For the Medical Record - Interview with Paul William Child
===

[00:00:00]

Mia Levenson: Hi, and welcome back to For the Medical Record, a podcast from Johns Hopkins University's Center for the Medical, humanities and Social Medicine. I'm your host, Mia Levinson and I'm flying solo. Today for this special episode. I'm joined by Paul William Child, a professor of English at Sam Houston State University, and an alum of our online master's program in the history of medicine.

He's here to talk about his new book, the Dean Disordered, Jonathan Swift and Humoral Medicine, which examines how the chronic ailments of Irish satirist Jonathan Swift shaped his life and writings. This book actually grew out of the thesis project he wrote in the Master's program, so I'm thrilled to have the chance to talk to him today.

Welcome, Paul!.

Paul Child: Thank you, Mia. Thanks very much. I appreciate the invitation.

Mia Levenson: Yeah. So happy you're here. So [00:01:00] just to get started, can you tell us a bit about how you came to this project? How did you get interested in Jonathan Swift?

Paul Child: Well, that's, that's a wonderful question. Uh, and, and again, thanks for the invitation because first of all, it gives me an opportunity to share the work that I've been doing for many years. Uh, it turns out that not that many people in my inner circle are all that interested in hearing me go on at length about my work.

In fact, there's a running quip if you wanna clear out the faculty lounge in a hurry, just ask Child about his research. But I, I think, but I think the more important reason is that, uh, it, this has given me the opportunity to reflect upon the process by which this project evolved, how it was born. It grew in adolescent fits and starts, and then finally came of age in the book itself.

And I use the word project, and I think that's the way you framed the question too. But, but really, it's rather a, a long course of interest in, in life itself. In the early 1990s, I wrote a doctoral dissertation for a degree in English, a PhD in English on George Cheney, and I don't know if you know him, but Cheney was an 18th century Scottish physician who was a [00:02:00] doctor to the Stars and lesser luminaries in in London and Bath, and also a bestselling author.

And so what I did is I looked at his medical writings as literature, um, you know, because it was a PhD in English, I did what a new critic might do. I looked at the structure and characterization techniques and rhetorical strategies and that sort of thing. Um, and, and now, now this is kind of commonplace, but in most days, I had to make the argument from the outset that I was reading literature as literature and the 18th century, the notion of literature was, you know, anything written.

But I had to make that argument theoretically because, you know, usually we look at canonical works, like plays of the kind you look at and, uh, you know, poems and, and, and novels, that sort of thing. So I, I, I looked at English literature. Um, An important part of that process though was establishing context and medical history, understanding who the practitioners were, what the qualifications were, what claims they made to authority, especially at a time when the profession was a very wobbly and chaotic collection of all sorts of practitioners from the learned physicians with Oxbridge degrees down to the the [00:03:00] wise woman next door. You know, who was pedaling who, who know, who knew what. And, and one of the things I discovered was that many of these people made their claims through writing, especially after the, there was a, a licensing law that lapsed in 1695.

And so many people had access to the press then that might not otherwise have. And so, uh, people began making judgements about, about practitioners authority based on what we now call literary style, you know. A quack, of course, would write it a low style and a learning physician would write in a high style.

But anyway, um, what, what happened was establishing these contexts, I I started into medical history itself in the most naive, roundabout and accidental way, but this had given me a foothold. And then, then I got the, you know, a PhD in hand. I, I got a job at Sam Houston State University, as you mentioned, which is a regional state university in east Texas, about an hour north of Houston.

And the reason this even matters in our conversation is that at a university like this, we were a teaching institution. The, uh, let's say the challenges, the requirements for tenure and [00:04:00] promotion through the ranks, are not quite as challenging as they are at other institutions. In fact, I likely would not have a job at a research institution.

But the good, the good thing was, uh, almost immediately. I was able to teach graduate courses in my specialty. In fact, my second semester, I had a grad course in 18th century literature. And then the other thing I think was more important, it gave me the leisure to work on this long-term study at greater length.

