the midst of this tedious, repetitive, quantitative work, something highly unusual occurs, something which cannot be ignored. “I have hit something” (p. 323), Martin aptly exclaims, something “at the mysterious source of life” (p. 321), something which is not mentioned in the manuals or journals of normal science. A violent, disruptive, completely unknown dimension of nature suddenly opens up to him. A peaceful strain of staphylococcus bacteria, which should be flourishing and multiplying in their flask, is suddenly missing. Instead of a colony of bugs, he discerns a “clearing” (p. 325). The microbes have all disappeared: a most uncanny situation. Under his microscope, he sees “nothing but shadows of what had been bacteria: thin outlines, the form still there but the substance gone; minute skeletons on an infinitesimal battlefield” (p. 323). While World War I is raging, Martin hovers over a perennial battlefield (existing since time immemorial) on the microbial level, spotting the ghostly remainders of his perished troops (with test–tubes turned into trenches). Something has dissolved them, wiped them out. It looks as if they committed “suicide” on the spot (p. 323). Something is relentlessly preying on these peaceful herds; something violent has entered the lab, reminiscent of Heraclites’s maxim that warfare (πόλεμος) is the essence of being. What is this intruding “something”?

Jacques Lacan would have called it the Real: something which cannot be discerned directly, but intrudes and flouts our expectations, something alien, amorphous, unknown and uncanny; something we were not looking for. All of a sudden, something is missing which should be there (something is Fort which should be Da): a researcher is suddenly deprived of his microbes. They are reduced to phantoms: ghostly, emptied organisms, bodies without organelles. Nothing survives the intruder’s attack. The Real is that which is discovered by coincidence, which resists the normal functioning of scientific practice (Lacan 2007, p. 29) but cannot be ignored any longer; something profoundly alien and “other”.¹² It can only be tamed if embedded in the symbolical order, by identifying, naming, counting and analysing it: the basic objective of university discourse, of laboratory research.¹³

Martin’s discovery of the bacteriophage is also a turning point in the movie version (Ford 1931). In mid–winter,¹⁴ with Manhattan covered in snow, Martin places three flasks in a refrigerator, thick with bugs. Returning to his laboratory later that evening, unable to detach himself from his work, he discovers that in one of them, the bugs have completely vanished. Instead of being turbid, the fluid is clear. Under his microscope, which he handles with professional ease, he discovers the remnants of what had been a thriving colony of bugs. Nothing like this ever happened. Is it good or bad? Bad, because it ruins his experiment, but he quickly considers the option that it might be something “good”, something “better”. Bugs don’t commit suicide: what slaughtered them? It must be something. In fact, it turns out to be the greatest thing that ever happened to him. “I have found something”, he triumphantly exclaims, “but don’t ask me what it is”. After days of prolonged labour, Gottlieb glances though his notes and says: “Martin, you have a big thing here, a great thing … You must find out what it is … You will begin working in earnest”.

Techno–scientific artefacts create a man-made, controllable reality, but the disconcerting real is never completely annihilated. It persists in the folds and margins of the laboratory world,¹⁵ offering resistance to complete “assimilation” (Lacan 1973, p. 65), revealing itself as a gap, a crevice, a rupture, something totally unexpected (Lacan 1991/2001, p. 58), unacknowledged, unnamed, unmeasured, un-visualised. The real is basically an intrusion, a disruption: that which resists our expectations. It is the “inexorable” (Lacan 2013, p. 565). As Heraclites phrased it, many centuries ago: real nature is wont to hide herself, but sudden revelations may prove quite disconcerting (Lacan 2004, p. 85 ff.). The real is that which, from the point of view of normal science, seems utterly “impossible” (Lacan 2011, p. 141).

Martin is confronted, not with an “object”, but rather with a gap, something which causes his bugs to be missing. A first important step towards “symbolisation” or domestication is the act of naming. Martin uses a provisional, empty signifier for his strange entity: “principle X”.¹⁶ It becomes his “object a” (in the upper-right position), alluring and disconcerting, uncanny par excellence, midway between being and non-being, living and non-living, a condensed fragment of (or window into) the real. In the struggle over priority which unfolds, d’Herelle emerges victoriously, not only because he is the first to publish his results, but also because he gives the new entity a convincing name, a signifier that sticks: the virus that preys on bugs, the bacteriophage. By coining this signifier, which aptly conveys (in shorthand) what the mysterious entity actually does, he definitely makes a name for himself, and turns the mysterious principle into an (albeit fairly intractable) object. We see science at work: with scientists achieving immortality by successfully adding a new signifier to the network of names, concepts and symbols which Lacan refers to as the symbolical order. By providing the weird non-object with a name, the bacteriophage, or “phage”, as Americans soon prefer to call it (Cairns et al. 1966), becomes something that can be analysed and normalised, something scientists can relate and refer to: equations can now be drafted; the anomaly becomes embedded in university discourse.¹⁷

