chapter
22 Pages

Introduction

Towards the end of his 1857 novel Little Dorrit, Charles Dickens provides an extended description of a character, “Physician.” The length and specificity of the details Dickens offers reflect the rising social identity of physicians during a dynamic period in medicine and professionalization. At the same time, the description encapsulates the focus of this book by articulating something more abstract. Dickens’s narrator shows Physician’s distinction from his assembled company, for his stock-in-trade confers on him a status and privileged access that makes his relationships unique. I quote the description at length to reveal this emphasis:

To Physician’s dinner guests, his medical purview facilitates two levels of “the real”: it represents the specialist knowledge of a trained professional, and it grants him intimate access to his patients. In turn, the effect of that knowledge and access on his relationships is transformative; as the narrator explains, it overrides the scheming and subterfuge so otherwise prevalent in Little Dorrit. As this description of Physician exemplifies, I am most interested in the belief systems that he (and other fictional Victorian doctors) represent, and by the effect of his medical experience on his personal relationships. Just as Physician’s proximity to the darker side of life allows his friends to pare away the specious

and elaborate facades that test Little Dorrit’s characters (and those in virtually all of Dickens’s novels), this equation between Physician and “the real” influences his characterization, too. Because he is named by his accreditation alone, his vocation consumes his personal identity; it is hard to imagine him also as a husband, a father, or a son. Physician stands apart from the rest of the novel’s characters whose personal desires, fears, and prejudices are the stuff of the story. In sum, Physician is so close to the truth that he is outside of the story, presiding over it and his dinner table in a generous but disinterested way.