I, I would not have been able to write this book in on a tenure clock. Uh, it, it took 35 years. This is not to diminish my institution, but it did gimme the leisure. And now, nowadays by the way, people are required to write a book per rank. But the reason that's important to me is that I really did have more leisure than other people might have had to assimilate the materials, do the, the, the legwork. One of our great librarians got Echo for me, the 18th century collections online, uh, about 10 years ago. But before that, I had to get grant money to go to the British library and, and look at primary documents.

So, um, you know, I, I needed more time to do this and it demanded years of reading around just, uh, sort of naively finding my way through. Now you [00:05:00] asked about the question of Swift, swift, uh, the interest in Swift itself, and that's the kinda question that's really hard to answer. I'm sure you found this with your own, you know, interest.

But, uh, you know, first of all, he is an important canonical author. I always tell my students that, you know, I, I would put him on the first string of the all British, uh, you know, basketball squad of great writers with Milton and Chauser and Shakespeare. But I think also he suited my temperament.

He's a great satist to common sensely ask questions about the world we live in, in the, in the behavior and misbehavior of those around us. And also compellingly, slippery and elusive almo, almost always speaking even about himself. Ironically. So he was biographically interesting. Uh, now, and not to go on too far, but along with this, but, but my first scholarly interest was in how Swift might have represented medical matters. I guess we still call this interdisciplinary work, but I, I, that may be irrelevant because I, I tended to dissolve disciplinary boundaries. But first I had an article about Swift and, uh, this is kind of crude, his excremental cures. And then another one on, uh, medical satire. Very clever medical satire he [00:06:00] wrote, but not, not really about Swift himself. I, I was, I've always been a little wary, biographical readings of works of literature, you know, because too often these become, you know, the way that the author represented her or his life in their works. So it becomes a sort of connect the dots between here are events in the, in the author's life, here are the events and, but eventually I did become more interested in Swift Biographically and I read all of his correspondence, five, five volumes worth, word for word, and found that he had incessantly complained about his disorders. In fact, um, you know, to the point at which I was getting a little tedious, and his three disorders were, persistent, chronic disorders were, what he called giddiness or vertigo, increasing deafness began in one, I've forgotten which ear, but then became bilateral and also tinnitus, or as we might say, tinnitus, the ringing in the ears and kind of collectively these became dis orders that, that I found him representing in, in the works that sit themselves.

One thing I'm gonna add just because you asked question about process, but, uh, I could not have written this book as, as a [00:07:00] young man. Not only because I needed time to assimilate and understand the medical history that, that I had no business being in it at one time. But also because increasingly his disorders, his deafness and terrifying fits of vertigo, isolated him from the social world, forced him to withdraw from the social world, which he thrived and made, didn't feel, feel irrelevant.

And uh, I, I get that now. I understand what was must have been like for him to feel increasingly inconsequential where he actually used that word. You know, just, I feel I don't matter in the world now. I think I matter and my, my health is good, but, but I, I understand him now, what it's like to face frailties and be less consequential, sort of, in the world.

Mia Levenson: So you, you bring up the multitude of ailments that Swift suffered from and in so many ways, this book is really responding to these claims that scholars and physicians have made throughout, you know, the past, like [00:08:00] century and a half, that swift suffered from Meniere's disease, an inner ear disorder.

You make this claim in your book that Swift couldn't suffer from a disease that was not available to him. And I'd like to hear sort of your thoughts of like, what do you make of this problem of retrospective diagnosis now that you've worked on someone like Swift.

Paul Child: That's another a great question, one that I kind of accidentally, uh, stumbled onto thanks to the medical history program there, At Hopkins, especially a conversation with Mary Fissell who directed the thesis. I'll, I'll start by saying there, there's certainly some value in retrospective diagnosis.