Why didn’t Martin publish his findings earlier? Because the scientific method, personified by Gottlieb (his epistemological conscience), prevented him from doing so. No preliminary results, however intriguing, even if they bring you everlasting fame: that is Gottlieb’s ethos. More research is always needed. As a super–ego (Über–Ich), Gottlieb proves too demanding. He refuses Martin to enjoy the fruits of his sacrifices, his late-night hours. Martin never seems to have laboured enough. With Gottlieb peering over his shoulder, he feels paralysed when it comes to putting his findings on paper. As Freud (1921/1940) phrased it, the leader of the organised group (the collective conscience or ego-ideal) is reluctant to grant his co-workers their personal triumphs, as this would set them apart from others and reward their striving for independence. Gottlieb already said it in his sermon: “I will try to protect you from success”. Whereas Director Tubbs (his formal superior at McGurk) urges Martin to hasten and publish his results, Gottlieb keeps discouraging him from doing so. And when the latter walks into Martin’s lab to tell him the bad news about d’Herelle’s publication (according to Gottlieb’s rigid standards a premature, sloppy publication), he is ambivalent about it. Although he deplores the fact that Martin (and, by implication, the Institute) has lost the race over priority, the sublime ethic of pure science nonetheless stood its ground, rather than compromising itself by hastily running into print, merely to attain worldly fame (a questionable research practice). Martin, the researcher in the trenches as it were, is sacrificed to these lofty ideals. And rather than regretting his reluctance, Martin himself experiences relief for not having published a “premature” paper (p. 345). He doesn’t revolt against Gottlieb’s sinister regime: not yet, but is willing to produce more knowledge, work harder, even risk his life, by travelling to plague-ridden St. Hubert, where his devotion to the lofty ideals of science will be put to the test even more relentlessly. Or should we rather see it as an escape from the laboratory, where the split between obligation and desire ($) had become untenable?

As was already outlined above, we may summarise these analyses with the help of Lacan’s dialectical scheme of “university discourse”, by inserting Lacan’s four symbols (S₁, S₂, $ and a), Lacan’s στοιχεῖα, as “variables” (in a fixed sequence) in the four positions in a rotating, revolving quadruped:

University discourse puts the qualified expert (S₂) in the position of the agent.

The scientist (as agent: S₂ in the upper-left position) is a committed, self-composed, ascetic researcher focussing on an exacting object (a in the upper-right position). Initially, this object seems a normalised, standardised, domesticated object: his carefully cultivated staphylococci, but due to the disconcerting intrusion of the real, the focus of attention shifts to something completely different (initially referred to as his principle X), a taxing, toxic and addictive object, claiming his full attention, while remaining intractable and inexorable (a in the upper-right position). Initially, the position of the researcher seems completely neutral and impassive, but the confrontation with this “object a” proves a taxing experience and reveals that something else (besides objectivity, precision, etc.) is at work in science as well, addressing scientists from beneath the bar. On certain occasions, during his “sermon” for instance, Gottlieb initiates him into a basic truth, namely that science is actually a religion, so that the true scientist is an ascetic devotee, an adept, something of a stylite, addressed by a secret calling, a will to power (S₁ in the lower–left position). And although research initially may seem repetitive and boring, this combination (the exposure to the intractable object, which reveals the hidden imperative) results in a destabilising by-product, an unexpected moment of intellectual jouissance, of θεία μανία, of divine madness ($ in the lower-right position), so that the normal relationship between an impassive subject and a domesticated object gives way to the matheme of desire: $ ◊ a. And indeed, this is what forces Martin to flee the Rockefeller Institute and seek shelter in the Caribbean: the tension between impassivity and desire (between super-ego and object a, between Gottlieb and X) has become untenable, resulting in an experience of dividedness or Spaltung ($ in the lower-right position). His competitor (d’Herelle) faced a similar tension, but apparently decided to publish his findings prematurely, without sufficient evidence (controls, replications, etc.), a questionable way-out (from a normative perspective). This compromised his methodological integrity, but brought him everlasting fame. For someone like Gottlieb, however, such an eagerness to publish is a most questionable research practice.

