Diagnosing some ariasof concern

December 25, 1998

A husband and wife team are examining ways physicians have historically been portrayed in opera as a way of understanding criticism of today's doctors.

In the world of opera, doctors have figured prominently in plots - buffoons in some early operas, mad scientists in later ones and an occasional strident hero. Linda and Michael Hutcheon, University of Toronto professors of literature and medicine respectively, say those roles have always reflected public opinion.

Opera, they say, offers a great prism through which one can see historical shifts of medical image.

They have presented their findings, in a presentation entitled "Pompous pedants, medical monsters and humane healers", to doctors and social scientists.

The two say that during the time of the greatest changes in medicine - the microscope's invention and advances in pathology and microbiology - physician characters in opera also changed, to figures who miraculously saw what others were not able to see. Works such as Offenbach's The Tales of Hoffmann showed a patient saved from an imminent death by Dr Miracle's diagnosis, singing out "He sees everything! He sees everything!" Doctors suddenly distanced themselves from other scientific fields that were still studying humours and other surrounding elements of life. They began to focus on the patient's disease rather than the patient. That created an alienation between doctor and patient, say the researchers, who add that this rift is still evident today with malpractice suits at an all-time high and approximately $10 billion spent on alternative medicine every year in North America.

Public distrust has been the opera world's bounty, as new characters, such as the despicable character of the doctor in Alan Berg's Wozzek, were created in the 20th century. The doctor watched with delight as his patient developed extreme signs of mental illness, crying out ecstatically "Oh! My hypothesis. Oh! My fame!" Michael Hutcheon has not been singing wildly in his office while conducting experiments on patients, but the Toronto respirologist knows he and his medical colleagues must continue to take a wider look at their image. "A lot of the doctors I know think that just because they work hard and they're nice people, the public will trust them," he says.

But he believes it is necessary for doctors to tap in to patients' needs rather than shooting diagnostic questions at them. Luckily, says Linda Hutcheon, there have been changes in medical education. There have also been new operas, such as the Michael Nyman adaptation of noted neurologist Oliver Sacks's story The Man Who Mistook His Wife for a Hat, where a doctor helps solve a man's mental illness by understanding the changes to his art work.

But where will opera be if doctors can not be portrayed as medical monsters and mirror our anxieties over modern illnesses? "Things will have to shift," Linda Hutcheon says.

"Doctors will be in (operas); they just won't be the villains any more."

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