You know, pe people in the modern clinic, looking back on figures like Shakespeare and, and others, John Milton and, diagnosing their illnesses according to our own modern clinical terms. So, both for biographers and also in my case for literary critics. For example, there's a recent article that came out about John Milton having suffered from a, a detached, uh, was it bilateral retinal detachment. Milton was blind. And this is interesting because it might suggest ways in which he could imagine [00:09:00] light without seeing. And then for example, if you read Paradise Loss, you know, it begins, there is flame without, or there is it, , fire without flame.

So imagine the sensation sight and light without actually having it. So anyway, I think there also, you know, it, it addresses interesting diagnostic riddles. But the problem comes with imposing our notions of disease and the body successfully upon a past that had very different notions as such. And here, my, my medical training, uh, my, my training at at in the master program there at Hopkins helps.

Just to give a little, a little context here, Prosper Menière, a French clinician in 1861, uh, looking for a pattern of illness among his patients. He, I think he was director of the The Blind and Deaf Institute in Paris, and he saw patients that, you know, as we say in the modern clinic, presented with this kind of constellation of what he saw as symptoms of vertigo, increasing deafness that began, in one ear and then became bilateral. And then, uh, a tinnitus that's ringing of the ears and, um. They, they weren't the [00:10:00] problem with Menière's disease.

And I, I have a sister who suffers from this, so I, I know, it's very irregular, very episodic. In fact, the people who suffer from this have had, had real problems getting, uh, passed through the ADA because, you know, do you really have this disorder if it just comes irregularly? My sister's had th three episodes in her entire life, and she's in her sixties.

You know, others have it chronically. But, uh, anyway, the, the problem is, you know, just defining this thing as a disease, uh, but Menière, what's the word we wanna use? Um, discovered this or created this or, you know, constructed in 1861 and then in 1881, an English physician, John Bucknell later, sir John, determined that that's what Swift had.

And because he read Swift's correspondence and he heard the persistent complaints about these, you know, particular disorders and almost without exception, that that diagnosis has held with medical writers and biographers and, important to me, literary critics and al also, it's the authority of the clinic that has held in, in, in the article, this famous article, which Bucknell Eds Swift with many years, [00:11:00] uh, disease.

He crows about the victory of the triumph of the modern clinic over the united past of humoral medicine. They had no idea. Swift had no idea what he himself suffered from. And my, my response is, he had, he, he knew exactly what he suffered from .His understanding of the body was that he, the body comprises four humors and that his humors were out of balance. Now I, I myself accepted this, , modern diagnosis with casual faith, you know, that's what he suffer from. In fact, actually a couple of the articles that I wrote, you know said with confidence, well, he suffered from Menière's disease. And then, uh, you know, realized I had, you know, the, the epiphany moment when he went, ah, duh, he could not have suffered from a disease that he, that didn't exist in his own day.

But I think that the more important part is that he didn't have the same body that the clinic understand. He had a very different perception of the body and so. That in mind. Then I, I tried to, I went back and, you know, historicized his body according, try, try to get the understanding of the body as he himself knew it.

And, again, not to belabor this, but the way he understood his diseases. So [00:12:00] he had this, these symptoms, you know, we, we now diagnose this as Menière's, but, he understood that, one of his, four humors, phlegm was, there was, there was, too much of it. And it, this is the thick gluey cold humor. And it, because he couldn't assimilate it, he couldn't digest it properly, it wasn't properly quote, attenuated it, it kind of accumulated in his head and stuffed his ear so he couldn't hear, threw off his equilibrium. So he'd have these, you know, terrifying bouts of vertigo. Well, he called giddiness usually. And the simple solution, of course was if the body's out of order, you try somehow to put it back in order.

And so he would eat food. He, he thought he had a cold stomach, so he would eat, he'd drink a lot of wine. Great, great excuse to quote, warm his stomach and, uh, you know, properly. Uh, what processed the, the cold phlegm and then also exercise. He was an obsessive exercise. Well, you, you know, we might call him an exercise nut.