5.6 The Medical–Ethical Dilemma (The Bacteriologist as a Researcher and as a Physician)

The history of the discovery of the bacteriophage is closely connected with World War I. Bacterial viruses were discovered in 1915 by the English microbiologist F.W. Twort, who had to discontinue his research because of the war effort. Two years later, in 1917, the phage was discovered for the second time¹⁸ by French–Canadian Felix d’Herelle at the Pasteur Institute. In d’Herelle’s original publication, he calls the bacteriophage a potential panacea, a “microbe of immunity”. Therapeutic trials proved unsuccessful, however, and phage therapy (the use of phage as a bacterium–killer, as a soldier in the war against infectious diseases) eventually gave way to more effective means: penicillin and other antibiotics (Dublanchet and Bourne 2007).¹⁹

Thus, the bacteriophage moved from medicine to pure science and became essentially a lab organism: a tool for basic research in molecular biology. As such, it achieved world-renown through the work of Max Delbrück at Caltech (Pasadena) who employed it as the “hydrogen atom of biology”, as a “minimal organism”, albeit too minimal for the word “organism” to apply. His Phage summer course at Cold Spring Harbor²⁰ put young James Watson on the road to success (Watson 1966). In Lewis’s novel, phage research is still in its earliest, applicatory stage. With De Kruif providing the necessary scientific details, Arrowsmith follows history quite closely, as if d’Herelle and Arrowsmith really were contemporaries, stumbling over bacterial viruses at different locations (Paris and New York) more or less at the same time.

Seeing the struggle for priority lost,²¹ Gottlieb urges Martin to reorient his agenda towards applied research. An outbreak of bubonic plague in the Lesser Antilles provides him with a perfect opportunity to test his phage in vivo. His motives are scientific rather than medical, however, and he sets off on an expedition which is not meant to save lives, but rather to produce a landmark publication. He wants to use humans instrumentally, in order to understand the phage. For him, human beings (coloured, illiterate inhabitants of a Caribbean island) are living test-tubes as it were. So far, the bacteriophage had been a laboratory artefact. Time had come to test his principle X in an outdoor setting, exposing it to the reality principle as it were. Bacterial viruses were still untried in the real world outside the lab. Will the vaccine work in the messy and complex environment called reality? The inhabitants of St. Hubert are seen as research subjects rather than suffering patients. The population of a remote village (providing optimal conditions for a field trial) is divided into two samples: the experimental condition (receiving the phage vaccine) and the control group (denied the life–saving serum and treated with traditional methods) – a strategy which Pasteur and his followers had successfully adopted in their experiments with cattle (Zwart 2008a, p 175 ff.).²² Indeed, the experiment (purportedly conducted for the benefit of mankind, but primarily designed for the prestige of McGurk) is performed by Americans at the expense of coloured, native human “bodies” (Lynch 2000). But as the phage vaccine begins to show results, it becomes increasingly difficult to uphold the experimental design in practice. This again reflects the dynamics of university discourse:

Initially, Martin is bent on extrapolating his phage research to the outside environment, conducting high-quality research which is sufficiently robust (methodologically speaking) to render (friendly but powerless) doctors obsolete for good. In the end, however, he acknowledges that he is “too human to be a satisfactory experimenter”. The panic–stricken controls (the anonymous indigenous masses) secretly begin to move over to the experimental sample, and finally, due to the death of Martin’s two most significant others (Western individuals with a name and a face, namely Sondelius and Leora),²³ Martin becomes aware of the disruptive logic of “pure” biomedical research. The experimental method may endanger rather than safeguard life. He decides to give his phage vaccine to everybody, ignoring Gottlieb’s instructions (his inflexible ego-ideal, summoning him from a distance, from beneath the bar). The objective is reversed: from conducting experiments (knowledge production) to beneficence (saving lives). With a scientific conscience weakened by inconsolable remorse, tropical heat and heavy liquor, he compromises his work and fails the test. The moral force field produces a cleavage or splitting ($) between epistemological and bioethical normativity, and he proves unable to maintain his integrity by upholding his unconditional allegiance to pure research.

