Joseph Merrick, the most famous man to have suffered from neurofibromatosis type I and Proteus syndrome, has inspired many plays, books and films with his curious life story. David Lynch works his surreal magic on him in his 1980 film The Elephant Man, starring John Hurt and a young Anthony Hopkins as the surgeon Frederick Treves. In the film, Treves teaches Merrick to communicate, and shows him the familial love that he so pitifully never experienced. It would seem that Treves is a man of virtue and a good doctor; that is, if all he desires is to care for Merrick. But unfortunately, the elephant man's deformities put him at a vulnerability so that, try as he might, the good doctor cannot take care of him. Merrick continues to be treated as an object of curiosity, both by the upper class and by the more openly cruel lower class.
The idea of a person being a curiosity is a disconcerting one, especially to a doctor. It infringes human dignity in a way that most of us cannot accept. Human curiosity exhibits were banned in the UK in 1886, but you can still gawp at dead people, to a certain extent. (This brings up the question of whether or not human dignity carries on after death, and it's a hairy one.) The Gordon Museum at King's College London has a collection of babies in jars with various birth defects. The ones with anencephaly are especially shocking. Then there was Gunter von Hagens' grotesquely beautiful Body Works exhibition, where corpses treated with plaster were dissected and placed in life-like anatomical positions. Nature's design is fascinating. But is it ever completely ethical to observe a body, dead or alive, as an object of curiosity?
Whenever I tell people that I'm a medical student, the first question that I usually get is if I've dissected a human cadaver. Yes I have, but unfortunately I'm not really allowed to talk about it (unfortunate because I am actually bursting with gruesome anecdotes from the dissection room). Neither am I allowed to discuss in detail about the dark and sometimes horrifying stories of patients whom I interview at hospitals, much less publish them in an article. Journalism and medicine, of course, should never mix. But still, I can't help being drawn to certain patients because of the grotesquery of their condition. It is not uncommon that a patient with a particularly unusual disease is overcrowded with medical students, and it's sometimes even encouraged by consultants. To take it to an extreme, there's nowhere better to observe the greatest object of curiosity, the human carnival, than at a hospital.
It is not only the elephant man's physical defects that makes him so fascinating to filmmakers and medics alike. As much as we can't help being disgusted by his deformities, we can't help being moved by his life story. Lynch's version of Merrick's life is an emotional rollercoaster where we feel anger at the brutish circus manager, joy when Merrick is is rescued and shown the pleasantries of domestic life, and ultimately pity and sadness at his inescapable fate. On one hand, the film is an exercise in empathy, and on the other hand, it is an exercise in emotional voyeurism. The audience may feel morally superior to the circus manager, but to a certain extent the audience also treats the elephant man as an object of curiosity, albeit on a more sophisticated level. The human carnival comprises not only physical curiosities, but also a whole landscape of emotions.
As a film-goer, I'm allowed to be swayed by the emotional impact of a film. It's a form of escapism and at the end of the day, escapism is a satisfying experience, for why else do we watch films in out free time? But what do you make of your doctor getting that kind of satisfaction out of your life story? It doesn't seem right; it doesn't seem moral; it seems to be taking advantage of human suffering. Empathy is hailed as a virtue in the profession of medicine, but there is a fine line between empathy and emotional voyeurism. A discreet side effect of empathy is a more delicate discrimination between the nuances of human emotion, and thereby a higher appreciation of others' feelings. Empathy makes for a good listener, and also a person who enjoys listening. You want your doctor to be the former, but there's something slightly perverse about the latter.
It's not only doctors who tread the fine line between empathy and emotional voyeurism. Anybody who works with charity or humanitarian relief will tell you that altruism, besides being a sense of duty to relieve human suffering, also brings great joy to their life. Helping people makes you feel great about yourself. On a neurobiological level, being charitable activates the same neural reward pathway as that activated by food and sex. To analyze altruism from a darker point of view, it is based upon the detection of suffering in another human being, and people with highly developed empathy, i.e. highly experienced emotional voyeurs, are especially good at being altruistic. Altruism, much like empathy, is hailed as a virtue by most people, but is there something perverse about getting a kick out of an activity that is ultimately based on another person's suffering?
At the end of the day, if we lived in a world where altruism and empathy didn't exist, where the human body is not naturally fascinating, we probably wouldn't have that many doctors. Medical school is competitive, long, and the average starting salary is lower than that of investment bankers and some law graduates. Is it really that unethical to be perversely interested in the human carnival of deformed bodies and emotional suffering? I suppose that's why laws about patient confidentiality are important in medicine, so that at least nobody but doctors are allowed to gawp at people when they're most vulnerable. But there's a reason why a story like The Elephant Man is fascinating to a filmmaker like David Lynch and the general public; the human carnival is one of the most interesting subjects of a story. Anton Chekhov and Sir Arthur Conan Doyle must have known this - they both started their novelist careers as doctors. But then, there's a difference between gawping and creating a fine piece of art. So maybe the moral of the story is that if you're as talented a filmmaker as David Lynch, then it’s alright to gawp.
Essay by our resident doctor in training
What the hell is the point of Valentine's Day? Except as a starting point for single people to whine about how lonely they are or to brag about how confident they are in their singledom (which begs the question: how much sexual frustration can one person suppress?) If you're in a relationship and you need a socially recognized holiday to afford romance then it's time to realize that you don't love each other, and maybe never have. Tragic. It's a bit of a cliche to show off how much insight you have into the inner working of capitalism by bitching about the commercialization of Valentine's Day but there are only so many restaurants making sweet, sweet cash off humdrum couples you can walk past without it making your blood boil a little because for fuck's sake love is so much more than that.
The only drawback was the price of the ticket. 50 quid will buy you many, many boxes of chocolate and bottles of cheap wine. The economically challenged romantic may want to wander around town throwing rocks at couples, or watch a film. Due to the sensitive nature of the day, it is important to choose an appropriate film. Annie Hall or Before Sunrise, which are appropriate films for a couple to watch any other time of the year, suggest a lack of imagination on Valentine's. Go for Blue Velvet instead.