He, he ran, you know, he ran, he, he walked miles and miles every day. He swam, which [00:13:00] very amusing sight in his own day in the river. And also his favorite exercise was to ride horses. I went to a, a, a a trip to Ireland several years ago, and I, I got on a train, from Dublin to Howth, which is out on the coast, and, that's what he would ride daily. It was 25 miles, you know, out and back, and he would ride that every other day or so. So anyway, all all that with an idea that he could shake loose the, the phlegm that was lodged in his head and then that would wash out. So anyway, all, all this to say that I think, um. The question was, well, so what, so we understand this, but, but I, I, now, it's not something, an intervention matter of restoring him to his own body, but also understanding better how he might have represented that body, imaginably his works.

So one of the works is "Gulliver's Travels". That's the work we know best. If we understand that he saw his own body disordered in a certain way, then I think we get a better sense of how, his particular disorders, his hearing problems and his disequilibrium might have caused shifts in perspective. If, you know, "Gulliver's Travels", you know, bodies are shrunk down and, you know, blown up [00:14:00] and they're weird sounds and, you know, everything, chaos and convergence of sense sensations. So, but I think we get a better sense of, uh, sense of what Gulliver's going through because that's what Swift himself went through. And there's one other thing I I I'd like to mention. 'cause this, this is, problematic , but Swift has a number of what we call scatological poems. Uh, I don't know if you're familiar with those, but they're the, the gross stuff. I always tell my students, you make sure you haven't eaten lunch before you read these books and, and many of them are about women and, you know, bodily functions and so forth. And so critics have had a field day. Some people see this, I mean, they're just out and out gross. But, some Freudian critics as psychopathy, like he, he was, uh, psychologically obsessed with such matters, and he's a Coprophilic.

Feminist critics have had a field day. Uh, you know, he's a misogynist because many of the the bodies that he represents are women. But I think if we restore these historically to the humoral understanding of the body., We understand these are, these are messy bodies and they're doing what bodies do well.

That begs the question, well, why women? Well, because women in the humoral tradition were thought to be moisture. They don't just sweat [00:15:00] and, you know, all the other bo but they also lactate. So, uh, Swift is writing the humoral body large here, the body that he knew and he tried to manage.

And, uh, it's the, the man, the voyeurs who are witnessing these. Humoral bodies and excreting, so that are really a fault because they fail to acknowledge those bodies. The very body, that Swift itself every day was trying to put back in order.

Mia Levenson: I love that you bring up the scatological poems and the inclusion of fluids and like bodily functions that appear in Swift's writing because it points to a key theme in your book, which is that it's not that you're trying to retrospectively diagnose or try to even come up with the, the singular term that, encompasses all of Swift's ailments, and then locate that within his writings and more so what you're doing is locating how Swift's own experiences of his [00:16:00] body and his own understandings of health and medicine show up in his writings in the same way that, you know, you know, I as like a, a a me, someone in the me medical humanities as well, is also thinking about how ideas about medicine, about, about health, about fitness are sort of arising in different forms of popular culture. And so, you know, me as someone who, you know, primarily works in 19th and early 20th century America, I, I found that this had, this book had a lot to offer me, as someone who's also thinking about disability studies. And one of the things that really caught me is that you make this argument that Swift was chronically ill rather than someone who was periodically sick. And you use both his personal writings and his imaginative works to illustrate how illness and disorder were part of his daily life.

From your own readings of his correspondence, do you think that Swift, saw himself as disabled by his chronic [00:17:00] conditions? And what do you think identifying Swift as chronically ill does for the study of his writings?

Paul Child: Uh, Mia that's another excellent question. Thank you for asking that. The problem with his particular disorders, they were persistent and they started at a very young age. It's hard to date, but you know, somewhere in his late teens, maybe, early twenties, certainly, when he experienced the giddiness and, um, and, and also the, the hearing disorders.