There are dramatic examples in real history of similar conflicts between the roles of physician and researcher (between caring for severely ill patients and trying to find a magic bullet), for instance in the case of AIDS. Another famous example is the discovery of cyclosporine to prevent rejection of organ transplants (Starzl 1967, 1992/2003). After the heroic first stage of organ transplantation (during the 1950s and 1960s), a severe crisis emerged in the 1970s. Implants were rejected, immune systems were ruined. Cyclosporine seemed to offer a miracle cure. Prospects for patients improved dramatically. But in order for the new product to become available, it had to be tested in randomised trials, allowing the results from the experimental condition (the saved) to be compared with those of the controls (the doomed).

Martin continues to waver between both roles. Initially, he remains loyal to the gospel of randomised trials preached by Gottlieb, but eventually he botches his experiment and spoils his results, assuming the role of “saviour” of the desperate. The plague disappears from the island, but it is no longer possible to conclusively prove that it was the phage vaccine that did the job (as plagues always have the tendency to disappear after a while, even in the absence of any biomedical intervention whatsoever).²⁴ Thus, his final big opportunity to acquire everlasting fame is thwarted. Martin’s fatal flaw is his incapacity to consistently uphold his loyalty to one of these two incommensurable deontologies: the demands of scientific rigour versus the principles of professional medical ethics, − even though the deontology of science is the dominant one because an Über–Ich is “introjected” (as Freud calls it) into his psyche, personified by Gottlieb. He feels haunted by the latter’s critical gaze, experiences any concessions to his duties as a physician as moral weakness and sees his West Indies expedition as a failure because he puts the well–being of people above research (Parry, p. ix).

Beneath his manifest allegiance to Gottlieb, however, a latent oedipal conflict is clearly at work as well. Throughout the novel, Martin struggles to distance himself from Gottlieb-the-father-figure, attempting to evade the inevitable oedipal collision that awaits him should they remain too close. This is what makes him leave the (promising) field of bacteriology to become a country doctor: an independent, married adult with an income, craving to free himself from the tyranny of “Gottliebism” (p. 116). Yet, Gottlieb crosses his path again and Martin, tormented by discontent, now eagerly subordinates himself to his found-again father-figure, wasting two long years on dreary, repetitive, meaningless lab work, without any output of significance. When suddenly the perennial microbial battlefield opens up before his eyes, for the first time in biomedical history, Gottlieb proves an excessively stern father, notably towards his “favourite” (p. 64), standing in the way between Martin and an international academic breakthrough, consciously retarding and discouraging his publication, so that the competition over priority is lost. Gottlieb effectively hinders Martin to seize the one big opportunity to “make a name for himself”, as Tubbs phrases it: gaining international recognition and achieving intellectual independence as a department head (a position offered to him by Tubbs, but withdrawn as soon as the news of d’Herelle’s publication reaches New York).

This is also reflected by Gottlieb’s comments on this occasion: “Something has happened, not altogether bad”. Now that the situation has become untenable, Martin is sent on a gloomy errand, all for the glory of Gottlieb himself, whose life-work Martin is supposed to fulfil: the St. Hubert expedition. But eventually he is overwhelmed by anger, resulting in an outburst of masculine oedipal protest: “To Hell with experiments! To Hell with Gottlieb!”, as the movie version phrases it.

In this latter scene, university discourse gives way to the discourse of the hysteric. Unable to overcome the split between conflicting deontologies, Martin now takes the floor as a tormented subject ($ in the upper-left position as agent), raising a voice of boisterous protest against the authoritative father-figure (the recipient of the message: Gottlieb now acting as S₁ in the upper-right position), both practically (by compromising his experiment) and verbally (the movie scene):

This type of discourse tends to be disruptive, but may nonetheless be functional. By challenging the “impossible” epistemic regime represented by Gottlieb, a less disruptive practice of knowledge production could perhaps emerge (S₂ in the lower-right position). But in order to achieve this, Martin (the divided subject) must work through the question what is really driving his research, his cupido sciendi (a in the lower-left position). And precisely this self-reflective deficit is Martin’s ἁμαρτία, his tragic fatal flaw. In order to analyse his experiences, he is in need of a therapist. Upon his return to New York City, he bursts into Gottlieb’s office to make a full–fledged “confession”: “I did not add to knowledge. I did the humane thing. I lost sight of science”. But this attempt to establish an analytical relationship falters, because he can’t get through to Gottlieb anymore, who has become senile, so that Martin cannot be “cleansed” (p. 422). Unable to accept his father’s place and become his substitute (the position of department head is offered to him, which would reposition him as S₂ in the upper-left position), he flees from McGurk for good, taking his microscope with him – an item which functions as a phallic symbol, an enabling contrivance, complementing his deficiencies – to follow a fugitive colleague into the forest.

This final gesture seems a final escape into Cynicism (in the ancient sense), for Cynics were itinerant scholars who already refused all societal roles and responsibilities, which they saw as enslaving, as indicated by their garment: bare feet and a rough cloak (Dudley 1967). Martin’s escape into the forest conveys his refusal or inability to accept endorsement by the professional, institutional, symbolic order. After the death of the father, Martin flees from the role he is expected to play, as well as from the claustrophobic embrace of his wealthy spouse, who mothers him and bereaves him of what is left of his independence. Beyond the civilised world, he wants to come to terms with his own desire. But should we see his “forest science” as an attempt at self-analysis, or rather as a relapse into the position of beautiful soul, a misguided effort to restore his integrity by withdrawing into “pure” science, rather than by trying to work-trough the inevitable conflict?

5.7 A Scientific Walden: The Pastoral of Cabin Science

As a researcher, Martin is torn between the profane world of everyday existence and the sacred realm of science. The normal world is depicted in a cynical and sarcastic manner. Only heavy drinking allows the hero to survive the imperfections of love, marriage and human company, where real-life people oftentimes prove disappointing and abusive.

Only in the realm of pure science can Martin hope to find purity and precision (integrity), instead of sloppiness and contamination (questionable practices or even misconduct). These two realms compare to one another as newspapers and popular magazines compare to the Journal of Infectious Diseases. But the scientific realm is not an innocent world. For here, the death drive reigns: Martin studies bugs in order to systematically eradicate them (to destroy these “amiable” pathogenic germs, with their “lovely flagella”, p. 41), while staggering numbers of test animals (rabbits and guinea pigs) are “sacrificed” on behalf of (often quite pointless) research, without any ethical review procedure whatsoever. At a certain point, Martin even starts using chimpanzees for a 2 year project that ends in failure, although “murdering monkeys proves expensive and grim” (p. 440). And finally, on St. Hubert, human beings are sent to death like guinea pigs for the sake of upholding the rigorous logic of randomised trials, represented by a highly charged term: the word “control”,²⁵ – the novel’s basic signifier, the most powerful term which Martin as a student adopts from Gottlieb, playing a decisive role in the structuring of the plot.

For Martin, the conflict seems unsolvable. One is either a scientist, or a doctor (Clarfield 2007). The normal, professional world (‘reality’) is a wasteland of boredom – a waste of time. The “religion” of science promises personal redemption, but this can only be achieved by conducting experiments, almost as a “religious exercise” (Löwy 1988), which are inherently destructive.

As a final solution, in a desperate quest for salvation, Martin prefers flight over fight, into the forest, the outdoors world, where a self–made cabin laboratory is installed. Thus, Martin moves from rural medicine (North Dakota) to public health (a small town in Iowa) to bacteriology (a fashionable Chicago clinic) to basic research (New York, the ‘ultimate’ city) and finally to “pastoralism” (Doctorow 2008, p. 456). Here, in a drastically simplified world (in stark contrast to the extravagantly furnished laboratory organization at McGurk),²⁶ he can finally act out his ideal of uncontaminated inquiry, albeit in a rather imaginary manner, since life in this tiny scientific hermitage (this “shrine”, p. 467) is almost completely out of touch with what is happening in the world at large. Here, in isolation, he really wants to begin working in earnest, continuously, day and night.²⁷ As a stranded researcher he conducts experiments which seem bereft of all purpose. For although he seemingly adheres to what Lacan sees as the basic imperative of modern science (“Go on, continue to produce more knowledge!; 1991, p. 120), real scientific productivity can only happen in a world of social networks.²⁸ In terms of Hegelian dialectics, the discourse of the hysteric concurs with the position of the “beautiful soul” who rises up against the world in the name of the “law of the heart” (Lacan 1966, p. 219) but proves unable to deal with the conflicting demands and tensions of the real world (the world of contracts, relationships, professional expectations, rivalling claims, priority conflicts and so on), and therefore decides to drastically simplify life. Only in this manner can Martin live up to his fantasy of pure, uncontaminated activity, instilled in him during his student days by Gottlieb.