But, um, the problem early on that they were of sort of irregular. I mean, did he have an episode and then he be, you know, he thought he was cured. Pretty soon it became apparent to him that he. These were indeed chronic. And he finally said something like, you know, they'll get me before I get them.

In other words, you know, uh, this vertigo will, you know, especially the giddiness was terrifying to him. So, you know, this is what's gonna kill me. But they came and they came in, what the word that he uses, again, is fits. Uh, but, he did, accept the fact that he was chronically ill and that the best he could do is keep them at bay. And he was, he even used a military [00:18:00] metaphor in one of his, court letters that, you know, he was sort of losing ground daily to this, uh, actually puts it in terms of, you know, sort of military terms. But, um, the, I I think one thing being in answer your great question is that, uh, the understanding of disability was certainly different.

That there wasn't, you know, people like Tobin Siebers, has theorized disability, talks about disability communities and a disability identity, but the 18th century. It has a different notion, and I, I, I know this only secondhand by reading, Daniel Turner, who's written about disability in the 18th century.

And, there wasn't a sense of a disability community per se or disability identity. So really it was more a matter of impairment, social impairment. So Swift's disability and what, you know, what, disabled him as we might say, was that he felt increasingly isolated and confined. He said, well, I had to confine myself to my garden here.

And, and the, but by the way, he, the, the subtitle of the book is the Dean. I'm sorry, that's the title. The Dean Disordered because he was the dean of St. Patrick's Cathedral. He was a, a clergyman in the church of Ireland. And so he was often confined to the deanery there in Dublin.

[00:19:00] And, often he would have to least he, he thrived on social, social life. He, that he controlled conversations he loved, but he'd find he'd have to leave the room and, and deputize one of his friends to kind of take over the proceedings at the table. And he, so his disabilities then, came as physical impairments, but also that increasingly isolated and confined and socially.

And I think another part of it too, you know, that he had a very traditional sense of what we call masculinity. Um, you know, men move in the world, men do things, important things in the world. And when he found himself confined and isolated by these disabilities, by his hearing disability, his, his vertigo, then he found himself confined to the domestic sphere and held, felt hell. And, dependent upon his servants and his close friends and his other domestics, then he found himself, you know, weak and powerless. So that was a real issue for him.

He prided himself on his athletic abilities and that he was always kind of goading his other male friends like Alexander Pope, you know, you need to ride more. You're hanging out at home too much. [00:20:00] So, um, I now your, your good question too about how he might have represented this, especially in Gulliver's Travels.

If listeners have read Book two, Gulliver has shrunk down. He's little. He's, you know, six inches tall. The broing nagging, the Giants are 12 times his size, and there he feels helpless and dependent and especially, physically helpless and feeble and unable , and silly. And I think that's the way Swift himself felt.

Mia Levenson: Yeah, I think that the, this idea of, of impairment of not being able to participate in daily life, this isolation, like all these things that kind of come out through his writings that you identify in his correspondences were just really fascinating to read. So we've talked, we've talked about Swift's writings. As you said, you're a literary scholar, and yet you chose to, , pursue this master's degree in the history of medicine. What do you think pursuing historical study offered your own understanding of Swift and his works, especially since you had been immersed in this archive for so [00:21:00] long? And do you have any suggestions for other literary scholars who are considering pursuing historical studies?

Paul Child: Well, thanks for that question too, Mia. As I said, most of my own medical history was entirely accidental just because lit scholars looked at, at medical history as context and background, and I think, you know, one of my, one of the developments in, in the last 40 years or so has just been the kind of the disappearance of background, I mean, what we, we used to consider context has become what we study now. So, you know, part, part of it was just my own sort of, uh, reapportionment or, I don't know what the right word is here, but the sort of new way to look at medical history, not as merely context, but as you know, the stuff that we grapple with. In some ways the medical historians that I've encountered, the, the, the, um, methods aren't all that different. I mean, you, you look at texts and you look at performances in, in the same way that we might look at a, you know, canonical work. But anyway, so my, my work was the result of accidental reading around in the field, just because I needed context.

Uh, what happened was, I've done very little strategic in my [00:22:00] career. Just everything was accidental, you know. But, um, one, one strategic thing I did was that I'd been working with Swift and I just Swift and medicine for years and years and years and just this, just globs, going nowhere. And then when I saw the advertisement for the online MA program at Johns Hopkins, and I realized that a thesis was required. I thought, aha, I work well under the guidance of other people. I'm not well, self-directed. Yes. So, ah, I could apply for the program and then I, I would be forced to write a thesis that would help me put my book in order.

And when I applied, I think I had to write a statement of purpose and Mary Fissell responded very generously and kindly as as she does. Yes, I, we'd love having the program. And by the way, I think I'll direct your thesis for you. So, that, that was wonderful. But anyway, back to your, your central question, when I did get into the, the classwork itself, you know, sort of stumbled in naively the, the formal training in medical history gave me a much more rigorous way to look at, to frame my own study of [00:23:00] Swift to consider how his, you know, how to, how to look, look at , his ailments with a little greater sort of, um, scholarly rigor than I had.

And you know, also by looking at the way that medical swearing worked, not only Mary, but also Graham Mooney, who's another kind of key figure in my, my development there. So I think, you know, as Mary said, well it gave you some chops. I guess that was the worst, I guess I can put it on my, a line item, my resume, really the training did, suggest to me or force me to, to look at medicine in the way that I was considering medical history more rigorously.

You asked the good question about how other people in, you know, literary scholars might, uh, you know, consider historical studies. And I, I, I, I'll, I'll work with medical history just because that's what I'm, I'm working with. But, one thing certainly that the study of medical history can, can enrich in layer the study of literature, partly by giving us more context, but also to understand how writers might represent their bodies and disorders imaginably. Even if accidentally again, I, I don't like that [00:24:00] biographical reading. I'm always suspicious that, you know, this is what an author is representing. But often as, especially in the case of someone like Swift, they're representing these things whether they want to or not, whether they mean to or not.

So I think if we understand better the medical milieu and the medical history of the day, we get a better sense of how they understood their own bodies and how they understood their own disorders.

Mia Levenson: Whenever we interview scholars about their newly published books, we always like to ask, uh, you know, we want everyone to go out and grab this book, but who is your ideal audience for this book? Who do you really want to pick up this book and, and read it? And, and what do you hope people will take away from reading "The Dean Disordered"?

Paul Child: I certainly think, anyone with interest in medical history, but literary scholars in general, Swift, particularly, and you know, I to, you know, one, one thing that consoles me occasionally is that there are pretty fair number of people who are still interested in reading and, and teaching Jonathan Swift.

So, um, you know, narrowly scholars [00:25:00] of what we're now calling the long 18th century and so forth. And I, I think biographers too. Every single biographer that I've read since the late 19th century accepts that Swift suffered from this particular sort. And I'm not asking that they overhaul their, you know, understanding of Swift, but certainly that they consider that we might historicize him as well. Now, I always joke to friends and family who've, who, you know, bothered to buy the book or, this is not a page turner, you know? But I do think that there, there may be some interest still for general readers who have you, some, some kind of interest in famous figures of the past and how they negotiated their lives and, and how they negotiated, especially illness.

Because we, we all, you know, especially we all, we go the way of all flesh, right? So, uh, here was a man who wanted to be consequential in the world. Um, tried hard. He was very ambitious, you know, and, uh, he tried to pretend that he wasn't, but he, he was. And he was stymied by these real physical issues in his life.

And I think there's so in that, in that sense, I think Mia, there's something in it. A little something in it for, for all of us.

Mia Levenson: Thank you so much, [00:26:00] Paul, for joining us. This has been a really great conversation. It was really great to hear more about your process and your experience with the program. Thank you so much for joining us.

Paul Child: Thanks for inviting me.