5.8 Conclusion: Conflicting Deontologies

Arrowsmith addresses a basic divide running through biomedicine, a clash between two (incommensurable) deontologies, two integrity regimes as it were: the principles of medical ethics on the one hand and the demands of experimental research on the other. Although biomedicine is allegedly motivated by the objective to promote well-being (enhancing the effectiveness of clinical practice), Arrowsmith emphasises that there is another, rather disruptive impulse at work as well: a violent will to control life, endangering rather than protecting the well-being, not only of research animals, but also of patients and, eventually, of biomedical researchers (such as Martin Arrowsmith) themselves. They must choose between two options, both of which are presented as morally unsatisfactory: on the one hand medical practice, portrayed as fundamentally insincere (permeated by mauvaise foi, to use the Sartrean term), on the other hand the methodology of randomised trials, depicted as inconsiderate and ruthless. After a series of fiascos, Martin’s “solution” is simplification and escape (flight instead of fight).

This raises the question whether this nihilistic portrayal of the moral dichotomy is inevitable. Dialectically, the relationship between medical practice and basic research may perhaps be seen in a different light. In Arrowsmith, the claim is made that, as soon as the principles of biomedical science (M₁) are applied to practical situations, multiple conflicts and contradictions emerge (M₂), but a more sustainable and satisfactory outcome would be the awareness that, eventually, the one cannot really function without the other (→M₃). In splendid isolation, pure science becomes thin and empty, so that the plea for “pure” research may actually be an immunisation strategy, a mechanism of defence (the beautiful soul position). Moreover, it is precisely in the confrontation with real-life situations that the relentless drive towards control, fuelling the quest for knowledge, is brought to the fore. In other words, application and extrapolation are necessary experiences to discover what science really is about. The experience of working through the conflict is then seen as a precondition for self-understanding.

But this outcome is not easily achieved. The chronic tension is there for real, as indicated when we read the novel in terms of the discourse of the analyst:

The phage is Martin Arrowsmith’s object a: the cause of his desire, that which gives meaning to his life, that which makes him move and act. But it also inflicts in him a tragic sense of Spaltung ($). Suffering, desperate patients are not his primary source of inspiration, and his profession is merely a pretext for his real desire: conducting research. In the exposure to the enigmatic object, professionalism becomes suspended (S₂ in the lower-left position). What really motivates him is an invisible, faceless laboratory phenomenon, inexorable and uncanny, hovering between living and non–living (a), and more addictive than heavy liquor. The phage is the one thing he wants to control, but which actually controls him, up to the point of impairment ($ in the upper-right position). His craving is to transform it into a predictable tool, to domesticate it into a normal object, so that university discourse can function smoothly again. A working vaccine would have been a perfect outcome in this disruptive struggle for power between the researcher and his virus ($ ◊ a). In that case, the phage would have ended his discontent, his anonymity, by making him famous, turning his life into a success story after all. But the idea of medical benefits functions as a façade, a pretext for his urge to dominate nature in her most elementary (viral and microbial) dimensions, working himself into a state of neurasthenia – in accordance with Dostoyevsky’s insistence that intellectual activity is, in final instance, a “disease” (1864/1972, p. 18).

In conclusion, we are not confronted with a moral dilemma in the sense of a problem that can be solved by developing or abiding to rules and regulations, such as the codes of conduct and ethical principles of research with human subjects. Although such practices (developed by professional ethicists) may help to subdue the tension, making microbial research more manageable no doubt, they will not abolish the basic divide. The desire to control life may become addictive precisely because it is driven by a disruptive compulsion. As a science novel, Arrowsmith opens up and dramatizes this basic rupture, thus furthering our awareness of the gap between what basic research produces and what clinical medicine basically needs. And this divide not only affects the knowledge dimension, but the normative dimension (the level of morality and of the Self) as well. According to Arrowsmith, what is considered integrity in the realm of basic research is regarded as misconduct in medical practice, and vice versa. But this may not the final word. Arrowsmith is the first real science novel, as we have seen. In the next sections we will explore how these tensions are addressed in other novels, notably in Chap. 7 (Cantor’s dilemma) and Chap. 9 (Intuition).